Use of Hotels as a Disposition Alternative to Hospital Admission for Undomiciled Patients Undergoing SARS-CoV-2 Testing

Introduction: The coronavirus 2019 (COVID-19) pandemic has presented various unprecedented challenges to healthcare systems globally, prompting society to adopt new preventative strategies to curb spread of the disease. Those experiencing homelessness have been particularly impacted because of barri...

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Main Authors: Lucia C. Lin, Brendan B. McIntyre, Kaitlin McIntyre, Edward Castillo, Rachna Subramony, Allyson Kreshak
Format: Article
Language:English
Published: eScholarship Publishing, University of California 2023-05-01
Series:Western Journal of Emergency Medicine
Online Access:https://escholarship.org/uc/item/8wr6g674
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author Lucia C. Lin
Brendan B. McIntyre
Kaitlin McIntyre
Edward Castillo
Rachna Subramony
Allyson Kreshak
author_facet Lucia C. Lin
Brendan B. McIntyre
Kaitlin McIntyre
Edward Castillo
Rachna Subramony
Allyson Kreshak
author_sort Lucia C. Lin
collection DOAJ
description Introduction: The coronavirus 2019 (COVID-19) pandemic has presented various unprecedented challenges to healthcare systems globally, prompting society to adopt new preventative strategies to curb spread of the disease. Those experiencing homelessness have been particularly impacted because of barriers to practicing social distancing, inability to isolate, and poor access to care. Project Roomkey was established in California as a statewide measure to provide non-congregate shelter options for individuals experiencing homelessness to properly quarantine. On goal in this study was to analyze the effectiveness of hotel rooms as a safe disposition alternative to hospital admission for patients experiencing homelessness and who were also positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: This was a retrospective, observational study that included chart review of patients who were discharged to the hotel from March 2020–December 2021. We recorded demographic information, index visit details, number of emergency department (ED) visits both a month prior to and following the index visit, admission rates, and number of deaths. Results: During this 21-month study period, a total of 2,015 patients who identified as undomiciled were tested for SARS-COV-2 in the ED for various reasons. Of those patients, 83 were discharged from the ED to the hotel. Of the 83 patients, 40 (48.2%) ultimately tested positive for SARS-CoV-2 during their index visit. Two patients returned to the ED within seven days with COVID-19-related symptoms, and 10 patients within 30 days. Two patients required subsequent admission with COVID-19 pneumonia. No deaths were recorded within the 30-day follow-up period. Conclusion: The availability of a hotel served as a safe alternative to hospital admission for patients experiencing homelessness and who were either suspected or confirmed to have COVID-19. It is reasonable to consider similar measures in the management of other transmissible diseases for patients experiencing homelessness who require isolation.
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spelling doaj.art-83f17086f19a47248b6facec8166e3822023-06-21T18:00:40ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182023-05-0124310.5811/westjem.57639wjem-24-431Use of Hotels as a Disposition Alternative to Hospital Admission for Undomiciled Patients Undergoing SARS-CoV-2 TestingLucia C. Lin0Brendan B. McIntyre1Kaitlin McIntyre2Edward Castillo3Rachna Subramony4Allyson Kreshak5University of California San Diego School of Medicine, San Diego, CaliforniaUniversity of California San Diego School of Medicine, San Diego, CaliforniaUniversity of San Diego, Department of Emergency Medicine, San Diego, CaliforniaUniversity of San Diego, Department of Emergency Medicine, San Diego, CaliforniaUniversity of San Diego, Department of Emergency Medicine, San Diego, CaliforniaUniversity of San Diego, Department of Emergency Medicine, San Diego, CaliforniaIntroduction: The coronavirus 2019 (COVID-19) pandemic has presented various unprecedented challenges to healthcare systems globally, prompting society to adopt new preventative strategies to curb spread of the disease. Those experiencing homelessness have been particularly impacted because of barriers to practicing social distancing, inability to isolate, and poor access to care. Project Roomkey was established in California as a statewide measure to provide non-congregate shelter options for individuals experiencing homelessness to properly quarantine. On goal in this study was to analyze the effectiveness of hotel rooms as a safe disposition alternative to hospital admission for patients experiencing homelessness and who were also positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: This was a retrospective, observational study that included chart review of patients who were discharged to the hotel from March 2020–December 2021. We recorded demographic information, index visit details, number of emergency department (ED) visits both a month prior to and following the index visit, admission rates, and number of deaths. Results: During this 21-month study period, a total of 2,015 patients who identified as undomiciled were tested for SARS-COV-2 in the ED for various reasons. Of those patients, 83 were discharged from the ED to the hotel. Of the 83 patients, 40 (48.2%) ultimately tested positive for SARS-CoV-2 during their index visit. Two patients returned to the ED within seven days with COVID-19-related symptoms, and 10 patients within 30 days. Two patients required subsequent admission with COVID-19 pneumonia. No deaths were recorded within the 30-day follow-up period. Conclusion: The availability of a hotel served as a safe alternative to hospital admission for patients experiencing homelessness and who were either suspected or confirmed to have COVID-19. It is reasonable to consider similar measures in the management of other transmissible diseases for patients experiencing homelessness who require isolation.https://escholarship.org/uc/item/8wr6g674
spellingShingle Lucia C. Lin
Brendan B. McIntyre
Kaitlin McIntyre
Edward Castillo
Rachna Subramony
Allyson Kreshak
Use of Hotels as a Disposition Alternative to Hospital Admission for Undomiciled Patients Undergoing SARS-CoV-2 Testing
Western Journal of Emergency Medicine
title Use of Hotels as a Disposition Alternative to Hospital Admission for Undomiciled Patients Undergoing SARS-CoV-2 Testing
title_full Use of Hotels as a Disposition Alternative to Hospital Admission for Undomiciled Patients Undergoing SARS-CoV-2 Testing
title_fullStr Use of Hotels as a Disposition Alternative to Hospital Admission for Undomiciled Patients Undergoing SARS-CoV-2 Testing
title_full_unstemmed Use of Hotels as a Disposition Alternative to Hospital Admission for Undomiciled Patients Undergoing SARS-CoV-2 Testing
title_short Use of Hotels as a Disposition Alternative to Hospital Admission for Undomiciled Patients Undergoing SARS-CoV-2 Testing
title_sort use of hotels as a disposition alternative to hospital admission for undomiciled patients undergoing sars cov 2 testing
url https://escholarship.org/uc/item/8wr6g674
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