Experiences of homeless individuals using ambulance services: a narrative review

Abstract

Background: Homeless individuals are vulnerable and have a higher burden of illness. Barriers to care exist and experiences can be negative, contributing to increased morbidity and mortality. The experiences of homeless individuals accessing healthcare through ambulance services is underexplored. Aims: The study aims to describe why homeless individuals access healthcare through ambulance services and identify lived experiences. Methods: A narrative literature review was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, with Critical Appraisal Skills Programme tools used to assess quality before thematic synthesis. Results: Twenty-three studies were included. Six themes were identified including frequency of ambulance use and clinical characteristics, why healthcare is accessed through ambulance services and the experiences of homeless individuals and paramedics. Conclusions: Evidence relating to homeless individuals accessing healthcare through ambulance services is limited. However, it is clear this group uses these services more often than non-homeless individuals, likely because of their higher chronic illness burden. Services should be developed to meet the needs of homeless individuals and to help ensure demand on ambulance services is manageable and affordable.