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Emergency department utilization among unhoused individuals: Impact of a nurse practitioner faculty led/student-run
Lindsey Torres1, Carolyn Rutledge1, Kathie Zimbro1
1Ellmer School of Nursing Old Dominion University, Norfolk, Virginia.
Background:
Unhoused individuals experience higher morbidity and mortality due to chronic conditions, injuries, untreated mental health conditions, and unmet social need leading to increased emergency department (ED) utilization.
Local Problem:
Although local organizations provide services like food and shelter to region's unhoused, they lack integrated health care services. This contributes to the ED usage of this population for nonemergent care.
Methods:
A nonexperimental causal-comparative retrospective design was used to analyze data from reginal EDs. A total of 252 clients served were identified and evaluated for ED utilization and diagnoses. Differences in ED usage between the days of clinic operation were evaluated.
Intervention:
A Nurse Practitioner (NP) Faculty-Led Student Run (NPF/SR) fee clinic was established withing a faith-based organization to offer integrated comprehensive services for the unhoused and provide educational opportunities NP students.
Results:
The study demonstrated that participants who attended the NP Faculty-Led Student Run clinic, compared with those that had not, had higher ED utilization rates. However, 83.8% of all ED visits occurred when the clinic was closed. Of 735 visits, 67.6% were no emergent. Mental health conditions, acute illnesses, wounds, and dental complaints were most prevalent.
Conclusions:
Findings support NPF/SR as a cost-effective method to address health care needs of the unhoused. Results demonstrated the need to increase operating hours and expand services.
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