Retrospective Analysis of Patient-Reported Reason for Visit

Unveiling the Most Common Presentations at a Student-Run Free Clinic Serving Patients with a History of Substance Use

Abstract

Background: Student-run free clinics are crucial in providing healthcare to underserved populations; however, few studies have evaluated common reasons patients seek care, particularly those in recovery from substance use. This study focuses on the patient population at Drexel University College of Medicine’s (DUCOM) Salvation Army Adult Rehabilitation Center (ARC) clinic, which serves individuals in recovery from substance use. The aim is to identify the most prevalent concerns addressed during beneficiary appointments to implement patient-centered efforts to improve care access for this group. Beneficiary is the preferred term used to describe patients.

Methods: The data was collected through a retrospective analysis of medical charts from DUCOM’s Salvation Army ARC Clinic covering April 2020 through June 2023. Data on demographics, clinic visit frequency, chief complaints, and referrals were extracted from beneficiary encounter notes in the clinic’s secure electronic medical record system.

Results: Of the 160 beneficiaries with a documented primary reason for visit, 419 chief complaints were identified. Forty-seven percent of beneficiaries visited once, 39% visited 2 to 4 times, and 14% visited more than 5 times. The most common chief complaint categories were Pain and Musculoskeletal (25.1%), Well-Visit/Medication Refill (24.1%), and Cardiovascular concerns (9.5%).

Conclusion: The primary chief complaints at the Salvation Army ARC clinic suggest significant barriers in chronic pain management, accessing routine primary care, and managing chronic cardiovascular conditions. A hypertension sub-clinic and a medication refill system have already been implemented, and further interventions, including academic center partnerships for streamlined referrals, and psychiatric training, have been proposed to reduce patient barriers to care and improve outcomes. Further research is needed to develop efficient interventions that will address the healthcare needs of this at-risk patient population, given the constraints of a student-run free clinic.