Research reinforces need for better healthcare for homeless

A Dr Foster investigation into the health needs of homeless people has revealed not only a significant rise in the number of hospital admissions, but that a more joined-up approach between housing, local authorities and health trusts is needed in order to properly address the often very complex needs of homeless people. The investigation involved Dr Foster’s population health management expertise, including patient segmentation and measuring inequalities and outcomes using healthcare data.

10 Feb 2021 | 2 min read

The data analysis, carried out in conjunction with University College London Hospitals, revealed that there has been a 134 per cent increase in hospital admissions for homeless people between 2010/2011 and 2018/19 rising from 5,397 inpatient spells to 12,368 respectively. The highest rates per 100,000 population were in Westminster at 48.96.

Readmissions too came into focus as part of the research, and with a higher rise in 28-day readmissions than the general population, analysis suggests that homeless patients do not have their needs fully addressed during their initial admission.

Caring for homeless patients is an extremely complex area. They often have a number of complex needs spanning different organisations, including mental health. The most common reason for admission to hospital in 2018/19 was for alcohol related mental disorders followed by poisoning by psychotropic agents. To ensure improved care, the report highlights the need to provide collaborative and holistic care so that it is delivered in the right way, at the right time and in the right place.

Dr Foster’s analysis also suggests a potential inconsistency within the documentation of homeless patients across the country, possibly creating a huge gap in collecting the information that can better identify where help is needed. These likely differences in coding between homeless people and the general population indicate that a more joined up approach is needed alongside a greater depth of coding.

However, Trusts may be under administrative and coding pressures to pick the most important code in the diagnosis, with homeless coding more likely to be a secondary diagnosis. Any lack of emphasis on the coding could also be attributed to a lack of training among clinical coders to pick up the homeless code and report on it. A lack of depth of coding could also mean hospitals are not generating enough income to handle the complexity of homeless patients.

Better documentation and data capture in this area could enable authorities to work together to identify the most significant areas that need addressing to improve care for this very vulnerable group of people.

To read the full report click here.