{"id":"https://openalex.org/W7225416136","doi":"https://doi.org/10.1097/phh.0000000000002492","title":"Impact of Low-Barrier Shelter and Street Medicine on Emergency Department Utilization and Days of Hospitalization of Persons Experiencing Homelessness","display_name":"Impact of Low-Barrier Shelter and Street Medicine on Emergency Department Utilization and Days of Hospitalization of Persons Experiencing Homelessness","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225416136","doi":"https://doi.org/10.1097/phh.0000000000002492","pmid":"https://pubmed.ncbi.nlm.nih.gov/42993901"},"language":"en","primary_location":{"id":"doi:10.1097/phh.0000000000002492","doi":"https://doi.org/10.1097/phh.0000000000002492","is_oa":false,"landing_page_url":"https://doi.org/10.1097/phh.0000000000002492","pdf_url":null,"source":{"id":"https://openalex.org/S146663148","display_name":"Journal of Public Health Management and Practice","issn_l":"1078-4659","issn":["1078-4659","1550-5022"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","jufo-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Public Health Management &amp; Practice","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161064361","display_name":"Natalie T. Kuebler","orcid":"https://orcid.org/0009-0009-6681-4465","observed_orcids":["https://orcid.org/0009-0009-6681-4465"]},"institutions":[{"id":"https://openalex.org/I107639228","display_name":"University of Notre Dame","ror":"https://ror.org/00mkhxb43","country_code":"US","type":"education","lineage":["https://openalex.org/I107639228"]},{"id":"https://openalex.org/I4210086927","display_name":"Beacon Health System","ror":"https://ror.org/0051tdp65","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210086927"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Natalie T. Kuebler","raw_affiliation_strings":["Author Affiliations: Memorial Family Medicine Residency, South Bend, Indiana (Mrs Kuebler, Ms Moore, Ms Jordan, Mr Bartsch, Dr Callaghan); Lucy Family Institute for Data & Society, Notre Dame, Indiana (Mrs Young); University of Notre Dame, Notre Dame, Indiana (Ms Jordan, Ms Barrow, Ms Lu, Dr Pfeil); Beacon Health System, South Bend, Indiana (Dr Zimmer); and New Day Intake Center, South Bend, Indiana (Dr Pfiel, Dr McCarthy)"],"raw_orcid":"https://orcid.org/0009-0009-6681-4465","affiliations":[{"raw_affiliation_string":"Author Affiliations: Memorial Family Medicine Residency, South Bend, Indiana (Mrs Kuebler, Ms Moore, Ms Jordan, Mr Bartsch, Dr Callaghan); Lucy Family Institute for Data & Society, Notre Dame, Indiana (Mrs Young); University of Notre Dame, Notre Dame, Indiana (Ms Jordan, Ms Barrow, Ms Lu, Dr Pfeil); Beacon Health System, South Bend, Indiana (Dr Zimmer); and New Day Intake Center, South Bend, Indiana (Dr Pfiel, Dr McCarthy)","institution_ids":["https://openalex.org/I107639228","https://openalex.org/I4210086927"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5104689134","display_name":"Meagan J. K. Moore","orcid":"https://orcid.org/0009-0008-7599-2637","observed_orcids":["https://orcid.org/0009-0008-7599-2637"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Meagan J. Moore","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0009-0008-7599-2637","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161128312","display_name":"Mary R. Jordan","orcid":"https://orcid.org/0009-0005-5219-733X","observed_orcids":["https://orcid.org/0009-0005-5219-733X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Mary R. Jordan","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0009-0005-5219-733X","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160991270","display_name":"Lindsay K. Barrow","orcid":"https://orcid.org/0009-0001-1501-6721","observed_orcids":["https://orcid.org/0009-0001-1501-6721"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Lindsay K. Barrow","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0009-0001-1501-6721","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161059928","display_name":"Hannah F. Lu","orcid":"https://orcid.org/0009-0004-7976-2119","observed_orcids":["https://orcid.org/0009-0004-7976-2119"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Hannah F. Lu","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0009-0004-7976-2119","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5087993951","display_name":"Jessica L Young","orcid":"https://orcid.org/0000-0002-5619-5113","observed_orcids":["https://orcid.org/0000-0002-5619-5113"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jessica A. Young","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0002-5619-5113","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161076562","display_name":"Sheila A. McCarthy","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Sheila