ArticleThe western journal of emergency medicine2022
Effect of an Emergency Department Closure on Homeless Patients and Adjacent Hospitals.
Article in The western journal of emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed.
- Article
- Emergency Department Closures and Patient Outcomes: Scoping Review of Impacts on Care, Equity, and System Performance.The western journal of emergency medicine · 2026Article
- Article
- Characteristics and Health Care Utilization of Patients With Housing Insecurity in the ED.JAMA network open · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHomeless and housed patients differ on several emergency department (ED) metrics (emergency medical services [EMS] use, chief complaints, admission rates, etc.). On January 1, 2018, Memorial Hospital (MH), a safety-net hospital in Pawtucket, Rhode Island, closed. We studied the impact of this closure by analyzing homeless patient utilization of the two closest EDs before and after MH closed.
methodsA retrospective chart review compared the ED records of The Miriam Hospital (TMH), (1.8 miles from MH) and Rhode Island Hospital (RIH), (4.3 miles from MH). We analyzed visits between January 1, 2017-December 30, 2018. (MH closed on 1/1/2018). Patients were identified as homeless if their address listed was either "homeless" or a shelter/homeless service provider. All other patients were assumed to be housed. We removed from the analysis visits without an address listed or visits missing other key study variables (1.6% of the total).
resultsA total of 113,925 unique patients visited the RIH and TMH EDs in 2017, as well as 117,167 in 2018. Homeless patients accounted for 1.18% of patients seen in 2017 and 1.32% in 2018. Between 2017 and 2018, this represents an increase of individual homeless patients of 15.46% (1553-1345), while the number of unique housed patients increased by 2.69% (115,614-112,580). The closer hospital, TMH, saw a 43.72% increase in homeless visits, while RIH saw an 8% increase. Homeless patients were discharged significantly more often than housed patients (74% vs 65%) and had significantly longer time to admission (466.0 vs 304.0 minutes) and discharge (397.9 vs 263.7 minutes) compared to housed patients. Homeless patients presented with suicidality (8.61% of visits) and alcohol-related concerns (29.88% of visits) significantly more than housed patients (1.43% and 2.94%, respectively).
conclusionWhen a local ED closes, other EDs are impacted. We found visits made by homeless patients increased more than those made by housed patients and skewed significantly toward the closer hospital. We also found that homeless patients spend significantly more time in the ED and presented with behavioral health complaints more frequently. This impact of hospital closure on patterns of ED utilization by homeless patients has implications for ED management and homeless services both in the ED and the community.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.