Profiling the medical admissions of the homeless

Profiling the medical admissions of the homeless

Abstract

Aim: to describe the characteristics and outcomes of homeless people admitted to our Internal Medicine service in St. James’s Hospital, Dublin (Ireland), between 2002 and 2011.

Methods: we interrogated an anonymized in-patient database.

Results: there were 1,460 homeless admissions (623 unique patients; 39% admitted more than once). Most patients were young, male, and had low comorbidity levels. Thirty-seven percent of the admissions were alcohol-related and 27% substance abuse-related. Thirteen percent had an active psychiatric illness. Their in-patient mortality rate was 5%. Seventy two percent were discharged without the residential arrangement being explicitly documented, 15% self-discharged or absconded, and 8% were discharged to a residential facility.

Conclusion: results are novel in our context and will be relevant for local policy and practice.

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References

  1. Moore G, Manias E, Gerdtz MF. Complex health service needs for people who are homeless. Aust Health Rev. 2011; 35(4): 480–5.
  2. Dibben C, Atherton I, Doherty J, Baldacchino A. Differences in 5-year survival after a ‘homeless’ or ‘housed’ drugs-related hospital admission: a study of 15--30-year olds in Scotland. J Epidemiol Community Health. 2011; 65(9): 780–5.
  3. Best JA, Young A. A SAFE DC: a conceptual framework for care of the homeless inpatient. J Hosp Med. 2009; 4(6): 375–81.
  4. Rodriguez RM, Fortman J, Chee C, et al. Food, shelter and safety needs motivating homeless persons’ visits to an urban emergency department. Ann Emerg Med. 2009; 53(5): 598–602.
  5. Mungo’s HLaS. Improving hospital admission and discharge for people who are homeless. http://homeless.org.uk/sites/default/files/attached-downloads/HOSPITAL_ADMISSION_AND_DISCHARGE._REPORTdoc.pdf. Accessed 1 July, 2012.
  6. Kramer CB, Gibran NS, Heimbach DM, et al. Assault and substance abuse characterize burn injuries in homeless patients. J Burn Care Res. 2008; 29(3): 461–7.
  7. Buchanan D, Kee R, Sadowski LS, et al. The health impact of supportive housing for HIV-positive homeless patients: a randomized controlled trial. Am J Public Health. 2009; 99(3): S675–680.
  8. Nosyk B, Li X, Sun H, et al. The effect of homelessness on hospitalisation among patients with HIV/AIDS. AIDS Care. 2007; 19(4): 546–53.
  9. Kidder DP, Wolitski RJ, Campsmith ML, et al. Health status, health care use, medication use, and medication adherence among homeless and housed people living with HIV/AIDS. Am J Public Health. 2007; 97(12): 2238–45.
  10. Kim TW, Kertesz SG, Horton NJ, et al. Episodic homelessness and health care utilization in a prospective cohort of HIV-infected persons with alcohol problems. BMC Health Serv Res. 2006; 6: 19.
  11. Tabuchi T, Takatorige T, Hirayama Y, et al. Tuberculosis infection among homeless persons and caregivers in a high-tuberculosisprevalence area in Japan: a cross-sectional study. BMC Infect Dis. 2011; 11: 22.
  12. Marks SM, Taylor Z, Burrows NR, et al. Hospitalization of homeless persons with tuberculosis in the United States. Am J Public Health. 2000; 90(3): 435–8.
  13. Suhrcke M, Stuckler D, Suk JE, et al. The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence. PLoS One. 2011; 6(6): e20724.
  14. Hwang SW, Weaver J, Aubry T, et al. Hospital costs and length of stay among homeless patients admitted to medical, surgical, and psychiatric services. Med Care. 2011; 49(4): 350–4.
  15. Hospital discharge of homeless people. Lancet. 2012; 379(9832):2118.
  16. Zerger S, Doblin B, Thompson L. Medical respite care for homeless people: a growing national phenomenon. J Health Care Poor Underserved. 2009; 20(1): 36–41.
  17. Marwick C. The sizable homeless population: a growing challenge for medicine. JAMA. 1985; 253(22): 3217–3219, 3223–15.
  18. Carney M. Challenges in healthcare delivery in an economic downturn, in the Republic of Ireland. J Nurs Manag. 2010; 18(5): 509–14.
  19. O’Carroll A, O’Reilly F. Health of the homeless in Dublin: has anything changed in the context of Ireland’s economic boom? Eur J Public Health. 2008; 18(5): 448–53.
  20. Kelly A, Teljeur C. The National Deprivation Index for health & health services research: SAHRU technical report December 2007. Dublin: SAHRU Department of Public Health and Primary Care, Trinity College Dublin; 2007.
  21. Whelan B, Bennett K, O’Riordan D, et al. Serum sodium as a risk factor for in-hospital mortality in acute unselected general medical patients. QJM. 2009; 102(3): 175–82.

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Profiling the medical admissions of the homeless

14th March 2016
PMID: 23364103
Authors Affiliations
Roman Romero-Ortuno PhD Division of Internal Medicine, St James’s Hospital, Dublin 8, Ireland
Deirdre O’Riordan MED Directorate, St James’s Hospital, Dublin 8, Ireland.
Bernard Silke MED Directorate, St James’s Hospital, Dublin 8, Ireland.

Profiling the medical admissions of the homeless

Cite this article as:

Romero-Ortuno R, O'Riordan D, Silke B. Profiling the medical admissions of the homeless. Acute Med. 2012;11(4):197-204. PMID: 23364103.

Profiling the medical admissions of the homeless

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