Impact of Itemized Versus Open Menu of Available Supplies and Services on Utilization of Street Medicine Program Resources – A Pre-post Study

Abstract

Background

Street medicine programs provide medical care to individuals experiencing homelessness through “street runs,” in which healthcare providers meet unhoused patients on the street and offer them care in that environment. Approximately 50 medical student-run street medicine programs operate in the United States. Data on strategies to improve street medicine services are limited. This study aimed to assess the impact of using an itemized menu of available supplies and services to guide patient encounters on a street medicine program’s distribution of resources and therefore the numbers of patient needs that were met.

Methods

We performed a pre-post assessment study in an established street medicine program providing care in an urban downtown setting. Data were collected on the number and type of resources utilized in four street runs pre- and four street runs post-itemized menu implementation. Volunteers assisted patients in navigating the menu. The difference between resource utilization pre-post was assessed using the Mann-Whitney U test.

Results

There were 98 patient encounters during the four street runs in the pre-itemized menu phase and 81 encounters in the post-itemized menu phase. There was a significant increase in patients’ uptake of comfort items (p < .001), as well as clinical (p < .001) and overall (p < .001) needs met. There was no distribution of 17 resources during the four street runs pre-itemized menu implementation, but these resources were requested and received by patients 71 times in the four street runs post-implementation.

Conclusions

Implementing an itemized menu significantly improved the street medicine program’s ability to meet unhoused patients’ needs.