Navigating the boundaries of emergency department care

Addressing the medical and social needs of patients who are homeless

Kelly Doran, Anita A. Vashi, Stephanie Platis, Leslie A. Curry, Michael Rowe, Maureen Gang, Federico E. Vaca

Research output: Contribution to journalArticle

Abstract

Objectives. We sought to understand interpersonal and systems-level factors relevant to delivering health care to emergency department (ED) patients who are homeless. Methods. We conducted semistructured interviews with emergency medicine residents from 2 residency programs, 1 in New York City and 1 in a medium-sized northeastern city, from February to September 2012. A team of researchers reviewed transcripts independently and coded text segments using a grounded theory approach. They reconciled differences in code interpretations and generated themes inductively. Data collection and analysis occurred iteratively, and interviews continued until theoretical saturation was achieved. Results. From 23 interviews, 3 key themes emerged: (1) use of pattern recognition in identifying and treating patients who are homeless, (2) variations from standard ED care for patients who are homeless, and (3) tensions in navigating the boundaries of ED social care. Conclusions. Our study revealed practical and philosophical tensions in providing social care to patients in the ED who are homeless. Screening for homelessness in the ED and admission practices for patients who are homeless are important areas for future research and intervention with implications for health care costs and patient outcomes.

Original languageEnglish (US)
JournalAmerican Journal of Public Health
Volume103
Issue numberSUPPL. 2
DOIs
StatePublished - Dec 2013

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Emergency Medical Services
Hospital Emergency Service
Interviews
Homeless Persons
Emergency Medicine
Patient Admission
Internship and Residency
Health Care Costs
Patient Care
Research Personnel
Delivery of Health Care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Navigating the boundaries of emergency department care : Addressing the medical and social needs of patients who are homeless. / Doran, Kelly; Vashi, Anita A.; Platis, Stephanie; Curry, Leslie A.; Rowe, Michael; Gang, Maureen; Vaca, Federico E.

In: American Journal of Public Health, Vol. 103, No. SUPPL. 2, 12.2013.

Research output: Contribution to journalArticle

Doran, Kelly ; Vashi, Anita A. ; Platis, Stephanie ; Curry, Leslie A. ; Rowe, Michael ; Gang, Maureen ; Vaca, Federico E. / Navigating the boundaries of emergency department care : Addressing the medical and social needs of patients who are homeless. In: American Journal of Public Health. 2013 ; Vol. 103, No. SUPPL. 2.
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