Academic Medical Support to the Ebola Virus Disease Outbreak in Liberia.

During the Ebola Virus Disease (EVD) epidemic in West Africa (2014-2016), many faculty, staff, and trainees from U.S. academic medical centers (i.e., teaching hospitals and their affiliated medical schools; AMCs) wished to contribute to the response to the outbreak, but many barriers prevented their participation. Here, the authors describe a successful long-term academic collaboration in Liberia that facilitated participation in the EVD response. This Perspective outlines the role the authors played in the response (providing equipment and training, supporting the return of medical education), the barriers they faced (logistical and financial), and elements that contributed to their success (partnering and coordinating their response with both U.S. and African institutions). There is a paucity of literature discussing the role of AMCs in disaster response, so the authors discuss the lessons learned and offer suggestions about the responsibilities that AMCs have and the roles they can play in responding to disaster situations.

A Successful US Academic Collaborative Supporting Medical Education in a Postconflict Setting.

This article describes a model employed by the Academic Collaborative to Support Medical Education in Liberia to augment medical education in a postconflict setting where the health and educational structures and funding are very limited. We effectively utilized a cohort of visiting US pediatric faculty and trainees for short-term but recurrent clinical work and teaching. This model allows US academic medical centers, especially those with smaller residency programs, to provide global health experiences for faculty and trainees while contributing to the strengthening of medical education in the host country. Those involved can work toward a goal of sustainable training with a strengthened host country specialty education system. Partnerships such as ours evolve over time and succeed by meeting the needs of the host country, even during unanticipated challenges, such as the Ebola virus outbreak in West Africa.

Health services utilization by low-income limited English proficient adults.

OBJECTIVES: We evaluated the health care utilization of limited English proficiency (LEP) compared to English proficient (EP) adults with the same health insurance (Medicaid managed care) and full access to professional medical interpreters. METHODS: Health care utilization over two years was compared for 567 LEP and 1162 EP adults. Multivariate analysis controlled for age, gender, months enrolled in Medicaid and morbidity. RESULTS: LEP compared to EP subjects were enrolled longer and more continuously in Medicaid, were 94% more likely to use primary care and 78% less likely to use the emergency department. Specialty visits and hospitalization did not differ. CONCLUSIONS: When language barriers are reduced and health insurance coverage is the same, LEP patients show ambulatory health care utilization associated with lower cost and more access to preventive care through establishing a primary care home.