University of Tennessee Health Science Center, Memphis, TN, USA.
Am Fam Physician. 2014 Apr 15;89(8):634-40.
Homelessness affects men, women, and children of all races and ethnicities. On any given night, more than 610,000 persons in the United States are homeless; a little more than one-third of these are families. Homeless persons are more likely to become ill, have greater hospitalization rates, and are more likely to die at a younger age than the general population. The average life span for a homeless person is between 42 and 52 years. Homeless children are much sicker and have more academic and behavioral problems. Insufficient personal income and the lack of affordable housing are the major reasons for homelessness. Complex, advanced medical problems and psychiatric illnesses, exacerbated by drug and alcohol abuse, in combination with the economic and social issues (such as the lack of housing and proper transportation) make this subset of the population a unique challenge for the health care system, local communities, and the government. An integrated, multidisciplinary health care team with an outreach focus, along with involvement of local and state agencies, seems best suited to address the components needed to ensure quality of care, to help make these patients self-sufficient, and to help them succeed. Family physicians are well suited to manage the needs of the homeless patient, provide continuity of care, and lead these multidisciplinary teams.
无家可归现象影响着不同种族和民族的男性、女性和儿童。在美国，任何一个夜晚都有超过 61 万人无家可归；其中略多于三分之一是家庭。无家可归者更容易生病，住院率更高，而且比一般人群更有可能在年轻的时候死亡。无家可归者的平均预期寿命在 42 至 52 岁之间。无家可归的儿童病得更重，而且在学业和行为方面存在更多问题。个人收入不足和缺乏负担得起的住房是导致无家可归的主要原因。复杂的、先进的医疗问题和精神疾病，加上药物和酒精滥用，再加上经济和社会问题（例如缺乏住房和适当的交通），使这部分人口成为医疗保健系统、当地社区和政府面临的独特挑战。一个以服务外展为重点的综合性多学科医疗团队，以及地方和州各级机构的参与，似乎最适合解决确保护理质量所需的各种问题，帮助这些患者实现自给自足，并帮助他们取得成功。家庭医生非常适合管理无家可归者患者的需求，提供持续的护理，并领导这些多学科团队。
