Comparison of clinical characteristics and outcomes between homeless and non-homeless patients admitted to intensive care units: An observational propensity-matched cohort study in Korea

Abstract

PurposeTo compare clinical characteristics and outcomes between critically ill homeless and non-homeless patients admitted to the intensive care unit (ICU) in a Korea. Materials and methodsWe retrospectively analyzed the medical charts of homeless and non-homeless patients admitted to ICU at Seoul Boramae Medical Center between January 2012 and December 2017. Patients were selected using 1: 2 propensity score matching including age, sex, and type of ICU and multivariate analyses were performed to determine risk factors for hospital and ICU mortality. Results56 homeless and 112 non-homeless matched patients were analyzed. The homeless patients were younger, included more men, and exhibited significantly higher readmission and ER admission rates. Although hospital and ICU mortality rates were similar between two groups, the homeless patients were significantly less likely to have family or substitute decision-makers and generally died after cardiopulmonary resuscitation. Adjusted multivariate analysis showed that homelessness was not an independent predictor of ICU or hospital mortality. The length of ICU stay was comparable between groups. ConclusionsIn Korea, ICU-admitted homeless patients are well managed without differences in terms of organ support quality and exhibit the same prognosis as non-homeless patients. However, the quality of end-of-life care for homeless patients remains poor.