title: Emergency Care for Homeless Patients: A French Multicenter Cohort Study.
abstract: OBJECTIVE
  To determine whether homeless patients experience suboptimal care in the emergency department (ED) by the provision of fewer health care resources.
  
  
  METHODS
  We conducted a prospective multicenter cohort study in 30 EDs in France. During 72 hours in March 2015, all homeless patients that visited the participating EDs were included in the study. The primary health care service measure was the order by the physician of a diagnostic investigation or provision of a treatment in the ED. Secondary measures of health care services included ED waiting time, number and type of investigations per patient, treatment in the ED, and discharge disposition.
  
  
  RESULTS
  A total of 254 homeless patients and 254 nonhomeless patients were included. After excluding homeless patients that attended the ED for the sole purpose of housing, we analyzed 214 homeless and 214 nonhomeless. We found no significant difference between the 2 groups in terms of health care resource consumption, and for our secondary endpoints.
  
  
  CONCLUSIONS
  We did not find significant differences in the level of medical care delivered in French EDs to homeless patients compared with matched nonhomeless patients.
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Feral-Pierssens
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Adeline
authors.initials: A
authors.lastname: Aubry
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Truchot
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Pierre-Alexis
authors.initials: PA
authors.lastname: Raynal
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Boiffier
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Alice
authors.initials: A
authors.lastname: Hutin
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Agathe
authors.initials: A
authors.lastname: Leleu
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Geraud
authors.initials: G
authors.lastname: Debruyne
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Luc-Marie
authors.initials: LM
authors.lastname: Joly
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Philippe
authors.initials: P
authors.lastname: Juvin
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Bruno
authors.initials: B
authors.lastname: Riou
authors.affiliation: Anne-Laure Feral-Pierssens and Philippe Juvin are with Emergency Department, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France. Adeline Aubry, Geraud Debruyne, Bruno Riou, and Yonathan Freund are with Emergency Department, Hôpital Pitié-Salpêtriere, APHP, Paris. Jennifer Truchot is with Emergency Department, Hôpital Lariboisière, APHP, Paris. Pierre-Alexis Raynal is with Emergency Department, Hôpital Saint-Antoine, APHP, Paris. Mathieu Boiffier is with Emergency Department, Centre Hospitalier Universitaire de Nice, France. Alice Hutin is with Emergency Department, Hôpital Cochin, APHP, Paris. Agathe Leleu is with Emergency Department, Hôpital Bichat, APHP, Paris. Luc-Marie Joly is with Emergency Department, Hôpital Charles Nicolle, Rouen, France. Pierre-Alexis Raynal, Bruno Riou, and Yanathan Freund are also with Sorbonne Université, UPMC univ Paris 06, Paris.
authors.forename: Yonathan
authors.initials: Y
authors.lastname: Freund
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D011446:Prospective Studies; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D014850:Waiting Lists