Panel Paper:
Exploring Emergency Department Early Return Rates of Homeless Individuals: Does Provider Type Matter?
*Names in bold indicate Presenter
Methods: Five years of data (2010-2014) from the National Hospital Ambulatory Medical Care Survey for U.S. emergency departments (NHAMCS-ED), a national representative probability sample, were analyzed through moderated logistic regression to determine predicted probability of return for each group along varying provider types. Provider types included in the analysis were attending physicians, resident/intern, nurse practitioner, physician assistant, and mental health provider.
Results: Homeless individuals had a 2.7% and 3.05% higher probability for early return when an attending or resident/intern was present, respectively, while private resident patients had a decrease of 2.24% and 0.63% probability when seeing an attending or resident/intern, respectively. Mental health providers, however, reflected the lowest probability of early return for both homeless and private residence populations.
Conclusion: Provider type present at ED visits may impact early return rates differentially by patient population based on residency. The data suggest that homeless individuals are more likely to experience an early return visit when seeing an attending or resident/intern in the ED, warranting further investigation into care provisions given by these providers for homeless patients. On the other hand, utilizing more mental health providers in the ED may decrease return rates by homeless individuals, while also decreasing return rates for private residence patients. These results further support measures to increase mental health provisions within health care systems.
