A Measure of Patient Satisfaction Amongst Individuals Experiencing Homelessness in an Inter-professional Student-Run Vision Clinic

As of 2016, 85% of the homeless population within Michigan were covered under Medicaid health insurance. Despite insurance coverage, many depend on student-run free clinics to meet their health care needs, however, few clinics are available to provide specialty-based care. The Community Homeless Interprofessional Program (CHIP) student-run free vision clinic in Detroit, Michigan works to address vision care. With great emphasis on preventative optical care, student-run vision clinics have provided satisfactory preliminary screenings to the homeless population. The purpose of this study is to determine if pre-clinical year medical students appropriately address vision care needs of the homeless population, as reported by patients through the use of a patient satisfaction survey. Medical students provided free basic ophthalmic examinations to patients. Following each eye examination, an anonymous patient exit survey regarding the encounter is administered. The survey focused on the patient-student relationship and satisfaction with the deliverance of vision care and education. Survey results showed that 82% of patients within the clinic strongly agreed that they had learned how to improve their vision and 95% strongly agreed that they were provided with useful information (n=22). Medical students were able to effectively perform fundamental ophthalmic screenings, educate patients, and refer them to nearby ophthalmic providers. The overall high outcomes of patient satisfaction indicate the current delivery of care and education to patients has had a positive impact. Incorporating patient satisfaction surveys in student-run clinics can provide useful feedback to providers affecting a clinic’s implementation and efficiency

Liver-specific case fatality due to chronic hepatitis C virus infection: A systematic review

Despite reports that mortality is increasing, overall case fatality due to hepatitis C virus (HCV) is thought to be low. Given the variability in published rates, we aimed to synthesize estimates of liver-specific case fatality and all-cause mortality in chronic HCV according to follow-up duration, sustained viral response (SVR) to treatment, and liver disease severity. A systematic review was conducted of studies published in English from 2003 to 2013, reporting liver-specific case fatality estimates from HCV-infected samples. Thirty-five eligible articles were identified; 26 also presented estimates of all-cause mortality. Among community-based samples, liver-specific case fatality ranged from 0.3% over 5.7 years to 9.2% over 8.2 years of follow-up; and of all-cause mortality, from 4.0% over 5.7 years, to 23.0% over 8.2 years of follow-up. Estimates were higher among clinic-based samples and those with more severe liver disease. Among treated patients achieving SVR, liver-specific case fatality was low: up to 1.4% over 11.5 years of follow-up among samples with any severity of liver disease. Estimates were higher among those without SVR: up to 14.0% over 10 years of followup among samples with any severity of liver disease, and higher still among samples with more severe liver disease. The proportion of deaths attributable to liver-specific causes ranged from 55 to 85% among those with severe liver disease. Published estimates of fatality are high among certain populations of chronic HCV patients, with liver-specific causes being an important contributor. Understanding current HCV mortality rates is important for quantifying the total burden of HCV disease