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Homeless status documentation at a metropolitan hospital emergency department
Author(s) -
Lee Stuart J,
Thomas Phillipa,
Newnham Harvey,
Freidin Julian,
Smith Cathie,
Lowthian Judy,
Borghmans Felice,
Gocentas Robert A,
De Silva Devereaux,
Stafrace Simon
Publication year - 2019
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.13256
Subject(s) - medicine , emergency department , audit , psychosocial , presentation (obstetrics) , retrospective cohort study , odds ratio , emergency medicine , odds , family medicine , pediatrics , logistic regression , psychiatry , management , economics , radiology
Abstract Objective This study compared the prevalence of homelessness in consecutive patients presenting to a metropolitan hospital ED measured via a prospective housing screen with the prevalence of homelessness determined via retrospective audit of hospital data. Factors that altered the odds of patients being homeless and service outcomes that differed were examined for screened patients. Methods All patients presenting to the ED during a 7 day period in 2017 were invited to complete a housing screen. A retrospective audit of all ED presentations during the same period also occurred. Demographic (e.g. age, gender), clinical (e.g. reason for presentation, ED presentation history) and arrival mode (e.g. time, how arrived) predictors of homeless status were examined alongside care outcomes (e.g. ED length of stay, admission and 28 day re‐presentation). Results Of 1208 presenting patients, 504 were prospectively screened and 7.9% were homeless. This compared with 0.8% of ED presentations coded as homeless in the Victorian Emergency Minimum Dataset and 2.3% of the 704 non‐screened patients identified as homeless using Victorian Emergency Minimum Dataset Usual Accommodation alongside primary diagnosis and registration address. Within the screened sample, homeless patients were more likely to be male, arrive by emergency ambulance/with police, have a psychosocial diagnosis, and be frequent presenters. Re‐presentation within 28 days occurred for 43% of homeless and 15% of not‐homeless patients. Conclusions Hospital ED administrative data substantially under‐recognises the prevalence of homelessness in presenting patients. Standardised use of brief housing screens could improve identification of and provision of support to this often highly vulnerable population.