橙县CalOptima街头医疗队走进营地与庇护所：为无家可归者提供初级护理、心理健康与戒毒转介
加利福尼亚州橙县的 CalOptima Health 是该县的 Medi-Cal 管理式医疗计划，其街头医疗（Street Medicine）项目把医疗队直接派到无家可归者生活的营地、庇护所与街头，为难以走进诊所的人群提供初级护理、心理健康服务与药物使用障碍的评估与转介。
按 CalOptima 公布的服务安排，街头医疗队由医生、护士与外展工作人员组成，在固定外展点与流动路线上提供伤口处理、慢性病管理、疫苗接种、心理健康筛查等服务，并协助患者预约后续门诊、领取药物与对接住房服务。服务对象以 CalOptima 的 Medi-Cal 会员为主，医疗队与县内的庇护所、城市外展队与非营利机构协同排班。
CalOptima 表示，街头医疗的思路是先在街头建立信任再衔接常规医疗：许多无家可归者因交通、证件与过往就医经历等原因回避医疗机构，把服务送到营地可以降低急诊室的非紧急使用，也让高血压、糖尿病与伤口感染等常见问题更早被处理。
橙县近年持续扩大对无家可归人群的外展医疗投入。需要协助的居民或发现需要医疗外展的营地，可通过 CalOptima 会员服务与县住房与健康系统的外展渠道联系，医疗队会按区域排班前往。
CalOptima Health Street Medicine Teams Bring Primary and Behavioral Care to Orange County Encampments and Shelters
CalOptima Health, Orange County's Medi-Cal managed care plan in Orange County, California, runs a Street Medicine program that sends clinical teams directly to encampments, shelters and street locations where people experiencing homelessness live, providing primary care, behavioral health services, and assessment and referral for substance use disorders to people who have difficulty reaching a clinic.
Under CalOptima's published service model, street medicine teams of physicians, nurses and outreach workers provide wound care, chronic disease management, vaccinations and mental health screening at fixed outreach sites and on mobile routes, and help patients book follow-up appointments, obtain medications and connect with housing services. The teams serve CalOptima's Medi-Cal members and coordinate schedules with county shelters, city outreach teams and nonprofit partners.
CalOptima says the street medicine approach is to build trust on the street first and then link people into regular care: many people experiencing homelessness avoid medical facilities because of transportation, identification and past experiences, and bringing care to encampments can reduce non-urgent emergency room use while getting common problems such as hypertension, diabetes and wound infections treated earlier.
Orange County has continued to expand outreach-based medical care for people experiencing homelessness. Residents who need help, or who know of an encampment needing medical outreach, can contact CalOptima member services or the county's housing and health outreach channels, and teams are dispatched on a regional schedule.
来源：GSM·美国（原文链接）
图片来源：医护人员工作场景（资料图）。James Gathany 摄，美国疾病控制与预防中心，公共领域，经 Wikimedia Commons。 / A health care worker (file photo). Photo by James Gathany, U.S. Centers for Disease Control and Prevention, public domain, via Wikimedia Commons.
