Street Medicine: A Program Evaluation

STREET MEDICINE: A PROGRAM EVALUATION By ARIEL L. EDWARDS DECEMBER 8, 2016 INTRODUCTION: Homeless individuals have poorer health outcomes than their housed counterparts, yet there are many barriers to receiving consistent medical and behavioral health care. Street Medicine is a method of health care delivery in which a multidisciplinary group of health care providers bring health care to people living on the streets. Street Medicine could be a promising solution to meeting the unmet health needs of people experiencing homelessness. AIM: The purpose of the evaluation was to examine the effectiveness of Mercy Care’s Street Medicine program at engaging their homeless patients in consistent care and decreasing the number of patients that seek unnecessary hospital services. METHODS: A retroactive medical records review was conducted for 284 patients. Of the 284 patients, 26 patients had to be excluded from data analysis because the patients had not been seen during the Street Medicine rounds and are not considered Street Medicine patients. All of the data that were extracted were collected using a computer-based data collection form. The data was analyzed using frequency tables and t-tests in SAS. RESULTS: Results suggest that 54.26% of the Street Medicine patients are connected to Mercy Care through Street Medicine and/or clinic visits and engaging in consistent primary care and behavioral health care services. The average number of total Street Medicine encounters per patient was lower than the average number of clinic encounters. For both Street Medicine and clinic encounters, the patients accessed more primary care services than behavioral health services and case management services. There was no significant difference in ED visits before or after the initial Mercy Care encounter. The average number of total hospital admission days significantly increased from 0.98 days before the patient’s initial Mercy Care encounter to 1.84 days after the initial Mercy Care encounter. DISCUSSION: The Street Medicine program may be a promising solution for getting and keeping people experiencing homelessness engaged in health care and decreasing the number of patients that turn to the hospital for avoidable and costly health care services. The Street Medicine program eliminates many of the barriers to care that people experiencing homelessness face and could potentially decrease the rates of morbidity and mortality in this vulnerable community.