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• W3203278096 abstract "<h3>Background</h3> Families represent the fastest growing homeless population in Europe. From 2014–2021, a 165% increase was observed in families accessing emergency homeless accommodation in Ireland, causing a 211% increase in child homelessness. In March 2021, there were 913 homeless families in Ireland, with children (n=2,326) accounting for 28% of homeless people. Over-represented vulnerable groups include Irish Travellers, the Roma, and international protection applicants. Homeless populations are more likely to use emergency departments (EDs) rather than primary care, with higher admission rates and durations. Most literature pertains to lone adult homelessness. <h3>Objectives</h3> To compare emergency presentations between homeless and non-homeless children, to investigate differences in demographics, vaccination, service usage, medical acuity, diagnoses and outcomes. <h3>Methods</h3> We performed a retrospective review of homeless children attending a tertiary paediatric emergency department in Dublin, Ireland, from 01/01/2017 - 31/12/2020. Homelessness was defined as those with addresses of no fixed abode, government homeless accommodation, direct provision, women’s refuges, drug rehabilitation centres, children’s residential homes, and prison. Those who provided residential addresses but were functionally homeless were also included. Comparison was made with non-homeless children attending in 2019. Data was extracted from electronic healthcare records, and analysed using SPSS. Hospital ethical approval was obtained. <h3>Results</h3> From 01/01/2017–31/12/2020, 3,138 homeless children presented, representing 1.6% of total attendances. Compared to non-homeless (n=1,500), homeless children were younger (29 vs 60 months, p<0.001; proportion ≤12 months: 25.7% vs 16.3%, p<0.001). Homeless children were less likely to have Irish ethnicity (37.4% vs 74.6%, p<0.001), or have been born in Ireland (82.3% versus 96.2%, p<0.001). Ethnicity varied between homeless and non-homeless (White Irish: 34.5% vs 73.7%; Irish Traveller: 3% vs 0.8%; Roma: 22.5% vs 2.4%; Black: 21.1% vs 4.2%; Asian: 8.6% vs 8.8%; White European 5.9% vs 9%; p<0.001). Homeless children were more likely to re-present (15.9% vs 10.5%, p<0.001), use ambulances (13.2% vs 6.7%, p<0.001), and have ≥4 ED attendances in 6 months (9.7% versus 5.4%, p<0.001), while being less likely to have registered GPs (89.7% versus 95.8%, p<0.001). Compared to non-homeless, homeless children were over-represented in lower triage categories (4: 48.5% vs 41.5%; 5: 2% vs 0.8%; p<0.001), ED discharges (93.6% vs 91.1%, p=0.002), and leaving prior to assessment (5% vs 3.7%, p=0.046), while having longer admissions (median duration: 3 vs 2 days, p=0.001). Vaccination status varied between homeless and non-homeless children (complete: 73.6% vs 81.9%; incomplete 18.5% vs 13.7%; unvaccinated: 3% vs 0.9%, p<0.001). There were no differences in gender or past medical history. <h3>Conclusions</h3> Although homeless children were less likely to have Irish ethnicity, 82.3% had been born in Ireland, with over-representation of Irish Traveller, Roma and black ethnicities, which compares with national data. Homeless children were less likely to have GPs, and be fully vaccinated. They had increased use of emergency services despite having lower triage categories, higher discharge rates, and no differences in past medical history. Vulnerable groups remain over-represented in the Irish paediatric homeless population. As with adults, paediatric homeless populations rely heavily on emergency services, being less likely to engage with primary healthcare." @default.
• W3203278096 created "2021-10-11" @default.
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• W3203278096 date "2021-09-30" @default.
• W3203278096 modified "2023-10-14" @default.
• W3203278096 title "1146 Emergency department utilisation by homeless children in Dublin, Ireland" @default.
• W3203278096 doi "https://doi.org/10.1136/archdischild-2021-rcpch.428" @default.
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