Geriatric Homelessness: Association with Emergency Department Utilization

Area of Science:

• Gerontology
• Public Health
• Emergency Medicine

Background:

• Homeless adults are frequent emergency department (ED) users.
• Limited research exists on ED utilization patterns among older homeless adults.
• This study addresses the gap by characterizing older homeless individuals in urban EDs.

Purpose of the Study:

• To characterize older homeless adults (age > 50) utilizing urban emergency departments.
• To compare demographic and clinical characteristics of older versus younger homeless adults seeking emergency care.

Main Methods:

• Analysis of ED encounters from three urban hospitals over 24 months.
• Comparison of older (age > 50) and younger (age ≤ 50) homeless patient groups.
• Examination of demographic and clinical data, including return visits and illness acuity.

Main Results:

• 66% of 1,330 homeless ED patients were over age 50.
• Older homeless adults had fewer ED visits within 30 days compared to younger counterparts.
• Older homeless women with primary care physician (PCP) access were more likely to return to the ED; men were less likely.

Conclusions:

• Reduced ED visits in older homeless adults, despite high acuity, is concerning due to high morbidity/mortality risks.
• Primary care access alone may not sufficiently decrease ED utilization in this population.
• Further research is needed on acute care interventions and targeted services for homeless patients in ED settings.