3101.0: Monday, October 22, 2001 - 3:30 PM

Abstract #26071

Continuity of care for housed and homeless persons with SMI

John C. Fortney, PhD1, Greer Sullivan2, Paul Koegle2, Catherine Jackson, PhD3, and Sally Morton, PhD4. (1) Psychiatry/Centers for Mental Healthcare Research, Univ. or Arkansas for Medical Sciences, Freeway Medical Tower, 5800 W. 10th St., Suite 605, Little Rock, AR 72205, (501) 660-7500, fortneyjohnc@uams.edu, (2) RAND Corporation, (3) RAND, (4) RAND Health, RAND, 1700 Main Street, P.O. Box 2138, Santa Monica, CA 90407

Objective: The purpose of this study was to compare the continuity of care received by housed and homeless persons with serious mental illness (SMI). Methods: In 1996, a multistage random sample was drawn from two SMI populations: 1) homeless were sampled from the shelters and streets of Houston, Texas; and 2) housed were sampled from Harris County (Houston) public mental health clinics. Weights were generated for each respondent which were equivalent to an estimate of the number of persons represented by that respondent in the target population. A baseline interview was administered to each respondent and three years of administrative data were retrospectively collected from relevant public health service sectors. Five dimensions of continuity of care were generated for mental and physical health services: frequency, stability, intensity, variety, and coordination. To capture temporal variation in continuity of care, repeated measures of continuity were calculated for each day of the year preceding the baseline interview using administrative data. Generalized linear models were used to compare the 365 repeated continuity of care measures across the housed and homeless groups controlling for differences in casemix. For each respondent, a coefficient of variation was calculated to determine the degree of temporal variation associated with continuity of care. Results: Compared to the homeless group, the housed group had greater continuity of care for mental health services, but not for physical health services. Compared to the homeless group (which consistently received few services), the housed group had greater day to day variations in continuity of care.

Learning Objectives: N/A

Keywords: Homeless Health Care, Public Housing

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA