The Homeless Population: A Case Study

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The homeless population can range from 250,000 to 3.5 million on any given night in the United States (O 'Connell et al., 2010). The uninsured in this population is at an all-time high due to increasing medical costs and programs such as Medicaid that are not available to most of this population (Zerger, Doblin, & Thompson, 2009). The homeless, indigent population are then unable to access medical care and medications without health insurance. Discharge planning in the indigent, homeless population is one of the biggest challenges that a hospital can face.
The challenge with this population is providing adequate follow up care and a place for their body to recover during the body’s healing process. Homeless, uninsured patients are having to
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According to the IOM, in order to provide patient centered care clinicians must evaluate and respect patient needs, communicate with patients, and allow patients to share in decision making about their healthcare (Rubenfeld & Scheffer, 2015). Understanding that each patient is unique and each patient’s situation is different will begin to break some of these stereotypes about the homeless, indigent population. A patient-centered approach to the homeless, indigent population can help clinicians identify where interventions are needed from a patient perspective to improve quality of care and reduce cost for acute care (Greysen et al., …show more content…
The biggest challenge with this population is they are often thought to be lost to follow up care. Inadequate follow up care then leads to readmission into the acute care setting. Best practice is to ensure medical follow up care. Taking the medical follow up care to the patient and not waiting for the patient to come to the medical follow up may be necessary due to lack of transportation resources available to the homeless, indigent population (O 'Connell et al., 2010). Boston Healthcare for the Homeless Program (BHCHP) began in the past 30 years and has been bringing medical follow up to the patient in their element (O 'Connell et al., 2010). By BHCHP bring the medical care to their patient in their element this eliminates the concern of the patient not having transportation. BHCHP has a "street team" that performs "street rounds" four days a week (O 'Connell et al., 2010). During "street rounds" the medical team that consists of physicians, physician assistants, and nurse practitioners deliver medical care to the homeless, indigent population whether they are living under bridges, on park benches, or in alleys (O 'Connell et al., 2010). Being in the element that the patient lives in not only allows them to get the follow up care that they need, it allows clinicians to experience firsthand the challenges that this population face from

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