Montgomery Ann E, Dichter Melissa E, Thomasson Arwin M, Roberts Christopher B
U.S. Department of Veterans Affairs, National Center on Homelessness Among Veterans, Philadelphia, Pennsylvania.
U.S. Department of Veterans Affairs, Center for Health Equity Research and Promotion, Philadelphia, Pennsylvania.
Am J Prev Med. 2016 Mar;50(3):336-343. doi: 10.1016/j.amepre.2015.06.035. Epub 2015 Nov 10.
The Veterans Health Administration seeks to reduce homelessness among Veterans by identifying, and providing prevention and supportive services to, patients with housing concerns. The objectives of this study were to assess the proportion of Veterans Health Administration patients who received homeless or social work services within 6 months of a positive screen for homelessness or risk in the Veterans Health Administration and the demographic and clinical characteristics that predicted services utilization.
Data were from a cohort of 27,403 Veteran outpatients who screened positive for homelessness or risk between November 1, 2012 and January 31, 2013. During 2013, AORs were calculated using a mixed-effects logistic regression to estimate the likelihood of patients' receipt of VHA homeless or social work services based on demographic and clinical characteristics.
The majority of patients received services within 6 months post-screening; predictors of services utilization varied by gender. Among women, diagnosis of drug abuse and psychosis predicted receipt of services, being unmarried increased the odds of using services among those screening positive for homelessness, and a diagnosis of post-traumatic stress disorder increased the odds of receiving services for at-risk women. Among men, being younger, unmarried, not service-connected/Medicaid-eligible, and having a medical or behavioral health condition predicted receipt of services.
Receipt of housing support services among Veterans post-homelessness screening differs by patient demographic and clinical characteristics. Future research should investigate the role that primary and secondary prevention interventions play in Veterans' resolution of risk for homelessness and experience of homelessness.
退伍军人健康管理局致力于通过识别有住房问题的患者并为其提供预防和支持性服务，来减少退伍军人中的无家可归现象。本研究的目的是评估在退伍军人健康管理局中，筛查出无家可归或存在无家可归风险呈阳性后的6个月内，接受过无家可归或社会工作服务的退伍军人健康管理局患者的比例，以及预测服务利用情况的人口统计学和临床特征。
数据来自于2012年11月1日至2013年1月31日期间筛查出无家可归或存在无家可归风险呈阳性的27403名退伍军人门诊患者队列。在2013年期间，使用混合效应逻辑回归计算调整后的比值比（AORs），以根据人口统计学和临床特征估计患者接受退伍军人健康管理局无家可归或社会工作服务的可能性。
大多数患者在筛查后的6个月内接受了服务；服务利用的预测因素因性别而异。在女性中，药物滥用和精神病的诊断预测了服务的接受情况，未婚增加了筛查出无家可归呈阳性者使用服务的几率，创伤后应激障碍的诊断增加了有风险女性接受服务的几率。在男性中，年龄较小、未婚、与服役无关/符合医疗补助条件以及患有医疗或行为健康状况预测了服务的接受情况。
退伍军人无家可归筛查后住房支持服务的接受情况因患者的人口统计学和临床特征而异。未来的研究应调查一级和二级预防干预措施在退伍军人解决无家可归风险和无家可归经历方面所起的作用。
