{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:20:41Z","timestamp":1784784041219,"version":"3.55.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T00:00:00Z","timestamp":1554163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Burn injuries are common in the homeless population. Little is known regarding whether homeless patients experience different outcomes when admitted for burns. We aim to 1) characterize the admitted homeless burn population, and 2) investigate differences in inpatient outcomes between the homeless and non-homeless populations. A retrospective cohort study was performed utilizing the Nationwide Inpatient Sample. Adult patients with complete data for burn characteristics were extracted. Variables included demographic, burn, and facility characteristics. Homelessness was identified with International Classification of Disease 9th edition codes. Outcomes were modeled with regression analysis and included length of stay, total operations, charges, disposition, and Patient Safety Indicators (PSIs). 43,872 encounters were included of which 0.76% were homeless. Homeless encounters were more likely to be male (P &lt; .001) and Medicaid-insured (P &lt; .001). Flame and frostbite injuries were more likely (P &lt; .001), and the mean %TBSA was smaller (15.0 vs 16.8, P &lt; .001). After adjustment, homeless patients had greater lengths of stay (11.5 vs 9.6, P = .046), greater charges ($73,597 vs $66,909, P = .030), fewer operations (P = .016), and three times higher likelihood leaving against medical advice (P = .002). There was no difference in PSIs or mortality. Homeless burn admissions represent a unique cohort that carries a higher comorbidity burden and experiences longer lengths of stay with greater difficulty in disposition. Ironically, these patients accumulate more charges with limited means to pay. Even though no differences were observed in PSIs or mortality, further research is needed to understand how the challenges within this population affect their recovery.<\/jats:p>","DOI":"10.1093\/jbcr\/irz045","type":"journal-article","created":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T05:41:01Z","timestamp":1554183661000},"page":"633-638","source":"Crossref","is-referenced-by-count":29,"title":["Homelessness and Inpatient Burn Outcomes in the United States"],"prefix":"10.1093","volume":"40","author":[{"given":"Harriet","family":"Kiwanuka","sequence":"first","affiliation":[{"name":"Division of Plastic & Reconstructive Surgery, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeshaan N","family":"Maan","sequence":"additional","affiliation":[{"name":"Division of Plastic & Reconstructive Surgery, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Rochlin","sequence":"additional","affiliation":[{"name":"Division of Plastic & Reconstructive Surgery, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Curtin","sequence":"additional","affiliation":[{"name":"Division of Plastic & Reconstructive Surgery, Stanford University, Stanford, California"},{"name":"Division of Plastic Surgery, Veterans Affairs Palo Alto, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Karanas","sequence":"additional","affiliation":[{"name":"Division of Plastic & Reconstructive Surgery, Stanford University, Stanford, California"},{"name":"Regional Burn Center, Santa Clara Valley Medical Center, San Jose, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford C","family":"Sheckter","sequence":"additional","affiliation":[{"name":"Division of Plastic & Reconstructive Surgery, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,4,2]]},"reference":[{"key":"2019081416345955000_CIT0001"},{"key":"2019081416345955000_CIT0002","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1001\/jama.285.2.200","article-title":"Factors associated with the health care utilization of homeless persons","volume":"285","author":"Kushel","year":"2001","journal-title":"JAMA"},{"key":"2019081416345955000_CIT0003","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1080\/17457300.2013.825631","article-title":"Homeless in America: injuries treated in US emergency departments, 2007\u20132011","volume":"21","author":"Mackelprang","year":"2014","journal-title":"Int J Inj Contr Saf 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Manage"},{"key":"2019081416345955000_CIT0012","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1001\/jama.2009.1548","article-title":"Geographic access to burn center hospitals","volume":"302","author":"Klein","year":"2009","journal-title":"JAMA"},{"key":"2019081416345955000_CIT0013","author":"Housing the Homeless"},{"key":"2019081416345955000_CIT0014","article-title":"Increasing ambulatory treatment of pediatric minor burns\u2014the emerging paradigm for burn care in children","author":"Sheckter","journal-title":"Burns"},{"key":"2019081416345955000_CIT0015","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/j.burns.2017.01.022","article-title":"Pre-existing psychiatric disorder in the burn patient is associated with worse outcomes","volume":"43","author":"Hudson","year":"2017","journal-title":"Burns"},{"key":"2019081416345955000_CIT0016","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/MOP.0b013e3283504fbf","article-title":"Psychiatric disease and 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