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Emergency Care for Homeless Patients: A French Multicenter Cohort Study
Anne-Laure Feral-Pierssens1, Adeline Aubry1, Jennifer Truchot1
1Anne-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.
Objectives:
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.
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