{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:03:17Z","timestamp":1781586197478,"version":"3.54.5"},"reference-count":7,"publisher":"American Public Health Association","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:p> Objectives. To describe a trend in emergency department (ED) use by homeless children and young adults before and after a state housing policy change in 2012 and to quantify financial and time costs to the health care system. <\/jats:p><jats:p> Methods. We retrospectively reviewed de-identified electronic medical records of homeless children and young adults aged 0 to 21 years seeking shelter at an urban tertiary pediatric ED in Boston, Massachusetts, between September 1, 2011, and August 31, 2016. <\/jats:p><jats:p> Results. We identified 1078 visits for homelessness by 916 children and young adults. The median number of visits per month increased from 3 before the policy change to 17 after (P\u2009&lt;\u2009.001). The total hospital charges were $578\u2009351, with a net payment of $214\u2009231, 97% paid by Medicaid. The average length of stay was 8 hours, totaling more than 8500 hours of occupancy. <\/jats:p><jats:p> Conclusions. The number of homeless children and young adults who visited a pediatric ED increased significantly following a housing policy change, leading to substantial resource burdens on the ED and Medicaid. <\/jats:p><jats:p> Public Health Implications. Policymakers should consider potential health care costs when designing housing policies and consider investing in housing to prevent unnecessary ED visits. <\/jats:p>","DOI":"10.2105\/ajph.2018.304493","type":"journal-article","created":{"date-parts":[[2018,6,21]],"date-time":"2018-06-21T20:02:52Z","timestamp":1529611372000},"page":"1076-1078","source":"Crossref","is-referenced-by-count":8,"title":["Trends in Homeless Children and Young Adults Seeking Shelter in a Boston Pediatric Emergency Department Following State Housing Policy Changes, 2011\u20132016"],"prefix":"10.2105","volume":"108","author":[{"given":"Mia","family":"Kanak","sequence":"first","affiliation":[{"name":"Mia Kanak is with the Department of Pediatrics at Boston Children\u2019s Hospital\/Harvard Medical School and Boston University School of Medicine\/Boston Medical Center, Boston, MA. Amanda Stewart is with the Division of Emergency Medicine, Boston Children\u2019s Hospital\/Harvard Medical School. Robert Vinci and Megan Sandel are with the Department of Pediatrics, Boston University School of Medicine\/Boston Medical Center. Shanshan Liu is with the Institutional Centers for Clinical and Translational Research, Boston..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Stewart","sequence":"additional","affiliation":[{"name":"Mia Kanak is with the Department of Pediatrics at Boston Children\u2019s Hospital\/Harvard Medical School and Boston University School of Medicine\/Boston Medical Center, Boston, MA. Amanda Stewart is with the Division of Emergency Medicine, Boston Children\u2019s Hospital\/Harvard Medical School. Robert Vinci and Megan Sandel are with the Department of Pediatrics, Boston University School of Medicine\/Boston Medical Center. Shanshan Liu is with the Institutional Centers for Clinical and Translational Research, Boston..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Vinci","sequence":"additional","affiliation":[{"name":"Mia Kanak is with the Department of Pediatrics at Boston Children\u2019s Hospital\/Harvard Medical School and Boston University School of Medicine\/Boston Medical Center, Boston, MA. Amanda Stewart is with the Division of Emergency Medicine, Boston Children\u2019s Hospital\/Harvard Medical School. Robert Vinci and Megan Sandel are with the Department of Pediatrics, Boston University School of Medicine\/Boston Medical Center. Shanshan Liu is with the Institutional Centers for Clinical and Translational Research, Boston..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Liu","sequence":"additional","affiliation":[{"name":"Mia Kanak is with the Department of Pediatrics at Boston Children\u2019s Hospital\/Harvard Medical School and Boston University School of Medicine\/Boston Medical Center, Boston, MA. Amanda Stewart is with the Division of Emergency Medicine, Boston Children\u2019s Hospital\/Harvard Medical School. Robert Vinci and Megan Sandel are with the Department of Pediatrics, Boston University School of Medicine\/Boston Medical Center. Shanshan Liu is with the Institutional Centers for Clinical and Translational Research, Boston..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Sandel","sequence":"additional","affiliation":[{"name":"Mia Kanak is with the Department of Pediatrics at Boston Children\u2019s Hospital\/Harvard Medical School and Boston University School of Medicine\/Boston Medical Center, Boston, MA. Amanda Stewart is with the Division of Emergency Medicine, Boston Children\u2019s Hospital\/Harvard Medical School. Robert Vinci and Megan Sandel are with the Department of Pediatrics, Boston University School of Medicine\/Boston Medical Center. Shanshan Liu is with the Institutional Centers for Clinical and Translational Research, Boston..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2005.070482"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2014.11.008"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1016\/j.yapd.2007.03.010"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.102.3.554"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000436"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.15771"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303649"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.2018.304493","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T23:24:47Z","timestamp":1652138687000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.2018.304493"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8]]},"references-count":7,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.2105\/AJPH.2018.304493"],"URL":"https:\/\/doi.org\/10.2105\/ajph.2018.304493","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8]]}}}