03 Nov Teaching Hospitals See Largest Number of Homeless Emergency Room Patients
MedicalResearch.com Interview with:
Ruirui Sun, Ph.D.
MedicalResearch.com: What is the background for this study?
Response: Homeless people are more likely than the members of the general public to use emergency department (ED) services, and it is usually at teaching hospitals when they seek medical care (Kushel et al., 2001; Bowdler and Barrell, 1987). This Healthcare Cost and Utilization Project (HCUP) Statistical Brief studies patient characteristics, insurance coverage and clinical profile of the ED visits among homeless individuals by hospital teaching status, during 2014 from eight States (AZ, FL, GA, MA, MD, MO, NY, and WI).
- More than three-fourths of all ED visits by homeless individuals were to teaching hospitals.
- In teaching hospitals, Medicaid was the most common payer for ED visits by homeless individuals (47.1 percent of treat-and-release ED visits and 72.1 percent of ED visits resulting in hospital admission).
- In nonteaching hospitals, more than 40 percent of ED visits by homeless individuals were uninsured.
- Among treat-and-release ED visits, alcohol-related disorders, screening and history of mental disorders and substance abuse, and mood disorders were the three most common conditions by homeless individuals with a mental or substance use disorder.
- Among ED visits resulting in hospital admission, schizophrenia and other psychotic disorders, mood disorders, and alcohol-related disorders were the three most common conditions by homeless individuals with a mental or substance use disorder.
- More than half of ED visits resulting in hospital admission for Black homeless individuals with a mental or substance use disorder were attributable to schizophrenia and other psychotic disorders.
- More than one-third of ED visits resulting in admission to nonteaching hospitals for White and Hispanic homeless individuals with a mental or substance use disorder were attributable to mood disorders.
MedicalResearch.com: What should readers take away from your report?
Response: Teaching hospitals received majority of the ED visits by homeless individuals. Among Treat-and-Release ED visits, mental or substance use disorders were diagnosed among approximately 60% of the homeless individuals. There were racial disparities in the clinical profile among ED visits by homeless individuals: In 2014, more than one-third of White and Hispanic homeless individuals admitted to hospitals through ED for mental or substance use disorder were due to Mood Disorders, whereas more than half of Black homeless individuals admitted to hospitals through ED for mental or substance use disorder were due to Schizophrenia and other psychotic disorders.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: We hope this brief generates interests to further look into the health condition and healthcare needs that the homeless population face. Several States now provide information on hospital and ED use by homeless individuals, and we encourage researchers to further evaluation the conditions for this population using our State Inpatient Database (SID) and State Emergency Department Database (SEDD).
MedicalResearch.com: Is there anything else you would like to add?
Response: No disclosures. For more information about HCUP, please see
Kushel MB, Vittinghoff E, Haas JS. Factors associated with the health care utilization of homeless persons. Journal of the American Medical Association. 2001;285(2):200–6.
Bowdler JE, Barrell LM. Health needs of homeless persons. Public Health Nursing. 1987;4(3):135–40.
No disclosures. For more information about HCUP,
please visit https://www.hcup-us.ahrq.gov/
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Sun R (AHRQ), Karaca Z (AHRQ), Wong HS (AHRQ). Characteristics of Homeless Individuals Using Emergency Department Services in 2014. HCUP Statistical Brief #229. October 2017. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/reports/statbriefs/sb229-Homeless-ED-Visits-2014.pdf.
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