Rhode Island Hospital and Lifespan Health System, Providence, RI.
The Warren Alpert Medical School of Brown University and the Providence VA Medical Center, Providence RI.
R I Med J (2013). 2023 May 1;106(4):30-34.
Patients experiencing homelessness have increased disease burden, increased severity of illness, and increased barriers to accessing care. The provision of high-quality palliative care is therefore essential for this population. State of Homelessness: 18 out of every 10,000 people in the US and 10 out of every 10,000 Rhode Islanders (down from 12 in 2010) experience homelessness. Conceptual Model: High-quality palliative care for patients experiencing homelessness requires a foundation of patient-provider trust, well-trained interdisciplinary teams, coordinated transitions of care, community support, integrated healthcare systems, and comprehensive population and public health measures.
Improving access to palliative care for those experiencing homelessness requires an interdisciplinary approach at all levels from individual providers to broader public health policies. A conceptual model rooted in patient-provider trust has the potential to address high-quality palliative care access disparities for this vulnerable population.
无家可归者患者的疾病负担增加、病情加重,并且在获得医疗方面存在更多障碍。因此,为这一人群提供高质量的姑息治疗至关重要。无家可归者状况:美国每 10000 人中就有 18 人,罗德岛每 10000 人中就有 10 人(低于 2010 年的 12 人)无家可归。概念模型:为无家可归者患者提供高质量的姑息治疗需要建立在患者与提供者之间的信任、训练有素的多学科团队、协调的护理过渡、社区支持、综合医疗保健系统以及全面的人群和公共卫生措施的基础上。
改善无家可归者获得姑息治疗的机会需要从个体提供者到更广泛的公共卫生政策,在各个层面采取跨学科的方法。以患者与提供者之间的信任为基础的概念模型有可能解决这一弱势群体在获得高质量姑息治疗方面的差距。