TY - JOUR T1 - Hospital readmission among people experiencing homelessness in England: a cohort study of 2772 matched homeless and housed inpatients JF - Journal of Epidemiology and Community Health JO - J Epidemiol Community Health SP - 681 LP - 688 DO - 10.1136/jech-2020-215204 VL - 75 IS - 7 AU - Dan Lewer AU - Dee Menezes AU - Michelle Cornes AU - Ruth M Blackburn AU - Richard Byng AU - Michael Clark AU - Spiros Denaxas AU - Hannah Evans AU - James Fuller AU - Nigel Hewett AU - Alan Kilmister AU - Serena April Luchenski AU - Jill Manthorpe AU - Martin McKee AU - Joanne Neale AU - Alistair Story AU - Michela Tinelli AU - Martin Whiteford AU - Fatima Wurie AU - Alexei Yavlinsky AU - Andrew Hayward AU - Robert Aldridge Y1 - 2021/07/01 UR - http://jech.bmj.com/content/75/7/681.abstract N2 - Background Inpatients experiencing homelessness are often discharged to unstable accommodation or the street, which may increase the risk of readmission.Methods We conducted a cohort study of 2772 homeless patients discharged after an emergency admission at 78 hospitals across England between November 2013 and November 2016. For each individual, we selected a housed patient who lived in a socioeconomically deprived area, matched on age, sex, hospital, and year of discharge. Counts of emergency readmissions, planned readmissions, and Accident and Emergency (A&E) visits post-discharge were derived from national hospital databases, with a median of 2.8 years of follow-up. We estimated the cumulative incidence of readmission over 12 months, and used negative binomial regression to estimate rate ratios.Results After adjusting for health measured at the index admission, homeless patients had 2.49 (95% CI 2.29 to 2.70) times the rate of emergency readmission, 0.60 (95% CI 0.53 to 0.68) times the rate of planned readmission and 2.57 (95% CI 2.41 to 2.73) times the rate of A&E visits compared with housed patients. The 12-month risk of emergency readmission was higher for homeless patients (61%, 95% CI 59% to 64%) than housed patients (33%, 95% CI 30% to 36%); and the risk of planned readmission was lower for homeless patients (17%, 95% CI 14% to 19%) than for housed patients (30%, 95% CI 28% to 32%). While the risk of emergency readmission varied with the reason for admission for housed patients, for example being higher for admissions due to cancers than for those due to accidents, the risk was high across all causes for homeless patients.Conclusions Hospital patients experiencing homelessness have high rates of emergency readmission that are not explained by health. This highlights the need for discharge arrangements that address their health, housing and social care needs.Data may be obtained from a third party and are not publicly available. As part of the approvals and information governance frameworks, we are unable to share the underlying data for this research study. Our approval only allowed researchers involved in this specific project to access data for the prespecified and approved analyses. Therefore, data collection and linkage would have to be repeated with new approvals sought by anyone wanting access to the underlying data used in this analysis. Application for access should be directed to the CAG of the Health Research Authority. Information regarding the application process and relevant links for applications are available from the CAG website. ER -