Journal of general internal medicine
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Editorial
Decoding Homelessness: Z-Codes and the Recognition of Homelessness as a Comorbid Condition.
There are an estimated 653,100 people across the United States experiencing homelessness. Homelessness is an important social determinant of health associated with increased morbidity and mortality. ⋯ Here, we review the historical purpose and utilization of codes to identify SDOH ("Z-codes"); describe how the recent CMS policy change elevates the importance of homelessness within medical care and impacts reimbursement; analyze the potential risks and benefits of this change to patients, clinicians, and health systems; and assess barriers to implementation. We conclude by calling for health systems to move beyond simply documenting homelessness to meaningfully addressing health inequities in PEH.
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Many individuals do not receive recommended vaccines, increasing infectious disease morbidity and mortality. It is unknown whether the financial practices of US healthcare institutions contribute to vaccine hesitancy. ⋯ Current medical debt is associated with lower likelihood of recent vaccine receipt in both insured and uninsured individuals. Policies that minimize medical debt may improve vaccine coverage.