June 17, 2024

Identifying the Prevalence and Consequences of Homelessness in Emergency Department Patients: Insights from a Vanderbilt University Medical Center Study

A recent study published in JAMA Network Open by researchers at Vanderbilt University Medical Center (VUMC) revealed that approximately 5% of patients who visit emergency departments (ED) at major medical centers in the Southeast are experiencing housing insecurity. This figure equates to one in every twenty patients.

The study, led by Madeleine Ball, a class of 2024 student at Vanderbilt University School of Medicine and 2023-2024 Research Committee Lead for VUMC’s Homeless Health Service, found that these patients were more likely to present with a primary complaint of suicide ideation, lack insurance coverage, and make multiple visits during the study period, which lasted from January 5 to May 16, 2023.

Ball emphasized the importance of addressing mental health care and homeless health teams within hospital settings, stating that “directing resources toward patients who frequently visit the ED could have a significant impact on their overall health and well-being.” She added that “screening for homelessness in all acute care centers is essential to optimize care for this vulnerable population.”

The research team analyzed a total of 23,795 ED visits, employing the Veterans Health Administration’s Homelessness Screening Clinical Reminder to identify patients experiencing housing insecurity. Data from the questionnaire was combined with demographic information, method of arrival, diagnoses, acuity, timing of presentation, disposition, and insurance status.

Unstable housing and homelessness can worsen health outcomes, increasing the risk of chronic diseases, injuries, and disabilities, according to the study authors. However, they noted that EDs currently lack a universal method to identify individuals at risk of, or currently experiencing, homelessness.

Ball and her team have implemented housing insecurity screening as a standard practice in the VUMC ED and plan to conduct a qualitative analysis of the implementation process to address various research questions aimed at enhancing care for this patient population.

Senior author Jennifer Hess, MD, an assistant professor of Emergency Medicine in the Department of Emergency Medicine at VUMC, expressed her hope that the analysis would encourage other institutions to adopt similar screening practices and create customized care plans for patients dealing with housing insecurity.

Hess stated, “This project represents a crucial first step in promoting health equity by identifying those who might benefit from additional resources and support.” She expressed gratitude for the collaborative, multidisciplinary team that made the project possible and looked forward to the potential outcomes.

As homelessness and housing insecurity continue to rise across the country, Hess emphasized the need to prioritize improving care for this often overlooked and susceptible patient population.

1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it.