Photo Credit: Rudzhan Nagiev
“Ultimately, these populations are quite diverse, so a solution that works for one safety-net hospital may not work for another,” says Shreya Patel, MD, MPH.
Improved gastrointestinal (GI) care must be inclusive of all patient populations. Unfortunately, underserved and vulnerable patients who need this specialty care face many barriers to receiving these services. This can lead to lower screening rates and limited treatment of advanced GI issues.
In a recent commentary, Shreya Patel, MD, MPH, and colleagues addressed the challenges that vulnerable and underserved patients face in GI care and proposed countermeasures that physicians could incorporate into standard practice protocol. Given the complexity of this issue and the individual needs of various patient populations, Dr. Patel and her colleagues identify various concerns and provide potential solutions while acknowledging that a great deal of work still needs to be done.
Dr. Patel spoke with Physician’s Weekly (PW) about the issues covered in the commentary published in Clinical Gastroenterology and Hepatology.
PW: Why did you feel this topic needed exploration?
Dr. Patel: Patients who are vulnerable or underserved often have difficulty accessing basic healthcare services or primary care. Traditionally, there has been less focus within specialty care, specifically gastroenterology, on the unique needs and strategies that can be used to provide high-level care to these patients.
What are the most important findings from your study?
One of the main goals of this article is to help gastroenterologists better understand the barriers to care that vulnerable and underserved patients may face. Standard practice management tools may not be as effective with these populations, and creative solutions may be needed. The other main goal was to highlight various solutions that can be implemented for practices trying to better engage these patients in GI care.
How can physicians incorporate these considerations into practice?
The supplemental figure (Table) included in the article highlights specific solutions for caring for this population, including things like telehealth and care outside of standard business hours, low health literacy and multilingual patient-facing materials, strong open access endoscopy program, virtual patient navigation, and wraparound services like pre- and post-procedure transportation.
What makes this issue particularly urgent in the healthcare landscape?
With rising healthcare costs, many gastroenterology practices struggle to accept Medicare and Medicaid reimbursement. For safety-net systems that already care for this population, this article offers practical solutions given increasing reimbursements tied to quality metrics. Finally, with at least 10 states not adopting Medicaid expansion, there is an ever-growing need for specialty care in this uninsured or underinsured population.
What would you like future research to be focused on?
While our article offers various solutions, the evidence base behind the options is limited. Ultimately, these populations are still quite diverse, so a solution that works for one safety-net hospital may not work for another. In exploring the efficacy of these solutions, we also need to better understand the drivers behind success in each scenario so they can be thoughtfully applied to other populations.
Dr. Patel and colleagues concluded their article by encouraging a proactive approach, “By using creative cost-effective solutions to engage the population, build structural capacity, support individual patients, and ensure high-quality care, there is ultimately cost saving to the health care system, in turn allowing for more resources for this population and better health outcomes overall.”
