title: Complex health service needs for people who are homeless.
abstract: BACKGROUND
  Homeless people face many challenges in accessing and utilising health services to obtain psychosocial supports offered in hospital and community settings. The complex nature of health issues is compounded by lack of accessibility to services and lack of appropriate and safe housing.
  
  
  OBJECTIVE
  To examine the perceptions and experiences of homeless people in relation to their health service needs as well as those of service providers involved with their care.
  
  
  METHODS
  A purposive sampling approach was undertaken with a thematic framework analysis of semi-structured interviews. Participants. Interviews were undertaken with 20 homeless people who accessed the emergency department in an acute hospital in Melbourne, Australia and 27 service providers involved in hospital and community care.
  
  
  RESULTS
  Six key themes were identified from interviews: complexity of care needs, respect for homeless people and co-workers, engagement as a key strategy in continued care, lack of after-hour services, lack of appropriate accommodation and complexity of services.
  
  
  CONCLUSIONS
  Findings revealed the complex and diverse nature of health concerns in homeless people. The demand on hospital services continues to increase and unless government policies take into consideration the psychosocial demands of the communities most vulnerable people efforts to divert hospital demand will continue to fail.
authors: Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, VIC 3010, Australia. dgmoore@optusnet.com.au
authors: Gaye
authors: G
authors: Moore
authors: Elizabeth
authors: E
authors: Manias
authors: Marie Frances
authors: MF
authors: Gerdtz
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006296:Health Services; D006301:Health Services Needs and Demand; D006703:Ill-Housed Persons; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009517:New South Wales