期刊
HEALTH SERVICES RESEARCH
卷 48, 期 3, 页码 992-1017出版社
WILEY-BLACKWELL
DOI: 10.1111/1475-6773.12009
关键词
Community health centers; homeless persons; health status; health services utilization; access to care; primary care
资金
- Health Resources and Services Administration (HRSA) of the U.S. Department of the Health and Human Services (HHS)
Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n=2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health statuslifetime burden of chronic conditions, mental health problems, and substance use problemscompared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR=1.98, 95 percent CI: 1.243.16) and twice the odds of having an ED visit in the past year (OR=2.00, 95 percent CI: 1.372.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use.
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