Mortality among homeless and nonhomeless mentally ill veterans
Mortality among homeless and nonhomeless mentally ill veterans
复制标题
DOI：
10.1097/00005053-200003000-00003
复制
发表时间：
2000-03-01
影响因子：
1.9
通讯作者：
Rosenheck, R
中科院分区：
文献类型：
--
作者：
Kasprow, WJ;Rosenheck, R
这项研究直接比较了无家可归和非无家可归的精神病退伍军人的死亡风险，并将这些群体的死亡率与美国普通人群进行了比较。该研究采用回顾性队列设计，评估了9年内无家可归（N = 6714）和非无家可归（N = 1715）男性退伍军人的死亡率，这些退伍军人接受了退伍军人事务部专门的心理健康计划。研究表明，该群体中所有无家可归者的死亡率明显高于美国普通人口。相对于非无家可归的队列成员，在基线年龄为45至54岁且无家可归1年或更短的队列成员中观察到死亡风险显著增加（RR = 1.55，95%CI = 1.02，2.36）和55岁及以上无家可归1年或以下者（RR = 1.83，95%CI = 1.33，2.52）。在基线时无家可归超过1年的队列成员中观察到类似但不显著的趋势。此外，基线时的医疗问题和既往因酒精问题住院史增加了死亡风险。基线就业和少数群体成员身份降低了死亡风险。该研究表明，与普通人群相比，由专门的VA心理健康计划服务的精神病退伍军人的死亡风险较高。无家可归增加了这种风险，特别是在老年退伍军人中，这种差异在进入医疗保健系统后不会减弱。
This study directly compared mortality risk in homeless and nonhomeless mentally ill veterans and compared mortality rates in these groups with the general U.S. population. The study used a retrospective cohort design to assess mortality over a 9-year period in homeless (N = 6714) and nonhomeless (N = 1715) male veterans who were treated by Department of Veterans Affairs specialized mental health programs. The study showed that mortality rates in all homeless members of the cohort were significantly higher than the general U.S. population. Relative to nonhomeless cohort members, significant increases in mortality risk were observed in cohort members who at baseline were age 45 to 54 and had been homeless 1 year or less (RR = 1.55, 95% CI = 1.02, 2.36) and those age 55 and older who had been homeless 1 year or less (RR = 1.83, 95% CI = 1.33, 2.52). Similar, but nonsignificant trends were observed in cohort members who had been homeless more than 1 year at baseline. Additionally, medical problems at baseline and history of prior hospitalization for alcohol problems elevated mortality risk. Employment at baseline and minority group membership reduced mortality risk. The study suggests that mentally ill veterans served by specialized VA mental health programs are at elevated risk of mortality, relative to the general population. Homelessness increases this risk, particularly in older veterans, and this difference does not abate after entry into a health care system.