Hard-to-Reach Populations and Administrative Health Data

A Serial Cross-sectional Study and Application of Data to Improve Interventions for People Experiencing Homelessness

Dados Bibliográficos

ID9101397
AutoresRahat Hossain (0000-0003-1656-3708, University of Toronto, autor correspondente), Jia Hong Dai (McMaster University), Shaila Jamani (Brock University), Zechen Ma (0000-0003-3064-8118, McMaster University), Erind Dvorani (0000-0001-8246-6151, ICES, Toronto, ON, Canada), Erin Graves (0000-0001-9759-4471, ICES, Toronto, ON, Canada), Ivana Burcul (McMaster University), Stephenson Strobel (0000-0001-9408-7992, Cornell University)
Ano2021
Volume59
FascículoSuppl 2
PáginasS139-S145
Data de publicação2021-04-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001481
PMID33710086
OpenAlexW3134277373
IdiomaEN
Citações recebidas1
Referências citadas36

BACKGROUND: Intervention studies with vulnerable groups in the emergency department (ED) suffer from lower quality and an absence of administrative health data. We used administrative health data to identify and describe people experiencing homelessness who access EDs, characterize patterns of ED use relative to the general population, and apply findings to inform the design of a peer support program. METHODS: We conducted a serial cross-sectional study using administrative health data to examine ED use by people experiencing homelessness and nonhomeless individuals in the Niagara region of Ontario, Canada from April 1, 2010 to March 31, 2018. Outcomes included number of visits; unique patients; group proportions of Canadian Triage and Acuity Scale (CTAS) scores; time spent in emergency; and time to see an MD. Descriptive statistics were generated with t tests for point estimates and a Mann-Whitney U test for distributional measures. RESULTS: We included 1,486,699 ED visits. The number of unique people experiencing homelessness ranged from 91 in 2010 to 344 in 2017, trending higher over the study period compared with nonhomeless patients. Rate of visits increased from 1.7 to 2.8 per person. People experiencing homelessness presented later with higher overall acuity compared with the general population. Time in the ED and time to see an MD were greater among people experiencing homelessness. CONCLUSIONS: People experiencing homelessness demonstrate increasing visits, worse health, and longer time in the ED when compared with the general population, which may be a burden on both patients and the health care system

Descriptive statistics · Emergency department · Environmental health · Health care · Intervention (counseling) · Medical emergency · Population · Triage · Demography · Emergency and Acute Care Studies · Food Security and Health in Diverse Populations · Homelessness and Social Issues · Medicine · Nursing · Gerontology