Homelessness is a critical social determinant of health, driving disparities in healthcare utilization, morbidity and mortality. In 2018, the Canadian Institute for Health Information (CIHI) mandated the coding of homelessness in hospital administrative data, which more than doubled case identification. However, 25 % of cases remain undetected, and two-thirds of flagged patients were not currently homeless, though they have a documented history of homelessness. We summarize recent evidence and present opportunities for CIHI and health systems to further improve the accuracy of homelessness coding in Canadian hospital administrative data, which would enhance its utility for health research, policy making and health system planning.

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