Health disparities and chronic disease associated with anemia in free clinics: A retrospective study of uninsured patients in Tampa Bay

ABSTRACT

Objectives: The objective of this study was to assess the diagnosis and management of anemic patients in free clinics around the Tampa Bay area.

Methods: In this retrospective study we extracted data including demographics, chronic diseases, and laboratory values from medical charts of uninsured patients seen in 9 free clinics from January 2016 through December 2017 in the Tampa Bay area, FL, USA. Multiple logistic regression analysis was used to assess relationships between socioeconomic variables and a documented history of anemia.

Results: From two years of documented data, 6971 patients were included, of which 367 (5%) had a documented diagnosis of anemia. Most were women (315, 86%), and the median age was 41 years (6–91). Among the 367 patients with anemia,191 (52%) patients had an unspecified type of anemia, 144 (39%) were diagnosed with IDA, 16 (4%) with anemia of chronic disease, and the remaining were other uncommon causes. Only 67% (97/144) of IDA patients had documented iron replacement. Colonoscopies were documented in only 32 (9%) of all patients with anemia, and in 23 (16%) IDA patients. Several chronic diseases were statistically associated and comorbid with a diagnosis of anemia.

Conclusions: Uninsured patients with IDA are prescribed iron and undergo colonoscopies at sub-optimal rates. Increasing resources, awareness, and education of providers in these settings could lead to improved treatment practices and decrease the risk of morbidity and mortality.

KEYWORDS:

• Anemia
• uninsured
• health disparities
• socioeconomic
• iron supplement
• colonoscopy
• secondary screening
• preventative health
• diagnostic medicine
• public health

Acknowledgments

This project was implemented by a consortium of volunteers composed of medical residents, public health, medical and pre-medical students. We thank patients, clinic directors, and other staff for their support of this work. We also thank Shirley Smith and Kevin Casey from the Morsani College of Medicine Office of Student Diversity and Enrichment Program for incorporating our research into their pre-medical curriculum.

Declaration of interest

No potential conflict of interest was reported by the authors.

Declaration of financial/other relationships

The authors and peer reviewers report no conflicts of interest.

Additional information

Funding

This research was supported in part by the Office of Research, Innovation and Scholarly Endeavors (RISE) at the University of South Florida Morsani College of Medicine.