HEALTH CARE USE FOR CHILDREN IN HOMELESS FAMILIES

描述(申请人提供)：这项研究的目标是改善无家可归家庭儿童的医疗保健和护理协调，这将导致改善这一弱势群体的健康结果。为了实现这一目标，拟议的研究将审查无家可归是否以及如何影响儿童的医疗保健使用。本研究的主要目的是考察1)无家可归儿童在首次无家可归前、期间和之后的卫生服务使用情况是否发生了变化；2)无家可归儿童在首次无家可归之前和之后的医疗保健使用情况是否与其他低收入住房儿童不同，以及无家可归儿童在无家可归期间相对于居住儿童在使用方面的变化是否存在差异。拟议的研究将采用基于行政数据纵向档案的回溯性队列设计。这项研究的纵向设计将允许调查服务使用的时间模式，这将使我们深入了解无家可归对儿童卫生服务利用的影响。这项研究还有一个额外的好处，就是将无家可归家庭的儿童与低收入家庭的儿童进行比较。拟议的研究设计将提供关于儿童在无家可归之前、期间和之后使用医疗保健的信息，以及低收入寄宿儿童的比较组。这项研究的结果将有助于确定一群非常需要医疗保健的儿童，这将使医疗保健和无家可归者服务提供者能够将其有限的资源用于那些需要及时、全面和综合卫生服务的人。这项研究的结果将提供有关服务的信息，以改善无家可归儿童的医疗保健使用情况，并加强医疗保健和无家可归者服务的协调。此外，这些发现将使我们能够为未来的研究做出更有针对性和更有效的抽样决定。

DESCRIPTION (provided by applicant): The goal of this research is to improve healthcare and coordination of care among children in homeless families, which will lead to improving health outcomes in this vulnerable population. To achieve this goal, the proposed study will examine whether and how homelessness influences healthcare use of children. The main research aims are to examine 1) whether children's health service use changes before, during and after their initial homeless episode and 2) whether children who become homeless differ from other low-income housed children in their healthcare use before their first homeless episode, afterwards, and whether there are differences in the change in use around the homeless episode relative to housed children. The proposed study will use a retrospective cohort design based on a longitudinal archive of administrative data. The longitudinal design of this study will allow for the investigation of temporal patterns of service use, which will provide insight into the impact of homelessness on health service utilization among children. This study will have the added benefit of comparing children in homeless families with low-income housed children. The proposed research design will provide information on the healthcare use of children before, during, after their episodes of homelessness, as well as a comparison group of low-income housed children. Results from this study will help identify a group of children with a great need for healthcare, which will enable healthcare and homeless service providers to use their limited resources for those who need timely, comprehensive, and integrated health services. The findings of this study will provide information on services to improve healthcare use for homeless children and to strengthen the coordination of healthcare and homeless services. In addition, the findings will allow us to make more targeted and efficient sampling decisions for future studies.