Swabri Jahbyn, Uzor Chiadika, Laird Eamon, O'Carroll Austin
School of Medicine, Trinity College Dublin, College Green, University of Dublin, Dublin 2, Ireland.
Division of Population Health Sciences, Department of Family Medicine and General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland.
Ir J Med Sci. 2019 May;188(2):545-554. doi: 10.1007/s11845-018-1892-0. Epub 2018 Sep 3.
Homeless people experience substantially higher rates of illness and significant barriers to accessing health services. The mobile health clinic (MHC), staffed by trainee general practitioners, targets and provides homeless people in Dublin with free and easy access to primary healthcare services.
To explore and determine the specific health reasons for attending the mobile health unit and to investigate whether the MHC improves access to primary healthcare for homeless people.
Interviewer-administered questionnaire addressed demographic characteristics, physical and mental health status.
Forty-two participants were recruited in this study. The majority were male (90%), single (74%), Irish (81%) and in the 25-44 age group (71%). Risky health behaviour was common: tobacco use (93%; 39/42), illicit drug use (60%; 25/42) and alcohol use (45%; 19/42). Most participants described their health status as fair (48%) or good (31%). There were high rates of physical and mental health conditions. Hepatitis C (29%; 12/42) and depression (43%; 18/42) were prevalent. Dental disease was present in 79%. Compared with MHC, most health conditions were diagnosed and treated at other healthcare facility (OHF) [134 vs 27]. Report of physical health symptoms, such as coughs (61%) and migraine headache (46%), was also high, an average of five per person/year.
While the findings of this study are limited by the small sample size, they nevertheless indicate that the MHC promotes access to primary care service. Results also highlight the need to expand the healthcare approaches on the MHC to adequately meet the health needs of its target population.
无家可归者患病几率显著更高，且在获取医疗服务方面存在重大障碍。由实习全科医生配备人员的流动医疗诊所，旨在为都柏林的无家可归者提供免费且便捷的初级医疗服务。
探究并确定前往流动医疗单位的具体健康原因，并调查流动医疗诊所是否改善了无家可归者获取初级医疗服务的机会。
采用由访谈员管理的问卷，涉及人口统计学特征、身心健康状况。
本研究招募了42名参与者。大多数为男性（90%）、单身（74%）、爱尔兰人（81%），年龄在25 - 44岁组（71%）。危险健康行为很常见：吸烟（93%；39/42）、使用非法药物（60%；25/42）和饮酒（45%；19/42）。大多数参与者将自己的健康状况描述为一般（48%）或良好（31%）。身心健康问题发生率较高。丙型肝炎（29%；12/42）和抑郁症（43%；18/42）很普遍。79%的人患有牙科疾病。与流动医疗诊所相比，大多数健康问题在其他医疗机构（OHF）得到诊断和治疗[134例对27例]。身体健康症状的报告也很高，如咳嗽（61%）和偏头痛（46%），平均每人每年五种症状。
虽然本研究结果受样本量小的限制，但仍表明流动医疗诊所促进了初级医疗服务的获取。结果还凸显了扩大流动医疗诊所医疗服务方式以充分满足其目标人群健康需求的必要性。