A. McCarthy","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5083840383","display_name":"Margaret R. Pfeil","orcid":"https://orcid.org/0000-0001-8749-0484","observed_orcids":["https://orcid.org/0000-0001-8749-0484"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Margaret R. Pfeil","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0001-8749-0484","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5137279399","display_name":"Reinhard C. L. Bartsch","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Reinhard C. L. Bartsch","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5060663549","display_name":"Katharine A. Callaghan","orcid":"https://orcid.org/0000-0003-4930-434X","observed_orcids":["https://orcid.org/0000-0003-4930-434X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Katharine A. Callaghan","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0003-4930-434X","affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5102887780","display_name":"Donald F. Zimmer","orcid":"https://orcid.org/0000-0001-9458-6118","observed_orcids":["https://orcid.org/0000-0001-9458-6118"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Donald F. Zimmer","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0001-9458-6118","affiliations":[]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11464","display_name":"Homelessness and Social Issues","score":1.0,"subfield":{"id":"https://openalex.org/subfields/3312","display_name":"Sociology and Political Science"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T11464","display_name":"Homelessness and Social Issues","score":1.0,"subfield":{"id":"https://openalex.org/subfields/3312","display_name":"Sociology and Political Science"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11095","display_name":"Emergency and Acute Care Studies","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11860","display_name":"HIV, Drug Use, Sexual Risk","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/homelessness","display_name":"homelessness","score":0.800000011920929},{"id":"https://openalex.org/keywords/housing-first","display_name":"Housing First","score":0.968999981880188},{"id":"https://openalex.org/keywords/street-medicine","display_name":"street medicine","score":0.8659999966621399},{"id":"https://openalex.org/keywords/emergency-department-use","display_name":"emergency department utilization","score":0.9319999814033508},{"id":"https://openalex.org/keywords/length-of-hospital-stay","display_name":"length of hospital stay","score":0.8410000205039978},{"id":"https://openalex.org/keywords/homeless-outreach","display_name":"homeless outreach","score":0.3790000081062317},{"id":"https://openalex.org/keywords/health-care-access","display_name":"health care access","score":0.41600000858306885},{"id":"https://openalex.org/keywords/south-bend-indiana","display_name":"South Bend, Indiana","score":0.8939999938011169}],"concepts":[{"id":"https://openalex.org/C2781400479","wikidata":"https://www.wikidata.org/wiki/Q11640","display_name":"Outreach","level":2,"score":0.8870999813079834},{"id":"https://openalex.org/C2780724011","wikidata":"https://www.wikidata.org/wiki/Q1295316","display_name":"Emergency department","level":2,"score":0.8009999990463257},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6820999979972839},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.6273000240325928},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.5167999863624573},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.49230000376701355},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.4846999943256378},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.4316999912261963},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.3481999933719635},{"id":"https://openalex.org/C2775949068","wikidata":"https://www.wikidata.org/wiki/Q4260475","display_name":"Health facility","level":4,"score":0.3352000117301941},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.3240000009536743},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.31049999594688416},{"id":"https://openalex.org/C2992870097","wikidata":"https://www.wikidata.org/wiki/Q3259564","display_name":"Patient discharge","level":3,"score":0.3102000057697296},{"id":"https://openalex.org/C2780084376","wikidata":"https://www.wikidata.org/wiki/Q7644625","display_name":"Supportive housing","level":2,"score":0.2928999960422516},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.2921999990940094},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2827000021934509},{"id":"https://openalex.org/C2989236134","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Patient care","level":2,"score":0.2635999917984009},{"id":"https://openalex.org/C187155963","wikidata":"https://www.wikidata.org/wiki/Q629029","display_name":"Occupational safety and