O'Toole T P, Gibbon J L, Hanusa B H, Fine M J
University of Pittsburgh, USA.
J Health Polit Policy Law. 1999 Feb;24(1):91-114. doi: 10.1215/03616878-24-1-91.
The objective of this study was to describe health services utilization by homeless and housed poor adults stratified by six-month primary sheltering arrangements. The primary method used in this study was a cross-sectional survey of 373 homeless adults. Interviews at twenty-four community-based sites (in Allegheny County, Pennsylvania) assessed demographic and clinical characteristics, reasons for homelessness, functional status and social support networks, and health services utilization during the previous six months. Multivariate logistic regression analysis identified factors independently associated with health services utilization. Subjects were classified as unsheltered, emergency-sheltered, bridge-housed, doubled-up, and housed-poor. The median age of the subjects was 38.4 years; 78.6 percent were African American and 69.9 percent had health insurance. Overall, 62.7 percent reported health services use in the past six months, with significantly more use among emergency-sheltered and bridge-housed subjects than among unsheltered subjects. The study concludes that health services use among the homeless is substantial and is independently associated with sheltering arrangement, comorbid illness, race, health insurance, and social support.
本研究的目的是描述按六个月主要庇护安排分层的无家可归者和有住所的贫困成年人的卫生服务利用情况。本研究采用的主要方法是对373名无家可归成年人进行横断面调查。在宾夕法尼亚州阿勒格尼县的24个社区站点进行的访谈评估了人口统计学和临床特征、无家可归的原因、功能状态和社会支持网络，以及前六个月的卫生服务利用情况。多变量逻辑回归分析确定了与卫生服务利用独立相关的因素。受试者被分为无庇护者、紧急庇护者、过渡性住房居住者、合住者和有住所的贫困人口。受试者的年龄中位数为38.4岁；78.6%为非裔美国人，69.9%有医疗保险。总体而言，62.7%的人报告在过去六个月中使用过卫生服务，紧急庇护者和过渡性住房居住者的使用率明显高于无庇护者。该研究得出结论，无家可归者的卫生服务使用情况很普遍，且与庇护安排、合并症、种族、医疗保险和社会支持独立相关。
