Morrow R, Halbach J L, Hopkins C, Wang C, Shortridge L
Department of Family Practice, St. Joseph's Medical Center, Yonkers, NY 10701.
Fam Med. 1992 May-Jun;24(4):312-6.
The growth of a large population of people without permanent housing in the United States has brought with it the necessity to address the unmet health needs of this group. As homelessness spreads, its demographic pattern has become more heterogeneous, with young vulnerable families now the major subgroup. This paper explores issues of homelessness in Westchester County, N.Y., which, despite being the 10th richest county in the United States, has the highest per capita homeless rate in the state. Children younger than age 18 represent the majority of this group. Barriers to the delivery of health care services are described, including fragmented life-styles, lack of insurance, insensitivity of care givers, distance from services, and inflexibility of traditional sources of health care. A model that has been developed for delivery of services is discussed. This model, the Outreach Health Care Unit, is run by nurse practitioners in collaboration with family physicians and is centered at the site of social service activities for homeless families and single men in Yonkers, N.Y. It is a collaborative endeavor of a nursing school, community hospital family practice residency program, and a network of social service agencies. The use of this model for education and research is also discussed since the goal is to provide both health services and training for health care providers.
美国大量无固定住房人口的增长带来了满足这一群体未得到满足的健康需求的必要性。随着无家可归现象的蔓延，其人口结构模式变得更加多样化，弱势年轻家庭如今成为主要的子群体。本文探讨了纽约州韦斯特切斯特县的无家可归问题，该县尽管是美国第十富裕的县，但却是该州人均无家可归率最高的县。18岁以下的儿童占这一群体的大多数。文中描述了提供医疗服务的障碍，包括生活方式零散、缺乏保险、医护人员冷漠、距离服务机构远以及传统医疗保健来源缺乏灵活性。文中还讨论了已开发的一种服务提供模式。这种模式即外展医疗保健单元，由执业护士与家庭医生合作运营，以纽约州扬克斯为无家可归家庭和单身男性开展社会服务活动的场所为中心。它是一所护理学校、社区医院家庭医疗住院医师培训项目以及一个社会服务机构网络的合作成果。文中还讨论了该模式在教育和研究方面的应用，因为其目标是为医疗保健提供者提供健康服务和培训。
