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dc.contributor.authorMitchell, Matthew S.en_US
dc.contributor.authorLeón, Casey L.K.en_US
dc.contributor.authorByrne, Thomas H.en_US
dc.contributor.authorLin, Wen-Chiehen_US
dc.contributor.authorBharel, Monicaen_US
dc.coverage.spatialUnited Statesen_US
dc.date.accessioned2017-07-06T19:51:31Z
dc.date.available2017-07-06T19:51:31Z
dc.date.issued2017-05
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/28481604
dc.identifier.citationMatthew S Mitchell, Casey LK León, Thomas H Byrne, Wen-Chieh Lin, Monica Bharel. 2017. "Cost of health care utilization among homeless frequent emergency department users.." Psychological Services, Vol 14(2), May 2017, 193-202. http://dx.doi.org/10.1037/ser0000113
dc.identifier.issn1939-148X
dc.identifier.urihttps://hdl.handle.net/2144/22769
dc.description.abstractResearch demonstrates that homelessness is associated with frequent use of emergency department (ED) services, yet prior studies have not adequately examined the relationship between frequent ED use and utilization of non-ED health care services among those experiencing homelessness. There has also been little effort to assess heterogeneity among homeless individuals who make frequent use of ED services. To address these gaps, the present study used Medicaid claims data from 2010 to estimate the association between the number of ED visits and non-ED health care costs for a cohort of 6,338 Boston Health Care for the Homeless Program patients, and to identify distinct subgroups of persons in this cohort who made frequent use of ED services based on their clinical and demographic characteristics. A series of gamma regression models found more frequent ED use to be associated with higher non-ED costs, even after adjusting for demographic and clinical characteristics. Latent class analysis was used to examine heterogeneity among frequent ED users, and the results identified 6 characteristically distinct subgroups among these persons. The subgroup of persons with trimorbid illness had non-ED costs that far exceeded members of all 5 other subgroups. Study findings reinforce the connection between frequent ED use and high health care costs among homeless individuals and suggest that different groups of homeless frequent ED users may benefit from interventions that vary in terms of their composition and intensity.en_US
dc.format.extentp. 193 - 202en_US
dc.languageeng
dc.relation.ispartofPsychol Serv
dc.subjectSocial sciencesen_US
dc.subjectPsychology, clinicalen_US
dc.subjectPsychologyen_US
dc.subjectEmergency department utilizationen_US
dc.subjectHealth care costsen_US
dc.subjectHomelessnessen_US
dc.subjectMedicaiden_US
dc.subjectPopulation-based cohorten_US
dc.subjectMedicaid expansionen_US
dc.subjectAffordable careen_US
dc.subjectUrbanen_US
dc.subjectAdultsen_US
dc.subjectHospitalizationsen_US
dc.subjectPredictorsen_US
dc.subjectPsychiatryen_US
dc.titleCost of health care utilization among homeless frequent emergency department usersen_US
dc.typeArticleen_US
dc.identifier.doi10.1037/ser0000113
dc.identifier.pmid28481604
pubs.elements-sourcepubmeden_US
pubs.notesEmbargo: Not knownen_US
pubs.organisational-groupBoston Universityen_US
pubs.organisational-groupBoston University, School of Social Worken_US
pubs.publication-statusPublisheden_US
dc.identifier.orcid0000-0003-4824-0284 (Byrne, Thomas H)


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