Infants Exposed To Homelessness: Health, Health Care Use, And Health Spending From Birth To Age Six
Infants Exposed To Homelessness: Health, Health Care Use, And Health Spending From Birth To Age Six
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DOI：
10.1377/hlthaff.2019.00090
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发表时间：
2019-05-01
期刊：
影响因子：
9.7
通讯作者：
Seifert, Robert W.
中科院分区：
文献类型：
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作者：
Clark, Robin E.;Weinreb, Linda;Seifert, Robert W.
众所周知，无家可归的婴儿出生结果不佳，但在生命的最初几年，无家可归对健康，医疗保健使用和医疗支出的纵向影响却很少受到关注。将2008- 2015年期间马萨诸塞州紧急避难所的登记记录与医疗补助申请联系起来，我们将5,762名经历无家可归事件的婴儿与5,553名在性别、种族/民族、地点和出生月份上匹配的婴儿进行了比较。在住房不稳定导致无家可归的时期出生的婴儿，低出生体重、呼吸道问题、发烧和其他常见疾病的发生率更高;新生儿重症监护室停留时间更长;急诊室就诊次数更多;年度支出更高。大多数健康状况的差异持续了两到三年。哮喘诊断，急诊室就诊和支出在6岁之前都显着增加。虽然可以改善无家可归婴儿的筛查和获得医疗保健的机会，但长期解决方案需要更广泛地关注住房和收入。
Homeless infants are known to have poor birth outcomes, but the longitudinal impact of homelessness on health, health care use, and health spending during the early years of life has received little attention. Linking Massachusetts emergency shelter enrollment records for the period 2008-15 with Medicaid claims, we compared 5,762 infants who experienced a homeless episode with a group of 5,553 infants matched on sex, race/ethnicity, location, and birth month. Infants born during a period of unstable housing resulting in homelessness had higher rates of low birthweight, respiratory problems, fever, and other common conditions; longer neonatal intensive care unit stays; more emergency department visits; and higher annual spending. Differences in most health conditions persisted for two to three years. Asthma diagnoses, emergency department visits, and spending were significantly higher through age six. While screening and access to health care can be improved for homeless infants, long-term solutions require a broader focus on housing and income.