SHM Converge Scientific Abstract ePoster Gallery-Patient Characteristics Associated With Missed Identification of Homelessness at an Urban Academic Hospital

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This study examined which patient characteristics were linked to missed documentation of homelessness in an urban academic hospital. Using the Homeless Management Information System and electronic medical records, researchers matched adults who used shelters or transitional housing in Washington, DC, to hospital encounters from September 2019 to February 2020. They reviewed up to two emergency department (ED) visits and two inpatient admissions per patient and used multivariable logistic regression to identify factors associated with failure to document housing status.<br /><br />The analysis included 586 patients and 227 repeat ED visits, plus 188 patients and 32 repeat admissions. Insurance, race, age, and primary diagnosis were all associated with whether homelessness was identified.<br /><br />Key findings differed by setting. In both ED visits and admissions, having DC Alliance insurance was associated with missed documentation, though the reason is unclear. DC Alliance is a coverage program for District residents below 200% of the federal poverty level who are not eligible for Medicaid or Medicare. In the ED, use of transitional housing was linked to missed identification, suggesting that clinicians may be more likely to recognize homelessness only when housing insecurity is severe. This supports the need for standardized screening tools. In both settings, having a primary psychiatric diagnosis was associated with correct identification, possibly because psychiatric evaluations routinely include questions about housing.<br /><br />Overall, the study suggests that homelessness is not consistently documented and that identification varies by patient and care setting. Standardized screening could improve recognition and help connect patients to appropriate resources.

Asset Subtitle

Kartik S. Patel

Meta Tag

Author List Aditya Maddali, Catherine H. McDowell, Hanna Haile, Jillian S. Catalanotti, Kartik S. Patel, Mario A. Pita, Matthew A. Tovar, Megan Phan, Nathan Errampalli, Richard L. Amdur

Category Research

Concept Homelessness

Concept Missed Identification

Concept Health-Related Social Needs Screening

Concept Care Decision

Concept Community Resource

Distinguished Non-Finalist

Presenter Organization George Washington University School of Medicine and Health Sciences - Washington, DC

Presenting Author Kartik S. Patel

Track Other

Keywords

homelessness documentation

emergency department

inpatient admissions

housing insecurity

standardized screening

DC Alliance insurance

transitional housing

psychiatric diagnosis

urban academic hospital

multivariable logistic regression

Homelessness

Missed Identification

Health-Related Social Needs Screening

Care Decision

Community Resource