Typology of Currently or Formerly Homeless Individuals Based on Their Use of Health and Social Services

Fleury, Marie‐Josée; Cao, Zhirong; Meng, Xiangyi

doi:10.1007/s10597-020-00693-6

Cited by 7 publications

(5 citation statements)

References 70 publications

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“…In regard to healthcare utilization, all groups in our study had significantly greater number of admissions, longer mean duration of admissions, and more ED visits in the 12 months after referral compared to the referent “low morbidity” group. These results align with those of prior latent group analyses that have used claims data ( 17 ), survey data ( 14 – 16 ), or administrative data ( 18 , 27 ) to demonstrate increased health services utilization among PEH. These findings further add to previous LCAs that have described subgroups of heterogeneous homeless populations based on social characteristics ( 28 ) or patterns of shelter use ( 29 , 30 ).…”

Section: Discussionsupporting

confidence: 84%

“…Our analysis supports similar findings of variable health care utilization among certain subgroups of PEH. Existing evidence indicates high ED utilization among subgroups of PEH with mental health disorders but without physical health disorders ( 16 ). Persistent hospital super-utilizers have been identified among subgroups with either mental health or substance use disorder ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

“…Early LCAs of PEH were used to describe the typology of psychiatric illness ( 11 ), substance use ( 12 ), and medical illness ( 13 ) in this population. More recently, LCA has been used as a method to assess social ( 14 – 16 ) and health services ( 17 , 18 ) utilization amongst distinct groups of PEH. An analysis of 2010 Medicaid claims data of PEH examined heterogeneity among frequent emergency department (ED) users in a single health care center and identified distinct subgroups in the LCA.…”

Section: Introductionmentioning

confidence: 99%

“…However, such analyses of PEH have not assessed differential health outcomes based on class assignment ( 14 – 16 ) and often aggregate medical, psychiatric and substance use conditions as a single entity ( 17 , 18 ). There are no published studies that classify individuals in medical respite or transitional care programs based on discrete medical, psychiatric, and substance use disorder profiles and compare clinical outcomes across these groups.…”

Section: Introductionmentioning

confidence: 99%

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Differences in Clinical Outcomes of Adults Referred to a Homeless Transitional Care Program Based on Multimorbid Health Profiles: A Latent Class Analysis

et al. 2021

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Background: People experiencing homelessness face significant medical and psychiatric illness, yet few studies have characterized the effects of multimorbidity within this population. This study aimed to (a) delineate unique groups of individuals based on medical, psychiatric, and substance use disorder profiles, and (b) compare clinical outcomes across groups.Methods: We extracted administrative data from a health system electronic health record for adults referred to the Durham Homeless Care Transitions program from July 2016 to June 2020. We used latent class analysis to estimate classes in this cohort based on clinically important medical, psychiatric and substance use disorder diagnoses and compared health care utilization, overdose, and mortality at 12 months after referral.Results: We included 497 patients in the study and found 5 distinct groups: “low morbidity” (referent), “high comorbidity,” “high tri-morbidity,” “high alcohol use,” and “high medical illness.” All groups had greater number of admissions, longer mean duration of admissions, and more ED visits in the 12 months after referral compared to the “low morbidity” group. The “high medical illness” group had greater mortality 12 months after referral compared to the “low morbidity” group (OR, 2.53, 1.03–6.16; 95% CI, 1.03–6.16; p = 0.04). The “high comorbidity” group (OR, 5.23; 95% CI, 1.57–17.39; p < 0.007) and “high tri-morbidity” group (OR, 4.20; 95% CI, 1.26–14.01; p < 0.02) had greater 12-month drug overdose risk after referral compared to the referent group.Conclusions: These data suggest that distinct groups of people experiencing homelessness are affected differently by comorbidities, thus health care programs for this population should address their risk factors accordingly.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Differences in Clinical Outcomes of Adults Referred to a Homeless Transitional Care Program Based on Multimorbid Health Profiles: A Latent Class Analysis

