Department of Policy Analysis and Management, Cornell University, Ithaca, NY, USA, and the Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Michael G. DeGroote School of Medicine, McMaster University, St. Catharines, Ontario.
Health Rep. 2021 Jan 20;32(1):13-23. doi: 10.25318/82-003-x202100100002-eng.
Data on people experiencing homelessness often come from time- and labour-intensive cross-sectional counts and surveys from selected samples. This study uses comprehensive administrative health data from emergency department (ED) visits to enumerate people experiencing homelessness and characterize demographic and geographic trends in the province of Ontario, Canada, from 2010 to 2017.
People experiencing homelessness were identified by their postal code, designated as "XX." Outcomes included the number of people experiencing homelessness stratified by year and week, gender and age plotted annually, the location of each ED visit, and composition changes in demographics and geographic distribution.
Over seven years, 39,408 individuals were identified as experiencing homelessness. The number of ED visits increased over the study period in all of Ontario. The average peak in the number of visits occurred annually in September, with the fewest visits in January. Rises in overall homelessness were secondary to increases in working-age homelessness. ED presentations were concentrated in urban centres. The total proportion of patients experiencing homelessness became less concentrated in Toronto, decreasing from 60% to 40% over the study period, with a shift toward EDs outside the city.
This study shows that administrative health data can provide comprehensive information on demographics and other characteristics analyzed over time. Surveillance can be conducted cost-effectively, and changes can be tracked in real time to allow for services to be coordinated and implemented in a time-sensitive manner.
无家可归者的数据通常来自于对选定样本进行的耗时且费力的横断面计数和调查。本研究利用来自加拿大安大略省急诊部（ED）就诊的综合行政健康数据，对 2010 年至 2017 年期间无家可归者进行计数，并描述该省的人口统计学和地理趋势。
通过邮政编码（指定为“XX”）来识别无家可归者。结果包括按年份和周划分的无家可归者人数、每年绘制的性别和年龄分布、每次 ED 就诊的地点以及人口统计学和地理分布的构成变化。
在七年期间，有 39408 人被确定为无家可归者。在整个安大略省，ED 就诊人数在研究期间呈上升趋势。每年访问量的平均峰值出现在 9 月，1 月最少。整体无家可归人数的增加主要是由于工作年龄无家可归人数的增加。ED 就诊主要集中在城市中心。无家可归者患者的总比例在多伦多的集中度降低，从研究期间的 60%降至 40%，而城市外的 ED 就诊比例有所上升。
本研究表明，行政健康数据可以提供随时间分析的人口统计学和其他特征的综合信息。监测可以具有成本效益，并且可以实时跟踪变化，以便协调和及时实施服务。
