Epidemiol Mikrobiol Imunol. 2022 Spring;71(1):21-31.
Homelessness is a social, societal, economic, and health problem. The aim of the study was to describe the characteristics of hospitalized homeless persons in the Czech Republic in relation to their health status and to propose targeted measures for improvement.
The study used anonymous data from the National Registry of Hospitalized Patients from 2006-2015, including the primary diagnosis at hospital admission and up to five additional diagnoses according to the 10th revision of the International Classification of Diseases (ICD-10). The basic statistical unit is the completed case of hospitalization of a homeless person in an inpatient health care facility such as hospital or nursing home.
Over the 10-year study period (2006-2015), 3387 homeless persons, 77.5% of them male, were admitted to inpatient health care facilities in the Czech Republic. The length of hospital stay tended to decrease over the years, with a median of six days. The majority of hospitalized homeless persons were aged between 40 and 69 years. Their distribution by type of health care facility: 2,710 (80.0%) were admitted to hospitals, 468 (13.8%) to psychiatric hospitals, 180 (5.3%) to long-term care facilities, and 29 (0.9%) to tuberculosis and respiratory disease hospitals. According to the mode of termination of hospitalization, 2189 (64.6%) homeless persons were discharged to their original environment, 280 (8.3%) were transferred to an after-care facility, 277 (8.2%) were transferred to an acute care facility, 222 (6.6%) left against medical advice, 180 (5.3%) were transferred to another ward, and 80 (2.4%) were transferred to a social care facility. A total of 159 (4.7%) in-hospital deaths occurred. The underlying causes of hospitalization according to ICD-10 were mostly those under Chapter V - Mental and behavioural disorders (19.9%) and Chapter XIX - Injury, poisoning and certain other consequences of external causes (18.1%). Among the 175 cases with a primary diagnosis from Chapter I - Certain infectious and parasitic diseases, the most common conditions were scabies, pediculosis, mycosis, bacterial infections, and tuberculosis.
Data on hospital admissions is one of the important tools for monitoring the health of homeless people. They illustrate the seriousness of the situation of homeless people and point to the need to obtain more information on this issue in order to improve the availability of specific health care and social care for sick homeless people. Prevention programs, residential services, and specific outreach health and social activities can contribute to reducing the negative impacts.
无家可归是一个社会、社会经济和健康问题。本研究的目的是描述捷克共和国住院 homeless 人群的特征，以及他们的健康状况，并提出有针对性的改善措施。
该研究使用了 2006-2015 年国家住院患者登记处的匿名数据，包括入院时的主要诊断以及根据国际疾病分类第 10 版（ICD-10）的多达五个附加诊断。基本统计单位是 homeless 人员在住院医疗机构（如医院或疗养院）住院的完整病例。
在 10 年的研究期间（2006-2015 年），3387 名 homeless 人员，其中 77.5%为男性，被收治在捷克共和国的住院医疗机构。住院时间呈下降趋势，中位数为六天。大多数住院 homeless 人员年龄在 40 至 69 岁之间。他们在医疗机构的分布情况如下：2710 人（80.0%）被收治在医院，468 人（13.8%）被收治在精神病院，180 人（5.3%）被收治在长期护理机构，29 人（0.9%）被收治在结核病和呼吸道疾病医院。根据住院结束方式，2189 名 homeless 人员（64.6%）出院返回原籍环境，280 人（8.3%）被转至后续护理机构，277 人（8.2%）转至急性护理机构，222 人（6.6%）未经医嘱离开，180 人（5.3%）转至其他病房，80 人（2.4%）转至社会护理机构。共有 159 人（4.7%）在院内死亡。根据 ICD-10，住院的根本原因主要是第五章——精神和行为障碍（19.9%）和第十九章——损伤、中毒和某些其他外部原因的后果（18.1%）。在有第一章——某些传染病和寄生虫病为主要诊断的 175 例病例中，最常见的病症是疥疮、头虱病、真菌病、细菌感染和结核病。
住院患者数据是监测 homeless 人群健康状况的重要工具之一。它们说明了 homeless 人群的情况的严重性，并指出需要获取更多关于这一问题的信息，以改善针对患病 homeless 人群的特定医疗和社会关怀的可及性。预防计划、居住服务以及具体的外展健康和社会活动可以有助于减少负面影响。
