Assessment and Diagnosis of Mental Illness in EDs Among Individuals Without a Home: Findings from the National Hospital Ambulatory Care Survey

Introduction: Homeless individuals lack resources for primary healthcare and as a result use the emergency department (ED) as a social safety net. Our primary objective in this study was to identify the differences between features of visits to United States (US) EDs made by patients without a home...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Hijab Ahmed, Jeff A. Dennis
Formato:	article
Lenguaje:	EN
Publicado:	eScholarship Publishing, University of California 2021
Materias:	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/c2732e3adf5a49e2a764559240603dbe
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:c2732e3adf5a49e2a764559240603dbe
record_format	dspace
spelling	oai:doaj.org-article:c2732e3adf5a49e2a764559240603dbe2021-11-17T15:19:27ZAssessment and Diagnosis of Mental Illness in EDs Among Individuals Without a Home: Findings from the National Hospital Ambulatory Care Survey1936-901810.5811/westjem.2021.7.51882https://doaj.org/article/c2732e3adf5a49e2a764559240603dbe2021-09-01T00:00:00Zhttps://escholarship.org/uc/item/0g29p7f4https://doaj.org/toc/1936-9018Introduction: Homeless individuals lack resources for primary healthcare and as a result use the emergency department (ED) as a social safety net. Our primary objective in this study was to identify the differences between features of visits to United States (US) EDs made by patients without a home and patients who live in a private residence presenting with mental health symptoms or no mental health symptoms at triage. Methods: Data for this study come from the 2009–2017 National Health and Ambulatory Medical Care Survey, a nationally representative cross-sectional survey of ED visits in the US. We examined differences in waiting time, length of visit, and triage score among homeless patients, and privately housed and nursing home residents. We used logistic regression to determine the odds of receiving a mental health diagnosis. Residence, age, gender, race, urgency, and whether the person was seen in the ED in the previous 72 hours were controlled. Results: Homeless individuals made up less than 1% of all ED visits during this period. Of these visits, 47.2% resulted in a mental health diagnosis compared to those who live in a private residence. Adjusting for age, race, gender, triage score, and whether the person had been seen in the prior 72 hours, homeless individuals were still six times more likely to receive a mental health diagnosis despite reporting no mental health symptoms compared to individuals who lived in a private residence. Homeless individuals reporting mental health symptoms were two times more likely to receive a mental health diagnosis compared to privately housed and nursing home residents. Conclusions: Homeless individuals are more likely to receive a mental health diagnosis in the ED whether or not they present with mental health symptoms at triage. This study suggests that homelessness as a status impacts how these individuals receive care in the ED. Community coordination is needed to expand treatment options for individuals experiencing emergent mental health symptoms.Hijab AhmedJeff A. DenniseScholarship Publishing, University of CaliforniaarticleMedicineRMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENWestern Journal of Emergency Medicine, Vol 22, Iss 6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Hijab Ahmed Jeff A. Dennis Assessment and Diagnosis of Mental Illness in EDs Among Individuals Without a Home: Findings from the National Hospital Ambulatory Care Survey
description	Introduction: Homeless individuals lack resources for primary healthcare and as a result use the emergency department (ED) as a social safety net. Our primary objective in this study was to identify the differences between features of visits to United States (US) EDs made by patients without a home and patients who live in a private residence presenting with mental health symptoms or no mental health symptoms at triage. Methods: Data for this study come from the 2009–2017 National Health and Ambulatory Medical Care Survey, a nationally representative cross-sectional survey of ED visits in the US. We examined differences in waiting time, length of visit, and triage score among homeless patients, and privately housed and nursing home residents. We used logistic regression to determine the odds of receiving a mental health diagnosis. Residence, age, gender, race, urgency, and whether the person was seen in the ED in the previous 72 hours were controlled. Results: Homeless individuals made up less than 1% of all ED visits during this period. Of these visits, 47.2% resulted in a mental health diagnosis compared to those who live in a private residence. Adjusting for age, race, gender, triage score, and whether the person had been seen in the prior 72 hours, homeless individuals were still six times more likely to receive a mental health diagnosis despite reporting no mental health symptoms compared to individuals who lived in a private residence. Homeless individuals reporting mental health symptoms were two times more likely to receive a mental health diagnosis compared to privately housed and nursing home residents. Conclusions: Homeless individuals are more likely to receive a mental health diagnosis in the ED whether or not they present with mental health symptoms at triage. This study suggests that homelessness as a status impacts how these individuals receive care in the ED. Community coordination is needed to expand treatment options for individuals experiencing emergent mental health symptoms.
format	article
author	Hijab Ahmed Jeff A. Dennis
author_facet	Hijab Ahmed Jeff A. Dennis
author_sort	Hijab Ahmed
title	Assessment and Diagnosis of Mental Illness in EDs Among Individuals Without a Home: Findings from the National Hospital Ambulatory Care Survey
title_short	Assessment and Diagnosis of Mental Illness in EDs Among Individuals Without a Home: Findings from the National Hospital Ambulatory Care Survey
title_full	Assessment and Diagnosis of Mental Illness in EDs Among Individuals Without a Home: Findings from the National Hospital Ambulatory Care Survey
title_fullStr	Assessment and Diagnosis of Mental Illness in EDs Among Individuals Without a Home: Findings from the National Hospital Ambulatory Care Survey
title_full_unstemmed	Assessment and Diagnosis of Mental Illness in EDs Among Individuals Without a Home: Findings from the National Hospital Ambulatory Care Survey
title_sort	assessment and diagnosis of mental illness in eds among individuals without a home: findings from the national hospital ambulatory care survey
publisher	eScholarship Publishing, University of California
publishDate	2021
url	https://doaj.org/article/c2732e3adf5a49e2a764559240603dbe
work_keys_str_mv	AT hijabahmed assessmentanddiagnosisofmentalillnessinedsamongindividualswithoutahomefindingsfromthenationalhospitalambulatorycaresurvey AT jeffadennis assessmentanddiagnosisofmentalillnessinedsamongindividualswithoutahomefindingsfromthenationalhospitalambulatorycaresurvey
_version_	1718425443064872960

Assessment and Diagnosis of Mental Illness in EDs Among Individuals Without a Home: Findings from the National Hospital Ambulatory Care Survey

Ejemplares similares