259334 "What women want:" Characteristics, shelter-based clinic usage, and predictors of health care utilization of homeless/marginally-housed women

Sunday, October 28, 2012

Monica Fung, BA , Peabody Society, Harvard Medical School, Boston, MA
Kym Williams, MBA, MPH , Monitoring and Evaluation, Women of Means, Inc., Wellesley, MA
Roseanna H. Means, MD MSc , Department of Medicine, Brigham and Women's Hospital, Wellesley, MA
Introduction: Though women are the fastest growing segment in the homeless population, their health needs and utilization patterns are underrepresented in existing literature on homelessness. Goals: The goals of this study were to (1) characterize medical co-morbidities, self-motivational behavior, and health care utilization of homeless/marginally-housed women, and (2) determine predictors of their usage of shelter-based medical care. Methods: A cross-sectional study was conducted using a de-identified database containing visit and patient-specific data from a women's day shelter medical clinic. Data analysis was conducted using StataIC11 software. Results: Records from 208 women were studied. Median age was 52 years with a median of 2 co-morbidities per woman. The most common were hypertension, diabetes, and psychiatric illness (prevalences 36%, 19%, and 39%, respectively). 10% had substance abuse. Of 208 charts reviewed, 68% listed a PCP, but PCP location was identified in only 46%. Reasons for shelter clinic visit were acute medical issue (58%), preventative medical care (45%), psychiatric issue (13%), and social assistance (64%). 47% had a self-motivated component for seeking care. Increased number of medical co-morbidities was associated with increased number of clinic visits (p<0.001), as well as increased visits for acute (p<0.005), preventative (p<0.001), and psychiatric (p<0.05) reasons. Having a stated PCP was associated with using shelter-based clinic for preventative care (p<0.005). Conclusions: These data characterize homeless/marginally-housed women and their reasons for health care utilization, which may be addressed by an integrated service model aimed at the complex medical, psychiatric, and social needs of this population.

Learning Areas:
Provision of health care to the public
Public health or related research

Learning Objectives:
1. Describe the medical co-morbidities of homeless women. 2. Identify reasons that homeless women seek medical care. 3. Demonstrate self-motivational behavior in homeless women. 4. Evaluate predictors of homeless women’s usage of shelter-based health care.

Keywords: Homeless Health Care, Women

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principle or co-principle investigator of several published or presented studies involving STD reinfection, service provision to STD-infected individuals, CMV infection of neonates, and antibiotic prophylaxis in the pediatric surgery population. Among my scientific interests has been the epidemiology, risk factors, and service provision of underrepresented and marginalized populations.
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: 2057.0: Women's health disparities