Using a "Big Events" framework to understand emergency department use among women experiencing homelessness or housing instability in San Francisco during the COVID-19 pandemic.
Using a "Big Events" framework to understand emergency department use among women experiencing homelessness or housing instability in San Francisco during the COVID-19 pandemic.
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DOI：
10.1016/j.drugpo.2021.103405
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Doran KM
中科院分区：
文献类型：
--
作者：
Riley ED;Raven MC;Dilworth SE;Braun C;Imbert E;Doran KM
COVID-19疫情造成重大公共卫生危机，扰乱了经济体系、社交网络和个人行为，导致医疗保健使用模式发生变化。在大流行期间，特别是高危人群中，与急诊科（艾德）就诊相关的因素尚不清楚。我们使用了“大事件”的方法，考虑造成社会不稳定的重大破坏，调查艾德在经历无家可归或住房不稳定的人中的使用，其中许多人使用药物。在2020年7月至12月期间，我们进行了一项以社区为基础的弗朗西斯科研究，以比较在大流行的前10个月使用和未使用艾德的无家可归和住房不稳定（HUH）妇女。在128名研究参与者中，34%在大流行期间有≥1次艾德访视。在调整分析中，与艾德使用显著相关的因素包括无家可归、可卡因使用和大流行期间接受药物使用治疗的困难增加。这些发现建立在“大事件”方法的基础上，以考虑吸毒者的风险途径。他们指出，在危机管理活动的同时，必须确保获得住房和低障碍的非COVID卫生服务，包括药物治疗，以减少公共卫生危机对健康的影响。
The COVID-19 pandemic created a major public health crisis that disrupted economic systems, social networks and individual behaviors, which led to changes in patterns of health care use. Factors associated with emergency department (ED) visits during the pandemic among especially high-risk individuals are unknown. We used a “Big Events” approach, which considers major disruptions that create social instability, to investigate ED use in people experiencing homelessness or housing instability, many of whom use drugs. Between July and December 2020, we conducted a community-based San Francisco study to compare homeless and unstably housed (HUH) women who did and did not use an ED during the first 10 months of the pandemic. Among 128 study participants, 34% had ≥1 ED visit during the pandemic. In adjusted analysis, factors significantly associated with ED use included experiencing homelessness, cocaine use and increased difficulties receiving drug use treatment during the pandemic. These findings build on the “Big Events” approach to considering risk pathways among people who use drugs. They suggest the importance of ensuring access to housing and low-barrier non-COVID health services, including drug treatment, alongside crisis management activities, to reduce the health impacts of public health crises.
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DOI：
10.1016/j.jemermed.2021.01.002
发表时间：
2021-06
期刊：
The Journal of emergency medicine
影响因子：
--
作者：
Gutovitz S;Pangia J;Finer A;Rymer K;Johnson D
通讯作者：
Johnson D
影响因子：
13.8
作者：
Appa A;Rodda LN;Cawley C;Zevin B;Coffin PO;Gandhi M;Imbert E
通讯作者：
Imbert E
影响因子：
12.7
作者：
Welch, Alice E.;Jeffers, Angela;Kunins, Hillary V.
通讯作者：
Kunins, Hillary V.
影响因子：
4.4
作者：
Friedman, Samuel R.;Rossi, Diana;Braine, Naomi
通讯作者：
Braine, Naomi
影响因子：
12.7
作者：
Kushel, MB;Perry, S;Moss, AR
通讯作者：
Moss, AR