东南部一家安全网急诊科患者中的无家可归情况

Homelessness Among Patients in a Southeastern Safety Net Emergency Department.

作者信息

Jackson Toni S, Moran Tim P, Lin Jonathan, Ackerman Jeremy, Salhi Bisan A

机构信息

From the Department of Emergency Medicine, Emory University, Atlanta, Georgia, and the Georgia Institute of Technology, Atlanta.

出版信息

South Med J. 2019 Sep;112(9):476-482. doi: 10.14423/SMJ.0000000000001016.

DOI:10.14423/SMJ.0000000000001016

PMID:31485585

Abstract

OBJECTIVES

Emergency departments (EDs) are important providers for homeless individuals, providing vital health care and meeting the subsistence needs of many homeless patients (eg, food, water, shelter). Studies that have examined the proportion of patients in the ED setting who experience homelessness have been conducted primarily in the northeastern United States. We hypothesized that findings from prior studies, conducted primarily in the Northeast, would not generalize to other regions of the United States. We conducted a direct patient survey to describe the proportion and demographics of ED patients who have experienced homelessness within the past 12 months in an urban safety net hospital in Atlanta, Georgia.

METHODS

A cross-sectional survey of a convenience sample of patients presenting to the ED from September to December 2016. A team of trained research assistants administered a structured survey instrument to patients who were 18 years old, English speakers, not incarcerated, and able to provide informed consent. Questions were based on the US Department of Health and Human Services definition of homelessness.

RESULTS

A total of 923 ED patients (55.1% male; median age 44 years) completed the survey. Of the ED patients surveyed, 51.5% reported some measure of homelessness in the past 12 months: lived with others but did not pay rent (n = 279, 30.2%), skipped mortgage or rent payment (n = 111, 12%), experienced eviction (n = 74, 8%), lived in a hotel or motel (n = 196, 21.2%), lived in a place not meant for human habitation (n = 76, 8.2%), slept in a shelter (n = 131, 14.2%), and slept on the street (n = 115, 12.5%). Men (odds ratio [OR] 1.56, 95% confidence interval [CI] 1.17-2.09), patients who completed some school (OR 2.85, 95% CI 1.72-4.71), and patients who completed high school (OR 2.32, 95% CI 1.53-3.52) were more likely to have experienced homelessness in the 12 months preceding their ED visit.

CONCLUSIONS

The rate of patients experiencing homelessness at our hospital is substantially greater than those reported in prior surveys of ED patients. More research is needed on homelessness and its implications for ED patients.

摘要

目的

急诊科是为无家可归者提供重要医疗服务的场所，提供至关重要的医疗保健并满足许多无家可归患者的基本生活需求（如食物、水、住所）。研究急诊科中经历无家可归的患者比例的研究主要在美国东北部进行。我们推测，主要在东北部进行的先前研究结果不能推广到美国其他地区。我们进行了一项直接患者调查，以描述佐治亚州亚特兰大市一家城市安全网医院中在过去12个月内经历过无家可归的急诊科患者的比例和人口统计学特征。

方法

对2016年9月至12月到急诊科就诊的便利样本患者进行横断面调查。一组经过培训的研究助理向年龄在18岁、讲英语、未被监禁且能够提供知情同意的患者发放结构化调查问卷。问题基于美国卫生与公众服务部对无家可归的定义。

结果

共有923名急诊科患者（55.1%为男性；中位年龄44岁）完成了调查。在接受调查的急诊科患者中，51.5%报告在过去12个月内有某种程度的无家可归经历：与他人合住但不付房租（n = 279，30.2%）、拖欠房贷或房租（n = 111，12%）、遭遇驱逐（n = 74，8%）、住在酒店或汽车旅馆（n = 196，21.2%）、住在不适合人类居住的地方（n = 76，8.2%）、睡在收容所（n = 131，14.2%）以及睡在街上（n = 115，12.5%）。男性（比值比[OR] 1.56，95%置信区间[CI] 1.17 - 2.09）、完成部分学业的患者（OR 2.85，95% CI 1.72 - 4.71）以及完成高中学业的患者（OR 2.32，95% CI 1.53 - 3.52）在急诊科就诊前12个月内更有可能经历过无家可归。