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无家可归者的医疗保健:应对提供初级保健的挑战。

Homeless health care: meeting the challenges of providing primary care.

机构信息

Homeless Healthcare, Perth, WA

University of Western Australia, Perth, WA.

出版信息

Med J Aust. 2018 Aug 3;209(5):230-234. doi: 10.5694/mja17.01264.

Abstract

People experiencing homelessness have multiple complex health conditions yet are typically disengaged from primary health care services and place a significant burden on the acute health system. Barriers preventing people who are homeless from accessing primary care can be both personal and practical and include competing needs and priorities, illness and poor health, physical access to health services, difficulty in contacting services, medication security, and the affordability of health care. Differences in social status and perceptions of being judged can lead to relationship barriers to accessing primary care. Key solutions include prioritising access to stable housing, continuity of health care, specialised homeless general practice, hospital inreach, discharge planning and coordinated care, general practice outreach, and medical recovery centres.

摘要

无家可归者通常患有多种复杂的健康状况,但往往无法获得基本医疗服务,并给急性医疗系统带来巨大负担。阻碍无家可归者获得基本医疗服务的因素既有个人因素,也有实际因素,包括相互竞争的需求和优先事项、疾病和健康状况不佳、获得医疗服务的实际困难、联系服务的困难、药物安全以及医疗保健的可负担性。社会地位的差异以及被评判的观念可能导致在获取基本医疗服务方面存在关系障碍。主要解决方案包括优先考虑获得稳定住房、医疗服务的连续性、专门的无家可归者全科医疗、医院延伸服务、出院计划和协调护理、全科医疗延伸服务以及医疗康复中心。

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