医院为离开急性护理的无家可归者制定出院计划：一个被忽视的问题。
Hospital Discharge Planning for People Experiencing Homelessness Leaving Acute Care: A Neglected Issue.
机构信息
PhD Candidate, Dalla Lana School of Public Health, University of Toronto, Toronto, ON.
Barrister and Solicitor, Crown Counsel, Ministry of the Attorney General, Toronto, ON.
出版信息
Healthc Policy. 2020 Aug;16(1):14-21. doi: 10.12927/hcpol.2020.26294.
Abstract
People experiencing homelessness have worse health outcomes than the general population and limited access to primary/preventative healthcare. This leads to high hospital readmission rates. Effective discharge planning can improve recovery rates and reduce hospital costs. However, most hospital discharge policies and best practice guidelines are not tailored to patients with no fixed address, contributing to inappropriate discharges and health inequities for people experiencing homelessness. We discuss the lack of discharge policies, identifiable processes or plans specifically tailored to this population as a healthcare and policy gap, and we identify key areas for better understanding and addressing this issue.
摘要
无家可归者的健康状况比一般人群差，获得初级/预防保健的机会有限。这导致了高住院再入院率。有效的出院计划可以提高康复率并降低医院成本。然而，大多数医院出院政策和最佳实践指南都不是针对无固定地址的患者量身定制的，这导致了对无家可归者的不适当出院和健康不平等。我们讨论了缺乏专门针对这一人群的出院政策、可识别的流程或计划，这是医疗保健和政策方面的一个差距，并确定了更好地理解和解决这个问题的关键领域。
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本文引用的文献
1
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BMJ Qual Saf. 2020 May;29(5):390-400. doi: 10.1136/bmjqs-2019-009993. Epub 2020 Jan 5.
2
Long-term effects of rent supplements and mental health support services on housing and health outcomes of homeless adults with mental illness: extension study of the At Home/Chez Soi randomised controlled trial.
Lancet Psychiatry. 2019 Nov;6(11):915-925. doi: 10.1016/S2215-0366(19)30371-2. Epub 2019 Oct 7.
3
Discharge planning in mental healthcare settings: A review and concept analysis.
Int J Ment Health Nurs. 2019 Aug;28(4):816-832. doi: 10.1111/inm.12599. Epub 2019 Apr 30.
4
Discharge planning from hospital.
Cochrane Database Syst Rev. 2016 Jan 27;2016(1):CD000313. doi: 10.1002/14651858.CD000313.pub5.
5
The health diagnoses of homeless adolescents: a systematic review of the literature.
J Adolesc. 2014 Jul;37(5):531-42. doi: 10.1016/j.adolescence.2014.04.003. Epub 2014 May 8.
6
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
Am J Public Health. 2013 Dec;103 Suppl 2(Suppl 2):S294-301. doi: 10.2105/AJPH.2013.301369. Epub 2013 Oct 22.
7
Improving the quality of discharge care for the homeless: a patient-centered approach.
J Health Care Poor Underserved. 2013 May;24(2):444-55. doi: 10.1353/hpu.2013.0070.
8
Preventing homelessness after discharge from psychiatric wards: perspectives of consumers and staff.
J Psychosoc Nurs Ment Health Serv. 2013 Mar;51(3):24-31. doi: 10.3928/02793695-20130130-02. Epub 2013 Feb 11.
9
Frequent-user patients: reducing costs while making appropriate discharges.
Healthc Financ Manage. 2012 Mar;66(3):98-100, 102, 104 passim.
10
Hospital costs and length of stay among homeless patients admitted to medical, surgical, and psychiatric services.
Med Care. 2011 Apr;49(4):350-4. doi: 10.1097/MLR.0b013e318206c50d.
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