{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T20:30:45Z","timestamp":1789849845196,"version":"4.0.1"},"reference-count":24,"publisher":"American Public Health Association","issue":"S2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:p> Objectives. We compared service use among homeless and nonhomeless veterans newly enrolled in a medical home model and identified patterns of use among homeless veterans associated with reductions in emergency department (ED) use. <\/jats:p><jats:p> Methods. We used case\u2013control matching with a nested cohort analysis to measure 6-month health services use, new diagnoses, and care use patterns in veterans at the Providence, Rhode Island, Veterans Affairs Medical Center from 2008 to 2011. <\/jats:p><jats:p> Results. We followed 127 homeless and 106 nonhomeless veterans. Both groups had similar rates of chronic medical and mental health diagnoses; 25.4% of the homeless and 18.1% of the nonhomeless group reported active substance abuse. Homeless veterans used significantly more primary, mental health, substance abuse, and ED care during the first 6 months. Homeless veterans who accessed primary care at higher rates (relative risk ratio [RRR]\u2009=\u20091.46; 95% confidence interval [CI]\u2009=\u20091.11, 1.92) or who used specialty and primary care (RRR\u2009=\u200910.95; 95% CI\u2009=\u20091.58, 75.78) had reduced ED usage. Homeless veterans in transitional housing or doubled-up at baseline (RRR\u2009=\u20093.41; 95% CI\u2009=\u20091.24, 9.42) had similar reductions in ED usage. <\/jats:p><jats:p> Conclusions. Homeless adults had substantial health needs when presenting for care. High-intensity primary care and access to specialty care services could reduce ED use. <\/jats:p>","DOI":"10.2105\/ajph.2013.301632","type":"journal-article","created":{"date-parts":[[2013,10,22]],"date-time":"2013-10-22T20:38:05Z","timestamp":1382474285000},"page":"S374-S379","source":"Crossref","is-referenced-by-count":37,"title":["New to Care: Demands on a Health System When Homeless Veterans Are Enrolled in a Medical Home Model"],"prefix":"10.2105","volume":"103","author":[{"given":"Thomas P.","family":"O\u2019Toole","sequence":"first","affiliation":[{"name":"Thomas P. O\u2019Toole, Claire Bourgault, Erin E. Johnson, Stephen G. Redihan, and Matthew Borgia are with the Providence Veterans Affairs (VA) Medical Center, Warren Alpert Medical School at Brown University, and VA National Center on Homelessness Among Veterans, Providence, RI. Riccardo Aiello and Vincent Kane are with the National Center on Homeless Among Veterans, Providence. Vincent Kane is also a guest editor for this supplement issue."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Bourgault","sequence":"additional","affiliation":[{"name":"Thomas P. O\u2019Toole, Claire Bourgault, Erin E. Johnson, Stephen G. Redihan, and Matthew Borgia are with the Providence Veterans Affairs (VA) Medical Center, Warren Alpert Medical School at Brown University, and VA National Center on Homelessness Among Veterans, Providence, RI. Riccardo Aiello and Vincent Kane are with the National Center on Homeless Among Veterans, Providence. Vincent Kane is also a guest editor for this supplement issue."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin E.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Thomas P. O\u2019Toole, Claire Bourgault, Erin E. Johnson, Stephen G. Redihan, and Matthew Borgia are with the Providence Veterans Affairs (VA) Medical Center, Warren Alpert Medical School at Brown University, and VA National Center on Homelessness Among Veterans, Providence, RI. Riccardo Aiello and Vincent Kane are with the National Center on Homeless Among Veterans, Providence. Vincent Kane is also a guest editor for this supplement issue."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen G.","family":"Redihan","sequence":"additional","affiliation":[{"name":"Thomas P. O\u2019Toole, Claire Bourgault, Erin E. Johnson, Stephen G. Redihan, and Matthew Borgia are with the Providence Veterans Affairs (VA) Medical Center, Warren Alpert Medical School at Brown University, and VA National Center on Homelessness Among Veterans, Providence, RI. Riccardo Aiello and Vincent Kane are with the National Center on Homeless Among Veterans, Providence. Vincent Kane is also a guest editor for this supplement issue."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Borgia","sequence":"additional","affiliation":[{"name":"Thomas P. O\u2019Toole, Claire Bourgault, Erin E. Johnson, Stephen G. Redihan, and Matthew Borgia are with the Providence Veterans Affairs (VA) Medical Center, Warren Alpert Medical School at Brown University, and VA National Center on Homelessness Among Veterans, Providence, RI. Riccardo Aiello and Vincent Kane are with the National Center on Homeless Among Veterans, Providence. Vincent Kane is also a guest editor for this supplement issue."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Aiello","sequence":"additional","affiliation":[{"name":"Thomas P. O\u2019Toole, Claire Bourgault, Erin E. Johnson, Stephen G. Redihan, and Matthew Borgia are with the Providence Veterans Affairs (VA) Medical Center, Warren Alpert Medical School at Brown University, and VA National Center on Homelessness Among Veterans, Providence, RI. Riccardo Aiello and Vincent Kane are with the National Center on Homeless Among Veterans, Providence. Vincent Kane is also a guest editor for this supplement issue."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Kane","sequence":"additional","affiliation":[{"name":"Thomas P. O\u2019Toole, Claire Bourgault, Erin E. Johnson, Stephen G. Redihan, and Matthew Borgia are with the Providence Veterans Affairs (VA) Medical Center, Warren Alpert Medical School at Brown University, and VA National Center on Homelessness Among Veterans, Providence, RI. Riccardo Aiello and Vincent Kane are with the National Center on Homeless Among Veterans, Providence. Vincent Kane is also a guest editor for this supplement issue."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-126-8-199704150-00007"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.1604"},{"key":"bib3","volume-title":"Under the Safety Net","author":"Brickner PW","year":"1990"},{"key":"bib4","volume-title":"Homelessness, Health, and Human Needs","author":"Institute of Medicine\/Committee on Health Care for Homeless People","year":"1988"},{"key":"bib5","volume-title":"Organizing Health Services for Homeless People","author":"McMurray-Avilla M","year":"1997"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.92.5.778"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2005.076190"},{"key":"bib11","volume-title":"International Classification of Diseases, Ninth Revision, Clinical Modification","year":"1980"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.179416"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1080\/00981380801985341"},{"key":"bib14","doi-asserted-by":"publisher","DOI":"10.1097\/00124784-200311000-00014"},{"key":"bib15","volume-title":"US Department of Veterans Affairs. 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