Gabrielian Sonya, Yuan Anita H, Andersen Ronald M, Gelberg Lillian
VA Greater Los Angeles, Los Angeles, CA, USA University of California at Los Angeles, Los Angeles, CA, USA
VA Greater Los Angeles, Los Angeles, CA, USA.
J Prim Care Community Health. 2016 Oct;7(4):281-7. doi: 10.1177/2150131916656009. Epub 2016 Jun 24.
Little is known about how permanent supported housing influences ambulatory care received by homeless persons. To fill this gap, we compared diagnoses treated in VA Greater Los Angeles (VAGLA) ambulatory care between Veterans who are formerly homeless-now housed/case managed through VA Supported Housing ("VASH Veterans")-and currently homeless.
We performed secondary database analyses of homeless-experienced Veterans (n = 3631) with VAGLA ambulatory care use from October 1, 2010 to September 30, 2011. We compared diagnoses treated-adjusting for demographics and need characteristics in regression analyses-between VASH Veterans (n = 1904) and currently homeless Veterans (n = 1727).
On average, considering 26 studied diagnoses, VASH (vs currently homeless) Veterans received care for more (P < .05) diagnoses (mean = 2.9/1.7). Adjusting for demographics and need characteristics, VASH Veterans were more likely (P < .05) than currently homeless Veterans to receive treatment for diagnoses across categories: chronic physical illness, acute physical illness, mental illness, and substance use disorders. Specifically, VASH Veterans had 2.5, 1.7, 2.1, and 1.8 times greater odds of receiving treatment for at least 2 condition in these categories, respectively. Among participants treated for chronic illnesses, adjusting for predisposing and need characteristics, VASH (vs currently homeless) Veterans were 9%, 8%, and 11% more likely to have 2 or more visits for chronic physical illnesses, mental illnesses, and substance use disorder, respectively.
Among homeless-experienced Veterans, permanent supported housing may reduce disparities in the treatment of diagnoses commonly seen in ambulatory care.
关于永久性支持性住房如何影响无家可归者接受的门诊护理，我们所知甚少。为填补这一空白，我们比较了大洛杉矶退伍军人事务部（VAGLA）门诊护理中，曾经无家可归现在已入住/通过退伍军人事务部支持性住房接受个案管理的退伍军人（“VASH退伍军人”）和目前仍无家可归的退伍军人所接受治疗的诊断情况。
我们对2010年10月1日至2011年9月30日期间使用VAGLA门诊护理的有过无家可归经历的退伍军人（n = 3631）进行了二次数据库分析。我们在回归分析中，对VASH退伍军人（n = 1904）和目前无家可归的退伍军人（n = 1727）之间接受治疗的诊断进行了比较，并对人口统计学和需求特征进行了调整。
平均而言，考虑到26项研究的诊断，VASH退伍军人（与目前无家可归的退伍军人相比）接受护理的诊断更多（P <.05）（平均值 = 2.9/1.7）。在对人口统计学和需求特征进行调整后，VASH退伍军人比目前无家可归的退伍军人更有可能（P <.05）接受各类诊断的治疗：慢性身体疾病、急性身体疾病、精神疾病和物质使用障碍。具体而言，VASH退伍军人在这些类别中接受至少2种疾病治疗的几率分别高出2.5倍、1.7倍、2.1倍和1.8倍。在接受慢性病治疗的参与者中，在对易患因素和需求特征进行调整后，VASH退伍军人（与目前无家可归的退伍军人相比）分别有9%、8%和11%的可能性因慢性身体疾病、精神疾病和物质使用障碍进行2次或更多次就诊。
在有过无家可归经历的退伍军人中，永久性支持性住房可能会减少门诊护理中常见诊断治疗方面的差异。
