Key causes and long‐term trends related to emergency department and inpatient hospital admissions of homeless persons in England
Dublin Core
Title
Key causes and long‐term trends related to emergency department and inpatient hospital admissions of homeless persons in England
Subject
Homelessness, Inpatient admissions, Emergency department visits, Health disparity
Description
Background It is estimated that approximately 300,000 people are experiencing homelessness in England. The aim
of this study was to evaluate key causes and long-term trends of emergency departments (EDs) and in hospital inpa-
tient admissions of persons experiencing homelessness in England.
Methods ED and hospital inpatient admissions data were obtained from Hospital Episode Statistics (HES) covering all
National Health Service (NHS) England hospitals. Anyone identified or declared to be experiencing homelessness dur-
ing the service usage are recorded in HES datasets. Data were extracted for the 10-year study period and compared
to the general population, which includes all patients attending the ED or admitted to inpatient care in England.
Results Drug- and alcohol-related causes contribute to the most frequent reasons for attendance and admissions
of persons experiencing homelessness in the ED and inpatient respectively. A total of 30,406 ED attendances were
recorded for persons experiencing homelessness in the year 2018/2019 (+44.9% rise vs 2009/10) of which injuries
and poisoning respectively represented 21.8% and 17.9% of all persons experiencing homelessness presentations
to the ED. Poisoning (including drug overdose) represented only 1.9% of all attendances by the general population
during the same study year (rate ratio vs general populations 9.2 95% CI 9.0–9.4). High mortality rates were observed
in relation to presentations attributed to drug- and alcohol-related causes. A total of 14,858 persons experiencing
homelessness inpatient admissions were recorded in 2018/2019 (+68.6% vs 2009/2010). Psychoactive substance
use constituted 12.7% of all admissions in 2018/2019 compared to 0.4% of in the general populations (rate ratio:
33.3, 95% CI: 31.9–34.7). There was a 44.3% rise in the number of admissions related to poisoning in the study period
amongst persons experiencing homelessness in England (vs 14.2% in general population).
Conclusion Marked disparities around primary causes of ED and inpatient admissions were identified between per-
sons experiencing homelessness and the general population. There is a continued need for prevention measures
to reduce the prevalence of drug and alcohol, injury and poisoning-related admissions to the ED, enhanced service
provision at the community level, and multisector collaborations. These initiatives should maximise opportunities
for early interventions and improve outcomes for persons experiencing homelessness, including increased accessibil-
ity of healthcare and mental health services, particularly in areas that demonstrate increasing ED and inpatient attend-
ance rates over time.
of this study was to evaluate key causes and long-term trends of emergency departments (EDs) and in hospital inpa-
tient admissions of persons experiencing homelessness in England.
Methods ED and hospital inpatient admissions data were obtained from Hospital Episode Statistics (HES) covering all
National Health Service (NHS) England hospitals. Anyone identified or declared to be experiencing homelessness dur-
ing the service usage are recorded in HES datasets. Data were extracted for the 10-year study period and compared
to the general population, which includes all patients attending the ED or admitted to inpatient care in England.
Results Drug- and alcohol-related causes contribute to the most frequent reasons for attendance and admissions
of persons experiencing homelessness in the ED and inpatient respectively. A total of 30,406 ED attendances were
recorded for persons experiencing homelessness in the year 2018/2019 (+44.9% rise vs 2009/10) of which injuries
and poisoning respectively represented 21.8% and 17.9% of all persons experiencing homelessness presentations
to the ED. Poisoning (including drug overdose) represented only 1.9% of all attendances by the general population
during the same study year (rate ratio vs general populations 9.2 95% CI 9.0–9.4). High mortality rates were observed
in relation to presentations attributed to drug- and alcohol-related causes. A total of 14,858 persons experiencing
homelessness inpatient admissions were recorded in 2018/2019 (+68.6% vs 2009/2010). Psychoactive substance
use constituted 12.7% of all admissions in 2018/2019 compared to 0.4% of in the general populations (rate ratio:
33.3, 95% CI: 31.9–34.7). There was a 44.3% rise in the number of admissions related to poisoning in the study period
amongst persons experiencing homelessness in England (vs 14.2% in general population).
Conclusion Marked disparities around primary causes of ED and inpatient admissions were identified between per-
sons experiencing homelessness and the general population. There is a continued need for prevention measures
to reduce the prevalence of drug and alcohol, injury and poisoning-related admissions to the ED, enhanced service
provision at the community level, and multisector collaborations. These initiatives should maximise opportunities
for early interventions and improve outcomes for persons experiencing homelessness, including increased accessibil-
ity of healthcare and mental health services, particularly in areas that demonstrate increasing ED and inpatient attend-
ance rates over time.
Creator
Vibhu Paudyal1*, Neha Vohra1
, Malcolm Price1,2, Zahraa Jalal1 and Karen Saunders3
, Malcolm Price1,2, Zahraa Jalal1 and Karen Saunders3
Source
https://doi.org/10.1186/s12245-023-00526-9
Date
2023
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Vibhu Paudyal1*, Neha Vohra1
, Malcolm Price1,2, Zahraa Jalal1 and Karen Saunders3, “Key causes and long‐term trends related to emergency department and inpatient hospital admissions of homeless persons in England,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12184.