COORDINATE Home
Maria Raven, MD, and Hemal Kanzaria, MD, lead BHHI’s research group COORDINATE Home (CrOss-sectOR Data INtegrAtion To End HOMElessness.)
The team analyzes San Francisco’s Coordinated Case Management System (CCMS) to evaluate policy-relevant questions. CCMS links data on the use of the homeless, public health, substance use and mental health systems, jail, and ambulances.
Background
Collaborating with the San Francisco Departments of Public Health and Homelessness and Supportive Housing, Drs. Raven and Kanzaria work closely with the BHHI data science and statistics team, project managers, a group of postdoctoral scholars, and other trainees to answer key policy questions.
Their publications continue to generate considerable media attention and policy interest. They are now collaborating with UC Berkeley’s California Policy Lab on additional analyses.
Our Research
Our Research
Access, Outcomes, and Costs Associated with Surgery for Malignancy Among People Experiencing Homelessness
December 10, 2023
Our Research
Access, Outcomes, and Costs Associated with Surgery for Malignancy Among People Experiencing Homelessness
December 10, 2023
Cancer is the leading cause of mortality for people experiencing homelessness (PEH). However, not much is known about cancer-related surgical outcomes among PEH. This retrospective cohort study aimed to characterize access to care among PEH, evaluate postoperative outcomes, and assess costs associated with surgery for malignancy among PEH. Researchers found that PEH were less likely to undergo surgery for malignancy at cancer centers than hose who are housed. People experiencing homelessness also had a higher risk of requiring unplanned surgery.
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Our Research
Association of Housing Status With Types of Operations and Postoperative Health Care Utilization
December 1, 2023
Our Research
Association of Housing Status With Types of Operations and Postoperative Health Care Utilization
December 1, 2023
Unhoused patients have worse outcomes and higher health care utilization compared to their housed counterparts. Previous research has primarily focused on physical and behavioral health. This retrospective cohort study investigated the association between housing status and the nature of surgical care provided, health care utilization, and operational outcomes. Researchers found that unhoused patients commonly underwent emergent operations and had more complex hospitalizations.
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Our Research
Injury Patterns and Hospital Admission After Trauma Among People Experiencing Homelessness
June 23, 2023
Our Research
Injury Patterns and Hospital Admission After Trauma Among People Experiencing Homelessness
June 23, 2023
Traumatic injury is a major cause of morbidity for people experiencing homelessness (PEH), however, injury patterns and subsequent hospitalization among PEH have not been studied on a national scale. In this national retrospective observational cohort study, researchers evaluated whether differences in mechanisms of injury exist between PEH and housed trauma patients in North America and whether the lack of housing is associated with increased adjusted odds of hospital admission. Researchers found that injured PEH had a significantly adjusted greater odds of hospital admissions.
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Our Research
Hospital Variability in Adoption of Alcohol and Drug Screening in Adult Trauma Patients
May 1, 2023
Our Research
Hospital Variability in Adoption of Alcohol and Drug Screening in Adult Trauma Patients
May 1, 2023
In this retrospective observational cross-sectional study of patients in the Trauma Quality Improvement Program (TQIP), researchers looked to determine if there was significant practice variability in adoption of alcohol and drug screening of injured patients among hospitals participating in TQIP. Researchers found that overall rates of recommended alcohol and drug screening of injured patients were low and varied significantly between hospitals.
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Related Content
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News
Homelessness Tied to Worse Cancer Outcomes Among Veterans
December 21, 2023
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In a cohort of over 100,000 patients who received care from the Department of Veterans Affairs (VA) health system, those experiencing homelessness were more likely to be diagnosed with stage IV colorectal cancer compared with those who had housing. The patients who experienced homelessness also had longer hospital stays for all the cancer types studied. However, the findings differed across healthcare settings. In a commentary accompanying the study, Maria C. Raven, MD, MPH, associate Professor and Chief of Emergency Medicine at UCSF, said "Reducing healthcare disparities for people experiencing homelessness is essential, and the [VA] can serve as an example of what it takes to do so."
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Policy Brief
766 San Francisco Residents May Be Eligible for Referral to CARE Court
February 27, 2023
Policy Brief
766 San Francisco Residents May Be Eligible for Referral to CARE Court
February 27, 2023
California passed the Community Assistance, Recovery, and Empowerment (CARE) Act in 2022 to provide behavioral health and housing services to individuals with psychotic spectrum and schizophrenia disorders who are deemed unable to care for themselves. This policy brief from the Benioff Homelessness and Housing Initiative at UCSF and the California Policy Lab uses anonymized data to estimate how many San Franciscans in a database of individuals who have contact with the urgent and emergent care system may be eligible for referral to CARE Court and describe their service needs.
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News
Video: How Hospital Discharge Data Can Inform State Homelessness Policy
October 7, 2022
California’s homeless population has increased in recent years, and so has public investment in addressing homelessness, making understanding the size and needs of the state’s homeless population more important than ever. Discharge data from emergency departments (EDs) can help. PPIC researcher Shannon McConville and UCSF professor Hemal Kanzaria, MD outlined key findings from a new report and discussed the implications for policymakers.
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Reports
Signals of Distress: High Utilization of Criminal Legal and Urgent and Emergent Health Services in San Francisco
September 27, 2022
People with multiple, complex health and housing needs frequently receive fragmented care because the providing systems operate independently. The California Policy Lab at UC Berkeley and the UCSF Benioff Homelessness and Housing Initiative worked with partners in San Francisco’s public health and criminal legal systems to link together ten years of data from the physical health, behavioral health, housing, and criminal legal sectors.
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