Year: 2024
Type: article
Study design: Observational Study
Abstract: We performed a cross-sectional analysis of adult patients (18 years old or older) evaluated by the Homeless Healthcare Collaborative (HHC), UCLA Health’s field-based homeless healthcare team. HHC provides free, trauma-informed health care, including preventative and urgent care, and social services to PEH in Los Angeles County. We examined encounters between HHC’s rollout in January 2022 through September 2023. We abstracted data from the electronic health records (EHR). This study was certified exempt by the UCLA Institutional Review Board. The outcome of interest was the presence of a diagnosis of one or more ACSCs during a clinical encounter: anemia, angina, asthma, cellulitis, congestive heart failure, chronic obstructive pulmonary disease (COPD), dental condition, diabetes mellitus, epilepsy, gangrene, gastroenteritis, hypertension, lower extremity ulcer, pneumonia, and urinary tract infection. Diagnoses were identified based on International Classification of Diseases, Tenth Revision (ICD-10) codes. Sociodemographic factors including age, sex, and race and ethnicity for each patient were extracted from the EHR. We performed descriptive statistics overall and by ACSC status. Factors associated with ACSCs were evaluated using multi-level multivariable logistic regression model which accounted for repeat visits for some patients. HHC performed 5,520 encounters among 3,226 unique patients. Overall, ACSCs were present in 1,706 (30.9%) encounters among 1,034 (32.1%) unique patients (Table 1 ). The most common ACSCs encountered were hypertension (796; 46.6%), cellulitis (347; 20.3%), diabetes (277; 16.2%), asthma (112; 6.6%), dental condition (107; 6.3%), and COPD (84; 4.9%). Based on multivariable analyses, the odds of having an encounter with an ACSC increased with age (adjusted OR 1.16 per age increase by 10 years, 95% CI 1.09, 1.25; p < 0.001) and differed by race and ethnicity with non-Hispanic Black patients having higher odds of ACSCs as compared to non-Hispanic White patients (adjusted OR 1.27, 95% CI 1.01, 1.61; p = 0.042) (Table 2 ).
Institutions: University of California, Los Angeles, UCLA Health
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,990
OpenAlex ID: W4404959221