MORGANTOWN, W.Va., Aug. 7 -- The first national study of homeless people's use of emergency rooms finds that homeless patients are more likely to arrive at the hospital by ambulance and more than twice as likely to be uninsured.
One-third of homeless patients arrived by ambulance -- at an estimated cost of almost $67 million, according to the researchers.
Analyzing almost half a million emergency room visits by homeless people, West Virginia University doctors also found that the homeless were more likely to receive more than two diagnostic tests -- a higher number compared with other patients.
At the same time, WVU researchers found no difference between the urgency of the medical emergencies in comparing both populations. The study is published in the current issue of the Journal of Health Care for the Poor and Underserved.
"The thing that surprised me the most was that acuity levels -- how sick the person was -- and hospital admissions rates were similar in comparing the homeless population to people with residences," said lead author Gary Oates, M.D., a WVU emergency medicine physician. "The sicker you are, the sooner you need to be seen by a doctor when you come to the emergency department. And the homeless patients were no sicker than others, looking at total visits to emergency departments nationwide."
Despite that, more diagnostic tests were ordered than for other patients. "This may be because emergency physicians needed to do baseline blood work because the homeless patient didn't have a primary care doctor," Dr. Oates explained. "Or it could be because the homeless population may be more prone to falls or injuries from assault -- injuries that may require x-rays."
Studying emergency room use is important in the context of the current national healthcare reform effort, Oates said.
"We already know that homeless patients make emergency room visits four times more often than others and are among the most frequent repeat visitors," he said. "Our study is the first study to look at data nationwide and compare the homeless population in terms of insurance status, use of ambulance transport, hospital admission rate, acuity level and other factors."
Two-thirds of the homeless patients were white and three-quarters were male.
The study's data came from the 2005 National Hospital Ambulatory Medical Care Survey, with information on more than 100 million emergency room visits during that year.
Federal hospitals were not represented in the data set, so populations such as homeless veterans were not included in the sample.
The study's other authors are Allison Tadros, M.D., also a WVU emergency medicine physician, and Stephen M. Davis, research coordinator for the WVU Department of Emergency Medicine.
SOURCE West Virginia University Health Sciences Center