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|Access to care in the nine federally funded hemophilia treatment centers in Michigan|
|Author||Dunford, Robert Lee, Jr|
|Summary||This research examined access to care as a healthcare access ingredient in improving the quality of life for African-Americans with hemophilia. The study focused on a model of care utilized in the nine Michigan Hemophilia Treatment Centers (HTCs). The sample included 1,403 patients with bleeding disorders and focused on the 626 males with Hemophilia A or B, 147 of whom were African-American.|
The U.S. government organized a system of HTCs in the mid-1970s to deliver comprehensive hemophilia care. The centers address clinical requirements and assist with health insurance and access to government support. This study examined whether access differences existed between Michigan's nine HTCs. The central purpose was to determine whether there was a statistical difference between the actual patients served versus the predicted number of patients expected to require service. Predicted numbers of patients were based on census data and hemophilia estimates were based on a Centers for Disease Controlstudy. Further data was analyzed to evaluate staffing levels in relation to access.
Four of nine centers surpassed the number of predicted male patients to be served, and only three of nine centers met or exceeded the predicted number of male African-American patients. Statistical differences between the nine HTCs were found based on an analysis and comparison of key variables. The number of full-time staff was strongly related to access to care for all male patients, r (7) = .898, p = .001, while the total number of psycho-social staff had no significant effect on access for all male patients, r (7) = .569,p = .110. However, the number of federally-funded psycho-social staff was strongly correlated with access for African-American males, r (7) = .904, p = .001.
Conclusions drawn from the study suggest that while most HTCs are doing a credible job meeting access goals for African-Americans, there is room for improvement. There was evidence that implementing a computerized reporting system, increasing psycho-social staff, and accomplishing continuous analysis of programs and services would be beneficial.
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