Differences in hospitalizations between the homeless and the general population in Camden, NJ S/A

Background: There are few recent publications describing hospital utilization of homeless people. This study examined differences between hospital admissions of homeless people and admissions of the general population in Camden, NJ. Methods: This cross-sectional study identified 761 homeless and 29,937 general population adult hospitalizations between 1/1/2002 and 6/30/2008 paid for by Medicaid or without insurance reimbursement by examining address data in a citywide Camden hospital database. The frequencies of the most common diagnoses, mean lengths of stay (LOS), and mean charged and paid claims amounts were compared between admissions of homeless people and admissions of the general population. Results: The most common admission diagnoses for homeless people were substance abuse (SA) 38.9%, and severe mental health (SMH) 20.5%, compared to 16.4% and 4.6% respectively for admissions of the general population. In admissions paid by Medicaid, homeless hospitalizations had 18.6% higher mean LOS than the general population, however claims amounts were not significantly different. In hospitalizations without insurance reimbursement, homeless people had 1.8% higher mean LOS, but 15.4% lower mean of charged and 39.0% lower mean of paid claims amounts (p<.001 all comparisons.) For hospitalizations involving SA or SMH, there was no significant difference for admissions of homeless people compared to the general population with respect to LOS or claims. Conclusions: The characteristics of hospitalizations paid by Medicaid or without reimbursement differ between admissions for homeless people and admissions for the general population in Camden, NJ. This difference may be explained by the distribution of types of illnesses for the admission.