| Autor: |
Mudiganti S; Sutter Health Institute for Advancing Health Equity, Sutter Health, Sacramento, California, USA., Nasrallah C; Division of Rheumatology, Medical Department, University of California San Francisco, San Francisco, California, USA., Brown S; Sutter Health Institute for Advancing Health Equity, Sutter Health, Sacramento, California, USA., Pressman A; Sutter Health Institute for Advancing Health Equity, Sutter Health, Sacramento, California, USA.; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA., Kiger A; Sutter Health Institute for Advancing Health Equity, Sutter Health, Sacramento, California, USA., Casey JA; Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA.; Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA., LaMori JC; Janssen Scientific Affairs, LLC, Titusville, New Jersey, USA., Pesa J; Janssen Scientific Affairs, LLC, Titusville, New Jersey, USA., Azar KMJ; Sutter Health Institute for Advancing Health Equity, Sutter Health, Sacramento, California, USA.; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA. |
| Abstrakt: |
The impacts of homelessness on health and health care access are detrimental. Intervention and efforts to improve outcomes and increase availability of affordable housing have mainly originated from the public health sector and government. The role that large community-based health systems may play has yet to be established. This study characterizes patients self-identified as homeless in acute care facilities in a large integrated health care system in Northern California to inform the development of collaborative interventions addressing unmet needs of this vulnerable population. The authors compared sociodemographic characteristics, clinical conditions, and health care utilization of individuals who did and did not self-identify as homeless and characterized their geographical distribution in relation to Sutter hospitals and homeless resources. Between July 1, 2019 and June 30, 2020, 5% ( N = 20,259) of the acute care settings patients had evidence of homelessness, among which 51.1% age <45 years, 66.4% males, and 24% non-Hispanic Black. Patients experiencing homelessness had higher emergency department utilization and lower utilization of outpatient and urgent care services. Mental health conditions were more common among patients experiencing homelessness. More than half of the hospitals had >5% of patients who identified as homeless. Some hospitals with higher proportions of patients experiencing homelessness are not located near many shelter resources. By understanding patients who self-identify as homeless, it is possible to assess the role of the health system in addressing their unmet needs. Accurate identification is the first step for the health systems to develop and deliver better solutions through collaborations with nonprofit organizations, community partners, and government agencies. |
