Article Figures & Data
Figures
- FIGURE 1
Total number of ED visits by homeless children (2010–2015). The year 2016 is not included in this figure because of incomplete data for the year. The dashed line indicates pre- and postpolicy periods.
- FIGURE 2
Frequencies of ED visits by homeless children (2010–2016).
- FIGURE 3
Comparison with the number of homeless children in Massachusetts.
Tables
Characteristic Before Policy (March 2010 to September 17, 2012), 30.5 mo After Policy (September 18, 2012 to March 2016), 41.5 mo Total visits, N 15 297 Average per mo 0.5 7.2 Age, range 6 wk–18 y 2 wk–18 y Median, y 1.89 3.32 Male sex, n (%) 8 (53.3) 160 (53.9) Race, n (%) White 3 (20.0) 13 (4.4) African American 6 (40.0) 93 (31.3) Other 0 (0.0) 15 (5.1) Unknown 0 (0.0) 6 (2.0 Ethnicity, n (%) Hispanic 6 (40.0) 170 (57.2) Medical complaint, n (%) Yes 12 (80.0) 103 (34.7) No 3 (20.0) 194 (65.3) Type of medical complaint, n (%)a Viral syndrome or fever 3 (20.0) 31 (10.4) Gastrointestinal 3 (20.0) 21 (7.1) Crying or ALTE 2 (13.3) 1 (0.3) Respiratory 1 (6.7) 15 (5.1) Developmental or growth 1 (6.7) 11 (3.7) Rash 1 (6.7) 9 (3.0) Injury 1 (6.7) 3 (1.0) Technology dependence 1 (6.7) 0 (0.0) Pregnancy 1 (6.7) 1 (0.3) Pharyngitis 0 (0.0 3 (1.0) Urinary tract infection 0 (0.0) 3 (1.0) Conjunctivitis 0 (0.0) 2 (0.7) Epistaxis 0 (0.0) 2 (0.7) Mental or behavioral health 0 (0.0) 2 (0.7) Neurologic problem 0 (0.0) 2 (0.7) Otitis media 0 (0.0) 1 (0.3) Anemia 0 (0.0) 1 (0.3) Chronic medical condition, n (%) Yes 8 (53.3) 78 (26.3) No 7 (46.7) 219 (73.7) Type of medical condition, n (%)a Medical complexity or technology dependence 3 (20.0) 15 (5.1) Asthma 2 13.3) 38 (12.7) Gastrointestinal 1 (6.7) 4 (1.3) Endocrinologic 1 (6.7) 1 (0.3) HIV 1 (6.7) 1 (0.3) Mental or behavioral health 0 (0.0) 9 (3.0) Cardiac 0 (0.0) 6 (2.0) Hematologic 0 (0.0) 4 (1.3) Neurologic 0 (0.0) 3 (1.0) Urologic 0 (0.0) 1 (0.3) Type of insurance, n (%) Commercial 3 (20.0) 4 (1.4) State based 12 (80.0) 268 (90.2) Out of state 0 (0.0) 15 (5.1) Uninsured 0 (0.0) 1 (0.3) Unknown 0 (0.0) 9 (3.0) Siblings present, n (%) 1 (11.1) 161 (60.5) Accompanied by a family member, n (%) Mother 11 (73.3) 285 (96.0) Father 4 (26.7) 26 (8.8) Grandparent 0 (0.0) 8 (2.7) Aunt or uncle 0 (0.0) 2 (0.7) Foster parent 0 (0.0) 0 (0.0) Other 0 (0.0) 2 (0.7) Unaccompanied 2 (13.3) 4 (1.4) Repeat visit for homelessness, n (%) 0 (0.0) 29 (9.1) Return visit for any reason within 1 mo, n (%) 5 (33.3) 44 (14.9) Seen at housing office (DHCD) within 2 wk before ED visit? Yes 2 (13.3) 141 (47.5) No 8 (53.3) 130 (43.8) Not documented or unknown 5 (33.3) 26 (8.8) ALTE, apparent life-threatening event.
↵a Numbers may not equal the total number of patients with a medical complaint or chronic medical problem because some patients had >1 medical complaint or chronic medical problem.
Circumstance Before Policy (2010–2012) (N = 15), n (%) After Policy (2012–2016) (N = 297), n (%) Rate Difference (95% CI) Reason for homelessnessa Eviction 2 (13.3) 58 (19.5) 0.06 (−0.11 to 0.24) No longer able to stay with friends or family 5 (33.3) 210 (70.7) 0.37 (0.13 to 0.62)b Unable to pay rent 0 (0.0) 34 (11.5) 0.11 (0.08 to 0.15)b Loss of income or fired 1 (6.7) 3 (1.0) −0.06 (−0.18 to 0.07) Moved from another state or country 3 (20.0) 63 (21.2) 0.01 (−0.20 to 0.22) Unsafe housing 5 (33.3) 38 (12.8) −0.21 (−0.45 to 0.04) Domestic violence 0 (0.0) 31 (10.4) 0.10 (0.07 to 0.14)b Other 2 (13.3) 5 (1.7) −0.11 (−0.30 to 0.06) Unknown or not described 1 (6.7) 0 (0.0) −0.07 (−0.19 to 0.06) Location staying beforehanda Own home 7 (46.7) 6 (2.0) −0.45 (−0.70 to −0.19)b With relatives 5 (33.3) 120 (40.4) 0.07 (−0.17 to 0.32) With friends 3 (20.0) 142 (47.8) 0.28 (0.07 to 0.49)b Street 1 (6.7) 30 (10.1) 0.03 (−0.10 to 0.17) Car 1 (6.7) 23 (7.7) 0.01 (−0.12 to 0.14) Other 2 (13.3) 9 (3.0) −0.10 (−0.28 to 0.07) Before Policy (2010–2012), N = 15 After Policy (2012–2016), N = 297 Total Visit charges paid, n (%) 13 (86.7) 254 (85.5) 267 (85.6) Total payments, $a 14 681 159 269 173 950 Payment by insurance type, $a Private 6423 11 911 18 334 MassHealth 5642 65 356 70 998 State-based managed care organization 2616 81 535 84 151 Other 0 467 467 Payment by visit type, $a Medical complaint 13 103 61 755 74 858 No medical complaint 1578 97 514 99 092 Average payment per visit, $a 979 536 557 ↵a All figures are adjusted to 2016 dollars.
In this issue
Pediatric Emergency Department Visits for Homelessness After Shelter Eligibility Policy Change
