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. 2019 Mar;11(3):157-164.
doi: 10.14740/jocmr3747. Epub 2019 Feb 13.

Status of Emergency Department Seventy-Two Hour Return Visits Among Homeless Patients

Heidi Knowles  1 , Charles Huggins  1 , Richard D Robinson  1 , Rosalia Mbugua  1 , Jessica Laureano-Phillips  1 , Shrunjal M Trivedi  2 , Jessica Kirby  1 , Nestor R Zenarosa  1 , Hao Wang  1
Affiliations

Status of Emergency Department Seventy-Two Hour Return Visits Among Homeless Patients

Heidi Knowles et al. J Clin Med Res. 2019 Mar.

Abstract

Background: We aim to externally validate the status of emergency department (ED) appropriate utilization and 72-h ED returns among homeless patients.

Methods: This is a retrospective single-center observational study. Patients were divided into two groups (homeless versus non-homeless). Patients' general characteristics, clinical variables, ED appropriate utilization, and ED return disposition deviations were compared and analyzed separately.

Results: Study enrolled a total of 63,990 ED visits. Homeless patients comprised 9.3% (5,926) of visits. Higher ED 72-h returns occurred among homeless patients in comparison to the non-homeless patients (17% versus 5%, P < 0.001). Rate of significant ED disposition deviations (e.g., admission, triage to operation room, or death) on return visits were lower in homeless patients when compared to non-homeless patient populations (15% versus 23%, P < 0.001).

Conclusions: Though ED return rate was higher among homeless patients, return visit case management seems appropriate, indicating that 72-h ED returns might not be an optimal healthcare quality measurement for homeless patients.

Keywords: Appropriate utilization; ED return visit; Emergency department; Homeless.

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Conflict of interest statement

No potential conflicts of interest exist for all authors.

Figures

Figure 1
Figure 1
Time interval from ED index discharge to ED return cures using Kaplan-Meier survival analysis. (a) Time interval from ED index discharge to ED return curve comparisons between homeless patients and other (non-homeless) patients. (b) Time interval from ED index discharge to ED return curve comparisons among homeless patients with different classifications of ED utilization as determined by New York University ED Algorithm.
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