Paediatric Emergency Medicine, Children's Health Ireland at Temple Street, Dublin, Ireland
Paediatric Emergency Medicine, Children's Health Ireland at Temple Street, Dublin, Ireland.
BMJ Paediatr Open. 2022 Mar;6(1). doi: 10.1136/bmjpo-2021-001368.
Despite increasing prevalence, European family homelessness remains under-researched.
A retrospective review was performed of homeless children attending a paediatric emergency department in Dublin, Ireland, from 1 January 2017 to 31 December 2020. Comparison was made with a random cohort of 1500 non-homeless paediatric attendances in 2019. Homelessness was defined using the European Typology of Homelessness and Housing Exclusion, including those with addresses of no fixed abode, government homeless accommodation and certain residential settings. The objectives were to compare presentations between homeless and non-homeless children. We were interested in determining differences regarding demographics, healthcare utilisation, clinical presentation and outcomes.
Of 197 437 attendances 3138 (1.59%) were homeless. Compared with the non homeless, homeless children were less likely to be ethnically Irish (37.4% vs 74.6%, p<0.001) or have been born in Ireland (82.3% vs 96.2%, p<0.001). Irish Travellers (3% vs 0.8%), Roma (22.5% vs 2.4%) and black (21.1% vs 4.2%) ethnicities were over-represented (p<0.001) in the homeless cohort.Homeless children were younger (age <12 months: 26% vs 16%; p<0.001), less likely to be fully vaccinated (73.6% vs 81.9%, p<0.001) and have registered general practitioners (89.7% vs 95.8%, p<0.001). They were more likely to represent within 2 weeks (15.9% vs 10.5%, p<0.001), and use ambulance transportation (13.2% vs 6.7%, p<0.001). Homeless children had lower acuity presentations (triage category 4-5: 47.2% vs 40.7%, p<0.001) and fewer admissions (5.9% vs 8.4%, p<0.001) than non-homeless children.
Infants, Irish Travellers, Roma and black ethnicities were over-represented in homeless presentations. Homeless children had increased reliance on emergency services for primary healthcare needs.
尽管欧洲无家可归者的比例不断上升，但对其的研究仍然不足。
对 2017 年 1 月 1 日至 2020 年 12 月 31 日期间在爱尔兰都柏林一家儿科急诊室就诊的流浪儿童进行了回顾性研究，并与 2019 年随机选择的 1500 名非流浪儿科就诊者进行了比较。无家可归的定义采用欧洲无家可归者和住房排斥分类法，包括那些没有固定住所、政府收容所和某些居住环境的人。目的是比较流浪儿童和非流浪儿童的就诊情况。我们有兴趣确定在人口统计学、医疗保健利用、临床表现和结果方面的差异。
在 197437 次就诊中，有 3138 人（1.59%）无家可归。与非无家可归者相比，无家可归的儿童更不可能是爱尔兰裔（37.4%对 74.6%，p<0.001）或在爱尔兰出生（82.3%对 96.2%，p<0.001）。爱尔兰旅行者（3%对 0.8%）、罗姆人（22.5%对 2.4%）和黑人（21.1%对 4.2%）的比例过高（p<0.001）。无家可归的儿童年龄更小（<12 个月：26%对 16%；p<0.001），疫苗接种率更低（73.6%对 81.9%，p<0.001），注册全科医生也更少（89.7%对 95.8%，p<0.001）。他们更有可能在 2 周内就诊（15.9%对 10.5%，p<0.001），并且更有可能使用救护车（13.2%对 6.7%，p<0.001）。无家可归的儿童表现出较低的严重程度（分类 4-5：47.2%对 40.7%，p<0.001），入院率也较低（5.9%对 8.4%，p<0.001）。
婴儿、爱尔兰旅行者、罗姆人和黑人在无家可归者中比例过高。无家可归的儿童更依赖于急诊服务来满足其基本医疗需求。
