The Role of Charity Care and Primary Care Physician Assignment on ED Use in Homeless Patients

Wang, Hao; Nejtek, Vicki A.; Zieger, Dawn; Robinson, Richard D.; Schrader, Chet D.; Phariss, Chase; Ku, Jocelyn; Zenarosa, Nestor R.

doi:10.1016/j.ajem.2015.04.026

Cited by 26 publications

(40 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As shown by the results of own study, homeless patients admitted to EDs are mainly men in the so-called "their prime" with an average age of 47 years. That data coincides with that reported by other authors [37][38][39][40][41]. This reflects the demographic characteristics of the general homeless population, in which men are the vast majority, and the most numerous age group ranges from 41 to 60 years [1].…”

Section: Discussion Of the Resultssupporting

confidence: 91%

See 1 more Smart Citation

Mental and behavioral disorders in the population of homeless patients admitted to hospital emergency departments

Burak

Kłopocka

Wyszkowska

2019

Curr Probl Psychiatry

View full text Add to dashboard Cite

The aim of the study is to identify the most common mental and behavioral disorders diagnosed in homeless patients admitted to hospital emergency departments and to identify performed medical procedures including diagnostic and therapeutic measures in this range. Material and Method:Data from information systems of three hospitals concerning stays of homeless people in ED in Bydgoszcz in 2013-2015 were analyzed. As any as 3133 stays were identified. The data was compiled using the Microsoft Excel spreadsheet and Statistica 10 statistical software package. Results: Diagnoses in the category of mental disorders and behavioral disorders constituted 23.3% of diagnoses made in the studied population, of which two thirds were psychiatric disorders and behavioral disorders caused by alcohol use. Specific personality disorders (5.84%), schizophrenia (3.82%), and mild mental retardation (2.24%) were diagnosed in patients. One tenth of all the ICD-9 procedures performed were the procedures of the category 94- Procedures related to mental condition Conclusions: Mental and behavioral disorders are one of the main reasons for admission of homeless people to hospital emergency departments. Most diseases is diagnosed in facilities where psychiatric consultation is possible, as well as where the number of procedures related to mental condition performed is the highest. Homeless patients suffering from mental and behavioral disorders are rarely admitted to hospital wards for hospitalization. Psychiatric care for homeless patients admitted to emergency departments is an ad hoc intervention and depends on the availability of a psychiatrist. Providing homeless patients with access to a psychiatric diagnosis at ED level would affect the quality of psychiatric care and would contribute to the improvement of mental health of homeless people.

show abstract

Section: Discussion Of the Resultssupporting

confidence: 91%

“…Jak wykazały wyniki badań własnych, bezdomni pacjenci w SOR to głównie mężczyźni w tzw. "sile wieku" [37][38][39][40][41]. Odzwierciedla to demograficzne cechy ogólnej populacji bezdomnych, w której mężczyźni stanowią zdecydowaną większość, a najliczniej prezentowana grupa mieści się w przedziale wiekowym 41-60 lat [1].…”

Section: Omówienie Wynikówunclassified

Mental and behavioral disorders in the population of homeless patients admitted to hospital emergency departments

Burak

Kłopocka

Wyszkowska

2019

Curr Probl Psychiatry

View full text Add to dashboard Cite

show abstract

“…It has been stated that people who are homeless tend to use the emergency department more often than people who are not homeless. 6 However, appropriate or inappropriate ER use among homeless patients is controversy. 6 , 7 , 8 In our study, of the 167 homeless patients, 160 (95.8%) were admitted to hospital for treatment.…”

Section: Discussionmentioning

confidence: 99%

“… 6 However, appropriate or inappropriate ER use among homeless patients is controversy. 6 , 7 , 8 In our study, of the 167 homeless patients, 160 (95.8%) were admitted to hospital for treatment. Due to high hospitalization rate among homeless patients, we can assume that their emergency department use is more often appropriate.…”

Section: Discussionmentioning

confidence: 99%

Demographic and clinical characteristics among Turkish homeless patients presenting to the emergency department

