TY - JOUR
T1 - Accident and emergency department attendance rates of people experiencing homelessness by GP registration
T2 - a retrospective analysis
AU - Reilly, Johanna
AU - Hassanally, Khalil
AU - Budde, John
AU - Mercer, Stewart
N1 - Copyright © 2020, The Authors.
PY - 2020/11/3
Y1 - 2020/11/3
N2 - BACKGROUND: People experiencing homelessness are known to have complex health needs and to be high users of hospital accident and emergency (A&E) departments. It is unclear whether access to a day-time specialist homeless medical practice, as opposed to routine general practice, influences A&E attendance rates.
AIM: This study investigated whether registration with a specialist homeless service would alter A&E attendance rates in a single geographical region in Scotland.
DESIGN & SETTING: A health board area with a specialist service for people experiencing homelessness was selected. Data were obtained from the hospital records of 4408 A&E attendances by people experiencing homelessness at NHS Lothian (based on a broad definition of homelessness and including those in temporary accommodation) between January 2015 and July 2017.
METHOD: The attendances were compared between people registered with a specialist service and those registered with a mainstream GP.
RESULTS: The reasons for attendance and urgency of attendance were broadly similar between the two groups. Repeat attendance was similarly high in both groups. Almost 70% in both groups attended with problems deemed urgent, very urgent, or requiring immediate resuscitation. The patients registered with the specialist homeless service were more likely to be older and male; however, this did not affect the frequency of attendance.
CONCLUSION: People experiencing homelessness attending A&E mainly do so for urgent or very urgent problems. This was not related to the type of day-time primary care service they had access to. Strategies to reduce attendances, such as out-of-hours mobile medical units, should be explored.
AB - BACKGROUND: People experiencing homelessness are known to have complex health needs and to be high users of hospital accident and emergency (A&E) departments. It is unclear whether access to a day-time specialist homeless medical practice, as opposed to routine general practice, influences A&E attendance rates.
AIM: This study investigated whether registration with a specialist homeless service would alter A&E attendance rates in a single geographical region in Scotland.
DESIGN & SETTING: A health board area with a specialist service for people experiencing homelessness was selected. Data were obtained from the hospital records of 4408 A&E attendances by people experiencing homelessness at NHS Lothian (based on a broad definition of homelessness and including those in temporary accommodation) between January 2015 and July 2017.
METHOD: The attendances were compared between people registered with a specialist service and those registered with a mainstream GP.
RESULTS: The reasons for attendance and urgency of attendance were broadly similar between the two groups. Repeat attendance was similarly high in both groups. Almost 70% in both groups attended with problems deemed urgent, very urgent, or requiring immediate resuscitation. The patients registered with the specialist homeless service were more likely to be older and male; however, this did not affect the frequency of attendance.
CONCLUSION: People experiencing homelessness attending A&E mainly do so for urgent or very urgent problems. This was not related to the type of day-time primary care service they had access to. Strategies to reduce attendances, such as out-of-hours mobile medical units, should be explored.
U2 - 10.3399/bjgpopen20X101089
DO - 10.3399/bjgpopen20X101089
M3 - Article
C2 - 33144361
SN - 2398-3795
JO - British Journal of General Practice Open (BJGP Open)
JF - British Journal of General Practice Open (BJGP Open)
ER -