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Strengthen the Evidence for Maternal and Child Health Programs

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Established Evidence Results

Results for Measure: Housing Instability: Child

Below are articles that support specific interventions to advance MCH National Performance Measures (NPMs) and Standardized Measures (SMs). Most interventions contain multiple components as part of a coordinated strategy/approach.

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Displaying records 1 through 1 (1 total).

Stewart, A. M., Kanak, M. M., Gerald, A. M., Kimia, A. A., Landschaft, A., Sandel, M. T., & Lee, L. K. (2018). Pediatric emergency department visits for homelessness after shelter eligibility policy change. Pediatrics, 142(5).

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Access,

Intervention Description: analyze the frequency and costs of pediatric ED visits for homelessness before and after this policy.

Intervention Results: There were 312 ED visits for homelessness; 95% (n = 297) of visits were after the policy. These visits increased 4.5 times after the policy (95% confidence interval: 1.33 to 15.23). Children seen after the policy were more likely to have no medical complaint (rate ratio: 3.27; 95% confidence interval: 1.18 to 9.01). Although the number of homeless children in Massachusetts increased 1.4 times over the study period, ED visits for homelessness increased 13-fold. Payments (average: $557 per visit) were >4 times what a night in a shelter would cost; 89% of payments were made through state-based insurance plans.

Conclusion: A policy change to Massachusetts’ shelter eligibility was associated with increased pediatric ED visits for homelessness along with substantial health care costs.

Study Design: retrospective study

Setting: Massachusetts

Age Range: families with children

Access Abstract

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.