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Am J Public Health. 2013 Dec;103 Suppl 2:S221-4. doi: 10.2105/AJPH.2013.301373. Epub 2013 Oct 22.

Resource-limited, collaborative pilot intervention for chronically homeless, alcohol-dependent frequent emergency department users.

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  • 1Ryan 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.


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.

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