Palliative care access and use among homeless individuals: a scoping review
Bibliographic record
Abstract
BACKGROUND: Homeless individuals experience severe health inequalities, increased rates of disease, and premature mortality. Yet the provision of palliative care for homeless individuals faces distinct challenges. The purpose of this scoping review was to understand previous research on the provision of palliative and end-of-life care for homeless populations and to clarify current knowledge about the unique needs and recommendations for care provision to this group. METHODS: A scoping review was conducted using PubMed, CINAHL, Embase (via Elsevier), and Web of Science databases. Peer-reviewed articles were included if they focused on palliative care in homeless populations and were published in English on or after January 1, 2010. RESULTS: Forty-five publications met the inclusion criteria. We first present the characteristics of these 45 studies, including country of origin, study design, the setting in which data were collected, sample size and characteristics, and terminology used. We then present a synthesis of study findings in three related themes: (1) the importance of the relationship between homeless individuals and healthcare staff; (2) provider-side barriers to palliative care access; and (3) the promise and perils of integrated models for palliative care provision for homeless individuals. CONCLUSIONS: Homeless individuals experience unique needs and challenges when accessing palliative care. Recommendations include future research into the experience of specific sub-populations within homelessness, inter-disciplinary initiatives and models of PC provision, and specialized staff training to work with this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.063 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.014 | 0.015 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".