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

摘要

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.