Status of Emergency Department Seventy-Two Hour Return Visits Among Homeless Patients

Heidi Knowles, Charles Huggins, Richard D. Robinson, Rosalia Mbugua, Jessica Laureano-Phillips, Shrunjal M. Trivedi, Jessica Kirby, Nestor R. Zenarosa, Hao Wang


Background: We aim to externally validate the status of emergency department (ED) appropriate utilization and 72-h ED returns among homeless patients.

Methods: This is a retrospective single-center observational study. Patients were divided into two groups (homeless versus non-homeless). Patients’ general characteristics, clinical variables, ED appropriate utilization, and ED return disposition deviations were compared and analyzed separately.

Results: Study enrolled a total of 63,990 ED visits. Homeless patients comprised 9.3% (5,926) of visits. Higher ED 72-h returns occurred among homeless patients in comparison to the non-homeless patients (17% versus 5%, P < 0.001). Rate of significant ED disposition deviations (e.g., admission, triage to operation room, or death) on return visits were lower in homeless patients when compared to non-homeless patient populations (15% versus 23%, P < 0.001).

Conclusions: Though ED return rate was higher among homeless patients, return visit case management seems appropriate, indicating that 72-h ED returns might not be an optimal healthcare quality measurement for homeless patients.

J Clin Med Res. 2019;11(3):157-164


Emergency department; Homeless; Appropriate utilization; ED return visit

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