Article Instance

HTTP 200 OK
Allow: GET
Content-Type: application/json
Vary: Accept

{
    "pk": 17535,
    "title": "Emergency Department Use Among Recently Homeless Adults in a Nationally Representative Sample",
    "subtitle": null,
    "abstract": "Introduction:\n In this study we examined the association of homelessness and emergency department (ED) use, considering social, medical, and mental health factors associated with both homelessness and ED use. We hypothesized that social disadvantage alone could account for most of the association between ED use and homelessness.\nMethods: \nWe used nationally representative data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). Emergency department use within the prior year was categorized into no use (27,674; 76.61%); moderate use (1–4 visits: 7,972; 22.1%); and high use (5 or more visits: 475; 1.32%). We used bivariate analyses followed by multivariable-adjusted logistic regression analyses to identify demographic, social, medical, and mental health characteristics associated with ED use.\nResults: \nAmong 36,121 respondents, unadjusted logistic regression showed prior-year homelessness was strongly associated with moderate and high prior-year ED use (odds ratio[OR] 2.31 and 7.34, respectively, P < 0.001). After adjusting for sociodemographic factors, the associations of homelessness with moderate/high ED use diminished (adjusted OR [AOR] 1.27 and 1.62, respectively, both P < 0.05). Adjusting for medical/mental health variables, alone, similarly diminished the association between homelessness and moderate/high ED use (AOR 1.26, P < .05 and 2.07, P < 0.001, respectively). In a final stepwise model including social and healthvariables, homelessness was no longer significantly associated with moderate or high ED usein the prior year.\nConclusion:\n After adjustment for social disadvantage and health problems, we found no statistically significant association between homelessness and ED use. The implications of our findings suggest that ED service delivery must address both health issues and social factors.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Social Emergency Medicine, Homelessness, Utilization, Health Equity"
        }
    ],
    "section": "Health Equity",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/9r3498q6",
    "frozenauthors": [
        {
            "first_name": "Caitlin",
            "middle_name": "R.",
            "last_name": "Ryus",
            "name_suffix": "",
            "institution": "Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut",
            "department": "None"
        },
        {
            "first_name": "Elina",
            "middle_name": "",
            "last_name": "Stefanovics",
            "name_suffix": "",
            "institution": "U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut",
            "department": "None"
        },
        {
            "first_name": "Jack",
            "middle_name": "",
            "last_name": "Tsai",
            "name_suffix": "",
            "institution": "Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; VA National Center on Homelessness among Veterans, Washington, DC; School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas",
            "department": "None"
        },
        {
            "first_name": "Taeho",
            "middle_name": "Greg",
            "last_name": "Rhee",
            "name_suffix": "",
            "institution": "U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut",
            "department": "None"
        },
        {
            "first_name": "Robert",
            "middle_name": "A.",
            "last_name": "Rosenheck",
            "name_suffix": "",
            "institution": "U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut",
            "department": "None"
        }
    ],
    "date_submitted": "2022-09-29T14:46:11-04:00",
    "date_accepted": "2022-09-29T14:46:11-04:00",
    "date_published": "2023-08-11T11:44:07-04:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/17535/galley/8941/download/"
        }
    ]
}