Status of Emergency Department Seventy-Two Hour Return Visits Among Homeless Patients

BACKGROUND: We aim to externally validate the status of emergency department (ED) appropriate utilization and 72-h ED returns among homeless patients. METHODS: This is a retrospective single-center observational study. Patients were divided into two groups (homeless versus non-homeless). Patients’ general characteristics, clinical variables, ED appropriate utilization, and ED return disposition deviations were compared and analyzed separately. RESULTS: Study enrolled a total of 63,990 ED visits. Homeless patients comprised 9.3% (5,926) of visits. Higher ED 72-h returns occurred among homeless patients in comparison to the non-homeless patients (17% versus 5%, P < 0.001). Rate of significant ED disposition deviations (e.g., admission, triage to operation room, or death) on return visits were lower in homeless patients when compared to non-homeless patient populations (15% versus 23%, P < 0.001). CONCLUSIONS: Though ED return rate was higher among homeless patients, return visit case management seems appropriate, indicating that 72-h ED returns might not be an optimal healthcare quality measurement for homeless patients.