Brown Rebecca T, Kimes Ryan V, Guzman David, Kushel Margot
Division of Gerontology, Beth Israel Deaconess Medical Center, USA.
J Health Care Poor Underserved. 2010 Aug;21(3):1060-70. doi: 10.1353/hpu.0.0344.
To examine whether demographic characteristics, health care access, and acute health care utilization differ by age among homeless adults.
We interviewed all 2,175 adult attendees of a citywide homeless outreach event.
Older participants were more likely than younger participants to have a regular place for health care (59.8% vs. 44.3%, p<.01), a regular health care provider (53.6% vs. 35.6%, p<.01), and health insurance (45.5% vs. 32.1%, p<.01). Older participants were less likely to be unable to obtain needed health care (15.6% vs. 20.9%, p=.05). In a multivariate analysis, only lack of health insurance predicted inability to obtain needed care (AOR 2.9, CI 1.76-4.8).
Older and younger homeless adults have similarly high rates of acute health care utilization. The better access to care among older homeless adults speaks to the importance of insurance in determining access to care among homeless adults.
探讨无家可归成年人的人口统计学特征、医疗保健可及性和急性医疗保健利用率是否因年龄而异。
我们对全市范围内一次无家可归者外展活动的所有2175名成年参与者进行了访谈。
年龄较大的参与者比年龄较小的参与者更有可能有固定的医疗保健场所（59.8%对44.3%，p<0.01）、固定的医疗保健提供者（53.6%对35.6%，p<0.01）和医疗保险（45.5%对32.1%，p<0.01）。年龄较大的参与者无法获得所需医疗保健的可能性较小（15.6%对20.9%，p=0.05）。在多变量分析中，只有缺乏医疗保险预示着无法获得所需的医疗保健（调整后比值比2.9，可信区间1.76-4.8）。
年龄较大和较小的无家可归成年人急性医疗保健利用率同样较高。年龄较大的无家可归成年人获得医疗保健的机会更好，这表明保险在决定无家可归成年人获得医疗保健机会方面的重要性。
