Winetrobe H, Rice E, Rhoades H, Milburn N
School of Social Work, University of Southern California, Los Angeles, CA 90015, USA.
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA 90024, USA.
J Public Health (Oxf). 2016 Mar;38(1):147-55. doi: 10.1093/pubmed/fdv001. Epub 2015 Jan 28.
Homeless young adults are a vulnerable population with great healthcare needs. Under the Affordable Care Act, homeless young adults are eligible for Medicaid, in some states, including California. This study assesses homeless young adults' health insurance coverage and healthcare utilization prior to Medicaid expansion.
All homeless young adults accessing services at a drop-in center in Venice, CA, were invited to complete a self-administered questionnaire; 70% of eligible clients participated (n = 125).
Within this majority White, heterosexual, male sample, 70% of homeless young adults did not have health insurance in the prior year, and 39% reported their last healthcare visit was at an emergency room. Past year unmet healthcare needs were reported by 31%, and financial cost was the main reported barrier to receiving care. Multivariable logistic regression found that homeless young adults with health insurance were almost 11 times more likely to report past year healthcare utilization.
Health insurance coverage is the sole variable significantly associated with healthcare utilization among homeless young adults, underlining the importance of insurance coverage within this vulnerable population. Service providers can play an important role by assisting homeless young adults with insurance applications and facilitating connections with regular sources of health care.
无家可归的年轻人是有巨大医疗需求的弱势群体。根据《平价医疗法案》，在包括加利福尼亚州在内的一些州，无家可归的年轻人有资格获得医疗补助。本研究评估了医疗补助扩大之前无家可归的年轻人的医疗保险覆盖情况和医疗服务利用情况。
邀请所有在加利福尼亚州威尼斯的一个救助中心接受服务的无家可归的年轻人填写一份自填式问卷；70%符合条件的客户参与了调查（n = 125）。
在这个以白人、异性恋男性为主的样本中，70%的无家可归的年轻人在上一年没有医疗保险，39%的人报告他们上一次就医是在急诊室。31%的人报告过去一年有未满足的医疗需求，经济成本是报告的接受治疗的主要障碍。多变量逻辑回归发现，有医疗保险的无家可归的年轻人报告过去一年使用医疗服务的可能性几乎高出11倍。
医疗保险覆盖是与无家可归的年轻人医疗服务利用显著相关的唯一变量，凸显了在这一弱势群体中保险覆盖的重要性。服务提供者可以通过协助无家可归的年轻人申请保险并促进他们与常规医疗保健来源建立联系发挥重要作用。
