When Crises Converge: Hospital Visits Before And After Shelter Use Among Homeless New Yorkers

Dan Treglia, Eileen L. Johns, Maryanne Schretzman, Jacob Berman, Dennis P. Culhane, David C. Lee, Kelly Doran

Research output: Contribution to journalArticle

Abstract

People who are homeless use more hospital-based care than average, yet little is known about how hospital and shelter use are interrelated. We examined the timing of emergency department (ED) visits and hospitalizations relative to entry into and exit from New York City homeless shelters, using an analysis of linked health care and shelter administrative databases. In the year before shelter entry and the year following shelter exit, 39.3 percent and 43.3 percent, respectively, of first-time adult shelter users had an ED visit or hospitalization. Hospital visits-particularly ED visits-began to increase several months before shelter entry and declined over several months after shelter exit, with spikes in ED visits and hospitalizations in the days immediately before shelter entry and following shelter exit. We recommend cross-system collaborations to better understand and address the co-occurring health and housing needs of vulnerable populations.

Original languageEnglish (US)
Pages (from-to)1458-1467
Number of pages10
JournalHealth affairs (Project Hope)
Volume38
Issue number9
DOIs
StatePublished - Sep 1 2019

Fingerprint

Hospital Emergency Service
Hospitalization
Vulnerable Populations
Databases
Delivery of Health Care
Health

Keywords

  • emergency department
  • health services use
  • homelessness
  • social determinants of health

ASJC Scopus subject areas

  • Health Policy

Cite this

When Crises Converge : Hospital Visits Before And After Shelter Use Among Homeless New Yorkers. / Treglia, Dan; Johns, Eileen L.; Schretzman, Maryanne; Berman, Jacob; Culhane, Dennis P.; Lee, David C.; Doran, Kelly.

In: Health affairs (Project Hope), Vol. 38, No. 9, 01.09.2019, p. 1458-1467.

Research output: Contribution to journalArticle

Treglia, Dan ; Johns, Eileen L. ; Schretzman, Maryanne ; Berman, Jacob ; Culhane, Dennis P. ; Lee, David C. ; Doran, Kelly. / When Crises Converge : Hospital Visits Before And After Shelter Use Among Homeless New Yorkers. In: Health affairs (Project Hope). 2019 ; Vol. 38, No. 9. pp. 1458-1467.
@article{1cfd65d3ee9f47ccad430f1dc6acb226,
title = "When Crises Converge: Hospital Visits Before And After Shelter Use Among Homeless New Yorkers",
abstract = "People who are homeless use more hospital-based care than average, yet little is known about how hospital and shelter use are interrelated. We examined the timing of emergency department (ED) visits and hospitalizations relative to entry into and exit from New York City homeless shelters, using an analysis of linked health care and shelter administrative databases. In the year before shelter entry and the year following shelter exit, 39.3 percent and 43.3 percent, respectively, of first-time adult shelter users had an ED visit or hospitalization. Hospital visits-particularly ED visits-began to increase several months before shelter entry and declined over several months after shelter exit, with spikes in ED visits and hospitalizations in the days immediately before shelter entry and following shelter exit. We recommend cross-system collaborations to better understand and address the co-occurring health and housing needs of vulnerable populations.",
keywords = "emergency department, health services use, homelessness, social determinants of health",
author = "Dan Treglia and Johns, {Eileen L.} and Maryanne Schretzman and Jacob Berman and Culhane, {Dennis P.} and Lee, {David C.} and Kelly Doran",
year = "2019",
month = "9",
day = "1",
doi = "10.1377/hlthaff.2018.05308",
language = "English (US)",
volume = "38",
pages = "1458--1467",
journal = "Health Affairs",
issn = "0278-2715",
publisher = "Project Hope",
number = "9",

}

TY - JOUR

T1 - When Crises Converge

T2 - Hospital Visits Before And After Shelter Use Among Homeless New Yorkers

AU - Treglia, Dan

AU - Johns, Eileen L.

AU - Schretzman, Maryanne

AU - Berman, Jacob

AU - Culhane, Dennis P.

AU - Lee, David C.

AU - Doran, Kelly

PY - 2019/9/1

Y1 - 2019/9/1

N2 - People who are homeless use more hospital-based care than average, yet little is known about how hospital and shelter use are interrelated. We examined the timing of emergency department (ED) visits and hospitalizations relative to entry into and exit from New York City homeless shelters, using an analysis of linked health care and shelter administrative databases. In the year before shelter entry and the year following shelter exit, 39.3 percent and 43.3 percent, respectively, of first-time adult shelter users had an ED visit or hospitalization. Hospital visits-particularly ED visits-began to increase several months before shelter entry and declined over several months after shelter exit, with spikes in ED visits and hospitalizations in the days immediately before shelter entry and following shelter exit. We recommend cross-system collaborations to better understand and address the co-occurring health and housing needs of vulnerable populations.

AB - People who are homeless use more hospital-based care than average, yet little is known about how hospital and shelter use are interrelated. We examined the timing of emergency department (ED) visits and hospitalizations relative to entry into and exit from New York City homeless shelters, using an analysis of linked health care and shelter administrative databases. In the year before shelter entry and the year following shelter exit, 39.3 percent and 43.3 percent, respectively, of first-time adult shelter users had an ED visit or hospitalization. Hospital visits-particularly ED visits-began to increase several months before shelter entry and declined over several months after shelter exit, with spikes in ED visits and hospitalizations in the days immediately before shelter entry and following shelter exit. We recommend cross-system collaborations to better understand and address the co-occurring health and housing needs of vulnerable populations.

KW - emergency department

KW - health services use

KW - homelessness

KW - social determinants of health

UR - http://www.scopus.com/inward/record.url?scp=85071748871&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071748871&partnerID=8YFLogxK

U2 - 10.1377/hlthaff.2018.05308

DO - 10.1377/hlthaff.2018.05308

M3 - Article

C2 - 31479375

AN - SCOPUS:85071748871

VL - 38

SP - 1458

EP - 1467

JO - Health Affairs

JF - Health Affairs

SN - 0278-2715

IS - 9

ER -