Health Outcomes of Obtaining Housing Among Older Homeless Adults.
Health Outcomes of Obtaining Housing Among Older Homeless Adults.
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DOI：
10.2105/ajph.2014.302539
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发表时间：
2015-07
影响因子：
12.7
通讯作者：
Steinman MA
中科院分区：
文献类型：
--
作者：
Brown RT;Miao Y;Mitchell SL;Bharel M;Patel M;Ard KL;Grande LJ;Blazey-Martin D;Floru D;Steinman MA
确定获得住房对老年无家可归者的老年状况和急性护理利用的影响。2010年1月至6月，我们从马萨诸塞州波士顿的收容所招募了250名无家可归的老年人，进行了一项为期12个月的前瞻性队列研究。我们确定了在后续访谈中报告的住房状况。我们在基线和12个月时检查了4项老年状况测量：日常生活活动和日常生活工具活动的独立性，抑郁症状和尿失禁症状。我们通过医疗记录审查确定了12个月内急诊室就诊和住院的次数。我们使用多元回归模型来评估获得住房与我们感兴趣的结果之间的关系。在12个月时，41%的参与者获得了住房。与那些在随访中仍然无家可归的参与者相比，那些有住房的参与者抑郁症状较少。随访时的其他健康状况测量没有因住房状况而异。获得住房的参与者在随访期间的急症护理使用率较低（IRR, 0.5; 95% CI, 0.4-0.6），获得住房的参与者的调整年急症护理就诊率为每年2.5次（95% CI, 1.7-3.3），而无家可归的参与者的调整年急症护理就诊率为每年5.3次（95% CI, 3.8-6.7）。与无家可归者相比，获得住房的老年无家可归者抑郁症状得到改善，急性护理利用率降低。
To determine the impact of obtaining housing on geriatric conditions and acute care utilization among older homeless adults. We conducted a 12-month prospective cohort study of 250 older homeless adults recruited from shelters in Boston, Massachusetts between January and June 2010. We determined housing status as reported at the follow-up interview. We examined 4 measures of geriatric conditions at baseline and 12 months: independence in activities of daily living and instrumental activities of daily living, depressive symptoms, and symptoms of urinary incontinence. We determined number of emergency department visits and hospitalizations over 12 months by medical record review. We used multivariate regression models to evaluate the association between obtaining housing and our outcomes of interest. At 12 months, 41% of participants had obtained housing. Compared to participants who remained homeless at follow-up, those with housing had fewer depressive symptoms. Other measures of health status at follow-up did not differ by housing status. Participants who obtained housing had a lower rate of acute care utilization over the follow-up period (IRR, 0.5; 95% CI, 0.4–0.6), with an adjusted annualized rate of acute care visits of 2.5 per year (95% CI, 1.7–3.3) among participants who obtained housed and 5.3 per year (95% CI, 3.8–6.7) among participants who remained homeless. Older homeless adults who obtained housing experienced improved depressive symptoms and reduced acute care utilization compared to those who remained homeless.