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Top 10 presenting diagnoses of homeless veterans seeking care at emergency departments

The American Journal of Emergency Medicine Feb 26, 2021

Tsai J, et al. - Using national VA administrative data from 2016 to 2019, researchers conducted an observational study examining the top 10 diagnostic categories for ED use among homeless and non-homeless veterans classified by age, gender, and race/ethnicity. They analyzed data on 260,783 homeless veterans and 2,295,704 non-homeless veterans. The order of the most common diagnostic categories for ED use among homeless veterans was as follows: musculoskeletal pain, alcohol-related disorders, suicidal behaviors, low back pain, and non-specified conditions; these together accounted for 22%–24% of all ED visits. Among non-homeless veterans, the top 10 diagnostic categories for ED use did not include alcohol-related disorders, suicidal behaviors, and depressive disorders. Some disparities between homeless and non-homeless veterans presenting for ED care, such as age, gender, and race/ethnicity greatly reflected known epidemiological disparities between these groups in general. But only the top 10 for black veterans included respiratory infections and symptoms and only the top 10 for Hispanic veterans included depressive disorder. Based on these data, they emphasize addressing psychosocial factors and optimizing healthcare for behavioral health and pain conditions among veterans experiencing homelessness in order to lower emergency care-seeking.

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