Development of a Tool to Identify Poverty in a Family Practice Setting : A Pilot Study

Abstract EN

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.