Critical illness among patients experiencing homelessness: a retrospective cohort study
To understand the epidemiology and healthcare use of critically ill patients experiencing homelessness compared to critically ill patients with stable housing. This retrospective population-based cohort study included adults admitted to any ICU in Alberta, Canada, for a 3-year period. Administrative...
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| Veröffentlicht in: | Critical care (London, England) England), 2023-12, Vol.27 (1), p.477-477, Article 477 |
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| creator | Sauro, K M O'Rielly, C M Kersen, J Soo, A Bagshaw, S M Stelfox, H T |
| description | To understand the epidemiology and healthcare use of critically ill patients experiencing homelessness compared to critically ill patients with stable housing.
This retrospective population-based cohort study included adults admitted to any ICU in Alberta, Canada, for a 3-year period. Administrative and clinical data from the hospital, ICU and emergency department were used to examine healthcare resource use (processes of care, ICU and hospital length of stay, hospital readmission and emergency room visits). Regression was used to quantify differences in healthcare use by housing status.
2.3% (n = 1086) of patients admitted to the ICU were experiencing homelessness; these patients were younger, more commonly admitted for medical reasons and had fewer comorbidities compared to those with stable housing. Processes of care in the ICU were mostly similar, but healthcare use after ICU was different; patients experiencing homelessness who survived their index hospitalization were more than twice as likely to have a visit to the emergency department (OR = 2.3 times, 95% CI 2.0-2.6, |
| doi_str_mv | 10.1186/s13054-023-04753-7 |
| format | Article |
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This retrospective population-based cohort study included adults admitted to any ICU in Alberta, Canada, for a 3-year period. Administrative and clinical data from the hospital, ICU and emergency department were used to examine healthcare resource use (processes of care, ICU and hospital length of stay, hospital readmission and emergency room visits). Regression was used to quantify differences in healthcare use by housing status.
2.3% (n = 1086) of patients admitted to the ICU were experiencing homelessness; these patients were younger, more commonly admitted for medical reasons and had fewer comorbidities compared to those with stable housing. Processes of care in the ICU were mostly similar, but healthcare use after ICU was different; patients experiencing homelessness who survived their index hospitalization were more than twice as likely to have a visit to the emergency department (OR = 2.3 times, 95% CI 2.0-2.6, < 0.001) or be readmitted to hospital (OR = 2.1, 95% CI 1.8-2.4, p < 0.001) within 30 days, and stayed 10.1 days longer in hospital (95% CI 8.6-11.6, p < 0.001), compared with those who have stable housing.
Patients experiencing homelessness have different characteristics at ICU admission and have similar processes of care in ICU, but their subsequent use of healthcare resources was higher than patients with stable housing. These findings can inform strategies to prepare patients experiencing homelessness for discharge from the ICU to reduce healthcare resource use after critical illness.</description><identifier>ISSN: 1364-8535</identifier><identifier>EISSN: 1466-609X</identifier><identifier>EISSN: 1364-8535</identifier><identifier>EISSN: 1366-609X</identifier><identifier>DOI: 10.1186/s13054-023-04753-7</identifier><identifier>PMID: 38053149</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; Alberta - epidemiology ; Algorithms ; Ambulatory care ; Care and treatment ; Codes ; Cohort analysis ; Cohort Studies ; Comorbidity ; Comparative analysis ; Critical care ; Critical Illness - epidemiology ; Critical Illness - therapy ; Critically ill ; Diagnosis ; Emergency medical care ; Emergency medical services ; Health aspects ; Health services ; Homeless people ; Homelessness ; Hospital patients ; Hospitals ; Humans ; Ill-Housed Persons ; Intensive care ; Medical research ; Medicine, Experimental ; Mental disorders ; Mortality ; Patient admissions ; Patient safety ; Population ; Psychological aspects ; Retrospective Studies ; Social aspects ; Trends ; Variables</subject><ispartof>Critical care (London, England), 2023-12, Vol.27 (1), p.477-477, Article 477</ispartof><rights>2023. The Author(s).</rights><rights>COPYRIGHT 2023 BioMed Central Ltd.</rights><rights>2023. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c393t-b586683685e9dc798fbde47bba1d6476b683352f03f70e8df6d73c2380193b803</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38053149$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sauro, K M</creatorcontrib><creatorcontrib>O'Rielly, C M</creatorcontrib><creatorcontrib>Kersen, J</creatorcontrib><creatorcontrib>Soo, A</creatorcontrib><creatorcontrib>Bagshaw, S M</creatorcontrib><creatorcontrib>Stelfox, H T</creatorcontrib><title>Critical illness among patients experiencing homelessness: a retrospective cohort study</title><title>Critical care (London, England)</title><addtitle>Crit Care</addtitle><description>To understand the epidemiology and healthcare use of critically ill patients experiencing homelessness compared to critically ill patients with stable housing.
