Background

1. Emergency Department Use Among a Sample of Shelter-Based Runaway and Homeless Youth Scott Harpin, PhD, MPH, RN1, Ethan Rosenberg, BS2, Jesse Francomano, BA1, Christine Gilroy, MD, MSPH2 1 University of Colorado, College of Nursing & 2 University of Colorado, School of Medicine TAKE HOME MESSAGES: a) Heavy ED use among runaway and homeless teens. b) Drug & ETOH are often-cited reasons for ED visits. c) Educate youth to discern emergent vs. non-emergent situations. • Discussion/Conclusions • MAIN FINDINGS • 55% visited the ED in the past year, multiple times • 38% reported being transported to ED by ambulance • 1/4 of those ED visits were ETOH-related; 1/3 were drug use-related • 70% in our sample reported having health insurance of some type • 1/2 had Medical Assistance or CICP (Colorado health plan) • LIMITATIONS • Small sample size; convenience sampling • Original survey items; no comparison to standardized instruments • Street-based RHY were not surveyed • One geographic location (Denver, CO) during a 2 month period of time • FUTURE IMPLICATIONS • Further research needed to examine how and why ED and primary care services are accessed in this population. • Consider agency policy to assure health insurance application and insurance use for RHY and other “upstream” adolescent populations. • Shelter agency policy and procedures to triage health issues and best option for ailing resident transportation to EDs (if needed). • RHY and homeless shelter primary care system coordination, particularly in the context of medical home framework. • Background • Research on the health utilization behaviors, including emergency department (ED) use, of runaway and homeless youth (RHY) is dated, sample-specific and very limited in scope. • Point prevalence from 4 studies, 29%-57% of RHY have used ED in past 12 months: Klein (shelter), 2000 Klein (street), 2000 Price, 2012 Harpin, prelim Geber, 1997 • Objectives • What proportion of Denver RHY report using ED services? • What proportion of RHY report having health insurance? What types of insurance are used? • What reasons do RHY report for their ED visit? • Methods • SETTING • Urban Peak (Denver) shelter program, 32-bed facility with housing, food, case management, vocational, GED & mental health services • Convenience sample of youth staying at the shelter. Approx. 53% response rate. • SURVEY • 30-item survey tool, original items that included: demographic characteristics, insurance coverage & reasons for ED use • $10 gift card incentive if survey & interview questions completed. • Study approved by COMIRB (Colorado Multiple IRB) • ANALYSIS • Univariate frequencies, using unweighted data. • Exploratory crosstabs, using Fishers Exact, reporting odds ratios • Acknowledgements • LEADS PROGRAM. University of Colorado interdisciplinary track dedicated to addressing the needs of the underserved and disadvantaged, by empowering health sciences students. • EDGAR & MARION ADLER MSA STUDENT AWARD. Med student award to support scholarly work to improve the health of patients overcoming health disparities • THANK YOU TO URBAN PEAK RESIDENT-PARTICIPANTS!