背景:与居住人口相比,经历无家可归(PEH)的人面临更高的不良健康结果和过早死亡的风险,并且在尝试获得医疗服务时经常面临重大障碍。这项研究旨在更好地了解PEH的具体医疗保健需求以及与他们在欧洲背景下及时,公平地获得医疗服务相关的障碍和促进者。
方法:我们进行了一项探索性的跨国定性研究,涉及奥地利有无家可归生活经验的人以及健康和社会护理专业人员,希腊,西班牙,和英国。共有69位半结构化面试,由15位社会护理专业人员组成,19名医疗保健专业人员,完成了35个PEH,转录,并按主题进行分析。
结果:研究结果分为与研究问题相关的三个总体主题:(a)PEH的医疗保健需求,(b)获得保健的障碍,(c)获得保健服务的促进者。总的来说,PEH的总体健康状况被描述为非常差,主流卫生服务被描述为没有能力满足这一人口的需求。采用量身定制的护理方法,特别是让值得信赖的专业人员参与提供护理,被确定为克服现有障碍的关键战略。
结论:这项研究的结果表明,PEH的医疗保健需求以及与他们在不同欧洲环境中获得医疗保健相关的障碍和促进因素具有高度的一致性。无家可归本身被认为是健康的重要社会决定因素,PEH面临获得医疗服务不平等的风险。因此,需要进行更改,以促进PEH获得主流初级保健。这也可以通过对“触达”服务和其他量身定制和以人为中心的医疗保健形式的投资来进一步补充。
背景:这项研究于2022年6月6日在ClinicalTrials.gov的注册表中进行了回顾性注册,编号为NCT05406687。
People experiencing homelessness (PEH) are known to be at higher risk of adverse health outcomes and premature mortality when compared to the housed population and often face significant barriers when attempting to access health services. This
study aimed to better understand the specific health care needs of PEH and the barriers and facilitators associated with their timely and equitable access to health services in the European context.
We conducted an exploratory cross-national qualitative
study involving people with lived experience of homelessness and health and social care professionals in Austria, Greece, Spain, and the UK. A total of 69 semi-structured interviews comprising 15 social care professionals, 19 health care professionals, and 35 PEH were completed, transcribed, and analysed thematically.
Findings were organised into three overarching themes relating to the research question: (a) Health care needs of PEH, (b) Barriers to health care access, and (c) Facilitators to health care access. Overall, the general health of PEH was depicted as extremely poor, and mainstream health services were portrayed as ill-equipped to respond to the needs of this population. Adopting tailored approaches to care, especially involving trusted professionals in the delivery of care, was identified as a key strategy for overcoming existing barriers.
The results of this
study indicate there to be a high degree of consistency in the health care needs of PEH and the barriers and facilitators associated with their access to health care across the various European settings. Homelessness in itself is recognized to represent an essential social determinant of health, with PEH at risk of unequal access to health services. Changes are thus required to facilitate PEH\'s access to mainstream primary care. This can also be further complemented by investment in \'in-reach\' services and other tailored and person-centred forms of health care.
This
study was registered retrospectively on June 6, 2022, in the registry of ClinicalTrials.gov under the number NCT05406687.