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Representation of persons experiencing homelessness and coding of homelessness in general practices descriptive evaluation using healthcare utilisation data
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Kaushal, Rishika, Jagpal, Parbir, Khanal, Saval, Vohra, Neha, Lowrie, Richard, Johal, Jaspal, Jenkins, Duncan, Saunders, Karen and Paudyal, Vibhu (2021) Representation of persons experiencing homelessness and coding of homelessness in general practices descriptive evaluation using healthcare utilisation data. BJGP Open, 5 (4). BJGPO.2021.0050. doi:10.3399/BJGPO.2021.0050 ISSN 2398-3795.
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Official URL: http://dx.doi.org/10.3399/BJGPO.2021.0050
Abstract
Background Epidemiological studies focused on primary healthcare needs of persons experiencing homelessness (PEH) are often based on data from specialist homeless healthcare services.
Aim To explore the presentation of PEH, coding of homelessness, and associated health conditions in mainstream primary care general practices in England.
Design & setting EMIS electronic database search of medical records was conducted across 48 general practices in a clinical commissioning group (CCG), representing one of the most socioeconomically deprived regions in England, which also lacks a specialist primary healthcare service for PEH.
Method Key terms and codes were used to identify PEH, their respective diagnoses across 22 health conditions, and prescribed medications over the past 4 years.
Results From a population of approximately 321 000, 43 (0.013%) people were coded as PEH, compared with a homelessness prevalence of 0.5% in the English general population. Mental health conditions were the most prevalent diagnoses among the PEH registrants (56.6%); the recorded prevalence of other common long-term conditions in PEH was lower than the levels observed in PEH registered with specialist homelessness health services.
Conclusion In a population with approximately four times higher rate of statutory homelessness, PEH representation in mainstream general practices was under-represented by several folds. As homelessness overlaps with mental health, substance misuse, and long-term health conditions, consistent coding of homelessness in medical records is imperative in order to offer tailored support and prevention actions when patients present for services.
Item Type: | Journal Article | ||||||
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Subjects: | H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RA Public aspects of medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
Library of Congress Subject Headings (LCSH): | Homeless persons -- Medical care -- Great Britain, Homelessness -- Great Britain, Homeless persons -- Services for -- Great Britain, Primary health care -- Great Britain, Homelessness -- Health aspects -- Great Britain | ||||||
Journal or Publication Title: | BJGP Open | ||||||
Publisher: | Royal College of General Practitioners | ||||||
ISSN: | 2398-3795 | ||||||
Official Date: | August 2021 | ||||||
Dates: |
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Volume: | 5 | ||||||
Number: | 4 | ||||||
Article Number: | BJGPO.2021.0050 | ||||||
DOI: | 10.3399/BJGPO.2021.0050 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 2 November 2021 | ||||||
Date of first compliant Open Access: | 2 November 2021 | ||||||
RIOXX Funder/Project Grant: |
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