Emergency department use among the homeless and marginally housed: results from a community-based study.
OBJECTIVE
This study examined factors associated with emergency department use among homeless and marginally housed persons.


METHODS
Interviews were conducted with 2578 homeless and marginally housed persons, and factors associated with different patterns of emergency department use were assessed in multivariate models.


RESULTS
Findings showed that 40.4% of respondents had 1 or more emergency department encounters in the previous year; 7.9% exhibited high rates of use (more than 3 visits) and accounted for 54.5% of all visits. Factors associated with high use rates included less stable housing, victimization, arrests, physical and mental illness, and substance abuse. Predisposing and need factors appeared to drive emergency department use.


CONCLUSIONS
Efforts to reduce emergency department use among the homeless should be targeted toward addressing underlying risk factors among those exhibiting high rates of use.
Kushel
Margot B
MB
Division of General Internal Medicine, University of California at San Francisco/San Francisco General Hospital, San Francisco, Calif 94143, USA. kushel@itsa.ucsf.edu
Perry
Sharon
S
Bangsberg
David
D
Clark
Richard
R
Moss
Andrew R
AR
D000328:Adult; D018672:Community Health Planning; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006304:Health Status; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012495:San Francisco / Q000453:epidemiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014600:Utilization Review