health","level":2,"score":0.2540999948978424}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1097/phh.0000000000002492","doi":"https://doi.org/10.1097/phh.0000000000002492","is_oa":false,"landing_page_url":"https://doi.org/10.1097/phh.0000000000002492","pdf_url":null,"source":{"id":"https://openalex.org/S146663148","display_name":"Journal of Public Health Management and Practice","issn_l":"1078-4659","issn":["1078-4659","1550-5022"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","jufo-1","medline","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Public Health Management &amp; Practice","raw_type":"journal-article"},{"id":"pmid:42993901","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42993901","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of public health management and practice : JPHMP","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0},{"display_name":"Reduced inequalities","id":"https://metadata.un.org/sdg/10","score":0.7390999794006348},{"display_name":"Sustainable cities and communities","id":"https://metadata.un.org/sdg/11","score":0.7250000238418579}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":14,"referenced_works":["https://openalex.org/W1852949982","https://openalex.org/W1968880408","https://openalex.org/W2012907711","https://openalex.org/W2019144437","https://openalex.org/W2043721816","https://openalex.org/W2091995252","https://openalex.org/W2128336124","https://openalex.org/W2169865138","https://openalex.org/W2563638732","https://openalex.org/W2772470047","https://openalex.org/W2912694069","https://openalex.org/W3120622121","https://openalex.org/W3174811171","https://openalex.org/W4282944187"],"related_works":["https://openalex.org/W2998693625","https://openalex.org/W2337633156","https://openalex.org/W610963173","https://openalex.org/W2971575375","https://openalex.org/W2091995252","https://openalex.org/W7216428428","https://openalex.org/W2122984307","https://openalex.org/W3174811171","https://openalex.org/W3000414581","https://openalex.org/W2613676442"],"abstract_inverted_index":{"OBJECTIVE:":[0],"To":[1],"assess":[2],"the":[3,31,102,107,120,126,130,233],"impact":[4],"of":[5,22,42,80,134,148,153],"Housing":[6],"First":[7],"(HF)":[8],"shelter":[9,49,167,205],"and":[10,20,50,68,76,82,101,104,123,141,151,169,206,213,221,224,232],"Street":[11],"Medicine":[12],"(SM)":[13],"outreach":[14,52],"on":[15],"emergency":[16],"department":[17],"(ED)":[18],"utilization":[19,212],"hospitalization":[21,69],"persons":[23],"experiencing":[24],"homelessness":[25],"(PEH).":[26],"DESIGN:":[27],"Using":[28],"data":[29],"from":[30,60],"Indiana":[32],"Health":[33],"Information":[34],"Exchange,":[35],"we":[36],"conducted":[37],"a":[38,87],"retrospective":[39],"chart":[40],"review":[41],"95":[43],"individuals":[44],"who":[45,116],"accessed":[46],"both":[47,139],"HF":[48,99,121,140,166,223],"SM":[51,84,93,127,142,178,225],"in":[53,106,129,138],"South":[54],"Bend,":[55],"Indiana.":[56],"These":[57,200],"dates":[58],"ranged":[59],"September":[61],"2019":[62],"to":[63],"November":[64],"2024.":[65],"ED":[66,149,156,211],"visits":[67,150,157],"days":[70,152,181],"were":[71],"compared":[72],"1":[73],"year":[74,133],"before":[75],"after":[77,176],"first":[78,83,132],"date":[79],"housing":[81,118],"encounter":[85],"using":[86],"2-sided":[88],"paired":[89],"t":[90],"test.":[91],"SETTING:":[92],"drop-in":[94],"clinics":[95],"located":[96],"at":[97,119,125],"an":[98],"facility":[100,122],"EDs":[103],"hospitals":[105],"surrounding":[108],"St.":[109],"Joseph":[110],"County":[111],"area.":[112],"PARTICIPANTS:":[113],"Ninety-five":[114],"PEH":[115,231],"received":[117],"care":[124],"clinic":[128],"clinic's":[131],"operations.":[135],"INTERVENTION:":[136],"Participation":[137],"programs.":[143],"MAIN":[144],"OUTCOME":[145],"MEASURE:":[146],"Number":[147],"hospitalization.":[154,217],"RESULTS:":[155],"decreased":[158],"by":[159,170],"30%":[160],"(322-226,":[161],"P":[162,173,187,192],"=":[163,174,188,193],".02)":[164],"following":[165],"entry":[168],"35%":[171],"(437-284,":[172],".04)":[175],"initial":[177],"engagement.":[179],"Hospitalization":[180],"also":[182,215],"declined":[183],"(259-146":[184],"post-HF":[185],"shelter,":[186],".14;":[189],"324-148":[190],"post-SM,":[191],".10),":[194],"although":[195],"not":[196],"statistically":[197],"significantly.":[198],"CONCLUSIONS:":[199],"findings":[201],"highlight":[202],"that":[203],"low-barrier":[204],"healthcare":[207],"initiatives":[208],"significantly":[209],"reduce":[210],"may":[214],"decrease":[216],"POLICY":[218],"IMPLICATIONS:":[219],"Expanding":[220],"integrating":[222],"interventions":[226],"could":[227],"maximize":[228],"benefits":[229],"for":[230],"communities":[234],"they":[235],"live":[236],"in.":[237]},"counts_by_year":[],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2026-11-07T00:00:00"}
