Evidence map›Paper›PMID 42270160›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie

Outpatient surgical referrals from primary care providers for people experiencing homelessness: a retrospective review.

Madeline McDonald, Peter Huan, Caroline Hircock, Christina Pizzola, Timothy O'Shea, Carolyn Lévis, Margherita Cadeddu

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Madeline McDonaldFrom the Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (McDonald, Cadeddu); the Department of Medicine, Western University, London, Ont. (Huan); Department of Radiation Oncology (Hircock), University of Toronto, Toronto, Ont., the Department of Medicine, McMaster University, Hamilton, Ont. (O'Shea); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Pizzola); the Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Lévis) madeline.mcdonald@medportal.ca.
Peter HuanFrom the Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (McDonald, Cadeddu); the Department of Medicine, Western University, London, Ont. (Huan); Department of Radiation Oncology (Hircock), University of Toronto, Toronto, Ont., the Department of Medicine, McMaster University, Hamilton, Ont. (O'Shea); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Pizzola); the Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Lévis).
Caroline HircockFrom the Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (McDonald, Cadeddu); the Department of Medicine, Western University, London, Ont. (Huan); Department of Radiation Oncology (Hircock), University of Toronto, Toronto, Ont., the Department of Medicine, McMaster University, Hamilton, Ont. (O'Shea); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Pizzola); the Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Lévis).
Christina PizzolaFrom the Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (McDonald, Cadeddu); the Department of Medicine, Western University, London, Ont. (Huan); Department of Radiation Oncology (Hircock), University of Toronto, Toronto, Ont., the Department of Medicine, McMaster University, Hamilton, Ont. (O'Shea); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Pizzola); the Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Lévis).
Timothy O'SheaFrom the Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (McDonald, Cadeddu); the Department of Medicine, Western University, London, Ont. (Huan); Department of Radiation Oncology (Hircock), University of Toronto, Toronto, Ont., the Department of Medicine, McMaster University, Hamilton, Ont. (O'Shea); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Pizzola); the Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Lévis).
Carolyn LévisFrom the Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (McDonald, Cadeddu); the Department of Medicine, Western University, London, Ont. (Huan); Department of Radiation Oncology (Hircock), University of Toronto, Toronto, Ont., the Department of Medicine, McMaster University, Hamilton, Ont. (O'Shea); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Pizzola); the Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Lévis).
Margherita CadedduFrom the Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (McDonald, Cadeddu); the Department of Medicine, Western University, London, Ont. (Huan); Department of Radiation Oncology (Hircock), University of Toronto, Toronto, Ont., the Department of Medicine, McMaster University, Hamilton, Ont. (O'Shea); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Pizzola); the Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Lévis).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeople experiencing homelessness suffer from a high burden of surgical conditions and face many barriers to accessing care. Our aim was to describe the unmeasured and unmet need of surgical care through outpatient surgical referrals.

methodsThis is a retrospective review of electronic patient charts from the Shelter Health Network, a health care and social service organization serving people experiencing homelessness in Hamilton, Ontario, Canada. The review spanned a 2-year period from 2017 to 2018 and included referrals to all outpatient surgical services (except ophthalmology) and endoscopy.

resultsIn total, 167 surgical referrals were sent for 129 patients over the 2-year period. The average age of patients was 46 years, and 95% had provincial health insurance. Among referrals, 93% resulted in a scheduled appointment, and 58% resulted in the patient seeing a surgical provider. Overall, 61 surgical procedures were proposed and 64% of these were completed. Major procedures were completed at a higher rate than minor procedures. Patient, provider, and system factors contributed to patients not receiving care.

conclusionTo our knowledge, this is the first study to describe outpatient surgical referrals by primary care providers for people experiencing homelessness. There were significant gaps in both the accessing of surgical consultation and in the completion of proposed surgical procedures. These represent an ongoing unmet need for surgical care. We divided barriers into systemic, provider, and patient barriers, and those that have direct applications to policy and practice.

Indexed as

Ambulatory Surgical ProceduresHealth Services AccessibilityIll-Housed PersonsPrimary Health CareReferral and ConsultationAdultAgedFemaleHumansMaleMiddle AgedOntarioRetrospective Studies

Identifiers

PMID42270160
PMCPMC13275139

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.