Unique health care utilization patterns in a homeless population in Ghent.

Evelyn Verlinde,Bruno Art,Jan De Maeseneer,Mieke Van De Walle,Sara Willems,Tine Verdée

doi:10.1186/1472-6963-10-242

Abstract

BackgroundExisting studies concerning the health care use of homeless people describe higher utilisation rates for hospital-based care and emergency care, and lower rates for primary care by homeless people compared to the general population. Homeless people are importantly hindered and/or steered in their health care use by barriers directly related to the organisation of care. Our goal is to describe the accessibility of primary health care services, secondary care and emergency care for homeless people living in an area with a universal primary health care system and active guidance towards this unique system.MethodsObservational, cross-sectional study design. Data from the Belgian National health survey were merged with comparable data collected by means of a face-to-face interview from homeless people in Ghent. 122 homeless people who made use of homeless centres and shelters in Ghent were interviewed using a reduced version of the Belgian National Health survey over a period of 5 months. 2-dimensional crosstabs were built in order to study the bivariate relationship between health care use (primary health care, secondary and emergency care) and being homeless. To determine the independent association, a logistic model was constructed adjusting for age and sex.Results and DiscussionHomeless people have a higher likelihood to consult a GP than the non-homeless people in Ghent, even after adjusting for age and sex. The same trend is demonstrated for secondary and emergency care.ConclusionsHomeless people in Ghent do find the way to primary health care and make use of it. It seems that the universal primary health care system in Ghent with an active guidance by social workers contributes to easier GP access.

Highlights

Existing studies concerning the health care use of homeless people describe higher utilisation rates for hospital-based care and emergency care, and lower rates for primary care by homeless people compared to the general population
It seems that the universal primary health care system in Ghent with an active guidance by social workers contributes to easier general practitioner (GP) access
Seen the particular organisation of the health care use in Ghent, we want to describe the accessibility of primary health care services, secondary care and emergency care for homeless people living in an area with a universal primary health care system and active guidance towards the system

Summary

Introduction

Existing studies concerning the health care use of homeless people describe higher utilisation rates for hospital-based care and emergency care, and lower rates for primary care by homeless people compared to the general population. In the USA, each year over three million people experience homelessness of which 1,3 million children [1]. Compared to a decade ago, the homeless population today is younger (between 30 and 50 years) with a growing number of women and children. This trend continues both in the USA and in Europe [4,5,6,7]. The way people become homeless can be attributed to a number of factors such as a disruptive family environment

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