Emergency Department Utilization, Costs and Effects of the Homeless in Hawai’i

Abstract

The homeless situation is a great concern for many here in Hawaii. Between 2012 and 2013, Hawaii had the 2nd highest homeless person per capita ratio, surpassed only by the District of Columbia (National Alliance to End Homelessness 2014). The purpose of this research is to find an estimate of the financial impact that the cost of homeless healthcare is having on hospitals, physicians and tax payers and increase what is known about the homeless in Hawai`i. My data will come from the HMIS homeless database and the MEPS medical database. My research will be done in four parts. The first will be to rebuild the fragmented homeless dataset. The second is to organize my homeless sample and the MEPS data into bins. The third is to create tables and other figures based upon that data. The fourth is to analyze my tables, other figures and dataset. The fifth is to use computational methods to derive the needed estimates. The findings of this paper were that the homeless go to the emergency department much more than those in the general population. The homeless have a much lower insurance coverage rate than that of the general population. The mean and median total unpaid estimate for the homeless population who received emergency and outreach services is $28,127,689.59 and $15,788,303.30. Having uninsured homeless individuals obtain Medicaid, does not immediately increase payment amounts to emergency physicians.