Exploring a hospital's response to children who have no fixed address

Area of Science:

• Pediatric Healthcare
• Public Health
• Social Determinants of Health

Background:

• Children experiencing homelessness, defined as 'no fixed address' (NFA), represent a vulnerable population with complex healthcare needs.
• Tertiary metropolitan public healthcare providers play a critical role in addressing the health and social well-being of these children.
• Effective identification and support systems are crucial for improving outcomes for NFA children within healthcare settings.

Purpose of the Study:

• To evaluate the support mechanisms in place for children presenting with 'no fixed address' (NFA) at a tertiary metropolitan public healthcare provider.
• To identify gaps in service delivery and psychosocial support for this population.
• To inform improvements in healthcare provision for vulnerable children.

Main Methods:

• Retrospective data mining of electronic medical records.
• Analysis of patients classified with 'no fixed address' (NFA) over a 12-month period.
• Focus on pediatric patients within the NFA cohort.

Main Results:

• The study identified 475 NFA patients, with children comprising 6% of this cohort.
• A significant majority (96%) of NFA children only attended the emergency department (ED).
• Findings indicated poor psychosocial support, with 69% lacking a recorded discharge location and 48% self-discharging before assessment.

Conclusions:

• The healthcare system demonstrated significant deficiencies in identifying and addressing the psychosocial needs of children with no fixed address.
• There is a critical need for enhanced protocols and integrated services to support NFA children within public healthcare settings.
• Improved discharge planning and psychosocial interventions are essential for this vulnerable pediatric population.