From Their Perspective: The Connection between Life Stressors and Health Care Service Use Patterns of Homeless Frequent Users of the Emergency Department. Issue 2 (11th March 2019)

• Record Type: Journal Article
• Authors: Moore, Megan; Conrick, Kelsey M; Reddy, Ashok; Allen, Ann; Jaffe, Craig
• Is Part Of: Health & social work. Volume 44:Issue 2(2019)
• Page Start: 113
• Page End: 122
• Publication Date: 2019-03-11
• Subjects: case management -- emergency department utilization -- frequent users -- homeless population; Medical social work -- Periodicals; Medical social work -- United States -- Periodicals; Medical care -- Periodicals; 362.10425
• DOI: 10.1093/hsw/hlz010
• Languages: English
• ISSNs: 0360-7283

Abstract

Abstract: The perspective of homeless adults on their health care service utilization is not well studied. This article describes a study that used in-depth, semistructured interviews with 18 individuals to highlight the viewpoints of homeless people who are frequent users of the emergency department (ED) about the influence of life events on service utilization. Participants reported high levels of pain and comorbid psychiatric, substance use, and medical conditions. They also reported an identifiable pattern of health care utilization, often centered on a crisis event, influenced by high perceived medical needs, inability to cope after crisis, predisposing vulnerability from social determinants of health, and health care system factors. A social work case management intervention often led to a period of stability and use of ED alternatives. Modifiable targets for intervention at the health care system and local levels include improving trust and convenience of ED alternatives, enhancing consistency of care at ED-alternative sites, and educating those at risk of frequent ED use about community alternatives.