The Impact of Specialized Medical Equipment Needs on Shelter Accessibility for Homeless Patients.

Housing insecurity is a well-recognized social determinant of health, with poverty and homelessness significantly impacting health outcomes. When faced with unstable housing, health often becomes a lower priority for patients. We present the case of a 52-year-old homeless, morbidly obese female who arrived at the emergency department with worsening dyspnea. She required Bilevel Positive Airway Pressure (BiPAP) support for acute-on-chronic hypercapnic respiratory failure. Her discharge planning was complicated by the need for a BiPAP machine, which limited her options for placement in a receiving facility. The patient ultimately left against medical advice (AMA) after a seven-day hospitalization but was readmitted hours later with recurrent symptoms, highlighting the ongoing challenges posed by her chronic conditions and social determinants of health. This case highlights how the requirement for specialized medical equipment can serve as an additional barrier to securing shelter for individuals experiencing homelessness.
Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
(Copyright © 2025, Santos-Rivera et al.)