title: Resource-limited, collaborative pilot intervention for chronically homeless, alcohol-dependent frequent emergency department users.
abstract: 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.
authors.affiliation: Ryan P. McCormack, Lily F. Hoffman, Stephen P. Wall, and Lewis R. Goldfrank are with the Department of Emergency Medicine, New York University School of Medicine, New York, NY.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: McCormack
authors.forename: Lily F
authors.initials: LF
authors.lastname: Hoffman
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Wall
authors.forename: Lewis R
authors.initials: LR
authors.lastname: Goldfrank
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D019090:Case Management / Q000706:statistics & numerical data*; D003299:Cooperative Behavior; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010865:Pilot Projects