The use of health care services by homeless shelter residents

ABSTRACT

This submitted article is based on partial data from the Health and Use of Health Care Services by Shelters Users research, taking advantage of the sequential synergy of qualitative and quantitative research strategies. The quantitative research involved 192 respondents, while the qualitative research involved 30 communication partners. The article aims at finding out the relationship between selected health characteristics of the shelter population and their impact on the use of health care services. The article presents data from the quantitative research that are further illustrated by qualitative data. The data were analysed using descriptive statistical methods, a Fisher's exact test, a Wilcoxon test and a Proportion Matching Test. The relationship between mental health and use of health care services (especially in the case of women) has been proven. Homeless people who do not use any health care services are, on average, for a longer period in temporary housing; whereas those who rated their health as more serious used health care services more frequently. In the conclusion, the authors present the implications for social work that resulted from the survey.

ABSTRAKT

Předložený článek je založen na dílčích údajích z oblasti zdravotní péče a využívání služeb zdravotní péče obyvateli azylových domů, s využitím sekvenční synergie kvalitativních a kvantitativních výzkumných strategií. Kvantitativní výzkum zahrnoval 192 respondentů, zatímco kvalitativní výzkum zahrnoval 30 komunikačních partnerů. Cílem článku je zjistit vztah mezi vybranými zdravotními charakteristikami populace z azylových domů a jejich dopadem na využívání zdravotnických služeb. Článek představuje údaje z kvantitativního výzkumu, který je ilustrován kvalitativními údaji. Data byla analyzována pomocí popisných statistických metod, Fisherova exaktního testu, Wilcoxonova testu a testu shody proporc. Vztah mezi duševním zdravím a využíváním služeb zdravotní péče (zejména u žen) byl prokázán. Bezdomovci, kteří nevyužívají žádné zdravotnické služby, jsou v prozatímním ubytování v průměru déle; zatímco ti, kteří považovali své zdraví za důležitější, využívali služby zdravotní péče častěji. V závěru autoři prezentují možné dopady na sociální práci, které vyplynuly z výzkumu.

KEYWORDS:

• Health
• health care services
• shelter users
• homelessness
• social work

KlÍČOVÁ SLOVA:

• Zdraví
• služby zdravotní péče
• obyvatelé azylových domů
• bezdomovectví
• sociální práce

Acknowledgements

This research was partially supported by the NPU II Project LQ1602 ‘IT4Innovations excellence in science’ provided by the MŠMT of Czech Republic.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Kateřina Glumbíková is an assistant professor at the Faculty of Social Studies at the University of Ostrava. In her dissertation thesis she dealt with the topis of reintegration of single mothers living in shelters into permanent forms of living. Her research interest focuses on reflexivity in social work with families and relationship-based approach in social work with families.

Alice Gojová is an associate professor at the Faculty of Social Studies at the University of Ostrava. In teaching and research she is interested in the topic of community social work and social work with families.

Michal Burda is a junior researcher at the Institute for Research and Applications of Fuzzy Modeling, University of Ostrava, Czech Republic. He obtained his Ph.D. degree in computer science and applied mathematics from VSB-Technical University in Ostrava. His research interests focus on data mining, fuzzy logic in expert systems and statistics.

Pavel Rusnok received amasters degree from the Czech Technical University (CTU) in mathematical engineering in 2008. Now he is assistant researcher at Institute for Research and Applications of Fuzzy Modeling at Ostrava University, where he is finishing his PhD in applied mathematics. His research interests include fuzzy logic, statistics, data mining and machine learning.

Radka Poláková is an employee of the University of Ostrava. Her research is focused on algorithms for global optimisation (especially differential evolution) and started in 2008. She was also a member of Biostatistics centre on the university. She is placed on the second and third rank with an optimisation algorithm on the Black Box Optimization Competition organised as part of Genetic and Evolutionary Computation conference in 2016 and 2018, respectively. Her algorithm won a part for constrained problems of optimisation competition held on CEC2017 world congress in San Sebastian. Her h-index on Scopus equals to 8.

Notes

1 In the Czech Republic, a shelter is described in the Act No. 108/2006 on Social Services, Section 57 as follows: ‘Shelters provide temporary residential services to persons in an unfavourable social situation associated with a loss of housing.’ The law on social services for shelters lays down the following basic (mandatory) activities: ‘(a) the provision of food or assistance in catering, (b) accommodation, (c) assistance in the application of the rights, legitimate interests and in obtaining clarity in personal affairs.’ The law on social services (No. 108/2006) further provides that ‘the provision of social services in shelters shall be made by payment … ’ The stay in a shelter is limited, most often for a period of one year.

2 SEEWOLF-Studie (Seelische Erkrankungsrate in den Einrichtungen der Wohnungslosenhilfe im Großraum München).

3 The questions used ranged from yes/no questions, for example: Do you take medications prescribed to you by your doctor? through multiple-choice questions, for example: What are the health care facilities you visit? (select one or more options) Options: general practitioner, ophthalmologist, emergency room, dentist, gynaecologist, psychiatrist, dermatologist, pulmonary doctor, ear-nose-throat; other (please specify), to questions where the respondents were asked to choose the degree of their agreement on the scale, for example: How do you rate your physical health? Scale: Very good – Good – Bad – Very bad.

4 There was no mention of the name of the person or the shelter where the survey took place in the questionnaire. In the final research report, the data are presented only as data summarised for the target group as a whole; data related to individual respondents is not stated in any outputs. The data presented in this form does not help to identify a particular person. Recordings of the qualitative interviews have been transcribed and then deleted in a way that even the voice of the respondent has not been stored. Any data leading to identification of the communication partner, third party, or organisation has been anonymised.

5 The researchers informed the participants the acquired information would not be passed to a third party outside the research team (primarily to the shelter staff). They also stated that they have a reporting obligation in case the participant would report very serious facts, such as grievous body harm to a third person.

6 The author presents an overview of the Czech Republic norms and requirements for ethics approval.

Additional information

Funding

This research was partially supported by the NPU II Project LQ1602 ‘IT4Innovations excellence in science’ provided by the Ministerstvo Školství, Mládeže a Tělovýchovy (MŠMT) of Czech Republic.