Patient Empowerment Strategies for a Safety Net

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Executive SummarySince 1995, when the county hospital in Milwaukee was closed, the uninsured residents of the city have received their care through the General Assistance Medical Program (GAMP).This innovative program created a network of existing community-based providers resembling a managed care model and emphasizing preventative care and appropriate utilization.Additional grant funding allowed GAMP to add 24-hour telephone nurse services for the purpose of providing patient education and triaging patient care needs to the appropriate venue for care.This study evaluated patient perceptions of the patient education and telephonic nursing support as well as utilization of the nursing services.Patients reported significantly improved confidence levels in managing their illness after a telephone conversation.An analysis of nurse call management comparing the callers' initial intention to the recommended disposition or intervention by the nurse revealed a 707% increase in performing self-care, a 169% increase in seeking an appointment, a 275% increase in seeking urgent care, and a 53% increase in emergency care.

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