Please use this identifier to cite or link to this item: http://localhost:8080/xmlui/handle/123456789/4680
Title: Health service use and predictors of high health service use among adults experiencing homelessness: a retrospective cohort study
Authors: Mitchell, Rebecca J.
Karin, Eyal
Power, Joseph
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Keywords: homeless
healthcare
readmission
cost
mortality
Issue Date: Dec-2022
Publisher: Australian and New Zealand Journal of Public Health
Series/Report no.: Community;896-902
Abstract: Objective: To describe the characteristics and cost of health service use of a cohort of 2,140 people attending homeless hostel clinics, and identify predictors of high health service use and time to readmission. Method: A retrospective cohort study of 2,140 adults who attended a homeless hostel clinic and were hospitalised in New South Wales (NSW) using linked clinic, health and mortality data from 1 July 2008 to 30 June 2021. Multivariable logistic regression examined predictors of high health service users. Results: There were 27,466 hospital admissions, with a median cost of A$81,481 per person, and a total cost of A$548.2 million. Twenty per cent of the cohort were readmitted within 28 days and 27.4% were classified as high users of health services. Factors associated with high use were age ≥45 years, female (AOR: 1.52; 95%CI 1.05-2.22), the presence of a mental disorder, substance use disorder (AOR: 1.36; 95%CI: 1.03-1.82), or if the person had been homeless for >1 year (AOR: 1.31; 95%CI: 1.06-1.62). Conclusions and implications for public health: The high health costs generated by homeless adults confirm the need to develop models of supported housing with a focus on integrated care, improved referral pathways and better coordination with community-based support agencies.
URI: http://localhost:8080/xmlui/handle/123456789/4680
ISSN: 1753-6405.13302
Appears in Collections:VOL 46 NO 6

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