Cassidy Michael, Currie Janet, Glied Sherry, Howland Renata
Center for Child Health Services Research, Icahn School of Medicine at Mount Sinai.
New York University Wagner Graduate School of Public Service, New York University, New York, NY, United States.
Am J Epidemiol. 2025 Jun 3;194(6):1534-1543. doi: 10.1093/aje/kwae345.
We identified children who resided in the New York City shelter system during 2015-2020 by matching address histories in Medicaid insurance claims to publicly available homeless shelter addresses, permitting examination of health care use before, during, and after shelter stays. We found that 4.5% of NYC children aged 4-17 with consistent Medicaid coverage entered shelter over a 3-to-5-year period. After shelter entry, children had increased probabilities of receiving mental health services, including therapy and diagnoses of neurodevelopmental disorders but little change in physical health service use. Children placed in shelters colocated with mental health services were similar to children entering other shelters prior to entry but had particularly large and sustained increases in use of mental health services afterwards. Children without prior mental health claims placed in shelters colocated with mental health services were 38%-48% more likely to receive mental health therapy and 14%-16% more likely to receive neurodevelopmental diagnoses than similar children placed elsewhere. These children were also more likely to receive Supplemental Security Income and stayed in shelter longer. This example illustrates the potential of linking administrative data sets in order to study vulnerable populations. This article is part of a Special Collection on Methods in Social Epidemiology.
我们通过将医疗补助保险理赔中的地址记录与公开的无家可归者收容所地址进行匹配，确定了2015年至2020年期间居住在纽约市收容所系统中的儿童，从而能够考察在收容所居住之前、期间和之后的医疗保健使用情况。我们发现，在3至5年的时间里，4.5%的有连续医疗补助覆盖的纽约市4至17岁儿童进入了收容所。进入收容所后，儿童接受心理健康服务（包括治疗和神经发育障碍诊断）的概率增加，但身体健康服务的使用变化不大。安置在与心理健康服务同处一地的收容所中的儿童在进入之前与进入其他收容所的儿童相似，但之后心理健康服务的使用有特别大且持续的增加。与安置在其他地方的类似儿童相比，安置在与心理健康服务同处一地的收容所中且之前没有心理健康理赔记录的儿童接受心理健康治疗的可能性高38%-48%，接受神经发育诊断的可能性高14%-16%。这些儿童也更有可能获得补充保障收入，并且在收容所停留的时间更长。这个例子说明了为研究弱势群体而链接行政数据集的潜力。本文是社会流行病学方法专题文集的一部分。
