• S Monty Ghosh, Khokan C Sikdar, Adetola Koleade, Jordan Ross, William Rioux, Eddy S Lang, Geoff Messier, Robert Tanguay, Stephen E Congly, Stephanie Van den Berg, and Karen L Tang.
• Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
• J Eval Clin Pract. 2025 Feb 1; 31 (1): e214236e214236.

BackgroundIndividuals experiencing homelessness (IEH) tend to have increased length of stay (LOS) in acute care settings, which negatively impacts health care costs and resource utilisation. It is unclear however, what specific factors account for this increased LOS. This study attempts to define which diagnoses most impact LOS for IEH and if there are differences based on their demographics.MethodsA retrospective cohort study was conducted looking at ICD-10 diagnosis codes and LOS for patients identified as IEH seen in Emergency Departments (ED) and also for those admitted to hospital. Data were stratified based on diagnosis, gender, and age. Statistical analysis was conducted to determine which ICD-10 diagnoses were significantly associated with increased ED and inpatient LOS for IEH compared to housed individuals.ResultsHomelessness was associated with increased LOS regardless of gender or age group. The absolute mean difference of LOS between IEH and housed individuals was 1.62 h [95% CI 1.49-1.75] in the ED and 3.02 days [95% CI 2.42-3.62] for inpatients. Males age 18-24 years spent on average 7.12 more days in hospital, and females aged 25-34 spent 7.32 more days in hospital compared to their housed counterparts. Thirty-one diagnoses were associated with increased LOS in EDs for IEH compared to their housed counterparts; maternity concerns and coronary artery disease were associated with significantly increased inpatient LOS.ConclusionHomelessness significantly increases the LOS of individuals within both ED and inpatient settings. We have identified several diagnoses that are associated with increased LOS in IE; these should inform the prioritisation and development of targeted interventions to improve the health of IEH.© 2024 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

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