Orenstein J B, Boenning D A, Engh E P, Zimmerman S J
Emergency Medical Trauma Center, Children's National Medical Center, Washington, DC.
Pediatr Emerg Care. 1992 Dec;8(6):313-7. doi: 10.1097/00006565-199212000-00001.
Children living in homeless shelters often lack the health care resources usually available to other children. They are often more acutely and chronically ill than domiciled children and frequently use the emergency department (ED) as their point of entry into the health care system. To identify differences in health status, we surveyed sheltered children and domiciled controls during a nine-month period in our ED. One hundred sixty-two families completed a self-administered questionnaire during the study period: 54 homeless and 108 age-matched controls. Mean patient age was 3.4 years, mean maternal age was 27 years in both groups, and average time spent in shelters was 7.8 months. Shelter families had more children, more single mothers, and higher rates of unemployment and uninsurance than did control families. Shelter children showed greater frequencies of immunization delay, lack of TB testing, and lack of a regular health care site and higher rates of medical admissions from the ED. These data show that children in shelters have limited personal, financial, and medical resources and suggest that there are significant disparities in health status. These patients need to be identified when they present to the ED in order to meet subtle, as well as obvious, health needs.
住在收容所的儿童往往缺乏其他儿童通常可获得的医疗资源。他们往往比居家儿童患有更严重的急性和慢性疾病，并且经常将急诊科作为他们进入医疗系统的入口。为了确定健康状况的差异，我们在九个月的时间里对收容所儿童和居家对照儿童进行了调查。在研究期间，162个家庭完成了一份自填式问卷：54个无家可归家庭和108个年龄匹配的对照家庭。患者平均年龄为3.4岁，两组的母亲平均年龄均为27岁，在收容所度过的平均时间为7.8个月。与对照家庭相比，收容所家庭的孩子更多，单身母亲更多，失业率和未参保率更高。收容所儿童出现免疫延迟、缺乏结核检测、没有固定医疗保健机构的频率更高，从急诊科入院的比例也更高。这些数据表明，收容所中的儿童个人、经济和医疗资源有限，表明健康状况存在显著差异。这些患者在前往急诊科时需要被识别出来，以便满足其细微以及明显的健康需求。
