Cox Koriann B, Malte Carol A, Saxon Andrew J
Center of Excellence in Substance Abuse Treatment and Education, Veterans Affairs Puget Sound Health Care System.
Psychol Serv. 2017 May;14(2):208-213. doi: 10.1037/ser0000133.
This article compares characteristics and health care utilization patterns of homeless veterans entering substance use disorder (SUD) treatment. Baseline self-report and medical record data were collected from 181 homeless veterans participating in a randomized trial of SUD/housing case management. Veterans, categorized as newly (n = 45), episodically (n = 61), or chronically homeless (n = 75), were compared on clinical characteristics and health care utilization in the year prior to baseline. Between-groups differences were seen in stimulant use, bipolar, and depressive disorders. A significant majority accessed VA emergency department services, and nearly half accessed inpatient services, with more utilization among chronically versus newly homeless. A majority in all groups attended VA primary care (73.5%) and mental health (56.9%) visits, and 26.7% newly, 32.8% episodically, and 56.0% chronically homeless veterans initiated multiple SUD treatment episodes (p = .002). A significant proportion of veterans struggling with homelessness and SUDs appear to remain unstable despite high utilization of VA acute and preventative services. (PsycINFO Database Record
本文比较了进入物质使用障碍(SUD)治疗的无家可归退伍军人的特征和医疗保健利用模式。从181名参与SUD/住房病例管理随机试验的无家可归退伍军人那里收集了基线自我报告和病历数据。将退伍军人分为新无家可归者(n = 45)、间歇性无家可归者(n = 61)或长期无家可归者(n = 75),并比较他们在基线前一年的临床特征和医疗保健利用情况。在兴奋剂使用、双相情感障碍和抑郁症方面存在组间差异。绝大多数人使用了退伍军人事务部(VA)的急诊科服务,近一半人使用了住院服务,长期无家可归者的利用率高于新无家可归者。所有组中的大多数人都接受了VA的初级保健(73.5%)和心理健康(56.9%)就诊,26.7%的新无家可归者、32.8%的间歇性无家可归者和56.0%的长期无家可归退伍军人开始了多次SUD治疗疗程(p = .002)。尽管大量使用了VA的急性和预防性服务,但很大一部分同时面临无家可归和SUD问题的退伍军人似乎仍然不稳定。(PsycINFO数据库记录)