Frequent Episodic Utilizers of Veterans Health Administration Homeless Programs Use: Background Characteristics and Health Services Use.

OBJECTIVE

To assess sociodemographic, diagnostic, and services use factors associated with veterans' repeated, episodic use of Veterans Health Administration (VHA) Homeless Programs.

DESIGN

This retrospective cohort study used stepwise multivariate logistic regression to assess the odds of veterans being frequent episodic utilizers of VHA Homeless Programs (ie, ≥4 services use episodes during the observation period).

SETTING

The study used administrative data from veterans who accessed VHA services across the United States.

PARTICIPANTS

The sample comprised 31 098 veterans who completed a VHA Homeless Program intake assessment in 2013 and accessed VHA Homeless Programs during 2013-2016.

MAIN OUTCOME MEASURE

Frequent episodic use of VHA Homeless Programs (ie, ≥4 services use episodes during the observation period).

RESULTS

Only 2.4% of the study sample had 4 or more episodes of VHA Homeless Program use during the observation period; risk factors included experience of military sexual trauma, history of incarceration, diagnosis of psychosis and substance use disorder, and use of acute care.

CONCLUSIONS

Addressing veterans' needs related to poverty, income, and postincarceration reintegration may reduce the frequent episodic use of VHA Homeless Programs. Interventions embedded in emergency departments and inpatient units may also be considered.