Recorded presentation

Roy Grant¹, Peter Sherman, MD², and Irwin Redlener¹. (1) The Children's Health Fund, 317 East 64th Street, New York, NY 10021, 212-535-9400, rgrant@chfund.org, (2) Division of Community Pediatrics, The Children's Hospital at Montefiore/ Albert Einstein College of Medicine, 317 East 64th Street, New York, NY 10021

Studies show that homeless children have more acute and chronic conditions, and worse health status, than housed low-income children. Prior to becoming homeless, they may have lacked access to health care. This study was designed to determine the specialist referral needs of homeless children when they begin a primary care medical home program; and to replicate findings of our earlier study which found a very high level of need in the population. Our method was retrospective chart review of all pediatric patients of the New York Children’s Health Project (NYCHP) referred to a specialist based on pediatric assessment in 1998. To allow virtually 100% turnover of the patient population, this was repeated for patients referred during 2001. The NYCHP is one of the nation’s largest providers of health care to the homeless; nearly all patients lived in a homeless or domestic violence shelter. In 1998, 509 of 2,205 pediatric patients (23.1%) required at least one specialist referral. Two ore more referrals were required by 183 patients (8.3% of patients; 35.9% of referred patients). Conditions included club foot, renal disease, hearing loss, visual impairment, seizure disorder, and hydrocephaly. In 2001, 544 of 2,425 pediatric patients (22.4%) were referred, of whom 150 (6.1% of patients; 27.6% of referred patients) required two or more specialist referrals. Similar conditions were identified. We conclude that medically underserved pediatric patients may present very serious needs when they enter a medical home setting. They may require longer than typical pediatric visits and urgent need for specialist care.

Learning Objectives: At the end of this presentation, participants will

• better understand the nature and urgency of medical conditions affecting homeless children;
• better understand the necessity of ensuring access to specialist care for medically underserved children;
• better understandt the need for Medicaid providers to meet EPSDT standards in their delivery of care

Keywords: Underserved Populations, Health Care Delivery

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation