Housing Instability Associated with Longer Hospital Stays, Higher Costs

By Jonathan Springston, Editor, Relias Media

Patients struggling with housing instability were hospitalized for mental, behavioral, and neurodevelopmental disorders, which led to longer stays and billions in extra costs, according to a study from the University of Michigan (UM).

Researchers from the UM Institute for Healthcare Policy and Innovation examined information collected in the National Inpatient Sample between January 2017 and December 2019. Among more than 87 million hospitalizations, staff coded housing instability for about 945,000.

Investigators reported the most common reason for hospitalization among these patients was mental, behavioral, and neurodevelopmental disorders, followed by injury and circulatory system diseases. This led to longer stays for patients and higher costs for administrators.

“Findings suggest that efforts to improve housing instability, mental and behavioral health, and inpatient hospital utilization across multiple sectors may find areas for synergistic collaboration,” the authors offered.

Digging deeper revealed another problem. Researchers noted hospital staff actually inputted a housing instability code for only 1% of the national sample. Almost all of that 1% were classified as experiencing homelessness, even though there are many nuanced ICD Z codes regarding housing.

“Because of the lack of use of Z codes, our findings are likely the tip of the iceberg,” said study author Kimberly Rollings, PhD. “If we want to improve care for these individuals, and make the best use of hospital beds, healthcare professionals and their institutions need to do more to improve screening for this important social driver.”

For more on this and related subjects, be sure to read the latest issues of ED Management and Hospital Case Management.