A policy change to Massachusetts' shelter eligibility was tied to increased pediatric emergency department visits for homelessness and substantial health care costs. The study was published in Pediatrics.

Researchers retrospectively evaluated emergency department visits for homelessness at a children's hospital from March 2010 to February 2016 to analyze the frequency and costs of pediatric emergency department visits for homelessness before and after the 2012 implementation of a policy changing emergency shelter eligibility for homeless families.

Eligibility Policy For Homeless Families

In 2012, Massachusetts changed its emergency shelter eligibility policy for homeless families. One new criterion to document homelessness was staying in a location “not meant for human habitation,” and the emergency department (ED) fulfilled this requirement. 

The researchers found there were 312 emergency department visits for homelessness, 95% of which were after the policy healthcare. The visits increased 4.5 times after the policy implementation.

Children seen after the policy was enacted were more likely to have no medical complaint (rate ratio, 3.27). During the study period, the number of homeless children in Massachusetts increased 1.4 times, but emergency department visits for homelessness increased 13-fold.  Payments averaged $557 per emergency department visit and cost more than four times what a night in a shelter would cost.

Pediatric ED Visits

A policy change to Massachusetts’ shelter eligibility was associated with increased pediatric ED visits for homelessness along with substantial health care costs. Potential health care effects should be considered in future housing policies.