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Housing instability tied to higher diabetes-related ED visits
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Adults with diabetes who reported unstable housing had higher rates of diabetes-related ED visits and hospitalizations compared with those who reported stable housing, according to findings published in Diabetes Care.
Seth A. Berkowitz, MD, MPH, assistant professor of medicine in the division of general medicine and clinical epidemiology at the University of North Carolina School of Medicine, and colleagues evaluated data from the 2014 Health Center Patient Survey, a cross-sectional, nationally representative survey of patients receiving care at federally funded safety-net health centers, on 1,087 adults (49.85% women; 29.86% mean age, 55 to 64 years; 58.01% white) representing 3,277,165 adults with diabetes. Researchers sought to determine whether unstable housing is associated with increased risk for diabetes-related ED use or hospitalization. The survey was conducted from September 2014 to April 2015.
Overall, most participants were seen in community health centers (93.78%), followed by migrant health centers (3.04%), health care for the homeless centers (1.92%) and public housing primary care centers (1.27%).
Nearly 14% of participants reported having a diabetes-related ED visit or hospitalization within the past year. More participants who were unstably housed reported having a diabetes-related ED visit or hospitalization in the past year compared with those who were stably housed (26% vs. 7%; P = .0005), according to unadjusted analyses. After adjustment, unstable housing was still associated with a greater risk for diabetes-related ED visit or hospitalization compared with stable housing (adjusted OR = 5.17; 95% CI, 2.08-12.87).
Many participants reported receiving help with traditional medical needs (30% to 50%) but fewer reported receiving help with housing, food or employment (< 5%). Overall, just 2% of participants reported receiving help with housing.
“Housing instability is common in diabetes patients and is associated with increased ED visits and hospitalizations,” Berkowitz told Endocrine Today. “However, very few patients receive help from their clinics in dealing with these problems. We need ways to respond, as a health care system, to the unmet social needs of our patients, like housing. This isn’t something an individual practitioner will tackle on their own; we need systematic and coordinated response. Right now, we know that housing issues are common and associated with worse outcomes, but we don’t know what the best way to help is. We need research regarding the best way to intervene on these issues.” – by Amber Cox
For more information:
Seth A. Berkowitz, MD, MPH, can be reached at seth_berkowitz@med.unc.edu.
Disclosures: Berkowitz reports no relevant financial disclosures. One author reports he receives royalty payments from UpToDate for authorship of a topic review on providing health care to homeless people.
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