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Using a “Big Events” framework to understand emergency department use among women experiencing homelessness or housing instability in San Francisco during the COVID-19 pandemic

BACKGROUND: The COVID-19 pandemic created a major public health crisis that disrupted economic systems, social networks and individual behaviors, which led to changes in patterns of health care use. Factors associated with emergency department (ED) visits during the pandemic among especially high-ri...

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Autores principales: Riley, Elise D., Raven, Maria C., Dilworth, Samantha E., Braun, Carl, Imbert, Elizabeth, Doran, Kelly M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier B.V. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8581479/
https://www.ncbi.nlm.nih.gov/pubmed/34403865
http://dx.doi.org/10.1016/j.drugpo.2021.103405
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author Riley, Elise D.
Raven, Maria C.
Dilworth, Samantha E.
Braun, Carl
Imbert, Elizabeth
Doran, Kelly M.
author_facet Riley, Elise D.
Raven, Maria C.
Dilworth, Samantha E.
Braun, Carl
Imbert, Elizabeth
Doran, Kelly M.
author_sort Riley, Elise D.
collection PubMed
description BACKGROUND: The COVID-19 pandemic created a major public health crisis that disrupted economic systems, social networks and individual behaviors, which led to changes in patterns of health care use. Factors associated with emergency department (ED) visits during the pandemic among especially high-risk individuals are unknown. We used a “Big Events” approach, which considers major disruptions that create social instability, to investigate ED use in people experiencing homelessness or housing instability, many of whom use drugs. METHODS: Between July and December 2020, we conducted a community-based San Francisco study to compare homeless and unstably housed (HUH) women who did and did not use an ED during the first 10 months of the pandemic. RESULTS: Among 128 study participants, 34% had ≥1 ED visit during the pandemic. In adjusted analysis, factors significantly associated with ED use included experiencing homelessness, cocaine use and increased difficulties receiving drug use treatment during the pandemic. CONCLUSION: These findings build on the “Big Events” approach to considering risk pathways among people who use drugs. They suggest the importance of ensuring access to housing and low-barrier non-COVID health services, including drug treatment, alongside crisis management activities, to reduce the health impacts of public health crises.
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spelling pubmed-85814792021-11-12 Using a “Big Events” framework to understand emergency department use among women experiencing homelessness or housing instability in San Francisco during the COVID-19 pandemic Riley, Elise D. Raven, Maria C. Dilworth, Samantha E. Braun, Carl Imbert, Elizabeth Doran, Kelly M. Int J Drug Policy Short Report BACKGROUND: The COVID-19 pandemic created a major public health crisis that disrupted economic systems, social networks and individual behaviors, which led to changes in patterns of health care use. Factors associated with emergency department (ED) visits during the pandemic among especially high-risk individuals are unknown. We used a “Big Events” approach, which considers major disruptions that create social instability, to investigate ED use in people experiencing homelessness or housing instability, many of whom use drugs. METHODS: Between July and December 2020, we conducted a community-based San Francisco study to compare homeless and unstably housed (HUH) women who did and did not use an ED during the first 10 months of the pandemic. RESULTS: Among 128 study participants, 34% had ≥1 ED visit during the pandemic. In adjusted analysis, factors significantly associated with ED use included experiencing homelessness, cocaine use and increased difficulties receiving drug use treatment during the pandemic. CONCLUSION: These findings build on the “Big Events” approach to considering risk pathways among people who use drugs. They suggest the importance of ensuring access to housing and low-barrier non-COVID health services, including drug treatment, alongside crisis management activities, to reduce the health impacts of public health crises. Elsevier B.V. 2021-11 2021-08-03 /pmc/articles/PMC8581479/ /pubmed/34403865 http://dx.doi.org/10.1016/j.drugpo.2021.103405 Text en © 2021 Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Short Report
Riley, Elise D.
Raven, Maria C.
Dilworth, Samantha E.
Braun, Carl
Imbert, Elizabeth
Doran, Kelly M.
Using a “Big Events” framework to understand emergency department use among women experiencing homelessness or housing instability in San Francisco during the COVID-19 pandemic
title Using a “Big Events” framework to understand emergency department use among women experiencing homelessness or housing instability in San Francisco during the COVID-19 pandemic
title_full Using a “Big Events” framework to understand emergency department use among women experiencing homelessness or housing instability in San Francisco during the COVID-19 pandemic
title_fullStr Using a “Big Events” framework to understand emergency department use among women experiencing homelessness or housing instability in San Francisco during the COVID-19 pandemic
title_full_unstemmed Using a “Big Events” framework to understand emergency department use among women experiencing homelessness or housing instability in San Francisco during the COVID-19 pandemic
title_short Using a “Big Events” framework to understand emergency department use among women experiencing homelessness or housing instability in San Francisco during the COVID-19 pandemic
title_sort using a “big events” framework to understand emergency department use among women experiencing homelessness or housing instability in san francisco during the covid-19 pandemic
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8581479/
https://www.ncbi.nlm.nih.gov/pubmed/34403865
http://dx.doi.org/10.1016/j.drugpo.2021.103405
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