Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization among a Cohort of Homeless and Vulnerably Housed Persons in Canada
Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization among a Cohort of Homeless and Vulnerably Housed Persons in Canada
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DOI：
10.1007/s11524-016-0065-6
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发表时间：
2016-08-01
影响因子：
6.6
通讯作者：
Palepu, Anita
中科院分区：
文献类型：
--
作者：
Jaworsky, Denise;Gadermann, Anne;Palepu, Anita
本研究探讨了住房状况随着时间的推移与未得到满足的身体保健需求和急诊室利用无家可归者和居住在加拿大的人之间的关联。无家可归者和居住条件适宜的个人在基线和每年4年内完成了关于住房、未满足的身体保健需求、保健利用、社会人口特征、物质使用和健康状况的访谈调查。广义logistic混合效应回归模型研究了居住稳定性与未满足的身体健康护理需求和急诊科利用率之间的关系，并对潜在的混杂因素进行了调整。参与者来自温哥华（n = 387）、多伦多（n = 390）和渥太华（n = 396）。在调整潜在混杂因素后，4年随访期间，居住稳定性与未满足身体健康需求的几率较低（调整后的比值比（AOR），0.82; 95%置信区间（CI），0.67，0.98）和急诊室利用率（AOR，0.74; 95% CI，0.62，0.88）相关。居住稳定性与无家可归者和居住条件不佳者的身体健康需求减少和急诊室利用率降低有关。这些调查结果突出表明，需要解决获得稳定住房的问题，因为这是健康差距的一个重要决定因素。
This study examined the association of housing status over time with unmet physical health care needs and emergency department utilization among homeless and vulnerably housed persons in Canada. Homeless and vulnerably housed individuals completed interviewer-administered surveys on housing, unmet physical health care needs, health care utilization, sociodemographic characteristics, substance use, and health conditions at baseline and annually for 4 years. Generalized logistic mixed effects regression models examined the association of residential stability with unmet physical health care needs and emergency department utilization, adjusting for potential confounders. Participants were from Vancouver (n = 387), Toronto (n = 390), and Ottawa (n = 396). Residential stability was associated with lower odds of having unmet physical health needs (adjusted odds ratio (AOR), 0.82; 95 % confidence interval (CI), 0.67, 0.98) and emergency department utilization (AOR, 0.74; 95 % CI, 0.62, 0.88) over the 4-year follow-up period, after adjusting for potential confounders. Residential stability is associated with fewer unmet physical health care needs and lower emergency department utilization among homeless and vulnerably housed individuals. These findings highlight the need to address access to stable housing as a significant determinant of health disparities.