Establishing Care Post Discharge Following a Heart Failure Hospitalization in an Uninsured Heart Failure Population.

Multidisciplinary interprofessional outpatient care improves mortality for patients with heart failure (HF) but is underutilized. We sought to identify factors associated with not establishing outpatient care among uninsured individuals with HF. We included uninsured individuals referred to an interprofessional clinic after a hospitalization with HF from 2016 to 2019. The primary outcome was establishing care, defined as presenting to clinic within 7 days of discharge from the hospital. We constructed multivariable adjusted logistic regression models to identify predictors of establishing care. A total of 698 uninsured individuals were referred, of whom 583 (84%) established care. Mean age was 49.5 ± 11 years, 15% were rural-dwelling, 59% were black, and 31% were female. Black participants who were rural-dwelling (adusted odds ratio [aOR] 0.07, 95% confidence interval [CI] 0.03 to 0.17) or reported alcohol use (aOR 0.32, 95% CI 0.16 to 0.64) had lower odds of establishing care. White participants who were rural-dwelling (aOR 2.63, 95% CI 1.17 to 5.90) had higher odds of establishing care. Uninsured black individuals with HF who live in rural communities or who are active alcohol users represent a group that is at high risk of not establishing outpatient follow-up after a hospitalization with HF. Efforts to reduce this disparity are warranted to improve health outcomes in this population.

Food Link: A Partnership Providing Healthy Foods to Food Insecure Patients.

BACKGROUND: Defined as an economic and social condition characterized by uncertain access to adequate food, food insecurity (FI) is associated with negative health outcomes and higher health care costs. OBJECTIVES: The purpose of this article is to discuss the implementation and results of Food Link, a population-based FI program serving vulnerable populations in Birmingham, Alabama. METHODS: Academic, clinical, and community partners implemented Food Link in two free clinics serving patients with diabetes and heart failure. Patients identified as FI using the Hunger Vital Signs Screener receive dry goods and produce, food pantry referrals and benefits education. RESULTS: During the first 18 months of Food Link, more than one-half of the patients (n = 466) screened as FI and received food, with a total of 1,179 food distributions. CONCLUSIONS: Academic, clinical, and community partners working together can help meet the FI needs of vulnerable populations with the goal of improving health and decreasing costs.

Caring for Underserved Patients with Heart Failure during the COVID-19 Pandemic.

COVID-19 places people with pre-existing cardiovascular disease at higher risk for mortality. Furthermore, COVID-19 disproportionately affects minorities and those experiencing adverse consequences of social determinants of health. Our report describes the practices put in place to care for underserved patients with heart failure and lessons learned during the COVID-19 pandemic.

The Implementation of a Patient Assistance Program in a Free Clinic Setting: A Case Report.

This article describes the implementation of a pharmaceutical Patient Assistance Program in a free clinic, including issues such as navigating complicated pharmaceutical company requirements, obtaining documentation for income verification, engaging healthcare providers, tracking and re-ordering medications, and developing clear expectations for patients. Successes, challenges, and lessons learned are also discussed.