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Housing Status and Healthcare Utilization in People Presenting With Seizure
Sandeepa S Mullady1, Andrew J Wood2, Elan L Guterman2,3,4
1Memory Divisions, Department of Neurology, Stanford University, San Francisco, CA, USA.
The Neurohospitalist
|February 17, 2025
Summary
People experiencing homelessness (PEH) with seizures utilized acute care services more frequently, including higher 30-day re-visits. This study highlights disparities in healthcare utilization for this vulnerable population.
Area of Science:
- Public Health
- Health Services Research
- Emergency Medicine
Background:
- Housing status is a significant social determinant of health.
- Understanding healthcare utilization patterns among vulnerable populations is crucial for targeted interventions.
- Seizures represent a common neurological condition presenting to emergency departments.
Purpose of the Study:
- To investigate the association between housing status and healthcare utilization in adults presenting with seizures.
- To compare healthcare utilization outcomes between people experiencing homelessness (PEH) and those with stable housing.
Main Methods:
- Retrospective cross-sectional analysis of adult patients presenting with seizures to a public hospital emergency department (2016-2019).
- Patients categorized into PEH and housed groups.
- Healthcare utilization outcomes included 30-day acute care re-visits, discharge disposition, and hospital length of stay.
- Multivariable regression models adjusted for age, comorbidities, and insurance status.
Main Results:
- PEH were younger, more likely to be people of color, and have Medicaid compared to housed individuals.
- Admitted PEH had higher odds of 30-day re-visits (aOR 1.87) and lower odds of facility discharge (aOR 0.37).
- Admitted PEH experienced a shorter hospital length of stay (coef -12.87).
Conclusions:
- People experiencing homelessness with seizures demonstrate increased healthcare utilization, particularly in terms of acute care re-visits.
- Findings underscore the need for tailored interventions to address the healthcare needs of PEH presenting with seizures.
- Further research should explore imaging, medication, and etiology to understand utilization drivers.
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