Street Medicine Program Outcomes
As a branch of medical science, street medicine should be guided by clear metrics and realistic goals, subject to evaluation and reexamination as needed. Programs should seek to accomplish tangible improvements person-by-person across a range of domains.
The United States Centers for Medicare and Medicaid set forth three core goals for population health in what is known as the Triple Aim. An additional measure can also be recognized, giving rise to the Quadruple Aim:18
- Enhanced patient experience.
- Improved population health.
- Lower health care costs.
- Clinician satisfaction.
A range of potential street medicine outcomes include:
- Reduced costs at the health system level.
- Reduced hospitalization rate for high utilizers.
- Reduced number of emergency room visits for high utilizers.
- Linkage to housing case management.
- Housing placement.
- Linkage to California Health Homes Program.
- Linkage to a medical home.
- Linkage to behavioral health and/or psychiatric care.
- Linkage to substance use treatment.
- Participation in population health and chronic care screenings (which are frequently missed by unsheltered patients given competing priorities)19
- Cancer screenings (cervical cancer, breast cancer, colorectal cancer).
- Comprehensive diabetes care (eye/foot exams and A1C monitoring).