Mobile point-of-care testing to improve access to care for people experiencing homelessness and diabetes in Los Angeles.
5 affiliations
- 1David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
- 2Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
- 3Homeless Healthcare Collaborative, UCLA Health, Los Angeles, CA, United States.
- 4Department of Emergency Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, United States.
- 5Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
Abstract
Objectives
To evaluate the utilization and results of point-of-care (POC) testing performed by the UCLA Health Homeless Healthcare Collaborative (HHC) to identify diagnostic patterns in patients experiencing homelessness (PEH) and specifically those with diabetes to inform future care models.Methods
A retrospective cohort study was performed using electronic health records of PEH who visited HHC mobile units between January 2023 and August 2024. Point-of-care test quantity, timing, and results were assessed. A comprehensive metabolic panel (CMP), blood glucose, and hemoglobin A1c (HbA1c) results were assessed for differences between diabetic and nondiabetic cohorts at initial presentation.Results
Between January 2023 and August 2024, the HHC served 4653 patients, with 836 receiving a POC test (17.97%). During this period, 126 basic metabolic panels, 197 CMPs, 102 COVID-19 antigen tests, 533 glucose tests, 166 HbA1c tests, 87 hemoglobin tests, 80 influenza A and B tests, 22 rapid strep A tests, 119 urinalysis dipstick tests, and 41 urine pregnancy tests were used. Of all tested, 190 (22.73%) received a diabetes International Classification of Diseases code. Within CMP results, mean sodium (139.5 vs 141.1 mmol/L; P < .05) and mean chloride (103.7 vs 105.8 mmol/L; P < .05) were both lower in patients with diabetes. The mean creatinine was not significantly different (0.91 vs 1.06 mg/dL; P = .097).Conclusions
Point-of-care testing provides critical diagnostic data for PEH, particularly those with diabetes, allowing for a clinician to initiate care prior to the development of severe disease. Expanding the test menu to include urinary albumin-to-creatinine ratio screening and creating POC-specific reference intervals is an opportunity for improvement.
Related
- Community-based interventions for managing frailty among people experiencing homelessness: a systematic review
- Disparities in Heat-Related Injuries Among People Experiencing Homelessness
- Exploring the views of people experiencing homelessness regarding their health and housing support, and their perspectives on deteriorating health and end of life support: a qualitative analysis
- Notes from the Field: Use of Enhanced Surveillance to Detect Severe Group A Streptococcus Infections Among Persons Experiencing Homelessness — Missoula County, Montana, July 2024–September 2025
- Patient Perceptions of Student Involvement and Satisfaction in a Student-Run Free Clinic Serving People Experiencing Homelessness
BibTeX
@article{bergercahn2026mobile,
title = {{Mobile point-of-care testing to improve access to care for people experiencing homelessness and diabetes in Los Angeles.}},
author = {Tobin Berger-Cahn and Evan M Shannon and Brian Zunner-Keating and Catherine Weaver and Joshua Lee and Sae Takada and Cullen M Lilley and Imir G Metushi and Omai B Garner},
journal = {American journal of clinical pathology},
year = {2026},
month = oct,
doi = {10.1093/ajcp/aqag107},
url = {https://europepmc.org/article/MED/42896849},
note = {CC BY},
}
RIS
TY - JOUR
TI - Mobile point-of-care testing to improve access to care for people experiencing homelessness and diabetes in Los Angeles.
AU - Tobin Berger-Cahn
AU - Evan M Shannon
AU - Brian Zunner-Keating
AU - Catherine Weaver
AU - Joshua Lee
AU - Sae Takada
AU - Cullen M Lilley
AU - Imir G Metushi
AU - Omai B Garner
PY - 2026
DA - 2026/10/01
JO - American journal of clinical pathology
DO - 10.1093/ajcp/aqag107
UR - https://europepmc.org/article/MED/42896849
AB - Objectives To evaluate the utilization and results of point-of-care (POC) testing performed by the UCLA Health Homeless Healthcare Collaborative (HHC) to identify diagnostic patterns in patients experiencing homelessness (PEH) and specifically those with diabetes to inform future care models.Methods A retrospective cohort study was performed using electronic health records of PEH who visited HHC mobile units between January 2023 and August 2024. Point-of-care test quantity, timing, and results were assessed. A comprehensive metabolic panel (CMP), blood glucose, and hemoglobin A1c (HbA1c) results were assessed for differences between diabetic and nondiabetic cohorts at initial presentation.Results Between January 2023 and August 2024, the HHC served 4653 patients, with 836 receiving a POC test (17.97%). During this period, 126 basic metabolic panels, 197 CMPs, 102 COVID-19 antigen tests, 533 glucose tests, 166 HbA1c tests, 87 hemoglobin tests, 80 influenza A and B tests, 22 rapid strep A tests, 119 urinalysis dipstick tests, and 41 urine pregnancy tests were used. Of all tested, 190 (22.73%) received a diabetes International Classification of Diseases code. Within CMP results, mean sodium (139.5 vs 141.1 mmol/L; P < .05) and mean chloride (103.7 vs 105.8 mmol/L; P < .05) were both lower in patients with diabetes. The mean creatinine was not significantly different (0.91 vs 1.06 mg/dL; P = .097).Conclusions Point-of-care testing provides critical diagnostic data for PEH, particularly those with diabetes, allowing for a clinician to initiate care prior to the development of severe disease. Expanding the test menu to include urinary albumin-to-creatinine ratio screening and creating POC-specific reference intervals is an opportunity for improvement.
SN - 0002-9173
SN - 1943-7722
ER -