A 5-year comparison of ED visits by homeless and nonhomeless patients

Tadros, Allison; Layman, Shelley M.; Brewer, Marissa Pantaleone; Davis, Stephen M.

doi:10.1016/j.ajem.2016.01.012

Cited by 33 publications

(30 citation statements)

References 10 publications

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“…In the national studies included in our review, homelessness rates among all ED visits were around 0.5% in NHAMCS studies and 1.2% to 5.6% in VHA studies . However, as noted earlier, NHAMCS relies on whatever information is present in the patient visit record, which likely undercounts homelessness significantly.…”

Section: Resultsmentioning

confidence: 87%

“…While national studies used databases representing tens of thousands to millions of patients or ED visits, most other studies had samples sizes in the hundreds, and one study had a sample size of 80 . Several national studies used the National Hospital Ambulatory Medical Care Survey (NHAMCS), which includes a national probability sample of EDs excluding VHA and other federal hospitals . NHAMCS includes a variable on patient residence, with response choices of private residence, nursing home, homeless, other, and unknown.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies included a single variable on current housing status, though one study included current homelessness, lifetime homelessness, and risk for future homelessness . Several studies examined differences in insurance, food and shelter needs, and health services use of homeless versus nonhomeless patients . Other parameters related to housing were relatively understudied compared to homelessness.…”

Section: Resultsmentioning

confidence: 99%

“…Studies varied considerably with respect to how they gathered material needs data. Twelve studies extracted material needs data from the medical chart or from a database, five of which used NHAMCS data . The remaining studies used self‐administered questionnaires or in‐person interviews.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Material Needs of Emergency Department Patients: A Systematic Review

Malecha

Williams

Kunzler

et al. 2018

Academic Emergency Medicine

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show abstract

Section: Resultsmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Material Needs of Emergency Department Patients: A Systematic Review

Malecha

Williams

Kunzler

et al. 2018

Academic Emergency Medicine

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show abstract

“…Kawakami et al [25] showed that increased annual income in Japan is associated with fewer calls for ambulance dispatch. Emergency services are more frequently used by individuals with lower socioeconomic status [26] or those without health insurance [2] than other groups. The present study additionally showed that unemployed people may frequently use ambulance transport for mild diseases that do not require hospital admission.…”

Section: Discussionmentioning

confidence: 99%

Ambulance Transport of Patients with Mild Conditions in Hokkaido, Japan

Yazaki

Nishiura

2020

IJERPH

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Understanding the epidemiological distributions of ambulance transport for patients with mild conditions according to age, disease, and geographic region could help in achieving optimal use of ambulance services. In the present study, we explored the descriptive epidemiology of ambulance transports in Hokkaido, the northernmost prefecture of Japan, identifying potential factors that determine the frequency of transports for mild diseases. Of the total 153,667 ambulance transports in Hokkaido during 2016, we found that two-thirds were for older people, of which about 60% resulted in hospital admission. There were 74,485 transports for mild cases, which were most commonly for psychiatric disorders among working-age adults (n = 4805), heart diseases among older people (n = 4246), and sensory organ diseases among older people (n = 3589). Examining the ecological correlations over 58 geographic units of ambulance services, the total unemployment rate and distance to the nearest tertiary care hospital were, respectively, positively and negatively correlated with the standardized transport ratio for multiple mild diseases. The proportion of working-age adults was uniquely identified as a possible positive predictor in mild cases of psychiatric disorders. As the identified potential predictors could be helpful in considering countermeasures, the causal links should be examined in future studies.

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Characteristics and Health Care Utilization of Patients With Housing Insecurity in the ED

Ball,

Sack,

Druffner

et al. 2024

JAMA Netw Open

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ImportanceUnstable housing and homelessness can exacerbate adverse health outcomes leading to increased risk of chronic disease, injury, and disability. However, emergency departments (EDs) have no universal method to identify those at risk of or currently experiencing homelessness.ObjectiveTo describe the extent of housing insecurity among patients who seek care in an urban ED, including chief concerns, demographics, and patterns of health care utilization.Design, Setting, and ParticipantsThis cross-sectional study included all adult patients presenting to the ED at Vanderbilt University Medical Center (VUMC), an urban tertiary care, level I trauma center in the Southeast US, from January 5 to May 16, 2023.Main Outcomes and MeasuresThe primary outcome was the proportion of ED visits at which patients screened positive for housing insecurity. Secondary outcomes included prevalence of insecurity by chief concerns, demographics, and patterns of health care utilization.ResultsOf all 23 795 VUMC ED visits with screenings for housing insecurity (12 465 visits among women [52%]; median age, 47 years [IQR, 32-48 years]), in 1185 (5%), patients screened positive for current homelessness or housing insecurity (660 unique patients); at 22 610 visits (95%), the screening result was negative. Of visits with positive results, the median age of patients was 46 years (IQR, 36-55 years) and 829 (70%) were among male patients. Suicide and intoxication were more common chief concerns among visits at which patients screened positive (132 [11%] and 118 [10%], respectively) than among those at which patients screened negative (220 [1%] and 335 [2%], respectively). Visits with positive results were more likely to be among patients who were uninsured (395 [33%] vs 2272 [10%]) and had multiple visits during the study period. A higher proportion of positive screening results occurred between 8 pm and 6 am. The social work team assessed patients at 919 visits (78%) with positive screening results.Conclusions and RelevanceIn this cross-sectional study of 23 795 ED visits, at 5% of visits, patients screened positive for housing insecurity and were more likely to present with a chief concern of suicide, to be uninsured, and to have multiple visits during the study period. This analysis provides a call for other institutions to introduce screening and create tailored care plans for patients experiencing housing insecurity to achieve equitable health care.

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A 5-year comparison of ED visits by homeless and nonhomeless patients

Cited by 33 publications

References 10 publications

Material Needs of Emergency Department Patients: A Systematic Review

Material Needs of Emergency Department Patients: A Systematic Review

Ambulance Transport of Patients with Mild Conditions in Hokkaido, Japan

Characteristics and Health Care Utilization of Patients With Housing Insecurity in the ED

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