A Study on the Change of Emergency Department Use Behavior of the Homeless Patients after the Implementation of the ‘Seoul Type Citizen Sympathy Emergency Room Project’

Oh, Se Yun; Park, Sang Hyun; Pyo, Chang Hae; Park, Keun Hong; Kwak, Myoung Kwan; Kim, Hahn Bom; Shin, Seoung Yul; Choi, Han Jo; Ha, Hyun Suk

J Korean Soc Emerg Med > Volume 29(1); 2018 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2018;29(1): 21-29.

‘서울형 시민 공감 응급실 운영사업’시행 후 행려환자의 응급의료센터 이용 행태 변화에 대한 고찰

오세윤¹, 박상현¹, 표창해¹, 박근홍¹, 곽명관¹, 김한범¹, 신승열¹, 최한조², 하현숙³

¹서울의료원 응급의학과
²서남병원 응급의학과
³서울특별시청 시민건강국 보건의료정책과

A Study on the Change of Emergency Department Use Behavior of the Homeless Patients after the Implementation of the ‘Seoul Type Citizen Sympathy Emergency Room Project’

Se Yun Oh¹, Sang Hyun Park¹, Chang Hae Pyo¹, Keun Hong Park¹, Myoung Kwan Kwak¹, Hahn Bom Kim¹, Seoung Yul Shin¹, Han Jo Choi², Hyun Suk Ha³

¹Department of Emergency Medicine, Seoul Medical Center, Seoul, Korea
²Department of Emergency Medicine, Seonam Hospital, Seoul, Korea
³Health Care Policy Division, Health for All Bureau, Seoul Metropolitan Government, Seoul, Korea

Correspondence

Sang Hyun Park ,Tel: 02-2276-7424, Fax: 02-2276-7418, Email: emergency70@hanmail.net,

Received: August 31, 2017; Revised: September 4, 2017 Accepted: October 16, 2017. Published online: February 28, 2018.

ABSTRACT

Purpose:
This study shows the change in emergency room use behavior by homeless patients after implementation of the ‘Seoul Type Citizen Sympathy Emergency Room Project’ in July 2015.
Method:
A retrospective study was conducted in a public hospital between January 2014 and December 2014 and January 2016 and December 2016. Homeless patients who visited the emergency room in 2014 and 2016 were compared based on age, gender, mode of insurance, admission, revisit within 48 hours, length of stay (LOS) in the emergency department (ED), total cost, and major diagnostic category.
Results
A total of 3,642 homeless patients were enrolled during the study period, of which 1,876 visited in 2014 and 1,766 in 2016. Fewer homeless patients in 2016 revisited within 48 hours (p=0.046). Homeless in 2016 had a shorter ED LOS (p<0.001) and lower total cost (p=0.040). More homeless patients who visited due to alcohol revisited within 48 hours in 2016 (p=0.036). Moreover, these patients did not have a different ED LOS (p=0.060) or total cost (p=0.475). Medicaid homeless patients were less connected compared health insurance by screening, brief intervention, referral to treatment program.
Conclusion:
Comparison of homeless patients who visited the emergency room in 2014 and 2016 revealed fewer total homeless patients in 2016, as well as less revisits within 48 hours, shorter ED LOS and lower total cost. These findings indicate that the ‘Seoul Type Citizen Sympathy Emergency Room Project’ was effective in the emergency room, but improvements for alcohol and medicaid homeless patients are needed.

Key words: Homeless persons, Emergency medical services, Health policy, Alcoholics