Health care for people experiencing homelessness-What outcomes matter?

The cohort study by Stewart et al describes the Safe, Healthy, Empowered (SHE) Clinic, which is colocated with a Seattle, Washington, drop-in community center and serves women experiencing homelessness 4 hours per week on a walk-in basis. Stewart et al compared nonemergent (as judged by 2 investigators) emergency department (ED) visits for women who accessed the clinic vs those who had not. While comparison between these groups is limited by selection bias and potential unmeasured confounders, Stewart et al report that the 41 women who accessed the clinic 1 or more times had a reduction from 37 nonemergent ED visits in the 6 months before they used the clinic to 22 visits in the next 6 months. A similar reduction was not observed for 35 women who had not used the clinic.