A N.J. hospital has identified traits in Asian-Americans that save healthcare money
Shortly after the Asian Health Services program at Holy Name Medical Center launched, Chief Medical Officer Dr. Hee Yang and his team noticed two main medical issues that were prevalent among their Korean patients.
The first were cases of abdominal pain, which were first thought to be appendicitis.
Up until about 10 years ago, such cases were often treated with surgery. But Yang said many of those early cases of abdominal pain among Korean patients were caused by diverticulitis, which occurs when pouches form along the wall of the colon and become inflamed. In Western patients, the condition is caused by diet and generally appears on the left side of the abdomen. In Korean patients, the condition tends to be congenital, occurs on the right side and has symptoms similar to appendicitis.
"These people would go into the operating room thinking it's appendicitis and end up getting a right-colon resection," Yang said. "But when we started putting all these patients together, we realized the difference in the epidemiology and the incidence of this disease."
So, clinicians began communicating with Korean-American community health partners and instructed them to perform CT scans to check for the possibility of diverticulitis among patients with symptoms that resembled appendicitis.
Once the word spread throughout the community, the number of misdiagnosed appendectomies declined within that patient group, and their diverticulitis was managed with antibiotics.
"If you see a problem and if you have the ability to do something about it, it is your responsibility to handle it," Yang said of the approach taken by the program's clinicians.
A similar approach was taken during those early days of the program when Yang and his team began noticing an unusually high number of advanced breast cancer cases among Korean women before the age of 40. Incidence rates of breast cancer among Asian women tend to be lower than for white or black women.
But the epidemiology of breast cancer among foreign-born Asian women begins at earlier ages than for white women in the U.S., with the disease first appearing in the former group in their late 20s or early 30s rather than their mid-40s or 50s. But many of the screening guidelines issued by the leading professional medical organizations as well as the U.S. Preventive Services Task Force recommend regular breast cancer screening among women at average risk to begin at age 50.
"Our goal was to raise awareness by promoting early detection through screening," Yang said.
In response, Asian Health Services began offering free mammography screenings. Within three years, the number of young women coming into Holy Name with advanced-stage breast cancer had dropped, and breast cancer was being detected and treated earlier, leading to an overall improvement in survival rates.
Yang credits the breast cancer program as being the first of the type of preventive services that have become Asian Health Services' hallmark. Those services have expanded to include hepatitis B and C screenings, as well as checks for diabetes and mental health disorders.
Maron said because of the continued growth rate of the immigrant population, the hospital has not seen a significant decline in the incidence rate of the conditions for which they screen. But he said the hospital's ability to diagnose and treat those conditions in their early stages has accelerated over the years and has led to greatly improved outcomes.
The culmination of the program's model has been an annual health fair, now in its 10th year, to mostly serve uninsured Asian immigrants.
Up to 80 doctors volunteer annually, providing checkups and more specialized care for up to 1,000 patients based on blood tests taken two weeks prior to fair; the blood tests check for 35 health markers.
"All these doctors in their heart are also community-minded," Choi said. "It's very much mission-driven work."
Asian Health Services was able to quickly build trust between Holy Name clinicians and Bergen's Asian-American community.
Maron believes that relationship has been key in helping the provider track certain health conditions that are known to be prevalent within the Korean population and communicating with community members to help them manage those conditions.
"This was happening way before population health became a common buzzword," Maron said.
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