[Healthcare for the homeless].

Abstract

Homeless people have more complex problems, poorer health and shorter life expectancy (14- 16 years) than others. They often stay in an unsafe environment. Loneliness and avoidance of care reinforce their health problems. One third has an intellectual disability. Doctors should tackle these problems together with non-medics. This requires: - Knowledge of their biography: you don't know what you (don't) see; - Alertness to previously (psychological and physical) trauma, sexual abuse and (partner-- related) violence, especially among women; - Integrated approach to substance abuse, debt and deviant behaviour to break a downward spiral; - Reporting when someone is uninsured, so that financing of care, an address and health insurance can be arranged; - Care beds to enable (1) care around operations and extreme underweight, and (2) arranging Identity Card, address, income and insurance; - Secondary prevention: cooperation between doctors and social work, addiction treatment and curator; - Fewer rules so that right of insurance, right of residence and care can advance the health of the homeless.