Objectives: To determine changes in the housing status of emergency department (ED) patients over the last 3 years and to determine the number of patients experiencing housing instability who present to the ED.
Methods: This was a cross-sectional study at an urban, Level I trauma center with 98,000 annual visits. We prospectively screened all adult patients presenting to the ED during a randomized distribution of 8-hour periods between 6/1 and 8/31 in 2007, 2008, and 2009. Consenting patients completed a survey on demographics and living situations. Patients who described themselves as homeless or living with friends/relatives were defined as experiencing housing instability. Data were analyzed using descriptive statistics and chi-square tests.
Results: 18,287 patients presented during the study, 10567 were eligible, and 8771 (83%) were enrolled (median age 39, range 18 to98, 52.6% male). For 2007, a living situation was described as: 5.1% homeless, 5.0% halfway house or group home, 16.2% living with friends/relatives, 55.0% renting, and 17.2% property owners. 44.6% described themselves as unemployed, 23.8% reported having no health insurance. For 2008, living situation was described as: 6.2% homeless, 7.4% halfway house or group home, 17.2% living with friends/relatives, 55.0% renting, and 15.7% property owners. 48.5% described themselves as unemployed, and 21.6% reported having no health insurance. For 2009, living situation was described as: 7.9% homeless, 4.5% halfway house or group home, 18.6% living with friends/relatives, 57.3% renting, and 11.7% property owners. 38.4% described themselves as unemployed, 20.1% reported having no health insurance. The rate of patients reporting an unstable living situation was 21.3% in 2007, 23.4% in 2008, and 26.5% in 2009 (p = 0.001).
Conclusions: The rate of patients who described themselves as homeless increased from 5.1% to 7.9% between 2007 and 2009. The rate of those experiencing housing instability among our ED patient population has increased over time.