This retrospective population-based cohort study included adults admitted to any ICU in Alberta, Canada, for a 3-year period. Administrative and clinical data from the hospital, ICU and emergency department were used to examine healthcare resource use (processes of care, ICU and hospital length of stay, hospital readmission and emergency room visits). Regression was used to quantify differences in healthcare use by housing status.
2.3% (n = 1086) of patients admitted to the ICU were experiencing homelessness; these patients were younger, more commonly admitted for medical reasons and had fewer comorbidities compared to those with stable housing. Processes of care in the ICU were mostly similar, but healthcare use after ICU was different; patients experiencing homelessness who survived their index hospitalization were more than twice as likely to have a visit to the emergency department (OR = 2.3 times, 95% CI 2.0-2.6, < 0.001) or be readmitted to hospital (OR = 2.1, 95% CI 1.8-2.4, p < 0.001) within 30 days, and stayed 10.1 days longer in hospital (95% CI 8.6-11.6, p < 0.001), compared with those who have stable housing.
Patients experiencing homelessness have different characteristics at ICU admission and have similar processes of care in ICU, but their subsequent use of healthcare resources was higher than patients with stable housing. These findings can inform strategies to prepare patients experiencing homelessness for discharge from the ICU to reduce healthcare resource use after critical illness.</description><subject>Adult</subject><subject>Alberta - epidemiology</subject><subject>Algorithms</subject><subject>Ambulatory care</subject><subject>Care and treatment</subject><subject>Codes</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Comparative analysis</subject><subject>Critical care</subject><subject>Critical Illness - epidemiology</subject><subject>Critical Illness - therapy</subject><subject>Critically ill</subject><subject>Diagnosis</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Health aspects</subject><subject>Health services</subject><subject>Homeless people</subject><subject>Homelessness</subject><subject>Hospital patients</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Ill-Housed Persons</subject><subject>Intensive care</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Mental disorders</subject><subject>Mortality</subject><subject>Patient admissions</subject><subject>Patient safety</subject><subject>Population</subject><subject>Psychological aspects</subject><subject>Retrospective Studies</subject><subject>Social aspects</subject><subject>Trends</subject><subject>Variables</subject><issn>1364-8535</issn><issn>1466-609X</issn><issn>1364-8535</issn><issn>1366-609X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptkUtv1TAQhS0Eou2FP8ACRWLDJsX2xC921RUvqRIbEOwsx5m0rpI42A5q_z2-3FIJhLzwaOY7o6M5hLxg9JwxLd9kBlR0LeXQ0k4JaNUjcso6KVtJzffHtQbZtVqAOCFnOd9QypSW8JScgKYCWGdOybd9CiV4NzVhmhbMuXFzXK6a1ZWAS8kN3q6YaulD7V7HGacKHcC3jWsSlhTzir6En9j4eB1TaXLZhrtn5MnopozP7_8d-fr-3Zf9x_by84dP-4vL1oOB0vZCS6lBaoFm8MrosR-wU33v2CA7Jfs6BMFHCqOiqIdRDgo8r_6ZgV5T2JHXx71rij82zMXOIXucJrdg3LLl2mgjDlsq-uof9CZuaanuLDeUM65ovc4DdeUmtGEZY0nOH5baC6WEkFxU5zty_h-qvgHn4OOCY6j9vwT8KPD1YDnhaNcUZpfuLKP2kKY9pmlrmvZ3mlZV0ct7x1s_4_Ag-RMf_AID95lP</recordid><startdate>20231206</startdate><enddate>20231206</enddate><creator>Sauro, K M</creator><creator>O'Rielly, C M</creator><creator>Kersen, J</creator><creator>Soo, A</creator><creator>Bagshaw, S M</creator><creator>Stelfox, H T</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20231206</creationdate><title>Critical illness among patients experiencing homelessness: a retrospective cohort study</title><author>Sauro, K M ; O'Rielly, C M ; Kersen, J ; Soo, A ; Bagshaw, S M ; Stelfox, H T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-b586683685e9dc798fbde47bba1d6476b683352f03f70e8df6d73c2380193b803</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Alberta - epidemiology</topic><topic>Algorithms</topic><topic>Ambulatory care</topic><topic>Care and treatment</topic><topic>Codes</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Comparative analysis</topic><topic>Critical care</topic><topic>Critical Illness - epidemiology</topic><topic>Critical Illness - therapy</topic><topic>Critically