Homeless Shelter Entry in the Year After an Emergency Department Visit: Results From a Linked Data Analysis

Doran, Kelly M.; Johns, Eileen; Schretzman, Maryanne; Zuiderveen, Sara; Shinn, Marybeth; Gulati, Rajneesh; Wittman, Ian; Culhane, Dennis P; Shelley, Donna; Mijanovich, Tod

doi:10.1016/j.annemergmed.2020.03.006

Cited by 14 publications

(14 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…52.0% were ineligible; reasons for ineligibility have been previously reported and primarily included language, medical instability, and intoxication, with fewer excluded due to being in prison/police custody, living outside New York City, psychological distress, or prior study participation. 14 Of 2924 eligible patients, 2396 (81.9%) participated. Eighty-four had participated more than once, leaving 2312 nonduplicated participants.…”

Section: Resultsmentioning

confidence: 99%

“…The New York City Center for Innovation through Data Intelligence (CIDI)-an agency in the Office of the Mayor that conducts cross-sector, policy-relevant data analysis-performed data linkage. 14 Study investigators provided CIDI with participant identifying information. CIDI used SAS Link King to conduct probabilistic and deterministic matching with CARES.…”

Section: Data Linkagementioning

confidence: 99%

See 1 more Smart Citation

Development of a homelessness risk screening tool for emergency department patients

Doran

Johns

Zuiderveen³

et al. 2021

Health Services Research

Self Cite

View full text Add to dashboard Cite

Objective: To develop a screening tool to identify emergency department (ED) patients at risk of entering a homeless shelter, which could inform targeting of interventions to prevent future homelessness episodes. Data sources: Linked data from (1) ED patient baseline questionnaires and (2) citywide administrative homeless shelter database. Study design: Stakeholder-informed predictive modeling utilizing ED patient questionnaires linked with prospective shelter administrative data. The outcome was shelter entry documented in administrative data within 6 months following the baseline ED visit. Exposures were responses to questions on homelessness risk factors from baseline questionnaires.Data collection/extraction methods: Research assistants completed questionnaires with randomly sampled ED patients who were medically stable, not in police/prison custody, and spoke English or Spanish. Questionnaires were linked to administrative data using deterministic and probabilistic matching.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Data Linkagementioning

confidence: 99%

Development of a homelessness risk screening tool for emergency department patients

Doran

Johns

Zuiderveen³

et al. 2021

Health Services Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…Data linkage with CARES was performed by the NYC Center for Innovation Through Data Intelligence using deterministic and probabilistic matching procedures described previously. 22…”

Section: Methodsmentioning

confidence: 99%

“…Patients were ineligible if they were medically unstable, in psychological distress, in police or prison custody, could not provide informed consent (eg, had dementia or were too intoxicated to participate), did not live in NYC, or had already participated. We used a random sampling scheme to approach patients, which we have described previously …”

Section: Methodsmentioning

confidence: 99%

Performance of 2 Single-Item Screening Questions to Identify Future Homelessness Among Emergency Department Patients

