Hospital Readmissions Among Patients Experiencing Homelessness: An Electronic Health Record Data Study.
Journal
The Permanente journal
ISSN: 1552-5775
Titre abrégé: Perm J
Pays: United States
ID NLM: 9800474
Informations de publication
Date de publication:
15 Mar 2024
15 Mar 2024
Historique:
medline:
18
3
2024
pubmed:
18
12
2023
entrez:
18
12
2023
Statut:
ppublish
Résumé
Population-level tracking of hospital use patterns with integrated care organizations in patients experiencing homelessness has been difficult. A California law implemented in 2019 (Senate Bill 1152) aimed to ensure safety for this population after discharge from the hospital by requiring additional documentation for patients experiencing homelessness, which provides an opportunity to evaluate hospital use by this population. In a large integrated health system in California, patients experiencing homelessness were identified through documentation change requirements associated with this law and compared with a matched group from the general population. Patients experiencing homelessness had increased rates of hospital readmission after discharge compared to the general population matched on demographics and medical comorbidity in 2019 and 2020. Any address change in the prior year for patients was associated with increased odds of emergency department readmission. Patients experiencing homelessness, both enrolled in an integrated delivery system and not, were successfully identified as having higher readmission rates compared with their housed counterparts. Documentation of housing status following Senate Bill 1152 has enabled improved study of hospital use among those with housing instability. Understanding patterns of hospital use in this vulnerable group will help practitioners identify timely points of intervention for further social and health care support.
Sections du résumé
BACKGROUND
BACKGROUND
Population-level tracking of hospital use patterns with integrated care organizations in patients experiencing homelessness has been difficult. A California law implemented in 2019 (Senate Bill 1152) aimed to ensure safety for this population after discharge from the hospital by requiring additional documentation for patients experiencing homelessness, which provides an opportunity to evaluate hospital use by this population.
METHODS
METHODS
In a large integrated health system in California, patients experiencing homelessness were identified through documentation change requirements associated with this law and compared with a matched group from the general population.
RESULTS
RESULTS
Patients experiencing homelessness had increased rates of hospital readmission after discharge compared to the general population matched on demographics and medical comorbidity in 2019 and 2020. Any address change in the prior year for patients was associated with increased odds of emergency department readmission. Patients experiencing homelessness, both enrolled in an integrated delivery system and not, were successfully identified as having higher readmission rates compared with their housed counterparts.
CONCLUSION
CONCLUSIONS
Documentation of housing status following Senate Bill 1152 has enabled improved study of hospital use among those with housing instability. Understanding patterns of hospital use in this vulnerable group will help practitioners identify timely points of intervention for further social and health care support.
Identifiants
pubmed: 38108331
doi: 10.7812/TPP/23.075
pmc: PMC10940252
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
55-61Subventions
Organisme : NIDDK NIH HHS
ID : P30 DK092924
Pays : United States
Déclaration de conflit d'intérêts
Conflicts of InterestNone declared
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