Anina Terry

Introduction/Objective: This study evaluates 4 years of data from the Seattle One Health Clinic (OHC), a novel model for clinical care which integrates human and animal health care services for youth and young adults experiencing homelessness (YPEH) and their pets. Methods: We analyzed deidentified data from standardized OHC visit forms, electronic medical records, and veterinary records from 2019 to 2022. We assessed the overlaps between human and animal healthcare provided and the impact of environmental stressors on both human and animal patients. Results: Over 50% of all human clients established healthcare for the first time in 2 years, with 85% attending one or more follow-up appointments with non-emergency healthcare services within 2 years following their initial OHC appointment. All animals received care during their visit. Needs addressed at the human-animal interface included zoonotic infections, animal allergies, and mental/behavioral health. The most common client-pet reported environmental concerns were food insecurity, heat, and cold. Conclusion: Our results suggest integrated human and animal healthcare is a feasible and acceptable model of care for YPEH to access acute and preventative care at the human-animal-environmental interface. This approach holds promise for increasing health-seeking behaviors, and engagement in preventative, therapeutic, and follow-up care.

Background: As opioid overdose rates remain high, systems-level tools are needed to monitor and improve the quality of care for opioid use disorder treatment. Although retention in care is a commonly used metric, the concept is variably defined in the literature, and clinics may not have real-time access to their own retention data. Methods: We designed a Structured Query Language (SQL)-based reporting tool to provide real-time and summative metrics related to buprenorphine retention. A retrospective observational design is used to characterize the summative metrics for an urban network of community health centers. Results: Among 569 patients started on buprenorphine between June 2020 and June 2022, by June 2023, 17% of patients remained actively engaged, 3% recently engaged, and 80% disengaged. Of those who disengaged, 55.4% did so after 3 or less prescriptions. The median duration of care was 5.3 months for all patients and 26.8 months for the 97 actively engaged patients. The median percentage of days covered by a buprenorphine prescription was 77.2% for actively engaged patients. Conclusion: Implementation of the SQL report has given the clinic network access to real-time, nuanced buprenorphine retention data and has guided targeted patient outreach.