Primary care services : episodes of care for acute upper respiratory infections at a free homeless clinic


This descriptive study examined the characteristics of primary care services in providing health care at a free homeless clinic. Many homeless receive primary health care services through the hospital emergency room which is expensive. In Florida, 46% of the homeless present at the emergency rooms with primary care problems. Some cities have established clinics that provide health care at the homeless shelter sites. A number of published studies and articles have identified the health problems of the homeless but few studies have identified the health services at the homeless clinics. Utilizing a retrospective review, 129 medical records with a diagnosis listed as acute upper respiratory infection or otitis media were examined for information that described the characteristics of health services at a free homeless clinic. The second question examined if differences existed among practitioners in their diagnostic and treatment patterns in the episodes of care for acute upper respiratory infections at a free clinic. Services and treatments had a monetary value assigned to them. Frequency distributions, measures of central tendencies, and MANOV A statistics were used to analyze the collected data. The average assigned value for office services was $3 5 with a standard deviation of $11 for all practitioners.

Amoxicillin was prescribed to 48% of the clients. The average value for antibiotics prescribed was $14 with a standard deviation of $38. The range for the antibiotic values was from zero to $132. The average total value for the episode of care was $47 with a standard deviation of $24. The findings indicate that few practitioners utilize diagnostic testing when prescribing oral antibiotics for non-specific acute upper respiratory infections. The volunteer physicians utilized more expensive antibiotics to treat the homeless clients than the other practitioners. A surprising finding was that no health education documentation on prevention of acute upper respiratory infections was found on the medical records. No statistical differences were found between the physician group and the nurse practitioner group in the assigned values to the diagnostics and treatments for the episodes of care. Further research is needed on why practitioners are prescribing antibiotics for acute upper respiratory infections that may viral. Even though the homeless clinic receives in-kind medications, research should be done to find out if the volunteer practitioners prescribe similarly in their own practices. Remedial education of practitioners is needed on documentation of preventive education.


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Graduation Date





Giovinco, Gina


Master of Science (M.S.)


College of Health and Public Affairs






102 p.



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Masters Thesis (Open Access)




Dissertations, Academic -- Health and Public Affairs; Health and Public Affairs -- Dissertations, Academic

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