Health status of the homeless in Dublin: does the mobile health clinic improve access to primary healthcare for its users?

Background: Homeless people experience substantially higher rates of illness and significant barriers to accessing health services. The mobile health clinic (MHC), staffed by trainee general practitioners, targets and provides homeless people in Dublin with free and easy access to primary healthcare services.

Aims: To explore and determine the specific health reasons for attending the mobile health unit and to investigate whether the MHC improves access to primary healthcare for homeless people.

Methods: Interviewer-administered questionnaire addressed demographic characteristics, physical and mental health status.

Results: Forty-two participants were recruited in this study. The majority were male (90%), single (74%), Irish (81%) and in the 25-44 age group (71%). Risky health behaviour was common: tobacco use (93%; 39/42), illicit drug use (60%; 25/42) and alcohol use (45%; 19/42). Most participants described their health status as fair (48%) or good (31%). There were high rates of physical and mental health conditions. Hepatitis C (29%; 12/42) and depression (43%; 18/42) were prevalent. Dental disease was present in 79%. Compared with MHC, most health conditions were diagnosed and treated at other healthcare facility (OHF) [134 vs 27]. Report of physical health symptoms, such as coughs (61%) and migraine headache (46%), was also high, an average of five per person/year.

Conclusion: While the findings of this study are limited by the small sample size, they nevertheless indicate that the MHC promotes access to primary care service. Results also highlight the need to expand the healthcare approaches on the MHC to adequately meet the health needs of its target population.