This article looked at the idea of having a managed care program that was available to the homeless for being able to receive the Hepatitis A and B Vaccine as both of these diseases are more common and a common problem for the homeless. Basically the article looked at a study that was influential in being able to identify the problems that Hepatitis has caused and is continuing to cause for the homeless. The study looked at three different groups of homeless individuals who were participating in the vaccination process. With both of these vaccines it is mandatory that a person be involved in a three injection series.
Those who were working under managed care guidelines and with nurses who were following them “had 2 times great odds of completion” (Nyamathi, Liu, Marflsee, Shoptaw, Gregerson, Saab, Leake, Tyler, Gelberg 2009). The study made some great points about the importance of the homeless getting vaccinated and how this would benefit all people in that there would not be as many homeless individuals who were sick with these highly infectious diseases. This would mean that there would be less deaths of the homeless, lower instances of hospitalization, and less of a chance of future infection of others.
These three things sound simple enough and really are a great example of how one small social program and social change could really benefit those who were involved and in the end benefit the entire surrounding community. Some homeless individuals are already in poor health and those who were in poor health were found to be more likely to follow through with the program. The study also showed that women were more likely to complete the program than men (Nyamathi, Liu, Marflsee, Shoptaw, Gregerson, Saab, Leake, Tyler, Gelberg 2009). Evaluation/Critque
The idea of a managed care program that is ran by nurses in order to be able to treat homeless individuals is a good idea. There would be a debate as to what type of nurse would need to be present and who would work on the duties that were associated with this like tracking down and monitoring the individuals who need their follow up injections and testing. The study really did look at a good subsection of the homeless population and really evaluated the other problem areas in their lives as well as how they were more susceptible to infectious diseases like Hepatitis A and B.
The overall impression of the article was that by preventing these infectious diseases the overall community would benefit in a number of ways. These ways being that they would be able to better control the spread of infection, have less homeless individuals in the hospital and save money on the follow up and care of these individuals. Also the idea that nurses manage the care is a good theory. The credibility of the nurses being able to be involved in all of this work might be a problem as in most areas nurses are understaffed and with being understaffed trying to follow up with patients on this level might be a bit unreasonable.
The overall ideas that were presented made sense, were good in theory and really promoted a better type of work environment for the nurses. Also the article only looked a particular subset of homeless adults. It would have been better if they had a better overall representation of the homeless population with specific criteria for the subgroups. This criteria being that the groups were typically the same size, same age range, same age representation and same representation of male and females in these age representations, all of this could have greatly changed some of the outcomes.