Case Study:
A 68-year-old Spanish-speaking male presented for a new patient appointment after hospitalization at your primary care clinic. Per interpreter services, he was recently admitted to a local hospital for four days due to a "cough and fever." The patient lost his discharge paperwork from the hospital but reported it didn't matter anyway because he couldn't read it as it was printed in English. He reports he is feeling better but continues to have shortness of breath with any exertion and has noticed swelling in both of his feet. He lives with his wife and his four grandchildren. He continues to work in a warehouse and is anxious to get back to work. On examination, he has pursed-lip breathing, respirations of 22 breaths per minute, heart rate of 98 beats per minute, and 94% on 2L nasal cannula at rest but with activity 92% on 4L nasal cannula.
After opening your electronic health record system, you can access his records from the hospitalization. He was admitted to the hospital related to complications from COVID, including acute hypoxic respiratory failure and viral pneumonia, for which he was discharged on home oxygen. During the hospitalization, he was diagnosed with type 2 diabetes. He started on insulin but transitioned to Glucophage XR 500 mg daily, and heart failure with reduced ejection fraction started on lisinopril 40mg PO metoprolol XL 25 mg BID and Lasix 40 mg daily. The insurance on the hospital visit has "self-pay." He has not had any of his medication because "I can't afford my medication." The patient's most significant concern is getting off the oxygen as soon as possible because he can't afford the equipment and getting back to work to help pay hospital costs.
Q1. Are there, if any, health disparities within this case?
Q2. In your professional clinical practice, have you come across health disparities? If so, please briefly describe the health disparities.
Q3. How can you as a healthcare provider, address disparities in healthcare?
Q4. How can you practice culturally competent care as a healthcare provider related to this patient?
Q5. What are our financial options for assisting this patient with the cost of office visits and therapies?
Q6. Based on the information above, how would you bill your services to this patient (E/M)