256654 Health status and health care experiences among homeless patients in federally supported health centers: Findings from the 2009 Patient Survey

Tuesday, October 30, 2012 : 8:50 AM - 9:10 AM

Lydie A. Lebrun, PhD, MPH , Bureau of Primary Health Care, U.S. Department of Health and Human Services, Health Resources and Services Administration, Rockville, MD
Travis P. Baggett, MD, MPH , General Medicine Division, Massachusetts General Hospital, Boston, MA
Darlene M. Jenkins, DrPH, CHES , Reseach, National Health Care for the Homeless Council, Nashville, TN
Alek Sripipatana, PhD, MPH , Bureau of Primary Health Care, U.S. Department of Health and Human Services, Health Resources and Services Administration, Rockville, MD
Ravi Sharma, PhD , Bureau of Primary Health Care, U.S. Department of Health and Human Services, Health Resources and Services Administration, Rockville, MD
A. Seiji Hayashi, MD, MPH , Bureau of Primary Health Care, U.S. Department of Health and Human Services, Health Resources and Services Administration, Rockville, MD
Charles A. Daly, MHA , Bureau of Primary Health Care, U.S. Department of Health and Human Services, Health Resources and Services Administration, Rockville, MD
Quyen Ngo-Metzger, MD, MPH , Bureau of Primary Health Care, U.S. Department of Health and Human Services, Health Resources and Services Administration, Rockville, MD
  
BACKGROUND: The Health Resources and Services Administration (HRSA) funds health centers to provide health services to homeless persons as well as other vulnerable populations. In 2010, health centers provided primary health care, mental health services, and substance abuse treatment, to over 1 million homeless patients and individuals who were formerly homeless or at risk of homelessness. We examined the health status and health care experiences of homeless patients in health centers, and compared them with their housed counterparts. METHODS: Nationally representative data came from the 2009 Health Center Patient Survey. Analyses were limited to adult patients (n=2,735). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and non-homeless patients. We also examined the independent effect of homelessness on health care access and utilization. RESULTS: Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. Homeless patients were twice as likely as housed patients to have an ED visit in the past year (OR=2.00, 95% CI: 1.37-2.92), and twice as likely to have unmet medical care needs (OR=1.98, 95% CI: 1.24-3.16). Among homeless patients, having a usual source of care was associated with 50% lower odds of an ED visit (OR=0.51, 95% CI: 0.29-0.90). CONCLUSIONS: Federally supported health centers play a key role in providing quality primary care to homeless patients. Addressing the primary and preventive care needs of homeless populations may help to curb ED visits and unmet medical needs.

Learning Areas:
Provision of health care to the public

Learning Objectives:
1. Describe the health status and health care experiences of homeless patients who visit health centers. 2. Compare the health and health care of homeless patients with that of housed patients seen in health centers. 3. Explain factors which are associated with access to health care among homeless patients seen in health centers.

Keywords: Health Centers, Homeless Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator on this study, and I led the conceptualization, data analysis and interpretation, and writing.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4015.0: Looking at homeless health care services from a systems-level perspective