无家可归者的健康和医疗保健使用情况：联合社会工作和医疗保健服务的评估研究。

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2024-10-15 DOI:10.1016/j.ijnurstu.2024.104929

Martin Šimon , Barbora Latečková , Oto Potluka

{"title":"无家可归者的健康和医疗保健使用情况：联合社会工作和医疗保健服务的评估研究。","authors":"Martin Šimon , Barbora Latečková , Oto Potluka","doi":"10.1016/j.ijnurstu.2024.104929","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Homelessness as an extreme form of poverty perpetuates and exacerbates health inequalities. People experiencing homelessness face a mortality rate 10 times higher than that of the general population, with an average age of death at 45. There is a significant disconnect between the mainstream healthcare system and the specific health needs of people experiencing homelessness, leading to substantial human and economic costs.</div></div><div><h3>Objective</h3><div>The objective of this evaluation study is to assess the impact of an intervention in nurse-led healthcare outreach services to people experiencing homelessness on their utilization of healthcare services.</div></div><div><h3>Design</h3><div>This study is a part of research program aimed at assuring health equity of most vulnerable members of a society. Detailed understanding of barriers to care is a necessary precondition for improvements in healthcare use.</div></div><div><h3>Data</h3><div>The study analyzes data on hospitalization and emergency department visits by people experiencing homelessness across three cities in Czechia from 2014 to 2021.</div></div><div><h3>Methods</h3><div>A quantitative difference-in-differences approach is complemented by insights from field studies in these three cities.</div></div><div><h3>Results</h3><div>The intervention in people experiencing homelessness outreach led to a reduction in both hospital admissions and the emergency visits by people experiencing homelessness, alleviating pressure on health service capacity and reducing associated healthcare costs. Enhanced primary nurse-led healthcare outreach, along with cross-sectoral integration and activation, has lowered the barriers to accessing essential healthcare services.</div></div><div><h3>Conclusion</h3><div>A pivotal policy outcome of this study is the establishment of an insurance provision that allows medical doctors to claim additional costs incurred in treating people experiencing homelessness from a public insurance system.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104929"},"PeriodicalIF":7.5000,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Health and healthcare use of homeless population: Evaluation study of joint social work and healthcare provision\",\"authors\":\"Martin Šimon , Barbora Latečková , Oto Potluka\",\"doi\":\"10.1016/j.ijnurstu.2024.104929\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Homelessness as an extreme form of poverty perpetuates and exacerbates health inequalities. People experiencing homelessness face a mortality rate 10 times higher than that of the general population, with an average age of death at 45. There is a significant disconnect between the mainstream healthcare system and the specific health needs of people experiencing homelessness, leading to substantial human and economic costs.</div></div><div><h3>Objective</h3><div>The objective of this evaluation study is to assess the impact of an intervention in nurse-led healthcare outreach services to people experiencing homelessness on their utilization of healthcare services.</div></div><div><h3>Design</h3><div>This study is a part of research program aimed at assuring health equity of most vulnerable members of a society. Detailed understanding of barriers to care is a necessary precondition for improvements in healthcare use.</div></div><div><h3>Data</h3><div>The study analyzes data on hospitalization and emergency department visits by people experiencing homelessness across three cities in Czechia from 2014 to 2021.</div></div><div><h3>Methods</h3><div>A quantitative difference-in-differences approach is complemented by insights from field studies in these three cities.</div></div><div><h3>Results</h3><div>The intervention in people experiencing homelessness outreach led to a reduction in both hospital admissions and the emergency visits by people experiencing homelessness, alleviating pressure on health service capacity and reducing associated healthcare costs. Enhanced primary nurse-led healthcare outreach, along with cross-sectoral integration and activation, has lowered the barriers to accessing essential healthcare services.</div></div><div><h3>Conclusion</h3><div>A pivotal policy outcome of this study is the establishment of an insurance provision that allows medical doctors to claim additional costs incurred in treating people experiencing homelessness from a public insurance system.</div></div>\",\"PeriodicalId\":50299,\"journal\":{\"name\":\"International Journal of Nursing Studies\",\"volume\":\"161 \",\"pages\":\"Article 104929\"},\"PeriodicalIF\":7.5000,\"publicationDate\":\"2024-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Nursing Studies\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0020748924002426\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Nursing Studies","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0020748924002426","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

摘要

背景：无家可归是一种极端形式的贫困，它延续并加剧了健康不平等。无家可归者的死亡率是普通人群的 10 倍，平均死亡年龄为 45 岁。主流医疗保健系统与无家可归者的特殊健康需求之间存在严重脱节，导致巨大的人力和经济成本：本评估研究旨在评估由护士主导的医疗保健外展服务对无家可归者使用医疗保健服务的影响：本研究是旨在确保社会最弱势成员健康公平的研究计划的一部分。详细了解就医障碍是改善医疗服务使用情况的必要前提：研究分析了捷克三个城市无家可归者在 2014 年至 2021 年期间的住院和急诊就诊数据：方法：采用定量差异分析方法，并辅以在这三个城市开展的实地研究：结果：对无家可归者的外联干预减少了无家可归者的入院率和急诊率，减轻了医疗服务能力的压力，降低了相关医疗成本。加强以初级护士为主导的医疗保健外联工作，同时进行跨部门整合和激活，减少了获得基本医疗保健服务的障碍：本研究的一项重要政策成果是制定了一项保险条款，允许医生向公共保险系统索赔在治疗无家可归者时产生的额外费用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Health and healthcare use of homeless population: Evaluation study of joint social work and healthcare provision

Background

Homelessness as an extreme form of poverty perpetuates and exacerbates health inequalities. People experiencing homelessness face a mortality rate 10 times higher than that of the general population, with an average age of death at 45. There is a significant disconnect between the mainstream healthcare system and the specific health needs of people experiencing homelessness, leading to substantial human and economic costs.

Objective

The objective of this evaluation study is to assess the impact of an intervention in nurse-led healthcare outreach services to people experiencing homelessness on their utilization of healthcare services.

Design

This study is a part of research program aimed at assuring health equity of most vulnerable members of a society. Detailed understanding of barriers to care is a necessary precondition for improvements in healthcare use.

Data

The study analyzes data on hospitalization and emergency department visits by people experiencing homelessness across three cities in Czechia from 2014 to 2021.

Methods

A quantitative difference-in-differences approach is complemented by insights from field studies in these three cities.

Results

The intervention in people experiencing homelessness outreach led to a reduction in both hospital admissions and the emergency visits by people experiencing homelessness, alleviating pressure on health service capacity and reducing associated healthcare costs. Enhanced primary nurse-led healthcare outreach, along with cross-sectoral integration and activation, has lowered the barriers to accessing essential healthcare services.

Conclusion

A pivotal policy outcome of this study is the establishment of an insurance provision that allows medical doctors to claim additional costs incurred in treating people experiencing homelessness from a public insurance system.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).