Transformation Partners in Health and Care, London, UK
Transformation Partners in Health and Care, London, UK.
Clin Med (Lond). 2023 Jul;23(4):395-402. doi: 10.7861/clinmed.2023-0074.
People experiencing homelessness frequently die young, from preventable and treatable conditions. They experience significant barriers to healthcare and are often critically ill when admitted to hospital. A hospital admission is an opportunity to intervene and prevent premature mortality by providing compassionate care and facilitating access to safe onward accommodation and support.
To quantify needs, a cross-sectional audit of inpatients experiencing homelessness across 15 acute hospital teams in London, was undertaken in February 2022. Integrated discharge and hospital homelessness teams were interviewed about each patient identified as homeless or vulnerably housed. Data was collected about patients' health, housing, support needs, and reasons for delayed discharges.
Detailed information was gathered on 86 patients. There was a high level of clinical complexity and multimorbidity. For a safe discharge 60% of individuals were deemed to need accommodation providing high or medium level support and at the time of the audit, half were delayed discharges.
There is an urgent need for a range of intermediate/step down and longer-term accommodation and support to enable safe appropriate discharge from hospital and start to address the huge inequity in health outcomes of this population. This paper includes recommendations for clinicians and commissioners.
无家可归者经常英年早逝，死于可预防和可治疗的疾病。他们在获得医疗保健方面面临重大障碍，并且在入院时常常病情危急。住院治疗是一个通过提供富有同情心的护理并为安全的后续住宿和支持提供便利来干预和预防过早死亡的机会。
为了量化需求，于 2022 年 2 月对伦敦 15 个急性医院团队中无家可归的住院患者进行了横断面审计。对被确定为无家可归或住房不稳定的每位患者，对综合出院和医院无家可归者团队进行了访谈。收集了有关患者健康、住房、支持需求以及延迟出院原因的数据。
详细收集了 86 名患者的信息。这些患者的临床情况复杂且多病共存。为了安全出院，60%的人被认为需要提供高或中等级别的支持的住所，在审计时，有一半人被延迟出院。
迫切需要一系列中级/降级和长期住所和支持，以确保从医院安全适当出院，并开始解决这一人群健康结果存在巨大不平等的问题。本文包括对临床医生和决策者的建议。
