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Related Experiment Video

Updated: Jul 13, 2025

Assessment of Acute Wound Healing using the Dorsal Subcutaneous Polyvinyl Alcohol Sponge Implantation and Excisional Tail Skin Wound Models.
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Community-Based Wound Care Programs for Unhoused Individuals.

Taichi Goto1, Christina Wang2, Catherine Kwiat1

  • 1National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, 20892, USA.

Journal of Epidemiology and Global Health
|October 17, 2023
PubMed
Summary

Managing wound care for unhoused individuals requires integrated, community-based programs. Successful models incorporate comprehensive services and address sustainability challenges like insurance reimbursement for street-based care.

Keywords:
Community-based careHomelessnessStreet medicineSubstance useWound care

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Area of Science:

  • Public Health
  • Community Medicine
  • Healthcare Management

Background:

  • Wound care for unhoused populations presents unique challenges due to limited healthcare infrastructure.
  • Effective management necessitates low-threshold, community-based, and tailored healthcare solutions.
  • Existing models often struggle to meet the complex needs of this vulnerable demographic.

Purpose of the Study:

  • To identify best practices for community-based wound care programs serving unhoused individuals.
  • To assess the cost-effectiveness and client/provider perspectives of a specific community-based program.
  • To highlight logistical and policy gaps hindering sustainable wound care for the unhoused.

Main Methods:

  • Conducted a targeted narrative literature review of existing or proposed community-based wound care programs.
  • Assessed cost-effectiveness and analyzed survey data from unhoused clients and healthcare providers in Honolulu, Hawai'i.
  • Synthesized findings to inform best practices and identify areas for policy improvement.

Main Results:

  • Literature review identified successful programs integrating wound care into broader social/health services, emphasizing cost-effectiveness and comprehensive care.
  • Survey results indicated the Honolulu program met client needs and was cost-effective.
  • Key challenges included client follow-up to wound closure and program sustainability, primarily due to lack of insurance reimbursement for street-based services.

Conclusions:

  • Community-based programs can effectively address unhoused individuals' wound care needs by tackling fundamental issues.
  • Addressing logistical and policy gaps, especially regarding insurance reimbursement, is crucial for program sustainability.
  • Integrated, comprehensive, and accessible wound care models are essential for this underserved population.