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Homelessness and Emergency Medicine: A Review of the Literature
Author(s) -
Salhi Bisan A.,
White Melissa H.,
Pitts Stephen R.,
Wright David W.
Publication year - 2018
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.13358
Subject(s) - medicine , emergency department , demographics , family medicine , inclusion (mineral) , medline , population , gerontology , psychiatry , demography , environmental health , gender studies , sociology , political science , law
Objectives We aimed to synthesize the available evidence on the demographics, prevalence, clinical characteristics, and evidence‐based management of homeless persons in the emergency department ( ED ). Where appropriate, we highlight knowledge gaps and suggest directions for future research. Methods We conducted a systematic literature search following databases: PubMed, Ovid, and Google Scholar for articles published between January 1, 1990, and December 31, 2016. We supplemented this search by cross‐referencing bibliographies of the retrieved publications. Peer‐reviewed studies written in English and conducted in the United States that examined homelessness within the ED setting were included. We used a qualitative approach to synthesize the existing literature. Results Twenty‐eight studies were identified that met the inclusion criteria. Based on our study objectives and the available literature, we grouped articles examining homeless populations in the ED into four broad categories: 1) prevalence and sociodemographic characteristics of homeless ED visits, 2) ED utilization by homeless adults, 3) clinical characteristics of homeless ED visits, and 4) medical education and evidence‐based management of homeless ED patients. Conclusion Homelessness may be underrecognized in the ED setting. Homeless ED patients have distinct care needs and patterns of ED utilization that are unmet by the current disease‐oriented and episodic models of emergency medicine. More research is needed to determine the prevalence and characteristics of homelessness in the ED and to develop evidence‐based treatment strategies in caring for this vulnerable population.