Individual Physician versus Team-Based Medical Encounters: Maximizing the Efficiency of a Medical Relief Service in Rural Honduras

摘要

Background. For several years, the Virginia Commonwealth University (VCU) Department of Internal Medicine has traveled to the towns of La Hicaca and Coyoles in rural Honduras. In 2010, a new encounter method was employed during the brigade in Coyoles.Objectives. To examine the differences in clinical encounters and adherence with chronic diseases and public health screening between the traditional and team-based encounter methods.Methods. Chi-square analysis was used to determine statistical significance between encounter methods over several variables used in the standard interview form.Results. 314 patients were interviewed using the team-based approach, and 153 patients were interviewed with the traditional model. Statistically significant increases in compliance using the team-based method were observed with diabetes screening and selecting candidacy for antihelminthic therapy. Other variables with significantly increased compliance using the team-based method were compliance with checking a blood glucose value, diagnosing GERD, and prescribing medication such as analgesics and multivitamins.Conclusion. Our results show a statistically significant increase in compliance with data collection and clinical screening using the new team-based encounter method. This design provides a more goal-oriented approach to the patient interview. These data will help guide more effective delivery of health care on future medical relief trips to Honduras.