OBJECTIVES: We evaluated the impact of a diagnosis of serious mental illness on use of a primary care provider (vs the emergency department [ED]) as a source of care by people who were chronically homeless. METHODS: We used data from 750 chronically homeless adults enrolled in the 11-site Collaborative Initiative to Help End Chronic Homelessness and identified demographic and clinical characteristics independently associated with using a primary care provider rather than an ED. RESULTS: The factor most strongly associated with using the ED as a regular source of medical care was previous-year lack of health insurance. Despite high rates of serious mental illness, neither a diagnosis of serious mental illness nor increased severity of psychiatric symptoms was associated with such use. CONCLUSIONS: Findings suggest that people who are chronically homeless and have chronic medical illness would be more likely to access care if they had health insurance. Individual states' deciding not to expand Medicaid coverage will likely have a tremendous impact on the health outcomes and health care costs associated with this and other vulnerable populations.
OBJECTIVES: We evaluated the impact of a diagnosis of serious mental illness on use of a primary care provider (vs the emergency department [ED]) as a source of care by people who were chronically homeless. METHODS: We used data from 750 chronically homeless adults enrolled in the 11-site Collaborative Initiative to Help End Chronic Homelessness and identified demographic and clinical characteristics independently associated with using a primary care provider rather than an ED. RESULTS: The factor most strongly associated with using the ED as a regular source of medical care was previous-year lack of health insurance. Despite high rates of serious mental illness, neither a diagnosis of serious mental illness nor increased severity of psychiatric symptoms was associated with such use. CONCLUSIONS: Findings suggest that people who are chronically homeless and have chronic medical illness would be more likely to access care if they had health insurance. Individual states' deciding not to expand Medicaid coverage will likely have a tremendous impact on the health outcomes and health care costs associated with this and other vulnerable populations.
Authors: Audrey L Jones; Leslie R M Hausmann; Gretchen L Haas; Maria K Mor; John P Cashy; James H Schaefer; Adam J Gordon Journal: Psychol Serv Date: 2017-05
Authors: Audrey L Jones; Leslie R M Hausmann; Stefan G Kertesz; Ying Suo; John P Cashy; Maria K Mor; Warren B P Pettey; James H Schaefer; Adam J Gordon; Adi V Gundlapalli Journal: Med Care Date: 2019-04 Impact factor: 2.983
Authors: Lori Ann Post; Federico E Vaca; Kelly M Doran; Cali Luco; Matthew Naftilan; James Dziura; Cynthia Brandt; Steven Bernstein; Liudvikas Jagminas; Gail D'Onofrio Journal: J Med Internet Res Date: 2013-09-03 Impact factor: 5.428
Authors: Rebecca Wells; Ellen D Breckenridge; Sasha Ajaz; Aman Narayan; Daniel Brossart; James H Zahniser; Jolene Rasmussen Journal: Int J Integr Care Date: 2019-10-29 Impact factor: 5.120
Authors: Lan-Ping Lin; Li-Yun Wang; Tai-Wen Wang; Yun-Cheng Chen; Jin-Ding Lin Journal: Int J Environ Res Public Health Date: 2021-05-17 Impact factor: 3.390