Elsayed, Kareem S, MS

Greenberg, Marna R, DO, MPH, FACEP

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health Network LVHN Scholarly Works USF-LVHN SELECT Addressing the Healthcare Needs of the Lehigh Valley Homeless Population in the Emergency Department Kareem S. Elsayed MS Lehigh Valley Health Network, kareem.elsayed@lvhn.org Marna R. Greenberg DO, MPH, FACEP Lehigh Valley Health Network, marna.greenberg@lvhn.org Follow this and additional works at: https://scholarlyworks.lvhn.org/select-program  Part of the Medical Education Commons Published In/Presented At Elsayed, K. Greenberg, M. (2018, March). Addressing the Healthcare Needs of the Lehigh Valley Homeless Population in the Emergency Department. Poster Presented at: 2017 SELECT Capstone Posters and Presentations Day. Kasych Family Pavilon, Lehigh Valley Health Network, Allentown, PA. This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org. Introduction•  Using a five-question screening tool, wesurveyed all patients meeting inclusion/exclusion criteria on scheduled shifts in oneof three EDs in Northeastern Pennsylvania.•  To participate, subjects had to be aregistered patient in the ED, be 18 years orolder, speak English, have the capacity toanswer survey questions, not be critically ill,be willing to participate, and not have takenthe survey before.•  We selected two survey periods to representseasonal variations.•  The protocol passed scientific reviewwithout major edits, granted IRB approval.© 2018 Lehigh Valley Health NetworkMethodology•  A total of 4395 patient surveys metinclusion criteria on 150 separatedays at one of the sites.•  A majority of the respondents werefemale (58.2% n=2557) and theaverage participant age was 50.8years (SD=20.5).•  Table 1 depicts those participateswho coded a positive or negativeanswer to each of the surveyquestions as it relates to their age.•  Table 2 depicts the difference inresponses based upon the day ofthe week during which the surveywas answered.•  Table 3 depicts the differences inrespondents who coded positiveor negative survey answers as itrelates to the season during whichthey participated the survey.•  Of note is the lack of statisticaldifference between positiveresponses whether completedduring the weekday, weekend,winter, or summer.Results•  Overall prevalence of homelessness or at risk for homelessness was over 10%.•  This prevalence did not vary between weekdays and weekends or by season: summer monthshad a prevalence as concerning as winter months.•  Respondents screening positive for homelessness significantly younger than those screenednegative.•  Understanding patterns of prevalence of homelessness is a step toward possible interventions toassist this vulnerable population and mobilizing the Street Medicine team accordingly.Conclusions and Future Implications•  1.5 million Americans experiencehomelessness each year with 600,000actively homelessness on any given night.•  Similarly in the Lehigh valley an estimated10,500 individuals qualify as homeless.•  Dearth of information regarding thedemographics and healthcare utilization ofthese patients.•  Empirically analyzing patient characteristicsmay aid in addressing their healthcareneeds.Problem StatementSince LVHN has few data regarding the Lehigh Valley homeless population’s demographics and utilization of the ED, this project aims to quantify these factors so the network can adequately provide patient-centered care and appropriate resources.* All odds ratio estimates adjusted for participant age, gender and survey administration location.* All odds ratio estimates adjusted for participant age, gender and survey administration location.Lehigh Valley Health Network, Allentown, PAAddressing the Healthcare Needs of the Lehigh Valley Homeless Population in the Emergency DepartmentKareem S. Elsayed, BS,  Mentor - Marna Greenberg, DO, MPH, Brett J. Feldman, MSPAS, PA-C, Cristina G. Calogero, BS, Osman Z. Abbasi, DO, Joshua Enyart, DO, Timothy J. Friel, MD, Yasir H. Abunamous, MD, Stephen W. Dusza, DrPHTable 1. Distribution of Survey Questions by AgeQuestion Coding Obs (%) Mean SD95% CIP-valueLower UpperChange in ResidenceNo 4320 (98.3) 50.9 20.5 50.3 51.6 <0.001Yes 75 (1.7) 42.6 17.4 38.6 46.6Been concerned about losing houseNo 4140 (94.2) 51.1 20.7 50.5 51.7<0.001Yes 255 (5.8) 45.9 15.9 43.9 47.8Lived with a family memberNo 4174 (95.0) 51.4 20.6 50.8 52.0<0.001Yes 221 (5.0) 39.6 15.1 37.6 41.6Been evicted or served evictionNo 4329 (98.5) 50.9 20.6 50.3 51.5<0.001 Yes 66 (1.5) 42.0 14.5 38.5 45.6Slept outside or in abandoned buildingNo 4314 (98.2) 51.0 20.6 50.4 51.6<0.001Yes 81 (1.8) 39.4 13.5 36.5 42.4Table 2. Distribution of Survey Questions by Time of Survey Administration (weekday or weekend)QuestionSurvey Administration TimingCoding Weekday Weekend Total OR (95% CI)-* p-valueChange in ResidenceNo 2,990 (98.4) 1,330 (98.1) 4,320 (98.3)0.37Yes 49 (1.6) 26 (1.9) 75 (1.7) 1.3 (0.8-2.0)Been concerned about losing houseNo 2,863 (94.2) 1,277 (94.2) 4,140 (94.2)0.76Yes 176 (5.8) 79 (5.8) 255 (5.8) 1.0 (0.8-1.4)Lived with a family memberNo 2,866 (95.0) 1,288 (95.0) 4,174 (95.0)0.88Yes 153 (5.0) 68 (5.0) 221 (5.0) 1.0 (0.8-1.4)Been evicted or served evictionNo 2,993 (98.5) 1,336 (98.5) 4,329 (98.5)0.97Yes 46 (1.5) 20 (1.5) 66 (1.5) 1.0 (0.6-1.7)Slept outside or in abandoned buildingNo 2,980 (98.1) 1,334 (98.4) 4,314 (98.20.6Yes 59 (1.9) 22 (1.6) 81 (1.8) 0.9 (0.5-1.4)Table 3. Distribution of Survey Questions by SeasonQuestionSurvey Administration TimingCoding Winter Summer Total OR (95% CI)-* p-valueChange in ResidenceNo 2,288 (98.6) 2,032 (98.0) 4,320 (98.3)0.35Yes 33 (1.4) 26 (2.0) 75 (1.7) 1.2 (0.8-2.0)Been concerned about losing houseNo 2,201 (94.8) 1,939 (93.5) 4,140 (94.2)0.28Yes 120 (5.2) 135 (6.5) 255 (5.8) 1.2 (0.9-1.5)Lived with a family memberNo 2,211 (95.3) 1,963 (94.6) 4,174 (95.0)0.84Yes 110 (4.7) 111 (5.4) 221 (5.0) 1.0 (0.7-1.3)Been evicted or served evictionNo 2,286 (98.5) 2,043 (98.5) 4,329 (98.5)0.54Yes 35 (1.5) 31 (1.5) 66 (1.5) 0.9 (0.5-1.4)Slept outside or in abandoned buildingNo 2,286 (98.5) 2,028 (97.8) 4,314 (98.2)0.36Yes 35 (1.5) 46 (2.2) 81 (1.8) 1.2 (0.8-1.9)

Addressing the Healthcare Needs of the Lehigh Valley Homeless Population in the Emergency Department

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