Improving Health Care Management in Primary Care for Homeless People: A Literature Review.

Maeva Jego,Maeva Jego,Diana-Elena Ștefan,Stéphanie Gentile,Céline Calvet-Montredon,Julien Abcaya

doi:10.3390/ijerph15020309

Abstract

Background: Homeless people have poorer health status than the general population. They need complex care management, because of associated medical troubles (somatic and psychiatric) and social difficulties. We aimed to describe the main characteristics of the primary care programs that take care of homeless people, and to identify which could be most relevant. Methods: We performed a literature review that included articles which described and evaluated primary care programs for homeless people. Results: Most of the programs presented a team-based approach, multidisciplinary and/or integrated care. They often proposed co-located services between somatic health services, mental health services and social support services. They also tried to answer to the specific needs of homeless people. Some characteristics of these programs were associated with significant positive outcomes: tailored primary care organizations, clinic orientation, multidisciplinary team-based models which included primary care physicians and clinic nurses, integration of social support, and engagement in the community’s health. Conclusions: Primary health care programs that aimed at taking care of the homeless people should emphasize a multidisciplinary approach and should consider an integrated (mental, somatic and social) care model.

Highlights

Homelessness has increased during the past 30 years in high-income countries [1]
In this review we aimed to describe the main characteristics of primary care programs that take care of homeless people, and to identify which could be most relevant for taking care of the homeless people
The primary care programs included in this literature review used mostly team-based approaches, multidisciplinary and/or integrated care

Summary

Introduction

Homelessness has increased during the past 30 years in high-income countries [1]. It is estimated that 4 million people experience homelessness each year in the European Union, and more than2.5 million in the USA [1]. It considers four conditions: rooflessness (living rough or in emergency shelters), houselessness (people living in shelters, more long-term accommodations or due to being released from institutions), insecure housing, and inadequate housing (for example living in caravans on illegal campsites, living in unfit housing, or extreme overcrowding) [2]. They tried to answer to the specific needs of homeless people Some characteristics of these programs were associated with significant positive outcomes: tailored primary care organizations, clinic orientation, multidisciplinary team-based models which included primary care physicians and clinic nurses, integration of social support, and engagement in the community’s health. Conclusions: Primary health care programs that aimed at taking care of the homeless people should emphasize a multidisciplinary approach and should consider an integrated (mental, somatic and social) care model

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