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J Am Med Inform Assoc. 2015 May;22(3):682-7. doi: 10.1093/jamia/ocu005. Epub 2015 Feb 10.

Identifying homelessness using health information exchange data.

Author information

1
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
2
Department of Emergency Medicine, Mount Sinai Beth Israel, New York, NY, 10003, USA.
3
Healthix, Inc., New York, NY, 10013, USA.
4
New York-Presbyterian Hospital, New York, NY, 10032, USA.
5
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA, jason.shapiro@mountsinai.org.

Abstract

BACKGROUND:

Homeless patients experience poor health outcomes and consume a disproportionate amount of health care resources compared with domiciled patients. There is increasing interest in the federal government in providing care coordination for homeless patients, which will require a systematic way of identifying these individuals.

OBJECTIVE:

We analyzed address data from Healthix, a New York City-based health information exchange, to identify patterns that could indicate homelessness.

METHODS:

Patients were categorized as likely to be homeless if they registered with the address of a hospital, homeless shelter, place of worship, or an address containing a keyword synonymous with "homelessness."

RESULTS:

We identified 78,460 out of 7,854,927 Healthix patients (1%) as likely to have been homeless over the study period of September 30, 2008 to July 19, 2013. We found that registration practices for these patients varied widely across sites.

CONCLUSIONS:

The use of health information exchange data enabled us to identify a large number of patients likely to be homeless and to observe the wide variation in registration practices for homeless patients within and across sites. Consideration of these results may suggest a way to improve the quality of record matching for homeless patients. Validation of these results is necessary to confirm the homeless status of identified individuals. Ultimately, creating a standardized and structured field to record a patient's housing status may be a preferable approach.

KEYWORDS:

health care costs; health care reform; health information exchange; homelessness

PMID:
25670759
DOI:
10.1093/jamia/ocu005
[Indexed for MEDLINE]

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