Date of Award

January 2014

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Haiqu Lin

Second Advisor

Robert Rosenheck


This study explored Emergency department (ED) use among the chronically homeless people based on the data from the federal Collaborative Initiative on Chronic Homelessness (CICH) program. The Behavioral Model for Vulnerable Populations (Gelberg L et al. 2000) was applied to identify and classify factors potentially associated with ED use.

Baseline ED use was modeled on 754 chronically homeless subjects, either later entered the CICH program (n=642) or received local usual care (n=112), in 11 communities. ED use was measured as the number of ED visits during 90 days prior to the interview. At baseline level, medical problems, mental health/substance use problems, substance abuse outpatient service use, alcohol addiction, proportion of time get insured, length of homelessness and overall quality of life are significantly correlated with frequency of ED visit.

Longitudinal ED use was modeled on CICH clients (n=252) receiving comprehensive housing and healthcare services and those receiving local usual care (n=102) in the matched 5 communities. The CICH program was not found to significantly change ED visits. Baseline ED visit is a strong predictor; medical, mental health and substance abuse problems, substance abuse outpatient service use and quality of life are also significantly correlated with the outcome.


This is an Open Access Thesis.

Open Access

This Article is Open Access