et al. 2022

Self Cite

View full text Add to dashboard Cite

ImportanceDespite increasing interest in assessing patient social needs in health care settings, there has been little research examining the performance of housing-related screening questions.ObjectiveTo examine the performance of 2 single-item screening questions assessing emergency department (ED) patients’ self-perceived risk of future homelessness.Design, Setting, and ParticipantsThis prospective cohort study was conducted among a randomly selected sample of adult ED patients from 2016 to 2017 in a public hospital ED in New York City. Data were analyzed from September 2019 through October 2021.ExposuresResponses on patient surveys conducted at the baseline ED visit for 2 single-item screening questions on self-perceived risk for future housing instability and homelessness were collected. One question asked patients if they were worried about having stable housing in the next 2 months, and the other question asked them to rate the likelihood that they would enter a homeless shelter in the next 6 months.OutcomesHomeless shelter entry 2, 6, and 12 months after an ED visit, assessed using shelter administrative data in the study city, which was linked with participant baseline survey responses.ResultsThere were 1919 study participants (976 [51.0%] men and 931 [48.6%] women among 1915 individuals with gender data; 700 individuals aged 31-50 years [36.5%] among 1918 individuals with age data; 1126 Hispanic or Latinx individuals [59.0%], 368 non-Hispanic Black individuals [19.3%], and 225 non-Hispanic White individuals [11.8%] among 1908 individuals with race and ethnicity data). Within 2, 6, and 12 months of the ED visit, 45 patients (2.3%), 66 patients (3.4%), and 95 patients (5.0%) had entered shelter, respectively. For both single-item screening questions, participants who answered affirmatively had significantly higher likelihood of future shelter entry at each time point examined (eg, at 2 months: 31 participants responding yes [6.5%] vs 14 participants responding no [1.0%] to the question concerning being worried about having stable housing in the next 2 months). Sensitivity of the screening questions ranged from 0.27 to 0.69, specificity from 0.76 to 0.97, positive predictive value from 0.07 to 0.27, and area under the receiver operating characteristic curve from 0.62 to 0.72.Conclusions and RelevanceThis study found that 2 single-item screening questions assessing ED patient self-perceived risk of future housing instability and homelessness had adequate to good performance in identifying risk for future shelter entry. Such single-item screening questions should be further tested before broad adoption.

show abstract

“…Recruitment occurred from May to August 2019 during weekday business hours to match availability of ED Leads services. Research assistants (RAs) approached patients using a random sampling scheme described previously 29 . If an ED provider identified specific patients who they felt would benefit from the study, RAs were allowed to break from the random sampling scheme to screen those patients for study eligibility; however, this occurred very infrequently.…”

Section: Methodsmentioning

confidence: 99%

ED‐Home: Pilot feasibility study of a targeted homelessness prevention intervention for emergency department patients with drug or unhealthy alcohol use

Fazio

Zuiderveen²,

Guyet³

et al. 2022

Academic Emergency Medicine

Self Cite

View full text Add to dashboard Cite

Background: Housing insecurity is prevalent among emergency department (ED) patients. Despite a surge of interest in screening for patients' social needs including housing insecurity, little research has examined ED social needs interventions. We worked together with government and community partners to develop and pilot test a homelessness prevention intervention targeted to ED patients with drug or unhealthy alcohol use. Methods: We approached randomly sampled patients at an urban public hospital ED, May to August 2019. Adult patients were eligible if they were medically stable, not incarcerated, spoke English, had unhealthy alcohol or any drug use, and were not currently homeless but screened positive for risk of future homelessness using a previously developed risk screening tool. Participants received a three-part intervention: (1) brief counseling and referral to treatment for substance use delivered through a preexisting ED program; (2) referral to Homebase, an evidence-based community homelessness prevention program; and (3) up to three troubleshooting phone calls by study staff. Participants completed surveys at baseline and 6 months. Results: Of 2183 patients screened, 51 were eligible and 40 (78.4%) participated; one later withdrew, leaving 39 participants. Participants were diverse in age, gender, race, and ethnicity. Of the 32 participants reached at 6 months, most said it was very or extremely helpful to talk to someone about their housing situation (n = 23, 71.9%) at the baseline ED visit. Thirteen (40.6%) said their housing situation had improved in the past 6 months and 16 (50.0%) said it had not changed. Twenty participants (62.5%) had made contact with a Homebase office. Participants shared ideas of how to improve the intervention.

show abstract

Homeless Shelter Entry in the Year After an Emergency Department Visit: Results From a Linked Data Analysis

Cited by 14 publications

References 7 publications

Development of a homelessness risk screening tool for emergency department patients

Development of a homelessness risk screening tool for emergency department patients

Performance of 2 Single-Item Screening Questions to Identify Future Homelessness Among Emergency Department Patients

ED‐Home: Pilot feasibility study of a targeted homelessness prevention intervention for emergency department patients with drug or unhealthy alcohol use

Contact Info

Product

Resources

About