O'Callaghan Cathy, Clenaghan Paul, Putra Alenda Dwiadila Matra, Haigh Fiona, Amanatidis Sue, Raffan Freya, Lynch Nicole, Barr Margo
International Centre for Future Health Systems (ICFHS), Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, NSW 2052, Australia.
Clinical Services Integration and Population Health, Sydney Local Health District (SLHD), Sydney, NSW 2050, Australia.
Int J Environ Res Public Health. 2024 Nov 29;21(12):1593. doi: 10.3390/ijerph21121593.
Individuals experiencing homelessness have higher rates of chronic disease and face challenges accessing primary care. Virtual health care can reduce health inequity but needs user acceptance. A virtual health hub (VHH) for people experiencing homelessness in Sydney provided virtual GP and psychologist care within a crisis accommodation service. This included nursing assistance.
The VHH evaluation assessed the feasibility of the service specifically examining accessibility, efficiency, costs, technology, quality, and outcomes through attendance data, patient measures, stakeholder interviews, and case studies.
Data indicated 40% client utilisation with high attendance for GPs and/or psychologists. All clients reported a high quality of care, appointment benefits, understanding clinicians, and treatment help, and that privacy was maintained. If the VHH was not available, one-third would not have sought treatment. The majority agreed that virtual care was the same or better than in-person care. Only a few experienced technical issues. Service provider interviews indicated the benefits of accessible and affordable care, perceived reduced hospital presentations, staff time saved, and reduced client costs. Limitations were the lack of physical examinations and lack of follow-up due to temporary accommodation. Strong stakeholder partnerships enabled implementation success.
The VHH service is feasible and replicable with on-site assistance and stakeholder commitment.
无家可归者患慢性病的比例较高，且在获得初级医疗服务方面面临挑战。虚拟医疗保健可以减少健康不平等现象，但需要用户接受。悉尼为无家可归者设立的虚拟健康中心（VHH）在危机住宿服务中提供虚拟全科医生和心理医生服务。这包括护理协助。
VHH评估通过出勤数据、患者测评、利益相关者访谈和案例研究，评估了该服务的可行性，特别考察了可及性、效率、成本、技术、质量和结果。
数据显示40%的客户使用了该服务，全科医生和/或心理医生的就诊率很高。所有客户都报告护理质量高、预约便利、理解临床医生以及治疗有帮助，并且隐私得到了保护。如果没有VHH，三分之一的人不会寻求治疗。大多数人认为虚拟护理与面对面护理相同或更好。只有少数人遇到技术问题。服务提供商访谈表明，可及且负担得起的护理有诸多益处，预计医院就诊人数减少，节省了工作人员时间，降低了客户成本。局限性在于缺乏体格检查以及因临时住宿而缺乏随访。强大的利益相关者伙伴关系促成了实施的成功。
VHH服务是可行的，在有现场协助和利益相关者承诺的情况下可复制。
