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ホームレスの人たちのための医療介入
1Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada; Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Lancet (London, England)
|November 13, 2014
まとめ
合わせた健康プログラムと支援住宅は,ホームレスの人々の健康状態を大幅に改善します. 社会政策への取り組みは,ホームレスに対する長期的な解決策に不可欠です.
科学分野:
- 公衆衛生は公衆衛生である.
- 医療サービス 研究 医療サービス
- 健康の社会的決定因子
背景:
- ホームレス状態は,個人および人口の健康に重大なリスクをもたらします.
- 標準的なプライマリーケアは,ホームレスの人々にとって,特別の介入よりも効果が低いかもしれません.
- 効果的なメンタルヘルスと薬物乱用介入は,この集団にとって非常に重要です.
研究 の 目的:
- ホームレスに対する効果的な医療介入の見直しを行う.
- メンタルヘルスケア,薬物乱用削減,退院の成功モデルを特定する.
- ホームレス化に寄与する構造的要因に対処する必要性を強調する.
主な方法:
- ホームレスの人々のための医療介入に関する科学文献のレビュー.
- ケースマネジメント,アサーティブ・コミュニティ・トリートメント,ハウジング・ファーストなど,様々なモデルの分析.
- 集中的なサービス利用者のための医療リヘイトプログラムとターゲットの介入の評価.
主要な成果:
- パーソナライズされたプライマリーヘルスケアプログラムは,標準的なケアよりも有望です.
- ハウジング・ファースト・モデルは,深刻な精神疾患を患っている人々の結果を改善します.
- ケースマネジメントと支援住宅は,特に高いニーズを持つ個人に効果的です.
- メディカルリフイトプログラムは,病院から転院するホームレスの患者に恩恵を与えます.
結論:
- "ハウジングファースト"や医療支援などの具体的な介入は,ホームレスに対して効果的です.
- 住居,ケースマネジメント,およびサポートサービスを組み合わせた統合的アプローチは,最良の結果をもたらします.
- 医療提供者は,ホームレスの根本的な原因に対処するための政策変更を提唱しなければなりません.
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