School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland.
National Rehabilitation Hospital, A96 E2H2 Dublin, Ireland.
Int J Environ Res Public Health. 2021 Jul 27;18(15):7917. doi: 10.3390/ijerph18157917.
People who become homeless have higher morbidity and mortality, use a disproportionate amount of healthcare resources, and generate a large volume of potentially preventable healthcare and other costs compared to more privileged individuals. Although access to rehabilitation is a human right under article 26 of the United Nations Convention on the Rights of Persons with Disabilities, the rehabilitation needs of individuals with homelessness have not been explored, and this project's purpose was to establish a baseline of need for this cohort.
A prospective audit of case discussions at an inclusion health service over a 2-month period in 2018.
Four multidisciplinary inclusion health clinics were observed with over 20 cases discussed in each and data were extracted using a bespoke audit data extraction tool. The inclusion health needs were diverse and complex with many unmet rehabilitation needs. Physical and cognitive rehabilitation needs were identified in over 50% of cases discussed. Musculoskeletal problems and acquired brain injuries were the most common cause of activity limitation. Most had concurrent medical conditions and addiction and/or mental health needs. None had access to rehabilitation services.
The results of this study show that the rehabilitative needs of this cohort are significant and are not being met through traditional models of care. We are currently exploring innovative ways to provide appropriate services to these individuals.
与享有更多特权的个体相比，无家可归者的发病率和死亡率更高，使用的医疗保健资源不成比例，产生的大量潜在可预防的医疗保健和其他费用也更多。尽管根据《联合国残疾人权利公约》第二十六条，获得康复是一项人权，但无家可归者的康复需求尚未得到探索，本项目的目的是确定这一群体的基本需求。
2018 年两个月期间，对纳入健康服务的病例讨论进行前瞻性审核。
观察了四个多学科的纳入健康诊所，每个诊所都有 20 多个病例进行了讨论，并使用专门的审核数据提取工具提取了数据。纳入健康的需求多种多样且复杂，许多康复需求未得到满足。超过 50%的讨论病例存在身体和认知康复需求。肌肉骨骼问题和获得性脑损伤是导致活动受限的最常见原因。大多数人同时存在医疗状况、成瘾和/或心理健康需求，但都无法获得康复服务。
本研究结果表明，这一群体的康复需求巨大，但通过传统的护理模式无法得到满足。我们目前正在探索为这些人提供适当服务的创新方法。
