Background: 

In 2023, an estimated 75,518 people in Los Angeles County were experiencing homelessness on any given night (1). People experiencing homelessness (PEH) often meet barriers to accessing medical services (2,3). Outreach clinics, such as the Mobile Clinic Project at UCLA (MCP), provide PEH with direct access to care. However, there is limited data describing the prevalence of medical conditions and interventions provided.

Objective: 

The objective of this review is to examine the medical conditions diagnosed at MCP and use this data to better inform treatment.

Methods: 

A thorough retrospective chart review of 675 medical visits from 359 unique clients seen between December 2020 - April 2024 was conducted that examined chief complaints, past medical and social history, vital signs, diagnosis, and treatment. Additionally, the review examines the rate of transfers to the emergency department and referrals to primary care. 

Results: 

Age range: 2 to 89 yrs, most common group: 41-50 yrs. In 19% of visits (128), patients reported a PMH of hypertension but in 25% of visits (166), were found to be hypertensive. Upon review of social history, 19% (126) reported alcohol use, 26% (178) reported tobacco use, and 25% (169) reported substance use. Dermatologic (e.g. abscesses, cellulitis) and musculoskeletal conditions (e.g. muscle pain, arthritis) were the most common diagnoses, comprising 35% (238) and 39% (263) of visits respectively. 11% (71) received antibiotics/anti-parasitics, 42% (280) received OTC pain medications. 4% (30) were referred to the ER to rule out emergent concerns (e.g. DVT and CHF exacerbation), 7% (48) of visits were plugged into primary care at a local FQHC.

Conclusion: 

Clinics like MCP are becoming increasingly important for medical care for PEH. Patients present with a variety of acute and chronic concerns, some of which can be adequately managed with over-the-counter/prescription medications and community partnerships. Although these clinics have limitations, this review can inform more effective treatment and follow up plans tailored specifically to PEH.

References: 

1. LAHSA releases results of 2023 Greater Los Angeles Homeless Count. (n.d.-c). https://www.lahsa.org/news?article=927-lahsa-releases-results-of-2023-greater-los-angeles-homeless-count

2. Ramsay, N., Hossain, R., Moore, M., Milo, M., & Brown, A. (2019). Health Care while Homeless: Barriers, facilitators, and the lived experiences of homeless individuals accessing health care in a Canadian regional municipality. Qualitative Health Research, 29(13), 1839–1849. https://doi.org/10.1177/1049732319829434

3. Purkey E, MacKenzie M. Experience of healthcare among the homeless and vulnerably housed a qualitative study: opportunities for equity-oriented health care. Int J Equity Health. 2019 Jul 1;18(1):101. doi: 10.1186/s12939-019-1004-4. PMID: 31262310; PMCID: PMC6604349.