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Describing the Medical Needs of Hawai'i's Houseless Population During COVID at Free Student Run Outpatient Clinics
Brendan K Seto1, Dylan S Singh1, Jason C Seto1
1John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (BKS, DSS, JCS, NL, JO, TS).
Insights
The HOME clinic provided vital medical services to 526 homeless individuals in Hawai'i during COVID-19. Services addressed high rates of wound care, pain, and chronic conditions like hypertension and diabetes.
Area of Science:
- Medical Education
- Public Health
- Social Determinants of Health
Background:
- Hawai'i faces high rates of homelessness, worsened by COVID-19, hindering access to medical care.
- The Houseless Outreach in Medical Education (HOME) clinic is Hawai'i's largest student-run free clinic serving this vulnerable population.
Purpose of the Study:
- To report on the demographics, medical needs, and services provided to homeless patients at Hawai'i's HOME clinic during the COVID-19 pandemic.
Main Methods:
- Analysis of patient data from September 2020 to 2021, including demographics, chief complaints, comorbidities, and substance use.
- Tracking of medical services provided by the student-run clinic.
Main Results:
- 1198 unique visits from 526 distinct patients were recorded.
- Top chief complaints: wound care (42.4%), pain (26.9%), skin issues (15.7%).
- High prevalence of comorbidities: elevated blood pressure (66%), hypertension (30.6%), diabetes (11.6%), psychiatric concerns (schizophrenia 5.2%, anxiety 5.1%).
- Significant substance use: 57.2% overall, including alcohol (17.8%), tobacco (48.5%), and marijuana (12.5%).
- Most common services: medication (58.7%), wound care (30.7%), substance cessation counseling (25.2%).
Conclusions:
- Homeless individuals represent a diverse population with complex and evolving medical needs.
- High prevalence of chronic diseases and comorbidities necessitates comprehensive care strategies.
- Student-run clinics play a crucial role in addressing healthcare disparities for the homeless population.
Abstract:
Hawai'i experiences some of the highest rates of houselessness per capita in the country. COVID-19 has exacerbated these disparities and made it difficult for these individuals to seek medical care. Hawai'i's Houseless Outreach in Medical Education (HOME) clinic is the largest student run free clinic in the state, which provides medical services to this patient population. This article reports the demographics, medical needs, and services provided to patients of Hawai'i's HOME clinic during the era of COVID-19. From September 2020 to 2021, the HOME clinic saw 1198 unique visits with 526 distinct patients. The most common chief complaints included wound care (42.4%), pain (26.9%), and skin complaints (15.7%). A large portion of the population suffered from comorbidities including elevated blood pressure (66%), a formal reported history of hypertension (30.6%), diabetes (11.6%), and psychiatric concerns including schizophrenia (5.2%) and generalized anxiety (5.1%). Additionally, a large portion of patients (57.2%) were substance users including 17.8% of patients endorsing use of alcohol, 48.5% tobacco and 12.5% marijuana. The most common services provided were dispensation of medication (58.7%), wound cleaning/dressing changes (30.7%), and alcohol or other drug cessation counseling (25.2%). This study emphasizes that the houseless are a diverse population with complex, evolving medical needs and a high prevalence of chronic diseases and comorbidities.
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