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Canada’s homeless stay in hospitals almost twice as long, cost over double

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Compared to Canada’s national average, the country’s homeless population stays in hospitals for almost twice as long and costs the taxpayer more than double, according to data released by the Canadian Institute for Health Information.

At least 25,000 Canadians experience homelessness on a given night, and an average of 235,000 Canadians experience a type of homelessness in a given year.

In 2018, Canadian hospitals became required to document when a patient was homeless. According to the Canadian Institute for Health Information, 29,321 homeless Canadians were hospitalized in 2022-2023.

The top three reasons for hospital stays for homeless Canadians were substance use disorders (18%), schizophrenia and other psychotic disorders (11%), and the skin infection known as cellulitis (7%).

“Most types of mental health and substance use hospitalizations are associated with longer-than-average hospital stays and repeat admissions,” read the study.

Patients in Canadian hospitals experiencing homelessness had an average length of stay of 15.4 days, compared to the national average of eight days. The estimated average cost of homeless Canadians’ stays in the hospital was $16,800, compared to the national average of $7,800.

“In addition to longer lengths of stay, hospitalization for (people experiencing homelessness) were more likely to include alternate level of care days, compared with the Canadian average (11.9% versus 6.2%),” read the study, noting that both percentages excluded Quebec.

Almost all patients experiencing homelessness, 93%, were admitted to the hospital through the emergency department.

“Many (patients experiencing homelessness) face barriers to accessing other types of healthcare services, including primary care. Getting appropriate care in the community may prevent emergency departments visits and hospital stays,” read the study.

The study revealed that homeless Canadians have “complex health needs” and are more likely to rely on hospitals for healthcare because homeless Canadians often struggle with accessing other types of healthcare, such as primary care. 

Non-hospital data sources show that the average age of a Canadian experiencing homelessness is 40.3 years old. However, the average age of a hospitalized homeless Canadian was 44.4 years old in 2022-23. 

While 70.3% of homeless Canadians were male from non-hospital data sources, an almost equal 70.8% of hospitalized homeless Canadians were male in 2022-23. 

The most commonly hospitalized homeless Canadian was aged 25-49 years old, which accounted for 56.4% of hospitalizations, followed by those aged 50-64 years old at 26.1%, 65 years and older at 10.4%, and 0-24 years old at 7.1%.

While nearly 30,000 hospitalizations included hospitals documenting a homeless patient in 2022-23, the study confirmed that this number was likely under-representative of the actual number of patients experiencing homelessness.

Factors that could have influenced under-representation were “Patients not identifying themselves as experiencing homelessness due to a concern about stigma or for other reasons; (and) variation in the processes hospitals use to ensure that healthcare providers ask patients about their housing status,” according to the study.

The data did not include residency status. 

True North previously reported that almost half of the occupants in Ottawa’s homeless shelters are new immigrants and refugee claimants.

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