Abstract The purpose of this research was to quantify the rates of specialty care referral completion and identify variables associated with successful completion among a population of low-income, elderly and/or disabled homebound patients with barriers to accessing office-based care. This was a cross-sectional study using descriptive and multivariate predictive analysis of specialty care referral completion, operationalized as attending an appointment of the same specialty care type within 6 months of being referred. Independent variables include patient age, sex, race, marital status, health insurance, blood pressure, and body mass index. Patient characteristics, referral information, and appointment information from July 1, 2014 to July 1, 2019 were extracted from electronic health record data of patients enrolled in the Just for Us primary care home visiting program in Durham, NC. Specialty care referrals were restricted to those for office-based consultations for chronic disease co-management originating from an outpatient primary care provider. Of 443 total referrals identified from 162 patients, 36% were successfully completed. Being married and female gender were found to be associated with successful referral completion. Of the 217 total patients in the study sample, 25% were identified as not having any referrals. No included patient characteristics were found to be significantly associated with being referred to specialty care. This study demonstrates that the specialty care needs of a medically and socially vulnerable population of homebound patients are not being adequately met.

OBJECTIVES:To determine whether binge eating disorder (BED) impacts weight-related quality of life in obese individuals seeking weight loss treatment and to investigate the role of psychological symptoms, BMI, and demographic variables in the relationship between BED and weight-related quality of life.RESEARCH METHODS AND PROCEDURES:Three hundred seventeen women (BMI = 37.6) and 213 men (BMI = 41.3) completed questionnaires on admission into an intensive residential lifestyle modification program. Weight-related quality of life was assessed using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite). The presence of BED was determined using the Questionnaire on Eating and Weight Patterns-Revised. Psychological symptoms were assessed using the Beck Depression Inventory and the global severity index of the Symptom Checklist 90-R.RESULTS:BED prevalence in this sample was 17.9%. Participants with BED, in comparison with those without BED, were more likely to be women (75.8% vs. 56.3%, p < 0.001), younger (45.0 vs. 49.7 years, p = 0.003), white (98.9% vs. 91.7%), heavier (BMI = 42.0 vs. 38.5, p = 0.002), psychologically distressed, and more impaired on total IWQOL-Lite (51.5 vs. 65.3, p < 0.001) and all IWQOL-Lite subscales. However, after controlling for demographic variables, BMI, and psychological symptoms, BED was not independently associated with weight-related quality of life.DISCUSSION:The association between BED and impairment in quality of life that has been previously reported in the literature may largely be accounted for by differences between those with and without BED on demographic variables, BMI, and psychological symptoms. BED does not seem to independently impact weight-related quality of life.