Buchanan David, Doblin Bruce, Sai Theophilus, Garcia Pablo
Department of Medicine at Stroger Hospital of Cook County, Chicago, Illinois, USA.
Am J Public Health. 2006 Jul;96(7):1278-81. doi: 10.2105/AJPH.2005.067850. Epub 2006 May 30.
Homeless individuals experience high rates of physical and mental illness, increased mortality, and frequent hospitalizations. Respite care provides homeless individuals with housing and services allowing more complete recovery from illnesses and stabilization of chronic conditions.
We investigated respite care's impact on 225 hospitalized homeless adults consecutively referred from an urban public hospital during a 26-month period. The cohort was separated into 2 groups: (1) patients referred and accepted into the respite center and (2) patients referred but denied admission because beds were unavailable. All patients met the center's predefined eligibility criteria. Main outcome measures were inpatient days, emergency department visits, and outpatient clinic visits.
The 2 groups had similar demographic characteristics, admitting diagnoses, and patterns of medical care use at baseline. During 12 months of follow-up, the respite care group required fewer hospital days than the usual care group (3.7 vs 8.3 days; P=.002), with no differences in emergency department or outpatient clinic visits. Individuals with HIV/AIDS experienced the greatest reduction in hospital days.
Respite care after hospital discharge reduces homeless patients' future hospitalizations.
无家可归者身心疾病发病率高、死亡率增加且频繁住院。临时护理为无家可归者提供住房和服务,使其能更彻底地从疾病中康复并稳定慢性病病情。
我们调查了在26个月期间从一家城市公立医院连续转诊的225名住院无家可归成年人接受临时护理的影响。该队列分为两组:(1)被转诊并被临时护理中心接收的患者;(2)被转诊但因床位不足而被拒绝入院的患者。所有患者均符合该中心预先设定的资格标准。主要结局指标为住院天数、急诊就诊次数和门诊就诊次数。
两组在基线时的人口统计学特征、入院诊断和医疗护理使用模式相似。在12个月的随访期间,临时护理组比常规护理组需要的住院天数更少(3.7天对8.3天;P = 0.002),急诊或门诊就诊次数无差异。艾滋病毒/艾滋病患者的住院天数减少最多。
出院后的临时护理可减少无家可归患者未来的住院次数。