Yeniocak

Kalkan

Söğüt

et al. 2017

Turkish Journal of Emergency Medicine

View full text Add to dashboard Cite

ObjectiveSince the homeless are at greater risk of encountering health problems than the general population, the reasons for and incidence of their presentations to emergency departments also vary. The purpose of this study was to determine the sociodemographic and clinical characteristics of Turkish homeless patients who brought to the emergency department by ambulance.Materials and methodsThe records of homeless adult patients brought to the ED by 112 emergency service ambulance teams over a 1-year period from January to December, 2014, were examined retrospectively.ResultsThirty-six (21.56%) of the homeless patients enrolled in the study presented due to trauma, and 131 (78.44%) due to non-traumatic causes. One hundred thirty-seven (82.04%) of the total patient group were male. The mean age of the non-trauma patients was 47.3 ± 15.2 years (range, 18–81 years), and the mean age of the trauma patients was 36.9 ± 14.4 years (range, 18–63 years). The most common reason for presentation among patients presenting to the emergency department for non-trauma reasons was clouded consciousness (n = 39, 23.35%), followed by general impaired condition (n = 26, 15.57%), respiratory difficulty (n = 25 14.97%) and abdominal pain (n = 21, 12.57%). The most common reason for presentation among trauma cases was traffic accidents (n = 13, 7.78%), followed by sharp implement injury (n = 9, 5.39%). Four (2.4%) homeless patients died in the emergency department, three (%1.8) homeless patients discharged from the emergency department, and the remaining 160 (95.8%) were admitted to the hospital.ConclusionHomeless patients may present to the emergency department due to traumatic or non-traumatic causes. Admission levels are high among these patients, who may have many acute and chronic problems, and appropriate precautions must be taken in the management of these subjects in the emergency department.

show abstract

“…In comparison with the general population, homeless individuals demonstrate higher rates of mental health issues including psychiatric disorders and substance abuse, infectious diseases, unintentional injuries, and early mortality (Fazel, Geddes, & Kushel, ). Increased morbidity leads to increased health system utilization, particularly emergency department (ED) visits (Wang et al, ). More hospital admissions and longer (Hwang et al, ) and more expensive (Hwang, Weaver, Aubry, & Hoch, ) inpatient stays are also common for homeless individuals in need of health care.…”

Section: Introductionmentioning

confidence: 99%

Health care utilization following a homeless medical respite pilot program

Biederman

Gamble

Wilson

et al. 2019

Public Health Nursing

View full text Add to dashboard Cite

Objective The purpose of this study was to evaluate a homeless medical respite pilot program to determine if program participants had health care utilization pattern changes and improved connection to income, housing, and health care resources post program. Design This is a quantitative descriptive pre‐/post‐program evaluation. Sample A total of 29 patients experiencing homelessness and discharged from an acute care hospital in the southeastern United States were provided with housing and nursing case management. Measurements Demographics including age, sex, race, and ethnicity were collected. Connection to primary care, mental health, substance abuse services, income, insurance, and housing were assessed at program entry and completion. Health care utilization and charge and payment data were collected 1 year prior and 1 year post‐respite stay. Results Participants demonstrated reduced hospital admissions (−36.7%) and when admitted, fewer inpatient days (−70.2%) and increased outpatient provider visits (+192.6%). Health care charges for the cohort decreased by 48.6% from the year prior to the program. Housing and income improved. Conclusions The medical respite pilot program was successful in guiding patients to community resources for more appropriate health care at a demonstrated cost savings. Participants also derived benefits in the form of improved housing and income.

show abstract

The Role of Charity Care and Primary Care Physician Assignment on ED Use in Homeless Patients

Cited by 26 publications

References 38 publications

Mental and behavioral disorders in the population of homeless patients admitted to hospital emergency departments

Mental and behavioral disorders in the population of homeless patients admitted to hospital emergency departments

Demographic and clinical characteristics among Turkish homeless patients presenting to the emergency department

Health care utilization following a homeless medical respite pilot program

Contact Info

Product

Resources

About