Use of EDs for Food and Shelter by Homeless People

Emergency departments often function as societal healthcare safety nets for the poor and disenfranchised. Homelessness is associated with myriad problems, including a higher disease burden, and homeless people have a higher rate of ED utilization, which has been postulated to be due to lack of access to primary care. In a prospective case-control study, 191 homeless and 63 not-homeless (control) ambulatory patients who presented to a single county ED in San Francisco were given a structured interview that assessed subsistence needs and reasons for the ED visit.

On average, homeless patients spent 3.5 nights per week sleeping without shelter and consumed 2.1 meals per day. Hunger, safety concerns, and lack of shelter were the primary reasons …