Evidence map›Paper›PMID 42759361›Full record

ArticleDrug and alcohol dependence2026

Association of experiencing homelessness with hospital utilization and medical bills among people who have injected drugs: A community-based cohort and data linkage study.

Kenneth A Feder, Nicole M Fong, Jacquie Astemborski, Jing Sun, Javier Cepeda, Jacqueline E Rudolph, Gregory D Kirk, Shruti H Mehta, Becky L Genberg

Abstract read
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In one paragraph

Article in Drug and alcohol dependence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

9 authors.

Kenneth A FederDepartment of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, USA. Electronic address: kfeder1@jhu.edu.
Nicole M FongDepartment of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, USA.
Jacquie AstemborskiDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, USA.
Jing SunDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, USA.
Javier CepedaDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, USA.
Jacqueline E RudolphDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, USA.
Gregory D KirkDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, USA; Department of Medicine, Johns Hopkins University School of Medicine, USA.
Shruti H MehtaDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, USA.
Becky L GenbergDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, USA.

Funding

Vaccine Response and Immunotherapeutics SWGP30AI094189 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Richard E. Chaisson · 2012 to 2026
$67.0M
The AIDS Linked to the Intravenous Experience (ALIVE) StudyU01DA036297 · NIDA · JOHNS HOPKINS UNIVERSITY · PI Gregory D Kirk, Shruti H Mehta · 2014 to 2026
$28.9M
When pandemics collide: The intersection of the opioid crisis, COVID-19 and HIV pandemics among people who inject drugs in the United StatesR01DA053136 · NIDA · JOHNS HOPKINS UNIVERSITY · PI GENBERG, BECKY LYNN · 2020 to 2024
$3.2M
Collaboration on HIV and AgingResearch through the Study of MitochondriaK01AI162247 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Jing Sun · 2022 to 2026
$677k
NIAID NIH HHS K01 AI162247NIAID NIH HHS P30 AI094189NIDA NIH HHS R01 DA053136NIDA NIH HHS U01 DA036297
6 · The paper itself

Abstract

backgroundHousing instability is common among people who inject drugs and is associated with poor health. We examined the association of homelessness with emergency department (ED) and inpatient (IP) utilization and charges among people who have injected drugs.

methodsParticipants were enrolled 2015-2024 in ALIVE, a cohort of Baltimore adults who have injected drugs. Past-six-month homelessness was reported at twice-annual study visits. ED and IP admissions and resulting charges to patients were ascertained through linkage to a state hospital billing registry. We estimated differences in rates of admissions and charges per-six-months comparing periods when participants did and did not experience homelessness, and adjusting for confounders such as substance use behaviors using balancing weights.

resultsAmong 1365 participants' 9896 study visits (66% male, 87% age 40-69), mean past-six-month rates of admissions and charges were 0.92 and $1408 respectively for the ED, and 0.19 and $4051 for IP. After confounding adjustment, ED admission rates (adjusted rate difference (aRD) = 1.37, 95% CI 0.79-2.42), IP admission rates (aRD 0.11, 95% CI 0.04-0.19), ED charges (aRD = $1720, 95% CI $1027 to $2726), and IP charges (aRD $2072, 95% CI $516 to $3760) were significantly higher during periods of homelessness. DISCUSSION: When people who injected drugs were experiencing homelessness, they experienced significantly elevated rates of ED and IP admissions and charges.

Indexed as

HomelessnessHospital usePeople who inject drugs

Identifiers

PMID42759361
PMCPMC13592521

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.