Prevalence of Homelessness in the Emergency Department Setting

Area of Science:

• Public Health
• Emergency Medicine
• Social Determinants of Health

Background:

• National homelessness rates are documented, but prevalence in emergency departments (EDs) remains unknown.
• The study addresses the gap in understanding homelessness within the acute care setting.
• Identifying vulnerable populations in the ED is crucial for targeted interventions.

Purpose of the Study:

• To determine the prevalence of homelessness or risk of homelessness among emergency department patients.
• To investigate variations in prevalence based on day of the week, season, and ED site characteristics.

Main Methods:

• A five-question screening tool based on federal definitions was administered to eligible ED patients.
• Surveys were conducted across three EDs in Northeastern Pennsylvania during two distinct periods to capture seasonal variations.
• Inclusion criteria focused on adult patients with capacity to participate, excluding those critically ill.

Main Results:

• Out of 4,395 subjects, 10.1% screened positive for homelessness or risk of homelessness.
• Prevalence did not significantly differ between weekdays (10.3%) and weekends (9.8%).
• Significant variation in prevalence was observed across different ED sites, with a center city site showing a higher rate (18.7%) compared to trauma (7.5%) and suburban (9.1%) sites.

Conclusions:

• The overall prevalence of homelessness or risk of homelessness in the ED setting is substantial at 10.1%.
• Prevalence is consistent across seasons and days of the week, highlighting a persistent need.
• ED site characteristics influence prevalence, suggesting localized factors are important for understanding and addressing homelessness in healthcare settings.