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Int J Family Med. 2011;2011:812182. doi: 10.1155/2011/812182. Epub 2011 May 26.

Development of a tool to identify poverty in a family practice setting: a pilot study.

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1
Department of Family Practice, Faculty of Medicine, University of British Columbia, 3rd floor David Strangway Building, 5950 University Boulevard, Vancouver, BC, Canada V6T 1Z3.

Abstract

OBJECTIVE:

The goal of this pilot study was to develop and field-test questions for use as a poverty case-finding tool to assist primary care providers in identifying poverty in clinical practice.

METHODS:

156 questionnaires were completed by a convenience sample of urban and rural primary care patients presenting to four family practices in British Columbia, Canada. Univariate and multivariate logistic regression analyses compared questionnaire responses with low-income cut-off (LICO) levels calculated for each respondent.

RESULTS:

35% of respondents were below the "poverty line" (LICO). The question "Do you (ever) have difficulty making ends meet at the end of the month?" was identified as a good predictor of poverty (sensitivity 98%; specificity 60%; OR 32.3, 95% CI 5.4-191.5). Multivariate analysis identified a 3-item case-finding tool including 2 additional questions about food and housing security (sensitivity 64.3%; specificity 94.4%; OR 30.2, 95% CI 10.3-88.1). 85% of below-LICO respondents felt that poverty screening was important and 67% felt comfortable speaking to their family physician about poverty.

CONCLUSIONS:

Asking patients directly about poverty may help identify patients with increased needs in primary care.

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