Date of Award

5-22-2020

Document Type

Thesis

Degree Name

Master of Medical Science (MMSc)

First Advisor

David Rosenthal, MD

Abstract

Homeless adults have higher rates of emergency department utilization than non-homeless adults. Social factors affecting homeless adults, such as housing instability and financial insecurity, contribute to this utilization disparity. One promising approach for addressing the social needs of homeless adults is case management. Case management is effective in meeting social needs of homeless adults in settings outside of the emergency department, and in decreasing emergency department utilization in high-frequency emergency department users. However, a case management intervention initiated at emergency department discharge in homeless adults has never been studied. This study will use a randomized controlled trial to evaluate a three-month, emergency department-initiated case management intervention in homeless adults. Mean emergency department visits in one year following intervention initiation will be measured as the primary outcome. This study may help emergency departments to better address the social needs of homeless patients and decrease avoidable high utilization patterns.

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