ArticleBMJ open2021
Comparative 4-year risk and type of hospital admission among homeless and housed emergency department attendees: longitudinal study of hospital records in England 2013-2018.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 19 citations in OpenAlex.
- 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
- Health Challenges in Vulnerable Populations: Neurological and Vascular Diseases Among People Experiencing Homelessness in Gdańsk, Poland: An Observational Study.Journal of clinical medicine · 2026Article
- Learnings from providing integrated health, housing and wider care for people rough sleeping during the COVID- 19 pandemic: a national qualitative study of the 'Everyone In' policy initiative.BMC health services research · 2025Article
- Estimating the scale of hospital admissions for people experiencing homelessness in England: a population-based multiple systems estimation study using national Hospital Episode Statistics.BMJ public health · 2025Article
- Secondary care for people experiencing homelessness in Scotland: a retrospective cohort study.BMJ public health · 2025Article
- Exploring the experiences and preferences of South Asian patients' of primary care in England since COVID-19.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- The homeless, seizures, and epilepsy: a review.Journal of neural transmission (Vienna, Austria : 1996) · 2023Review
- Injury Patterns and Hospital Admission After Trauma Among People Experiencing Homelessness.JAMA network open · 2023Observational
- Emergency department outcomes for patients experiencing homelessness in England: retrospective cross-sectional study.European journal of public health · 2023Article
- Making the invisible visible: using national surveillance data to identify people experiencing homelessness in England with COVID-19.Epidemiology and infection · 2023Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPeople experiencing homelessness are frequent users of secondary care. Currently, there is no study of potentially preventable admissions for homeless patients in England. We aim to estimate the number of potentially preventable hospital admissions for homeless patients and compare to housed patients with similar characteristics.
designRetrospective matched cohort study.
settingHospitals in England.
participants16 161 homeless patients and 74 780 housed patients aged 16-75 years who attended an emergency department (ED) in England in 2013/2014, matched on the basis of age, sex, ED attended and primary diagnosis. PRIMARY AND SECONDARY OUTCOME MEASURES: Annual counts of admissions, emergency admissions, ambulatory care-sensitive (ACS) emergency admissions, acute ACS emergency admissions and chronic ACS emergency admissions over the following 4 years (2014/2015-2017/2018). We additionally compare the prevalence of specific ACS conditions for homeless and housed patients.
resultsMean admissions per 1000 patients per year were 470 for homeless patients and 230 for housed patients. Adjusted for confounders, annual admissions were 1.79 times higher (incident rate ratio (IRR)=1.79; 95% CI 1.69 to 1.90), emergency admissions 2.08 times higher (IRR=2.08; 95% CI 1.95 to 2.21) and ACS admissions 1.65 times higher (IRR=1.65; 95% CI 1.51 to 1.80), compared with housed patients. The effect was greater for acute (IRR=1.78; 95% CI 1.64 to 1.93) than chronic (IRR=1.45; 95% CI 1.27 to 1.66) ACS conditions. ACS conditions that were relatively more common for homeless patients were cellulitis, convulsions/epilepsy and chronic angina.
conclusionsHomeless patients use hospital services at higher rates than housed patients, particularly emergency admissions. ACS admissions of homeless patients are higher which suggests some admissions may be potentially preventable with improved access to primary care. However, these admissions comprise a small share of total admissions.
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