Student researches homeless patients’ ED visits and admissions

SUNY Upstate College of Medicine

Master of Public Health student Lauren Wetterhahn will speak at Upstate's College of Medicine Commencement.

As a student in our Master of Public Health program, Upstate’s Lauren Wetterhahn became interested in the inequitable allocation of health care resources — in particular as they apply to a specific population.

“Homeless patients are repeat users of the health care system, but with bad outcomes,” she said.

For the capstone project required for her MPH degree, Lauren tackled a “huge, huge data set” of statewide Emergency Department visits and hospital admissions to zero in on visits by the homeless population in Syracuse.

She worked with a de-identified list of 760 patients classified as homeless, and compared them to a random sample of non-homeless patients.

In Lauren’s study, which covered 2006 to 2011, patients classified as homeless tended to present for mental health issues and conditions related to drug and alcohol use. The homeless patients were less likely to be discharged from the Emergency Department the same day they arrived, and if they were admitted their hospital stays were often longer than those of patients who were not homeless.

Those lengthy stays are especially costly for hospitals, Lauren said, because of lump-sum government health insurance payments that don’t increase for longer stays.

Lauren said she was concerned by the reliability of the data she looked at because of significant fluctuations in the number of homeless patients seen year to year in her six-year study.

Lauren recommends a greater consistency in how hospitals “code” or categorize patients who are homeless or “unstably housed.”  She also would like to see Syracuse adopt more “Housing First” approaches to its homeless population, and a system of transitional placements for homeless patients after they are discharged from the hospital.

On Sunday, Lauren will speak at Upstate’s College of Medicine Commencement, representing the CNYMPH Class of 2014.

On Monday, she’ll report to work at her current position of research assistant in Upstate’s Center for Bioethics and Humanities, where she’s also editorial assistant for the Healing Muse literary and visual arts journal.

Lauren grew up in northern New York, where her father, Upstate alumnus Joseph Wetterhahn, MD, is a primary care physician.

She earned a bachelor’s degree in biology from Cornell University and worked for a year in biotechnology research before coming to Upstate for her MPH degree.

 

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