J Health Care Poor Underserved. 2023;34(3):910-930.
Housing insecurity can take multiple forms, such as unaffordability, crowding, forced moves, multiple moves, and homelessness. Existing research has linked homelessness to increased emergency department (ED) use, but gaps remain in understanding the relationship between different types of housing insecurity and ED use. In this study, we examined the association between different types of housing insecurity, including detailed measures of homelessness, and future ED use among a cohort of patients initially seen in an urban safety-net hospital ED in the United States between November 2016 and January 2018. We found that homelessness was associated with a higher mean number of ED visits in the year post-baseline. Other measures of housing insecurity (unaffordability, crowding, forced moves, and multiple moves) were not associated with greater ED use in the year post-baseline in multivariable models. We also found that only specific types of homelessness, primarily unsheltered homelessness, were associated with increased ED use.
住房无保障有多种表现形式,如负担不起、过度拥挤、被迫搬迁、多次搬迁和无家可归。现有研究表明,无家可归与急诊科(ED)就诊次数增加有关,但对于不同类型的住房无保障与 ED 就诊次数之间的关系仍存在理解上的差距。在这项研究中,我们在美国一家城市医疗救助医院的 ED 中对一组患者进行了初步观察,研究了不同类型的住房无保障(包括无家可归的详细测量)与未来 ED 就诊之间的关联,时间跨度为 2016 年 11 月至 2018 年 1 月。我们发现,与基线后一年相比,无家可归与 ED 就诊次数较多有关。在多变量模型中,其他住房无保障措施(负担不起、过度拥挤、被迫搬迁和多次搬迁)与基线后一年 ED 使用量增加无关。我们还发现,只有特定类型的无家可归,主要是无庇护所的无家可归,与 ED 使用量增加有关。