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Housing Status and Longitudinal Care Patterns After Injury.

Hannah Decker1, Jennifer Evans2, Dave Graham Squire2

  • 1Department of Surgery, University of California, San Francisco, San Francisco, CA.

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|May 7, 2025
PubMed
Summary
This summary is machine-generated.

People experiencing homelessness had significantly higher healthcare use, including emergency department visits and mental health encounters, in the 12 months after injury compared to housed individuals. This highlights critical post-injury care disparities for vulnerable populations.

Keywords:
Health equityHomelessnessHousing statusSocial determinants of healthTrauma

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Area of Science:

  • Health Services Research
  • Trauma Care
  • Health Disparities

Background:

  • Injury is a major cause of hospitalization among individuals experiencing homelessness.
  • Post-injury healthcare utilization patterns for this population remain understudied.

Purpose of the Study:

  • To compare healthcare use in the 12 months following injury between people experiencing homelessness and housed, low-income Medicaid beneficiaries.
  • To identify patterns in emergency department visits, hospital admissions, outpatient visits, and mental health encounters.

Main Methods:

  • Retrospective cohort study of injured Medicaid beneficiaries in San Francisco (2015-2022).
  • Housing status at injury linked via Trauma Registry and Coordinated Care Management System.
  • Adjusted for demographic, clinical, injury, and pre-injury care variables.

Main Results:

  • 32.9% of 5,998 injured individuals were experiencing homelessness.
  • People experiencing homelessness showed a greater adjusted increase in emergency department visits post-injury compared to housed individuals (P<.001).
  • This increased utilization extended to inpatient admissions, outpatient visits, and mental health encounters, persisting above pre-injury levels for 12 months.

Conclusions:

  • The 12 months following injury are associated with higher healthcare sector utilization for individuals experiencing homelessness compared to their housed counterparts.
  • Significant disparities in post-injury care access and utilization exist for vulnerable populations.