Marcel Slockers

48 Chapter 3 • What are the demographic and medical characteristics of homeless people at the Rotterdam street doctor’s consultancy hours with a care episode between 2014 and 2017? • What are the differences between these homeless patients with care episodes and patients in a regular General Practitioners (GP) practice in Rotterdam? • What changes are noticeable between 2006 and 2017 in the characteristics of homeless people with an episode of care? Method We carried out descriptive research using data registered by street doctors between 2006 and 2017. In six shelter locations, nine street doctors registered age, gender and care episodes according to the ICPC classification in a GP’s information system administered by the Gemeentelijke Gezondheidsdienst (GGD), the Dutch Municipal Health Authority. Characteristics of homeless patients were analysed for three 4-year periods, during which important political developments took place: 2006-2009, 2010-2013, 2014-2017. This patient population fluctuated considerably. From the 1,529 people in the 2006-2009 patient population group, for example, only 186 visited the street doctors again in the period 2014-2017, while during this latter period a total of 2051 patients consulted the street doctors. As the population is so dynamic, the number of person years within a certain time span is unknown, and no incidence rates can be calculated. Therefore, we based our analysis on the number of unique patients who consulted the street doctors at least once in a particular period. For each unique patient, in addition to age and gender, record was kept of the ICPC codes assigned at least once during a particular period. With these data, the number of patients who went through an episode of care for a particular health problem could be determined. The research distinguished between the following eight main ICPC categories: psychiatric (including addiction problems), cardiovascular diseases, respiratory diseases, neurological disorders, endocrine diseases, problems with the musculoskeletal system, gastrointestinal disorders and oncological disorders. The categories of infectious diseases and trauma-re- lated problems were also included as they are typical for the homeless patient population, and had been used previously in the Rotterdam mortality survey. 8 Furthermore, we made distinctions between specific ICPC codes that are illustrative of health problems among the