Predictors of medical or surgical and psychiatric hospitalizations among a population-based cohort of homeless adults

C. Chambers, M. Katic, S. Chiu, D.A. Redelmeier, W. Levinson, A. Kiss and S.W. Hwang

American Journal of Public Health, 2013, vol. 103, issue S2, S380-S388

Abstract: Objectives. We identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. Methods. We recruited participants from shelters and meal programs. We then linked them to administrative databases to capture hospital admissions during the study (2005-2009). We used logistic regression to identify predictors of medical or surgical and psychiatric hospitalizations. Results. Among 1165 homeless adults, 20% had a medical or surgical hospitalization, and 12% had a psychiatric hospitalization during the study. These individuals had a total of 921 hospitalizations, of which 548 were medical or surgical and 373 were psychiatric. Independent predictors of medical or surgical hospitalization included birth in Canada, having a primary care provider, higher perceived external health locus of control, and lower health status. Independent predictors of psychiatric hospitalization included being a current smoker, having a recent mental health problem, and having a lower perceived internal health locus of control. Being accompanied by a partner or dependent children was protective for hospitalization. Conclusions. Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services.

Keywords: addiction; article; Canada; cohort analysis; female; health status; homelessness; hospitalization; human; male; mental health; mental hospital; risk factor; social support; socioeconomics; statistics; Canada; homelessness; hospitalization; statistics and numerical data; Substance-Related Disorders, Cohort Studies; Female; Health Status; Homeless Persons; Hospitalization; Hospitals, Psychiatric; Humans; Male; Mental Health; Ontario; Risk Factors; Social Support; Socioeconomic Factors; Substance-Related Disorders, Cohort Studies; Female; Health Status; Homeless Persons; Hospitalization; Hospitals, Psychiatric; Humans; Male; Mental Health; Ontario; Risk Factors; Social Support; Socioeconomic Factors; Substance-Related Disorders (search for similar items in EconPapers)
Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301646_8

DOI: 10.2105/AJPH.2013.301646

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