Association of Homelessness With Emergency Department Use Among Children in New York

Chang, Lawrence; Stewart, Amanda M.; Kester, Katherine; Routhier, Giselle; Michelson, Kenneth A.

doi:10.1001/jamapediatrics.2023.0478

JAMA Pediatr

2023

DOI: 10.1001/jamapediatrics.2023.0478

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Association of Homelessness With Emergency Department Use Among Children in New York

Lawrence Chang

Amanda M. Stewart

Katherine Kester

et al.

Abstract: This cross-sectional study uses statewide data to evaluate the association of homelessness with emergency department use patterns of children in New York.

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2024

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Associations of Homelessness With Primary Care and Acute Care Utilization Among Medicaid-Enrolled Youth

Yue,

Chuang,

Zhou

et al. 2024

Medical Care

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Background: Youth comprise one-third of the US homeless population. However, little is known about how homelessness affects health care utilization. Objective: Examine associations of homelessness with hospitalization, primary care, and ED visits, varying by race/ethnicity, among Medicaid-enrolled youth. Research Design: A cross-sectional analysis was conducted using California Medicaid claims data on youth beneficiaries with complex needs. We examined the number of hospitalizations, preventable and nonpreventable ED, and primary care visits using a multivariate regression. We further explored the differential associations by race/ethnicity. Results: Approximately 17% of our sampled youth experienced homelessness in 2018 (N=90,202). Compared with their housed counterparts, youth experiencing homelessness had a 1.9 percentage point (pp) higher likelihood of frequent ED visits (95% CI: 1.7–2.2) but a 2.9 pp lower probability of any primary care visits (95% CI: -3.9 to -1.9). Homelessness was associated with 221 more ED visits (95% CI: 182–260), 100 more preventable ED visits (95% CI: 84–116), 19.9 more hospitalizations (95% CI: 12–27), but 56 fewer primary care visits (95% CI: -104 to -7), per 1000 youth. The associations of homelessness with total ED visits, preventable ED visits, and needed and nonpreventable ED visits were all higher among Whites and, particularly, Blacks than for Hispanics and Asians. Conclusions: Medicaid-enrolled youth who experienced homelessness had more overall ED, preventable ED, and hospital visits, but fewer primary care visits than their housed peers. Our results suggest promoting primary care use should be considered among strategies to improve health and reduce costs.

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Associations of Homelessness With Primary Care and Acute Care Utilization Among Medicaid-Enrolled Youth

Yue,

Chuang,

Zhou

et al. 2024

Medical Care

View full text Add to dashboard Cite

show abstract

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Association of Homelessness With Emergency Department Use Among Children in New York

Abstract: This cross-sectional study uses statewide data to evaluate the association of homelessness with emergency department use patterns of children in New York.

Cited by 1 publication

References 3 publications

Associations of Homelessness With Primary Care and Acute Care Utilization Among Medicaid-Enrolled Youth

Associations of Homelessness With Primary Care and Acute Care Utilization Among Medicaid-Enrolled Youth

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