Timeliness of injury care and housing status.

Injury Pub Date : 2025-06-17 DOI:10.1016/j.injury.2025.112531

Hannah Decker, Jennifer Evans, Dave Graham Squire, Sara Colom, Kenneth Perez, Maria Raven, Rebecca Plevin, Hemal K Kanzaria, Anne Stey

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Abstract

Background: Unhoused people have longer hospital lengths of stays than housed. This study examined if unhoused people have less timely injury care than housed.

Methods: We conducted a retrospective cohort study of adult injury encounters from January 2015 - December 2022 at the only level 1 trauma center in an urban county. We merged the trauma registry with a county-wide integrated dataset to reliably identify our primary exposure: housing status in the fiscal year of injury. The primary outcome was time to the operating room in hours. Secondary outcomes were emergency department (ED) length of stay in minutes and additional timeliness measures. Multivariable linear regression models with clustered standard errors estimated the association of housing status with each log-transformed outcome, adjusting for clinical and demographic covariates.

Results: Among 21,264 trauma encounters, 18.8 % (N = 4003) were in unhoused people. Unhoused and housed people had similar adjusted times to operating room (9.2 versus 9.9 h; adjusted geometric mean ratio 1.07 (95 %CI 0.97-1.19; p = 0.19). ED length of stay was 17 % longer for unhoused people compared to housed (381 versus 326 min); adjusted geometric mean ratio 1.17, 95 %CI 1.13-1.21; p < 0.001). There were no clinically significant differences in Emergency Medical Services (EMS) transport time, EMS scene time, time to venous thromboembolism prophylaxis, nor time to angiography by housing status.

Conclusions: Timeliness of injury care is similar between unhoused and housed people.

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受伤护理的及时性和住房状况。

背景：无家可归的人比有住房的人住院时间更长。这项研究调查了无家可归的人是否比有住房的人得到更少的及时伤害护理。方法：我们对2015年1月至2022年12月在某城市县唯一的一级创伤中心发生的成人损伤进行了回顾性队列研究。我们将创伤登记与全国范围内的综合数据集合并，以可靠地确定我们的主要暴露：受伤财政年度的住房状况。主要结果是到达手术室的时间（以小时为单位）。次要结果是急诊科（ED）的住院时间（分钟）和额外的及时性措施。具有聚类标准误差的多变量线性回归模型估计了住房状况与每个对数转换结果的关联，调整了临床和人口统计协变量。结果：在21264例创伤患者中，18.8% （N = 4003）为无家可归者。无住房和有住房的人与手术室的调整时间相似(9.2小时对9.9小时；校正几何平均比1.07 (95% CI 0.97-1.19)；P = 0.19)。无住房者的ED停留时间比有住房者长17%（381分钟对326分钟）；校正几何平均比1.17,95% CI 1.13-1.21；P < 0.001)。急诊医疗服务（EMS）运送时间、EMS现场时间、静脉血栓栓塞预防时间和血管造影时间均无临床显著差异。结论：无住房者和有住房者受伤护理的及时性相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Injury

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