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Pathways & Barriers to Delivering Type 2 Diabetes Care to Indigent Undocumented Persons: Procedure Transportability & Policy Implications

Marisel Losa, MHSA1, Maria Elena Torres, MSN, APRNBC-ADM1, Frederick L. Newman, PhD2, and Pedrro Greer, MD3. (1) St. John Bosco Cliniic, St. Johns Bosco Clinic & Merci Hospital of Miami, 1301 West Flagler Street, Miami, FL 33135, (2) Health Services Administration -- School of Policy and Management, Florida International University, 11200 S.W. 8th Street, University Park PCA 367B, Miami, FL 33199, 305-348-0426, newmanf@fiu.edu, (3) Merci Hospital & St. John Bosco Clinic, 3661 S. Miami Avenue, Suite 806, Miami, FL 33133, Afghanistan

The project identified the pathways and barriers in assisting indigent, undocumented, (predominantly Hispanic) persons exhibiting symptoms of diabetes to gain entry into the healthcare system to receive appropriate services. Type 2 Diabetes is the major diagosis of patients seeking services at the St. John Bosco Clinic, located in the East Little Havana section of Miami. During 2001, the clinic staff performed 6,850 patient visits; approximately 50% of which were for the treatment/ management of Type 2 diabetes. The prevalence of diabetes is high in the Hispanic population and exceptionally so among the population served by the clinic since this indigent undocumented population has had very little, if any prior formal medical care or education. Most do not present to the clinic until their condition is in an advanced stage and are feeling quite ill. This population does not understand the need for preventative or routine medical care; therefore they must experience severe symptoms before they will seek medical assistance. Many have little options and must wait until the last minute due to work or childcare issues. Others simply do not know how to access the healthcare system or are afraid to because of their immigration status. Through the use of key informants and individual case analyses, pathways and barriers were identified. The identified barriers were then analyzed to identify needed changes in management and clinical practices, in the Miami-Dade County and elsewhere. Learning Objectives: To be able to evaluate the transportability and policy implications of these procedures to other environments.

Learning Objectives:

Keywords: Access to Care, Diabetes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Obesity, Diabetes and Nutrition: Addressing Lifestyles and Environmental Issues

The 132nd Annual Meeting (November 6-10, 2004) of APHA