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    Development of a Homelessness Risk Screening Tool for Emergency Department Patients

    Health Services Research

    Year: 2021

    Objective: To develop a screening tool to identify emergency department (ED) patients at risk of entering a homeless shelter, which could inform targeting of interventions to prevent future homelessness episodes.
    Data sources: Linked data from (1) ED patient baseline questionnaires and (2) citywide administrative homeless shelter database.
    Study design: Stakeholder-informed predictive modeling utilizing ED patient questionnaires linked with prospective shelter administrative data. The outcome was shelter entry documented in administrative data within 6 months following the baseline ED visit. Exposures were responses to questions on homelessness risk factors from baseline questionnaires.
    Data collection/extraction methods: Research assistants completed questionnaires with randomly sampled ED patients who were medically stable, not in police/prison custody, and spoke English or Spanish. Questionnaires were linked to administrative data using deterministic and probabilistic matching.
    Principal findings: Of 1993 ED patients who were not homeless at baseline, 5.6% entered a shelter in the next 6 months. A screening tool consisting of two measures of past shelter use and one of past criminal justice involvement had 83.0% sensitivity and 20.4% positive predictive value for future shelter entry.
    Conclusions: Our study demonstrates the potential of using cross-sector data to improve hospital initiatives to address patients’ social needs.

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