Application of the Frailty Framework among Vulnerable Populations to Hospitalization Outcomes of Individuals Experiencing Homelessness in Long Beach, California.
Application of the Frailty Framework among Vulnerable Populations to Hospitalization Outcomes of Individuals Experiencing Homelessness in Long Beach, California.
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DOI：
10.1080/10530789.2021.1908487
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发表时间：
2022
影响因子：
1.4
通讯作者：
Rannalli, Debby
中科院分区：
文献类型：
--
作者：
Fisher, Dennis G.;Reynolds, Grace L.;Khoiny, Noushin;Huckabay, Loucine;Rannalli, Debby
无家可归的人患传染病的几率很高，可能导致住院。然而，医疗系统的低能力和缺乏医疗保险可能意味着那些正在经历无家可归的人可能得不到他们需要的医疗保健。这项研究使用基线上的危险因素来预测随访时的住院情况。本文还介绍了报告无家可归者与选定传染病之间的关系。2000年8月至2014年7月进行了基线和随访的纵向研究。4916无家平均年龄37.9岁，女性29%，2692岁无家可归年龄42.1岁，29%女性从加州长滩低收入、高犯罪率地区的研究/服务中心接受服务。风险行为评估、风险行为跟踪评估、甲型肝炎、乙型肝炎、丙型肝炎、梅毒、衣原体和淋病的实验室检测。在随访中住院的预测因素是曾经使用过强效可卡因，从社会保障或残疾中获得的收入，报告无家可归的人，女性，以及与白人种族/民族相比认为自己是黑人的人。来自社会保障或残疾的安全网的收入似乎为参与者提供了能够获得医疗保健的经验。与那些没有经历过无家可归的人相比，经历过无家可归的人中，似乎有更高的比例在后续治疗中住院。女性，那些认为自己是黑人的人，以及那些在基线上使用可卡因的人，无论他们是否经历过无家可归，都更有可能在后续行动中住院。我们建议与药物滥用治疗计划协调，为无家可归的患者制定出院计划。我们的研究结果支持在与同时经历无家可归和住院的个人合作时使用脆弱框架。
Individuals experiencing homelessness have a high prevalence of infectious diseases that may result in hospitalization. However, low ability to navigate the healthcare system and lack of health insurance may mean that those who are experiencing homelessness may not receive the healthcare that they need. This study uses risk factors at baseline to predict hospitalization at follow-up. This paper also presents the associations between reporting homelessness and selected infectious diseases. Longitudinal study of baseline and follow-up conducted August 2000 through July 2014. 4916 Not experiencing homelessness mean age 37.9 years, 29% female, and 2692 experiencing homelessness age 42.1 years, 29% female received services from a research/service center in a low-income, high-crime area of Long Beach, CA. Risk Behavior Assessment, Risk Behavior Follow-up Assessment, laboratory testing for hepatitis A, hepatitis B, hepatitis C, syphilis, chlamydia, and gonorrhea. Predictors of hospitalization at follow-up were ever use of crack cocaine, income from Social Security or disability, reporting homelessness, female, and those who identify as Black compared to White race/ethnicity. Income from the safety net of Social Security or disability appears to provide the participant with experience that transfers to being able to obtain healthcare. A higher proportion of those experiencing homelessness, compared to those not experiencing homelessness, appear to be hospitalized at follow-up. Women, those who identified as Black, and those who used crack at baseline are more likely to be hospitalized at follow-up whether or not they were experiencing homelessness. We recommend coordination with substance abuse treatment programs for discharge planning for homeless patients. Our findings support use of the Frailty Framework when working with individuals experiencing both homelessness and hospitalization.
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