Performance of 2 Single-Item Screening Questions to Identify Future Homelessness Among Emergency Department Patients.

Area of Science:

• Public Health
• Health Services Research
• Social Determinants of Health

Background:

• Assessing social needs, including housing instability, is increasingly important in healthcare.
• Limited research exists on the effectiveness of housing-related screening tools in clinical settings.

Purpose of the Study:

• To evaluate the performance of two single-item screening questions for predicting future homelessness among emergency department (ED) patients.

Main Methods:

• Prospective cohort study of adult ED patients in New York City (2016-2017).
• Collected survey data on self-perceived risk for housing instability and homelessness.
• Linked survey responses with administrative data on homeless shelter entry at 2, 6, and 12 months post-ED visit.

Main Results:

• 1919 participants were included; 2.3% to 5.0% entered shelter within 12 months.
• Affirmative responses to screening questions significantly correlated with higher likelihood of future shelter entry.
• Screening questions demonstrated adequate to good performance metrics (sensitivity 0.27-0.69, specificity 0.76-0.97, AUC 0.62-0.72).

Conclusions:

• Two single-item screening questions show promise for identifying ED patients at risk of future homelessness.
• These tools exhibited adequate to good performance in predicting shelter entry.
• Further validation is recommended before widespread implementation of these screening questions.