National Center on Homelessness Among Veterans (Drs Szymkowiak, Montgomery, and Tsai) and Veterans Health Administration (Dr O'Toole), US Department of Veterans Affairs, Washington, District of Columbia; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama (Dr Montgomery); School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama (Dr Montgomery); University of Texas Health Science Center, Houston, Texas (Dr Tsai); and School of Medicine, Brown University, Providence, Rhode Island (Dr O'Toole).
J Public Health Manag Pract. 2022;28(1):E211-E218. doi: 10.1097/PHH.0000000000001252.
To assess sociodemographic, diagnostic, and services use factors associated with veterans' repeated, episodic use of Veterans Health Administration (VHA) Homeless Programs.
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).
The study used administrative data from veterans who accessed VHA services across the United States.
The sample comprised 31 098 veterans who completed a VHA Homeless Program intake assessment in 2013 and accessed VHA Homeless Programs during 2013-2016.
Frequent episodic use of VHA Homeless Programs (ie, ≥4 services use episodes during the observation period).
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.
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.
评估与退伍军人反复、间歇性使用退伍军人健康管理局（VHA）无家可归者项目相关的社会人口学、诊断和服务使用因素。
本回顾性队列研究使用逐步多元逻辑回归评估退伍军人成为 VHA 无家可归者项目频繁间歇性使用者（即，在观察期内使用≥4 次服务）的几率。
该研究使用了在美国接受 VHA 服务的退伍军人的行政数据。
样本包括 2013 年完成 VHA 无家可归者项目入院评估并在 2013-2016 年期间使用 VHA 无家可归者项目的 31098 名退伍军人。
VHA 无家可归者项目的频繁间歇性使用（即，在观察期内使用≥4 次服务）。
研究样本中只有 2.4%的人在观察期内有 4 次或更多次 VHA 无家可归者项目使用；风险因素包括经历过军事性创伤、监禁史、精神分裂症和物质使用障碍的诊断以及急症护理的使用。
解决退伍军人与贫困、收入和监禁后重新融入社会相关的需求，可能会减少 VHA 无家可归者项目的频繁间歇性使用。也可以考虑在急诊室和住院病房中实施干预措施。
