The Clinical Analysis of the Homeless Visiting Emergency Medical Centers

ABSTRACT

PURPOSE: The homeless patients in our country get their medical services in government facilities. Supposedly, they have clinical characteristics different from those of general population, but most published papers dealing with the homeless have focused on sociologic problems. With the necessity for epidemiologic data, we decided to find clinical patterns for the homeless who visited our emergency medical center. METHODS: Between December 1999 and July 2001, 3,905 homeless patients visited the Seoul Municipal Boramae Hospital. Based on their medical records and radiologic images, we categorized and compared their complaints, medical needs, and clinical findings. RESULTS: The number of male patients dominated over female patients (MF=13.71), 70.9% were in their thirties, forties, and fifties, and 47% of the patients had been brought to the center by police while the others had been referred from institutions for the homeless, smaller hospitals, or mental health institutions. The common reason for visit was altered mentality due to acute alcohol intoxication (18.6%), followed by medical follow-up (15.4%), gastrointestinal symptoms (12.3%), and neurologic problems (10.6%). Of the patients 36.1% were sent to institutions, but 31.8% were returned to the streets, 9.7% were admitted to a ward, and 2.6% died. The main causes of death were pneumonia and intracranial hemorrhage. CONCLUSION: Most homeless patients were relatively young men. Alcohol-related symptoms and gastrointestinal troubles overwhelmingly led the homeless to the hospital. Many homeless patients returned to the streets or other institutions. Later, more sophisticated studies are expected for homeless-patients management.