Summary
Youth comprise one-third of the U.S. homeless population. However, little is known about how homelessness affects health care utilization. Authors examine associations of homelessness with hospitalization, primary care, and emergency department (ED) visits, varying by race/ethnicity, among Medicaid-enrolled youth.
Findings: Approximately 17% of sampled youth experienced homelessness in 2018 (N=90,202). Compared with their housed counterparts, youth experiencing homelessness had a 1.9 percentage point (pp) higher likelihood of frequent ED visits but a 2.9 pp lower probability of any primary care visits. Homelessness was associated with 221 more ED visits, 100 more preventable ED visits, 19.9 more hospitalizations, but 56 fewer primary care visits, per 1,000 youth. The associations of homelessness with total ED visits, preventable ED visits, and needed and nonpreventable ED visits were all higher among whites and, particularly, Blacks, than for Hispanics and Asians.
Medicaid-enrolled youth who experienced homelessness had more overall ED, preventable ED, and hospital visits, but fewer primary care visits than their housed peers. Results suggest promoting primary care use should be considered among strategies to improve health and reduce costs.