The following is a summary of “Association of Housing Status With Types of Operations and Postoperative Health Care Utilization,” published in the December 2023 issue of Surgery by Decker, et al.
For a study, researchers sought to look into the link between where someone lives and the type of surgery they get, how much health care they use, and how well the surgery goes. Patients who don’t have a place to live have worse results and use more health care in several clinical areas. But only a little has been written about the impact of medical disease on people who don’t have a place to live. They looked back at 111,267 treatments that happened from 2013 to 2022 and recorded living status at a single tertiary care facility. They did baseline bivariate and multivariate studies that considered clinical and sociodemographic factors.
Out of a total of 998 surgeries (0.8%), more emergency surgeries (56%) were done on homeless patients than on housed patients (22%). In an unadjusted analysis, patients who were not housed stayed longer (18.7 days vs. 8.7 days), were readmitted more often (9.5% vs. 7.5%), died more often in the hospital (2.9% vs. 1.8%), had more reoperations in the hospital (34.6% vs. 15.9%), and used more social work, physical therapy, and occupational therapy services. When age, sex, conditions, insurance status, and the reason for the surgery were taken into account, along with the difference between an emergency and a planned surgery, these differences disappeared for emergency surgeries.
This retrospective cohort study showed that patients who were not housed had more emergency surgeries than those who were housed. They also had more complicated hospital stays when the data wasn’t changed for patient and procedure factors. The results showed that there are problems with the way people get to surgery that, if not fixed, may make this fragile group more likely to have more complicated hospital stays and worse long-term outcomes.
