The Unhoused Burn Population: An Alarming Increase of Leaving Against Medical Advice

• Published in: Journal of burn care & research 2024-07
• Main Authors: Speiser, Noah, Donohue, Sean J, Pickering, Trevor A, Pham, Christopher, Johnson, Maxwell, Gillenwater, T Justin, Yenikomshian, Haig A
• Format: Article
• Language: English
• ISSN: 1559-047X; 1559-0488; 1559-0488
• DOI: 10.1093/jbcr/irae137

Unhoused burn patients (UBP) have historically been more likely to leave against medical advice (AMA) and suffer worse health outcomes than the general population. The coronavirus disease 2019 (COVID-19) pandemic created a major strain on the healthcare system, resulting in worse overall health outcomes for burn patients. We sought to investigate how COVID-19 impacted treatment for UBP, specifically the rate of leaving AMA. We conducted a retrospective chart analysis of patients admitted to a regional burn center between June 2015 and January 2023. March 1, 2020, was used as a cut point to separate the cohorts into patients seen pre-COVID-19 (p-CV) and during COVID-19 (CV). Outcomes included leaving treatment AMA and readmission within 30 days. 385 patients met criteria for being unhoused and were included in our analytic sample, of which 199 were in the p-CV cohort and 186 in the CV cohort. UBP were significantly more likely to leave AMA during CV compared to p-CV (22.6% vs. 7.5%, p