ArticleBMJ open2019
Validation study of health administrative data algorithms to identify individuals experiencing homelessness and estimate population prevalence of homelessness in Ontario, Canada.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence and Risk of Dementia Among Adults Who Have Experienced Homelessness, a Meta-Analysis.Journal of the American Geriatrics Society · 2026Pooled it
- Cardiovascular disease in homeless versus housed individuals: a systematic review of observational and interventional studies.Heart (British Cardiac Society) · 2020Pooled it
- Prevalence and Risk of Heart Failure Among Older Adults Experiencing Homelessness: A Systematic Review and Meta-Analysis.Canadian geriatrics journal : CGJ · 2026Review
- Association Between Homelessness and Mental Healthcare Utilization Among People With Addictions and Mental Health Problems: A Population-Based Study From Alberta Canada.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2026Article
- Cold-Related Illness Among Older Adults Experiencing Homelessness.JAMA network open · 2026Article
- Health services use for injury amongst persons experiencing homelessness in Ontario, Canada: a population-based retrospective matched cohort study.BMC public health · 2026Article
- Risk factors and circumstances associated with homelessness in older adults: a scoping review of quantitative and qualitative studies.The Gerontologist · 2026Article
- The Impact of Homelessness on Kidney Outcomes Among Adults With Diabetes.Kidney international reports · 2026Article
- Evaluating sociodemographic bias in a deployed machine-learned patient deterioration model.JAMIA open · 2025Article
- Effect of disability, homelessness, and neighborhood marginalization on risk adjustment for hospital performance measurement.American journal of epidemiology · 2025Article
- Classification of Homelessness in Medicaid Claims and Homeless Services Administrative Records: Application of a Concordance Analysis Framework.AJPM focus · 2025Article
- Physician explanation of Z-coded homelessness in medicaid claims.Health services & outcomes research methodology · 2025Article
- Article
- Dementia care and mortality in people experiencing homelessness: A matched cohort study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Addressing the needs of individuals experiencing homelessness: An epidemiological perspective.Biosocial health journal · 2025Article
- Cohort profile: the provincial opioid agonist treatment cohort in Ontario, Canada.European journal of epidemiology · 2025Article
- Exploring unregulated substance use health data in Ontario, Canada: Identifying gaps, addressing challenges, and uncovering opportunities.Frontiers in public health · 2025Article
- Turbulence in the system: Higher rates of left-without-being-seen emergency department visits and associations with increased risks of adverse patient outcomes since 2020.Journal of the American College of Emergency Physicians open · 2024Article
- Disparities in healthcare costs of people experiencing homelessness in Toronto, Canada in the post COVID-19 pandemic era: a matched cohort study.BMC health services research · 2024Article
- Examining the experiences of vulnerably housed patients visiting Kingston, Ontario's emergency departments: a qualitative analysis.International journal for equity in health · 2024Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectivesTo validate case ascertainment algorithms for identifying individuals experiencing homelessness in health administrative databases between 2007 and 2014; and to estimate homelessness prevalence trends in Ontario, Canada, between 2007 and 2016.
designA population-based retrospective validation study.
settingOntario, Canada, from 2007 to 2014 (validation) and 2007 to 2016 (estimation).
participantsOur reference standard was the known housing status of a longitudinal cohort of housed (n=137 200) and homeless or vulnerably housed (n=686) individuals. Two reference standard definitions of homelessness were adopted: the housing episode and the annual housing experience (any homelessness within a calendar year).
main outcome measuresSensitivity, specificity, positive and negative predictive values and positive likelihood ratios of 30 case ascertainment algorithms for detecting homelessness using up to eight health service databases.
resultsSensitivity estimates ranged from 10.8% to 28.9% (housing episode definition) and 18.5% to 35.6% (annual housing experience definition). Specificities exceeded 99% and positive likelihood ratios were high using both definitions. The most optimal algorithm estimates that 59 974 (95% CI 55 231 to 65 208) Ontarians (0.53% of the adult population) experienced homelessness in 2016, a 67.3% increase from 2007.
conclusionsIn Ontario, case ascertainment algorithms for identifying homelessness had low sensitivity but very high specificity and positive likelihood ratio. The use of health administrative databases may offer opportunities to track individuals experiencing homelessness over time and inform efforts to improve housing and health status in this vulnerable population.
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