et al. 2021

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“…Medical resources for the homeless population are found often inadequate [ 45 ]. Moreover, the high basic needs of this population may prevent them to seek help for their mental disorders [ 46 ]. Previous studies also found a relationship between increased mental health QoL and perceived social network among patients with SUD [ 41 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Quality of life and its correlated factors among patients with substance use disorders: a systematic review and meta-analysis

et al. 2022

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Background Patients with substance use disorder (SUD) usually report lower quality of life (QoL) than other patients and as much as patients with other mental disorders. The present study investigated variables associated with QoL domains among patients with SUD. Methods Studies in English published before December 1st 2021, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on factors associated with QoL domains among patients with SUD. After reviewing for study duplicates, the full-texts of selected papers were assessed for eligibility using PECO (Participants, Exposures, Comparison and Outcome) criteria: (a) participants: patients with SUD; (b) exposures: sociodemographic factors, clinical, and service use variables; (c) comparison: patient groups without SUD; and (d) outcomes: four domains of QoL (physical, mental, social, and environmental domains). Three researchers recorded the data independently using predefined Excel spreadsheets. The Newcastle–Ottawa Scale (NOS) was used for assessing risk of bias and rated each study in terms of exposure, outcome, and comparability. Pooled odds ratios (ORs) and β coefficient were utilized at a 95% confidence level, and because sampling methods differed between studies’ pooled estimates, a random effects model was utilized. Results After the assessment of over 10,230 papers, a total of 17 studies met the eligibility criteria. Five studies (1260 participants) found that patients with SUD who were older were less likely to have a good physical Qol (OR = 0.86, 95% CI = 0.78, 0.95). Two studies (1171 participants) indicated that patients with SUD who were homeless were less likely to have a good environmental Qol (β = -0.47, p = 0.003). However, a better mental QoL was observed in four studies (1126 participants) among those receiving support from their family or friends (social networks) (OR = 1.05, 95% CI = 1.04, 1.07). Two studies (588 participants) showed that those using cocaine were less likely to have a good mental QoL (OR = 0.83, 95% CI = 0.75, 0.93). Two studies (22,534 participants) showed that those using alcohol were less likely to have a good physical QoL (β = -2.21, p = 0.001). Two studies (956 participants) showed that those having severe substance use disorders were less likely to have a good mental (β = -5.44, p = 0.002) and environmental (β = -0.59, p = 0.006) QoL respectively. Four studies (3515 participants) showed that those having mental disorders were less likely to have a good physical QoL (β = -1.05, p = 0.001), and another three studies (1211 participants) that those having mental disorders were less likely to have a good mental QoL (β = -0.33, p = 0.001). Finally, two studies (609 and 682 participants) showed that individuals who experienced trauma symptoms or mental disorders were less likely to have good social and environmental QoL, respectively (OR = 0.78, 95% CI = 0.61, 1.00) and (OR = 0.92, 95% CI = 0.9, 0.94). Conclusions The findings suggest the need for mental health services to improve the QOL among patients with SUD but further study is needed. Cocaine may cause behavioral changes which can increase the possibility of reckless and suicidal behaviors. Therefore, identifying cocaine user access, adherence, and satisfaction with treatment is recommended as an important component of adaptive functioning. Interventions that help patients with SUD get support from people within their social networks who support their recovery are also essential to their QoL.

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Profiles of Permanent Supportive Housing Residents Related to Their Housing Conditions, Service Use, and Associated Sociodemographic and Clinical Characteristics

Fleury,

Armoon

2024

Psychiatr Q

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Typology of Currently or Formerly Homeless Individuals Based on Their Use of Health and Social Services

Cited by 7 publications

References 70 publications

Differences in Clinical Outcomes of Adults Referred to a Homeless Transitional Care Program Based on Multimorbid Health Profiles: A Latent Class Analysis

Differences in Clinical Outcomes of Adults Referred to a Homeless Transitional Care Program Based on Multimorbid Health Profiles: A Latent Class Analysis

Quality of life and its correlated factors among patients with substance use disorders: a systematic review and meta-analysis

Profiles of Permanent Supportive Housing Residents Related to Their Housing Conditions, Service Use, and Associated Sociodemographic and Clinical Characteristics

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