Hermes Eric, Rosenheck Robert
VA New England Mental Illness Research, Education, and Clinical Center, 950 Campbell Ave., West Haven, CT, 06516, USA.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Community Ment Health J. 2016 Feb;52(2):142-7. doi: 10.1007/s10597-015-9904-2. Epub 2015 Jul 23.
Using national Veterans Health Administration (VHA) administrative data, this study evaluated differences in psychotropic medication use between homeless and non-homeless adults with serious mental illness (SMI) who used VHA services in 2010. The adjusted mean number of psychotropic prescription fills associated with homeless individuals were identified using regression models adjusted for socio-demographics, diagnoses, and use of health services. Of the 876,989 individuals with SMI using VHA services, 7.2 % were homeless at some time during 2010. In bivariate analysis, homeless individuals filled more psychotropic medication prescriptions compared with non-homeless individuals. However, after adjusting for potentially confounding variables, homeless individuals were found to have filled 16.2 % fewer prescriptions than non-homeless individuals when all psychotropics were analyzed together (F = 6947.1, p < .001) and for most individual classes of psychotropics. Greater use of residential/inpatient mental health services by the homeless was the most important single factor associated with filling more psychotropic prescriptions than non-homeless individuals.
本研究利用美国退伍军人健康管理局(VHA)的全国行政数据,评估了2010年使用VHA服务的患有严重精神疾病(SMI)的无家可归成年人与非无家可归成年人在使用精神药物方面的差异。通过对社会人口统计学、诊断和医疗服务使用情况进行调整的回归模型,确定了与无家可归者相关的精神药物处方填充的调整后平均数量。在使用VHA服务的876,989名患有SMI的个体中,7.2%在2010年的某个时候无家可归。在双变量分析中,与非无家可归者相比,无家可归者填充的精神药物处方更多。然而,在对潜在的混杂变量进行调整后,当对所有精神药物进行综合分析时(F = 6947.1,p <.001)以及对大多数个别类别的精神药物进行分析时,发现无家可归者填充的处方比非无家可归者少16.2%。与非无家可归者相比,无家可归者更多地使用住院/住院心理健康服务是与填充更多精神药物处方相关的最重要的单一因素。