Resource-Limited, Collaborative Pilot Intervention for Chronically Homeless, Alcohol-Dependent Frequent Emergency Department Users

Resource-Limited, Collaborative Pilot Intervention for Chronically Homeless, Alcohol-Dependent Frequent Emergency Department Users
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DOI:
10.2105/ajph.2013.301373
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发表时间:
2013-12-01
影响因子:
12.7
通讯作者:
Goldfrank, Lewis R.
Goldfrank, Lewis R.
中科院分区:
医学2区
文献类型:
--
作者:
McCormack, Ryan P.;Hoffman, Lily F.;Goldfrank, Lewis R.

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我们利用现有资源,对长期无家可归、酒精依赖、经常急诊科(ED)访客引入了病例管理和无家可归者外展。我们采用前瞻性、非等效对照组试验评估干预前后6个月ED就诊的差异。次要结局包括住院和住房的变化。在急诊科就诊时,干预组与前瞻性患者和回顾性对照组的差异分别为-12.1 (95% CI = -22.1, -2.0)和-12.8 (95% CI = -26.1, 0.6),住院天数分别为-8.5 (95% CI = -22.8, 5.8)和-19.0 (95% CI = -34.3, -3.6)。18名参与者接受了庇护;没有控制装置。通过干预,ED的使用减少,住房得以实现。
We introduced case management and homeless outreach to chronically homeless, alcohol-dependent, frequent emergency department (ED) visitors using existing resources. We assessed the difference in differences of ED visits 6 months pre- and postintervention using a prospective, nonequivalent control group trial. Secondary outcomes included changes in hospitalizations and housing. The differences in differences between intervention and prospective patients and retrospective controls were -12.1 (95% CI = -22.1, -2.0) and -12.8 (95% CI = -26.1, 0.6) for ED visits and -8.5 (95% CI = -22.8, 5.8) and -19.0 (95% CI = -34.3, -3.6) for inpatient days, respectively. Eighteen participants accepted shelter; no controls were housed. Through intervention, ED use decreased and housing was achieved.