Alan Albert, Ennabe Michelle, Withers James, Joshi Neil, Weinand Martin
Department of Neurosurgery Mayo Clinic, Rochester, Minnesota, United States.
Global Neurosurgical Alliance, Rochester, Minnesota, United States.
Surg Neurol Int. 2024 Feb 16;15:49. doi: 10.25259/SNI_549_2023. eCollection 2024.
Homelessness is a growing concern in the US, with 3.5 million people experiencing it annually and 600,000 on any given night. Homeless individuals face increased vulnerability to 30-day hospital readmissions and higher mortality rates, straining the healthcare system and exacerbating existing disparities. This study aims to inform neurosurgeons on evidence-based strategies to reduce readmission and mortality rates among homeless patients by reviewing the literature on the impact of medical respite on 30-day readmission rates. The study aims to gauge the efficacy of medical respite in reducing hospital readmissions and improving health outcomes for homeless individuals.
A comprehensive literature search was conducted across PubMed, Embase/Medline, and Cochrane databases, as well as consulting the National Institute for Medical Respite Care and the Department of Health Care Access and Information. Ten articles were chosen from an initial 296 to investigate the impact of respite programs on readmission rates among homeless patients.
Homeless patients experience high readmission rates due to various factors. Interventions such as respite programs and a comprehensive approach to healthcare can lower these rates. Collaboration between hospitals and medical respites has proven particularly effective.
Inadequate healthcare for homeless individuals leads to increased readmissions, longer hospital stays, and higher costs. Medical respites are a viable solution, but limited resources hamper their effectiveness. Therefore, it is crucial to facilitate cooperation between hospitals, respites, and other entities. Future research should focus on disparity in neurosurgical procedures and explore alternative services. An interdisciplinary approach is key to addressing healthcare inequalities.
在美国,无家可归问题日益受到关注,每年有350万人经历无家可归,每晚有60万人处于这种状态。无家可归者面临更高的30天内再次入院风险和更高的死亡率,给医疗系统带来压力并加剧了现有的差距。本研究旨在通过回顾关于医疗暂托对30天再入院率影响的文献,为神经外科医生提供基于证据的策略,以降低无家可归患者的再入院率和死亡率。该研究旨在评估医疗暂托在降低无家可归者医院再入院率和改善健康结局方面的效果。
在PubMed、Embase/Medline和Cochrane数据库中进行了全面的文献检索,并咨询了国家医疗暂托护理研究所和医疗保健获取与信息部。从最初的296篇文章中选取了10篇,以调查暂托项目对无家可归患者再入院率的影响。
由于各种因素,无家可归患者的再入院率很高。诸如暂托项目和全面的医疗保健方法等干预措施可以降低这些比率。事实证明,医院与医疗暂托机构之间的合作特别有效。
无家可归者的医疗保健不足导致再入院率增加、住院时间延长和成本上升。医疗暂托是一个可行的解决方案,但资源有限阻碍了其有效性。因此,促进医院、暂托机构和其他实体之间的合作至关重要。未来的研究应关注神经外科手术中的差距,并探索替代服务。跨学科方法是解决医疗保健不平等问题的关键。