Hospital stays more expensive for Canadian homeless, study shows

Hospital data shows that patients experiencing homelessness across the country are living longer and more expensively.

Nearly 30,000 people who were homeless last year were hospitalized, According to the Canadian Institute for Health Information (CIHI). In general due to the complexity of their illnesses, the stay averaged 15.4 days, twice the national average. About 3,500, or 12 percent, of homeless patients required a hospital stay for more than a month.

“To put it in perspective, a decade ago the average life expectancy in Canada was 79 for men, 81 for women. But in the homeless population, it was 47 for men and 48 for women,” says Dr. Cheryl Forchuk, assistant scientific director of the Lawson Health Research Institute and co-author of the study. “It’s a profound difference.”

The new analysis used CIHI’s database to take a detailed look at Canadian hospitals. A mandatory record-keeping code, Z59.0, is used to identify patients experiencing homelessness and improve services for them. The CIHI draws on health information from every hospital in Canada and recently added a factor called homelessness.

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“We talked to about 30,000 people who were homeless and admitted to our hospitals within a year,” Forchuk says. “The truth is that when they come to the hospital, they are sicker. “They take a lot longer to recover than other people suffering from the same disease.”

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The purpose of this data collection is to develop more accurate sources of data related to homelessness so that appropriate supports and services are available. Forchuk says the longer a person needs to stay in the hospital, the longer they are out of work and the more likely it is to disenfranchise these marginalized populations with complex medical needs. it occurs.

Forchuk highlights how housing is linked to health and well-being, and how this directly impacts health and homelessness initiatives. affordable housing According to the study it is this intervention that will prevent the severity of illnesses experienced by the homeless population.

“For example, we try to manage our health through good nutrition. Well, how do you maintain good nutrition when you’re homeless? Most people I talk to eat once a day. How do you handle constant exposure to the elements or lack of proper sleep? Forchuk says. “It doesn’t matter whether you’re sheltering in place, couch-surfing or camping out, the quality of your sleep is going to be affected. These are all things that help our general health condition.

According to the CIHI, the leading cause of homeless individuals requiring hospitalization were substance use disorders, which equates to approximately 18 percent of stays; schizophrenia spectrum and other psychotic disorders, totaling 11 percent; and cellulitis, a bacterial infection often seen on the legs, resulting in about seven percent of deaths.

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“It doesn’t matter what homeless situation you’re looking at, and with our algorithm we looked at many different issues,” Forchuk says. “People experiencing homelessness are always disadvantaged.”

93 percent of patients experiencing homelessness were admitted to the hospital after an emergency department visit. The average cost of living due to the complexity of health concerns was $16,800, compared to $7,800 for housed individuals.

“Sometimes people say, ‘Well, we can’t afford to expand our public housing,’ which is far cheaper than shelters. You know, putting someone in a shelter bed versus actually housing them. Get it,” Forchuk says. “But it’s like, ‘Pay me now or pay me later.’ Not providing adequate housing will actually result in higher costs due to a variety of problems, including more widespread health care problems.

Patients experiencing homelessness typically do not have access to a family doctor’s care, and so rely on a hospital for medical treatment. Having appropriate medical teams in the community or services such as Arch Aid or Intercommunity Health Center in London, Ontario can prevent emergency department visits in many cases.

“Hospital and service utilization data is essential to understanding emergency department patterns for people living without stable housing in our community,” says Brad Campbell, corporate hospital administrative executive at LHSC. “Through collaborations such as our partnership with London Cares, we have leveraged data to help individuals in our community access supportive housing and comprehensive 24/7 health and social support services.”

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Campbell believes this work is consistent with the priorities expressed by the Ontario health care sector. It increases collaboration across sectors and removes barriers to care by allowing stronger inter-agency communication to support increased capacity and access to health care.

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