Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #105557

Christine Savage, RN, PhD¹, R. Lee, RN, MSN, MPH¹, A. Corbin, RN, MSN², G. Gillespie, RN, MSN¹, A. Dempsey, RN, MSN¹, and B. McKinstry, RN, MSN¹. (1) University of Cincinnati, College of Nursing, 3110 Vine St, Cincinnati, OH 45221, 513-558-5241, savagece@email.uc.edu, (2) Nursing, University Hospital, 234 Goodman Ave, Cincinnati, OH 45219

PURPOSE: The homeless population has a higher rate of ill health with a reported prevalence of physical illness ranging from 33 to 55 percent (Bassuk & Rosenburg, 1988). In addition, the homeless often utilize the emergency department (ED) for routine health care (Han, Wells & Taylor, 2003). To address barriers to care for the homeless a nurse managed health clinic was opened at a site where the homeless come for meals and shelter. To evaluate the effectiveness of the clinic, patients were asked to complete a survey related to health status and their use of the ED prior to beginning to come to the clinic. The purpose of this preliminary analysis of the data was to review baseline data related to their health status and their use of the ED for care prior to coming to the clinic. FINDINGS: Of the 278 clients who had received care at the clinic 59 (21%) completed a baseline health survey. The majority of those who completed the survey were African American (66%) and male (95%). These demographics were similar to the clinic clients as a whole. Length of homelessness was available on 45 of the participants. Of these 40% were chronically homeless (> 12 months). Forty-four percent of the participants reported that prior to coming to the clinic they used the ED as a source of health care. More of the chronically homeless had used the ED in the past six months (45% vs. 33%). The most frequently reported medical diagnoses were hypertension, depression, substance dependence and chronic back pain. Almost a quarter of the participants stated that pain interfered in their daily activities and that physical or emotional problems interfered with their social activities. CONCLUSIONS: The health issues for the participants in the survey were chronic in nature rather than emergent and require long term interventions. Despite this, close to half had sought health care services at an ED in the past six months. Providing care at a clinic located where they seek other essential services has the potential to reduce ED use and provide long term care for chronic conditions.

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