Recent estimates suggest 60,000 or Los Angeles’s 4 million residents are homeless, including a large concentration in the downtown area, where the local fire department (the sole EMS provider) regularly makes 20 runs per day in response to calls from this area. For a 12-month (January-December 2018) retrospective study, investigators assess electronic health records—in which housing status is a mandatory field for reports completed by out-of-hospital responders on scene for all incidents—for 911-EMS incidents attended by the Los Angeles Fire Department. Among incidents recorded during the study period, 10.2% were for homeless individuals, 31.4% in the downtown area were for homeless patients, and 13.3% of calls resulting in treatment and transport were for homeless individuals, despite the homeless population making up just 0.8% of the city’s residents during the study period. That translates to 1,135 911-EMC calls per 1,000 people without housing versus 81 per 1,000 for people with housing and 909 hospital transports per 1,000 people without housing versus 48 per 1,000 for those with housing. The session moderator noted that the situation is not unique to Los Angeles, with the presenting study author stating “The emergency departments [ED] are becoming overcrowded and overwhelmed, so if we can do things to divert certain populations away from the ED resources… do these people really need ED care or do they need something else?”
