Journal of Student-Run Clinics

Patient-Level Factors Associated with Antihypertensive Prescribing Patterns in a Free Clinic Setting

Leah Barnes — 2025-03-18

Background: Hypertension is the world’s leading cause of cardiovascular disease and premature death. In the United States, non-White adults have higher rates of hypertension, yet lower rates of treatment. Furthermore, underinsured and uninsured populations experience unique barriers, receive fewer and lower quality healthcare services, and are the focus of less research; however, student-run free clinics (SRFCs) help address this gap and treat conditions like hypertension. This study assessed patient-level factors that may influence prescribing patterns for hypertension at SRFCs.

Methods: A chart review was conducted on patients diagnosed with hypertension (N=799) seen from January 2013-February 2020 inclusive at one SRFC network. The outcome variable was receipt of antihypertensive medication. A logistic regression analysis assessed the association between antihypertensive prescribing and patient-level variables (age, comorbidities, race, sex, education, language, housing, insurance status, transportation, employment status).

Results: After controlling for other factors, those with two or more comorbidities were more likely to be prescribed an antihypertensive than those with no comorbidities (odds ratio [OR] 1.31, 95% Confidence interval [CI] 1.04-1.65, p=0.021). When compared to non-Hispanic White patients, Hispanic patients were around 40% less likely to be prescribed an antihypertensive (OR 0.58, 95% CI 0.36-0.92, p=0.03). Insured patients were 60% less likely to be prescribed an antihypertensive than uninsured patients (OR 0.40, 95% CI 0.22-0.75, p=0.004).

Conclusions: This study found that, at an SRFC network, differences in antihypertensive prescribing exist by comorbidities, race, and insurance status, indicating patient-level hypertension treatment disparities in this population. This study suggests the need for research into how patient-level factors influence physicians’ treatment decisions and how educating SRFC patients about medication assistance programs can mitigate insurance-related disparities.

Characterization of Metabolic Illnesses and Metabolic Syndrome in an Underserved, Predominantly Hispanic/Latino Population at a Local Student Run Free Clinic

Luke Chi — 2025-04-07

Background: Lestonnac Clinics address a disparity in access to United States healthcare, providing free primary care to underserved populations. Student-run free clinics (SRFCs) consistently report high rates of metabolic illnesses, particularly within Latinx communities. However, research is limited on how these conditions co-occur within SRFC settings, leaving a gap in understanding their interplay and priority areas of care. This study aims to assess metabolic illness prevalence and comorbidity patterns in a SRFC with primarily Latinx patients.

Methods: This retrospective study analyzed data from uninsured patients (n=564) seen at a Lestonnac free clinic in Orange County, California, between 2019 and 2021. De-identified electronic health records were collected and included demographics, vitals, body mass index, and diagnoses of diabetes, fatty liver, hyperlipidemia, and hypertension. Statistical analysis using JMP were run including descriptive statistics, prevalence of metabolic illnesses and comorbidities, and Chi-square tests comparing condition proportions between two age groups, <50 years and ≥50 years (p<0.050).

Results: Findings revealed differences in diagnosis prevalence between age groups of 564 total patients, with those ages ≥50 showing the higher rates of hyperlipidemia, hypertension, and their co-occurrence, compared to those ages <50. Patients exhibited elevated rates of diabetes (28.7%), and hyperlipidemia (33.2%), surpassing national averages for Hispanic/Latino populations, 11.1% and 10.9%, respectively. However, our clinic demonstrated lower prevalence of fatty liver (15.3%), and hypertension (34.0%) compared to national data, 22.9% and 38.6%, respectively.

Conclusion: Our patients aged ≥50 had significantly higher rates of hyperlipidemia, hypertension, and their co-occurrence, while younger cohorts exhibited a high rate of hyperlipidemia. Diabetes and hyperlipidemia rates at our clinic exceeded national averages, underscoring the need for interventions targeting hyperlipidemia prevention in younger cohorts and hypertension, hyperlipidemia, and diabetes management in the aging population. Future research should aim to identify social determinants of health experienced by these patients to enhance prevention effectiveness.

Reaching the Homeless Patient Population: A Novel Student-Run Clinic Outreach Program

Bailee Lichter — 2025-03-28

Introduction: The Bishop Dudley Hospitality House (BDHH) is a non-profit organization founded in 2015 that provides support services, resources, and shelter to the poor and homeless community members of Sioux Falls, South Dakota. Recognizing that physical access to healthcare is a major barrier for many individuals that utilize the BDHH, University of South Dakota Sanford School of Medicine student leaders at the Coyote Clinic instituted a bimonthly satellite clinic in the on-site BDHH clinic room.

Methods: In this study, we first describe the establishment of the collaboration between a student-run free clinic and a community homeless shelter. Additionally, to demonstrate the impact of such an outreach and subsequent referral program, we have collected and analyzed data regarding the demographics, insurance status, and access to a primary care provider of the patients, their chief complaints, acuity level, referrals, and whether they attended their follow-up appointment.

Results: Over the course of February 1, 2022 through June 30, 2023, a total of 80 clinical encounters and 57 patients were seen at the Coyote Clinic BDHH Satellite Clinic. A total of 29 referrals to the main Coyote Clinic downtown were made and one patient was sent to the Emergency Department directly from BDHH.

Conclusions: The BDHH satellite clinic has created an additional entry point for healthcare to a high-risk population. Our hope is this model can be adopted by other student-run free clinics seeking to serve similar patient populations.

Dermatology Centered Student Run Free Clinics: A Community Necessity

Rebecca Fliorent — 2025-04-01

Background: Student-run free clinics (SRFCs) play a crucial role in providing preventive healthcare and addressing disparities, especially in underserved communities. However, dermatologic care remains largely unavailable in SRFCs. This review examines the need for dermatology-centered SRFCs, evaluates current literature, and suggests ways to enhance dermatologic access for underserved populations, focusing on Camden County, New Jersey.

Methods: A comprehensive literature review was conducted using PubMed, Embase, Cochrane, and Google Scholar databases to identify studies on dermatologic services in SRFCs and barriers to care, particularly for minority and uninsured populations.

Results: The review identified limited availability of dermatologic services in SRFCs, with only a few successfully integrating dermatology clinics. Partnerships between SRFCs and dermatology departments have shown positive outcomes, such as reduced wait times, improved access to care for conditions like acne and skin cancers, and better early disease detection. Challenges include logistical barriers, financial limitations, and limited provider availability, with minority and uninsured patients most affected.

Conclusion: The findings highlight an unmet need for dermatologic care within SRFCs. Collaborations between SRFCs and dermatology departments offer promise in improving care access and outcomes, enhancing medical education, and fostering community engagement. Establishing dermatology-focused SRFCs could address healthcare disparities and boost dermatologic health literacy in underserved communities. Further research is needed to assess the long-term impact of these initiatives on health outcomes.