A retrospective cohort study of trauma patients experiencing homelessness within a universal health care system

Individuals experiencing homelessness are known to be at an increased risk of poor health outcomes compared to those of relatively higher socioeconomic statuses. Specifically, a major cause of morbidity for people experiencing homelessness is traumatic injury. While poor outcomes after a traumatic injury for people experiencing homelessness is well documented in the American context, such literature for the Canadian context remains sparse. In this retrospective cohort study of 4551 trauma patients admitted at a Level 1 trauma center in Montreal, Canada, from 2016-2019 (inclusive), we determined the trauma outcomes of patients experiencing homelessness. We found that the outcomes between homeless and non-homeless trauma patients to be similar, but experiencing homelessness was associated with a 71 % increase in the odds of intubation. Healthcare coverage may have the potential to mitigate some of the adverse effects of a low socioeconomic status.