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01.06.2011 | Original Research

Food Insufficiency and Health Services Utilization in a National Sample of Homeless Adults

verfasst von: Travis P. Baggett, MD, MPH, Daniel E. Singer, MD, Sowmya R. Rao, PhD, James J. O’Connell, MD, Monica Bharel, MD, Nancy A. Rigotti, MD

Erschienen in: Journal of General Internal Medicine | Ausgabe 6/2011

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BACKGROUND

Homeless people have high rates of hospitalization and emergency department (ED) use. Obtaining adequate food is a common concern among homeless people and may influence health care utilization.

OBJECTIVE

We tested the hypothesis that food insufficiency is related to higher rates of hospitalization and ED use in a national sample of homeless adults.

DESIGN

We analyzed data from the 2003 Health Care for the Homeless (HCH) User Survey.

PARTICIPANTS

Participants were 966 adults surveyed at 79 HCH clinic sites throughout the US. The study sample was representative of over 436,000 HCH clinic users nationally.

MEASURES

We determined the prevalence and characteristics of food insufficiency among respondents. Using multivariable logistic regression, we examined the association between food insufficiency and four past-year acute health services utilization outcomes: (1) hospitalization for any reason, (2) psychiatric hospitalization, (3) any ED use, and (4) high ED use (≥4 visits).

RESULTS

Overall, 25% of respondents reported food insufficiency. Among them, 68% went a whole day without eating in the past month. Chronically homeless (p = 0.01) and traumatically victimized (p = 0.001) respondents were more likely to be food insufficient. In multivariable analyses, food insufficiency was associated with significantly greater odds of hospitalization for any reason (AOR 1.59, 95% CI 1.07, 2.36), psychiatric hospitalization (AOR 3.12, 95% CI 1.73, 5.62), and high ED utilization (AOR 2.83, 95% CI 1.32, 6.08).

CONCLUSIONS

One-fourth of homeless adults in this national survey were food insufficient, and this was associated with increased odds of acute health services utilization. Addressing the adverse health services utilization patterns of homeless adults will require attention to the social circumstances that may contribute to this issue.

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Titel: Food Insufficiency and Health Services Utilization in a National Sample of Homeless Adults
verfasst von: Travis P. Baggett, MD, MPH
Daniel E. Singer, MD
Sowmya R. Rao, PhD
James J. O’Connell, MD
Monica Bharel, MD
Nancy A. Rigotti, MD
Publikationsdatum: 01.06.2011
Verlag: Springer-Verlag
Erschienen in: Journal of General Internal Medicine / Ausgabe 6/2011
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-011-1638-4

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Food Insufficiency and Health Services Utilization in a National Sample of Homeless Adults

BACKGROUND

OBJECTIVE

DESIGN

PARTICIPANTS

MEASURES

RESULTS

CONCLUSIONS

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BACKGROUND

OBJECTIVE

DESIGN

PARTICIPANTS

MEASURES

RESULTS

CONCLUSIONS

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