Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Telemed J E Health. 2021 Aug;27(8):851-858. doi: 10.1089/tmj.2021.0127. Epub 2021 Jul 23.
People experiencing homelessness (PEH) encounter barriers to health care, increasing their vulnerability to illness, hospitalization, and death. Telehealth can improve access to health care, but its use in PEH has been insufficiently evaluated. Needs assessment surveys completed by clients at an urban drop-in center for PEH ( = 63) showed mental (58.7%) and physical (52.4%) health challenges were common, as was emergency department (ED) use (75.9%, = 54). Surveys collected after in-person and telehealth clinical visits showed patient satisfaction was >90% for both visit types ( = 125, 44.0% telehealth and 56.0% in person). Without access to telehealth visits, 29.1% of patients would have gone to the ED and 38.2% would not have gotten care. Providers ( = 93, 69.6% telehealth and 30.4% in person) were more likely to agree/strongly agree they made a positive impact on patients' health through telehealth (92.2%) than in person (71.4%) ( = 0.019). Telehealth is a feasible and potentially cost-effective method to increase access to health care and reduce health outcome disparities in PEH.
无家可归者(PEH)在获得医疗保健方面面临障碍,这增加了他们患病、住院和死亡的脆弱性。远程医疗可以改善医疗保健的可及性,但在 PEH 中的应用尚未得到充分评估。在城市无家可归者临时收容所进行的客户需求评估调查( = 63)显示,常见的心理健康(58.7%)和身体健康(52.4%)挑战,以及急诊科就诊(75.9%, = 54)。在面对面和远程医疗临床访问后收集的调查显示,两种访问类型的患者满意度均>90%( = 125,44.0%远程医疗和 56.0%面对面)。如果无法进行远程医疗访问,29.1%的患者将去急诊科就诊,38.2%的患者将无法获得治疗。与面对面相比,提供远程医疗服务的提供者( = 93,69.6%远程医疗和 30.4%面对面)更有可能同意/强烈同意他们通过远程医疗对患者的健康产生了积极影响(92.2%比 71.4%)( = 0.019)。远程医疗是增加医疗保健可及性和减少无家可归者健康结果差异的一种可行且具有潜在成本效益的方法。