{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T23:38:29Z","timestamp":1788046709370,"version":"build-2784847793"},"reference-count":30,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Queen Elizabeth II Scholarship in Science & Technology"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Qual Health Res"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>About 900 youth experiencing homelessness (YEH) reside at an emergency youth shelter (EYS) in Toronto on any given night. Several EYSs offer access to healthcare based on youths\u2019 needs, including access to primary care, and mental health and addictions support. However, youth also require healthcare from the broader health system, which is often challenging to navigate and access. Currently, little is known about healthcare coordination efforts between the EYS and health systems for YEH. Using grounded theory methodology, we interviewed 24 stakeholders and concurrently analyzed and compared data to explore pathways to healthcare coordinated for youth who reside at an EYS in Toronto. We also investigated fundamental parts (i.e., norms, resources, regulations, and operations) within the EYS and health systems that influence these pathways to healthcare using thematic analysis. A significant healthcare coordination gap was found between these two systems, typically when youth experience crises, often resulting in a recurring loop of transition and discharge between EYSs and hospitals. Several parts within each system act interdependently in hindering adequate healthcare coordination between the EYS and health systems. Incorporating training for system staff on how to effectively coordinate healthcare and work with homeless populations who have complex health needs, and rethinking information-sharing policies within circles of care are examples of how system parts can be targeted to improve healthcare coordination for YEH. Establishing multidisciplinary healthcare teams specialized to serve the complex needs of YEH may also improve healthcare coordination between systems, and access and quality of healthcare for this population.<\/jats:p>","DOI":"10.1177\/10497323231208417","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T15:29:52Z","timestamp":1699630192000},"page":"298-310","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Where\u2019s the Disconnect? Exploring Pathways to Healthcare Coordinated for Youth Experiencing Homelessness in Toronto, Canada, Using Grounded Theory Methodology"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3455-9596","authenticated-orcid":false,"given":"Alzahra","family":"Hudani","sequence":"first","affiliation":[{"name":"Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Labont\u00e9","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanni","family":"Yaya","sequence":"additional","affiliation":[{"name":"School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada"},{"name":"The George Institute for Global Health, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,11,10]]},"reference":[{"key":"bibr1-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1093\/jamiaopen\/ooy046"},{"key":"bibr2-10497323231208417","doi-asserted-by":"publisher","DOI":"10.4135\/9781483328546"},{"key":"bibr3-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1007\/BF03405183"},{"key":"bibr4-10497323231208417","volume-title":"A cure for chaos? Ontario\u2019s health system transformation from street level","author":"Bond A. J.","year":"2019"},{"key":"bibr5-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1080\/17439760.2016.1262612"},{"key":"bibr6-10497323231208417","unstructured":"City of Toronto. (2021). Street needs assessment 2021: Results report (p. 82). https:\/\/www.toronto.ca\/legdocs\/mmis\/2021\/ec\/bgrd\/backgroundfile-171729.pdf"},{"key":"bibr7-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1080\/17439760.2016.1262613"},{"key":"bibr8-10497323231208417","doi-asserted-by":"publisher","DOI":"10.5694\/mja17.01264"},{"key":"bibr9-10497323231208417","doi-asserted-by":"publisher","DOI":"10.12968\/bjhc.2016.22.4.215"},{"key":"bibr10-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1007\/s10464-007-9109-0"},{"key":"bibr11-10497323231208417","volume-title":"Coming of age: Reimagining the response to youth homelessness in Canada","author":"Gaetz S.","year":"2014"},{"key":"bibr12-10497323231208417","unstructured":"Gaetz S., O\u2019Grady B., Buccieri K. (2010). Surviving crime and violence: Street youth and victimization in Toronto (p. 97). JFCY and Homeless Hub."},{"key":"bibr13-10497323231208417","volume-title":"Without a home: The national youth homelessness survey","author":"Gaetz S.","year":"2016"},{"key":"bibr14-10497323231208417","doi-asserted-by":"publisher","DOI":"10.2307\/258605"},{"key":"bibr15-10497323231208417","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2011.561516"},{"key":"bibr16-10497323231208417","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.16-3-223"},{"key":"bibr17-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61133-8"},{"key":"bibr18-10497323231208417","doi-asserted-by":"publisher","DOI":"10.15453\/0191-5096.2850"},{"key":"bibr19-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1177\/0706743717702076"},{"key":"bibr20-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1177\/0706743721990310"},{"key":"bibr21-10497323231208417","volume-title":"Mental health and addiction interventions for youth experiencing homelessness: Practical strategies for front-line providers","author":"Kidd S.","year":"2018"},{"key":"bibr22-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1007\/s10560-019-00610-1"},{"key":"bibr23-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/16.6.e43"},{"key":"bibr24-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0273502"},{"key":"bibr25-10497323231208417","doi-asserted-by":"publisher","DOI":"10.1177\/1609406917733847"},{"key":"bibr26-10497323231208417","unstructured":"Reynolds V. 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