Marcel Slockers

53 Health status of homeless people measured by health problems Discussion Answering the research questions Within the homeless patient population, the proportion of patients who visited the con- sultation hours at least once with a particular health problem was largest for psychiatric problems, followed by cardiovascular diseases and endocrine diseases. There is a much higher incidence of psychiatric problems in the homeless patient population, compared to a regular GP’s practice. There is a lower incidence of traumata, but it is still higher than in a general practice. The proportion of women and older people in the homeless patient population has been rising since 2006. The proportion of homeless patients suffering cardiovascular diseases (in particular hypertension) and endocrine diseases (in particular diabetes and thyroid problems) has increased. However, the proportion of infectious diseases (mainly HIV) and traumata has decreased over time. Comparison to other studies International studies also show that psychiatric problems, 10,11,12,13,14 infectious diseases, 13 cardiovascular diseases and traumata 15 account for a substantial quantity of the registered diagnoses. An increased proportion of elderly homeless people with a demand for care has also been observed in other countries. 13 When looking at the increase in the proportion of homeless people with chronic conditions, it should be noted that these conditions have increased in regular GP practices as well. 14 After the implementation of the Action Plan for Social Support, the proportion of homeless people with a demand for care arising from hard drug use, HIV and traumatology has decreased. This is in line with studies that show that taking good care of homeless people justifies the effort, 3,16,17,18,19,20,21 as well as with our own findings of a decline in unnatural deaths. 8 Limitations of the study The homeless patient population described in this article does not include all homeless people in Rotterdam. Only since 2016, has the registration of homeless patients of street doctor’s consultation hours been expanded to (sometimes homeless) undocumented people who turned to the Pauluskerk (a Diaconal centre in Rotterdam that supports people who cannot survive without help). These undocumented people are not included in the analysis due to a lack of data during a large part of this study. This should be considered when interpreting the results. In the description of demographic characteristics of the homeless patient population, only age and gender were included as no reliable data on the socio-eco- nomic status and ethnicity were recorded.