Characteristics of Hospitalizations of Homwless Persons in Seville, Spain

Background: It is well known from studies in different countries that homeless persons have a higher morbidity and mortality. This fact has not been sufficiently investigated in Spain from the perspective of hospital care. The aim was to determine the characteristics of hospital admissions of homeless persons in Seville. Methods: Observational study of 103,802 hospital admissions of 71,756 patients admitted in the Hospitals "Virgen del Rocio" and "Virgen Macarena" (Seville), in 2013 and 2014. Bivariate analysis were performed using chi(2) and t-Student tests and multivariate analysis using binomial logistic regression model. Results: 0.16% (n = 163) of admissions were homeless persons and 99.84% (n = 103,639) were not. The mean age at admission in homeless patients was 48 years and 76.5% of them were men. Hospital deaths of homeless patients occurred being 23 years younger (p = 0.009). 92% of hospital admissions came from emergency departments (p<0.001) and 10.0% of their discharges were against medical advice (p<0.001). The average length of stay was 4.8 days longer in homeless persons (p = 0.001) and the most frequent diagnoses on admission were mental (27.0%), infectious (19.6%) and respiratory diseases (18.4%). Mental disorders were present on 83.7% of homeless patients as secondary diagnose and 77.6% referred drugs consumption. Conclusions: Hospital admissions characteristics of homeless persons were particularly different. Homeless patients were hospitalized and died at a younger age than non-homeless patients. The morbidity and mortality of homeless persons reflect their vulnerable health condition.