Policy Issues in Primary Health Care Access: Psychiatric Patients Lacking a Primary Care Physician Experience More Lifestyle and Health Problems

A recurring theme of the National Conferences on Primary Health Care Access is care to underserved and vulnerable populations. At the 24th National Conference, April 8-11, 2013 at the Grand Hyatt Kaua’i, Doctors John Boltri (Wayne State University, Detroit) and Mark E. Clasen (Wright State University (Wright State University, Dayton) will share their research on the management of care for psychiatric patients. A summary of their research so far is presented here:


John Boltri, MD; Wayne State University, Detroit

Patients with moderate to severe psychiatric illness frequently find navigating the health care system to be challenging and often lack the knowledge or resources to avoid preventable illness. While it may seem intuitive that lacking a primary care physician (PCP) may significantly impact the health and well being of psychiatric patients, the relationship of having/lacking a PCP on psychiatric patients health is not clearly understood. This study was conducted to asses the detrimental effect of lacking a PCP on psychiatric patients health and well being.

We hypothesized that compared to patients who do have a PCP, those who do not have a PCP experience less preventive care and have greater burden of suffering from lifestyle problems and cervical cancer (for women).

This study included 70 inpatients and 70 outpatients under the care of a psychiatrist. Nineteen of the inpatients had a PCP and 67 of the outpatients had a PCP while the remainder of the patients did not have a PCP.

We collected baseline information on every patient, including demographic information, diagnoses, health status, medications, and activities of daily living score.  All female patients who had not received a recent PAP smear were provided one.

We performed a series of multiple linear regression analyses to asses the relationship of lacking a PCP to the likelihood (1) of receiving preventive care, (2) of having significant lifestyle problems, and (3) total burden of suffering and (4) for women, of having moderate to severe cervical dysplasia or frank cervical cancer.

This study highlights the importance of having a PCP on preventive care and health status.  Details of our findings will be reported at the 24th National Conference on Primary Health Care Access.