Emergency Care for Homeless Patients: A French Multicenter Cohort Study

• DOI: 10.2105/ajph.2015.303038
• Publication Date: 2016-03-17T19:57:05Z
• Authors: Anne-Laure Feral-...; Adeline Aubry; Jennifer Truchot; Pierre-Alexis Raynal; Mathieu Boiffier; Alice Hutin; Agathe Leleu; Geraud Debruyne; Luc-Marie Joly; Philippe Juvin; Bruno Riou; Yonathan Freund
• Keywords: Adult; Male; Waiting Lists; 1. No poverty; Middle Aged; Severity of Illness Index; Patient Discharge; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Ill-Housed Persons; Humans; Female; France; Prospective Studies; Emergency Service, Hospital; Aged; Quality Indicators, Health Care; Quality of Health Care

Objectives. To determine whether homeless patients experience suboptimal care in the emergency department (ED) by the provision of fewer health care resources. Methods. We conducted a prospective multicenter cohort study in 30 EDs in France. During 72 hours in March 2015, all homeless patients that visited the participating EDs were included in the study. The primary health care service measure was the order by the physician of a diagnostic investigation or provision of a treatment in the ED. Secondary measures of health care services included ED waiting time, number and type of investigations per patient, treatment in the ED, and discharge disposition. Results. A total of 254 homeless patients and 254 nonhomeless patients were included. After excluding homeless patients that attended the ED for the sole purpose of housing, we analyzed 214 homeless and 214 nonhomeless. We found no significant difference between the 2 groups in terms of health care resource consumption, and for our secondary endpoints. Conclusions. We did not find significant differences in the level of medical care delivered in French EDs to homeless patients compared with matched nonhomeless patients.