RT Journal Article
SR Electronic
T1 Accident and emergency department attendance rates of people experiencing homelessness by GP registration: a retrospective analysis
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP bjgpopen20X101089
DO 10.3399/bjgpopen20X101089
VO 4
IS 5
A1 Johanna Reilly
A1 Khalil Hassanally
A1 John Budd
A1 Stewart Mercer
YR 2020
UL http://bjgpopen.org/content/4/5/bjgpopen20X101089.abstract
AB Background People experiencing homelessness are known to have complex health needs and to be high users of hospital accident and emergency (A&E) departments. It is unclear whether access to a day-time specialist homeless medical practice, as opposed to routine general practice, influences A&E attendance rates.Aim This study investigated whether registration with a specialist homeless service would alter A&E attendance rates in a single geographical region in Scotland.Design & setting A health board area with a specialist service for people experiencing homelessness was selected. Data were obtained from the hospital records of 4408 A&E attendances by people experiencing homelessness at NHS Lothian (based on a broad definition of homelessness and including those in temporary accommodation) between January 2015 and July 2017.Method The attendances were compared between people registered with a specialist service and those registered with a mainstream GP.Results The reasons for attendance and urgency of attendance were broadly similar between the two groups. Repeat attendance was similarly high in both groups. Almost 70% in both groups attended with problems deemed urgent, very urgent, or requiring immediate resuscitation. The patients registered with the specialist homeless service were more likely to be older and male; however, this did not affect the frequency of attendance.Conclusion People experiencing homelessness attending A&E mainly do so for urgent or very urgent problems. This was not related to the type of day-time primary care service they had access to. Strategies to reduce attendances, such as out-of-hours mobile medical units, should be explored.