ill</topic><topic>Diagnosis</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Health aspects</topic><topic>Health services</topic><topic>Homeless people</topic><topic>Homelessness</topic><topic>Hospital patients</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Ill-Housed Persons</topic><topic>Intensive care</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Mental disorders</topic><topic>Mortality</topic><topic>Patient admissions</topic><topic>Patient safety</topic><topic>Population</topic><topic>Psychological aspects</topic><topic>Retrospective Studies</topic><topic>Social aspects</topic><topic>Trends</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sauro, K M</creatorcontrib><creatorcontrib>O'Rielly, C M</creatorcontrib><creatorcontrib>Kersen, J</creatorcontrib><creatorcontrib>Soo, A</creatorcontrib><creatorcontrib>Bagshaw, S M</creatorcontrib><creatorcontrib>Stelfox, H T</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Critical care (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sauro, K M</au><au>O'Rielly, C M</au><au>Kersen, J</au><au>Soo, A</au><au>Bagshaw, S M</au><au>Stelfox, H T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Critical illness among patients experiencing homelessness: a retrospective cohort study</atitle><jtitle>Critical care (London, England)</jtitle><addtitle>Crit Care</addtitle><date>2023-12-06</date><risdate>2023</risdate><volume>27</volume><issue>1</issue><spage>477</spage><epage>477</epage><pages>477-477</pages><artnum>477</artnum><issn>1364-8535</issn><eissn>1466-609X</eissn><eissn>1364-8535</eissn><eissn>1366-609X</eissn><abstract>To understand the epidemiology and healthcare use of critically ill patients experiencing homelessness compared to critically ill patients with stable housing.
This retrospective population-based cohort study included adults admitted to any ICU in Alberta, Canada, for a 3-year period. Administrative and clinical data from the hospital, ICU and emergency department were used to examine healthcare resource use (processes of care, ICU and hospital length of stay, hospital readmission and emergency room visits). Regression was used to quantify differences in healthcare use by housing status.
2.3% (n = 1086) of patients admitted to the ICU were experiencing homelessness; these patients were younger, more commonly admitted for medical reasons and had fewer comorbidities compared to those with stable housing. Processes of care in the ICU were mostly similar, but healthcare use after ICU was different; patients experiencing homelessness who survived their index hospitalization were more than twice as likely to have a visit to the emergency department (OR = 2.3 times, 95% CI 2.0-2.6, < 0.001) or be readmitted to hospital (OR = 2.1, 95% CI 1.8-2.4, p < 0.001) within 30 days, and stayed 10.1 days longer in hospital (95% CI 8.6-11.6, p < 0.001), compared with those who have stable housing.
Patients experiencing homelessness have different characteristics at ICU admission and have similar processes of care in ICU, but their subsequent use of healthcare resources was higher than patients with stable housing. These findings can inform strategies to prepare patients experiencing homelessness for discharge from the ICU to reduce healthcare resource use after critical illness.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>38053149</pmid><doi>10.1186/s13054-023-04753-7</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection; Springer Nature OA Free Journals |
| subjects | Adult Alberta - epidemiology Algorithms Ambulatory care Care and treatment Codes Cohort analysis Cohort Studies Comorbidity Comparative analysis Critical care Critical Illness - epidemiology Critical Illness - therapy Critically ill Diagnosis Emergency medical care Emergency medical services Health aspects Health services Homeless people Homelessness Hospital patients Hospitals Humans Ill-Housed Persons Intensive care Medical research Medicine, Experimental Mental disorders Mortality Patient admissions Patient safety Population Psychological aspects Retrospective Studies Social aspects Trends Variables |
| title | Critical illness among patients experiencing homelessness: a retrospective cohort study |
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