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Inpatient Hospitalizations and Emergency Department Visits for Persons Experiencing Homelessness in California: Patient Demographics By Facility

From 2019-2020, persons experiencing homelessness (PEH) accounted for 3.0 percent of hospital encounters in California hospitals.

The visualizations show the percent of encounters (IP hospitalizations or ED visits) for “Homeless” patients and the percent of encounters for “Non-Homeless” patients, which enables the user to identify disparities between the two groups. The statewide percentages are provided in the hover over function (Tool Tip) for each of the bar charts to compare custom selections to the related statewide percentages.

From 2019-2020, there were 896,185 encounters for persons experiencing homelessness: 237,541 inpatient (IP) hospitalizations and 658,644 emergency department (ED) visits. For Non-Homeless patients, there were 29,246,708 encounters: 7,034,191 IP hospitalizations and 22,212,517 ED visits. 

Age Group

The visualization below displays four age groups for patient encounters. Within each age group, the percent of encounters for both “Homeless” patients and “Non-Homeless” patients is displayed.

  • For both encounter settings combined, the “19 to 39” combined with the “40 to 59” age group account for 81.2 percent of encounters for PEH versus 52.7 percent for Non-Homeless patients.
  • For Non-Homeless IP hospitalizations, the “60+” age group (41.2 percent) is the highest; however, for Non-Homeless ED visits, the “19 to 39” age group (32.5 percent) is greatest and the “60+” group ranks third at 22.6 percent.

Note: Unknown age is not included

Race/Ethnicity

  • In both encounter settings, Black PEH (22.3 percent) is over double the amount of Non-Homeless (9.9 percent) and American Indian/Alaska Native PEH (0.6 percent) is considerably higher than Non-Homeless (0.4 percent).
  • In both encounter settings, Hispanic PEH (23.2 percent) is considerably lower than Non-Homeless (39.6 percent) and Asian/Pacific Islander PEH (1.9 percent) is less than a third the amount of Non-Homeless (7.2 percent).

Note: Other Race/Ethnicity includes Multi-Racial, Other, Unknown, Invalid, and Missing

Sex

  • Regardless of setting, males comprise over 70 percent of encounters for PEH, whereas only about 45 percent for the Non-Homeless encounters.

Note: Unknown sex is not included

Expected Payer

  • Medi-Cal is the expected payer for most IP hospitalizations for PEH (64.3 percent), whereas Medicare (35.0 percent), Medi-Cal (30.1 percent), and Private Coverage (29.4 percent) are all highly represented in Non-Homeless IP hospitalizations.

Note: Other Payer includes Workers’ Compensation, Other Government, Title V, Disability, VA Plan, Other Payer, Invalid, and Missing

View Underlying Data

How HCAI created this product

• “Homeless” encounters are identified by an ICD-10-CM diagnosis code of “Z59.0” (homelessness) in any diagnosis position and/or Patient ZIP Code of “ZZZZZ” (homeless).
• County is based on the location of the treating hospital.

Additional Information

Topic: Healthcare Utilization
Source: Healthcare Utilization – Patient-Level Administrative Data
Citation: HCAI – Patient Discharge Data; Emergency Department Data – Hospital Encounters for Homeless Patients, 2019-2020
Temporal Coverage: 2019-2020
Spatial/Geographic Coverage: Statewide, County
Frequency: Annual