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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.
See this image and copyright information in PMC

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