Catharine Chambers1, Marko Katic, Shirley Chiu, Donald A Redelmeier, Wendy Levinson, Alex Kiss, Stephen W Hwang. 1. Catharine Chambers, Shirley Chiu, and Stephen W. Hwang are with the Centre for Research on Inner City Health, part of the Keenan Research Centre in the Li Ka Shing Knowledge Institute at St Michael's Hospital, Toronto, Ontario. Marko Katic and Alex Kiss are with the Department of Research Design and Biostatistics, Sunnybrook Health Sciences Centre, Toronto. Donald A. Redelmeier is with the Institute for Clinical Evaluative Sciences, Sunnybrook Health Sciences Centre, Toronto. Wendy Levinson is with the Department of Medicine, University of Toronto, Toronto.
Abstract
OBJECTIVES: We identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. METHODS: We recruited participants from shelters and meal programs. We then linked them to administrative databases to capture hospital admissions during the study (2005-2009). We used logistic regression to identify predictors of medical or surgical and psychiatric hospitalizations. RESULTS: Among 1165 homeless adults, 20% had a medical or surgical hospitalization, and 12% had a psychiatric hospitalization during the study. These individuals had a total of 921 hospitalizations, of which 548 were medical or surgical and 373 were psychiatric. Independent predictors of medical or surgical hospitalization included birth in Canada, having a primary care provider, higher perceived external health locus of control, and lower health status. Independent predictors of psychiatric hospitalization included being a current smoker, having a recent mental health problem, and having a lower perceived internal health locus of control. Being accompanied by a partner or dependent children was protective for hospitalization. CONCLUSIONS: Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services.
OBJECTIVES: We identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. METHODS: We recruited participants from shelters and meal programs. We then linked them to administrative databases to capture hospital admissions during the study (2005-2009). We used logistic regression to identify predictors of medical or surgical and psychiatric hospitalizations. RESULTS: Among 1165 homeless adults, 20% had a medical or surgical hospitalization, and 12% had a psychiatric hospitalization during the study. These individuals had a total of 921 hospitalizations, of which 548 were medical or surgical and 373 were psychiatric. Independent predictors of medical or surgical hospitalization included birth in Canada, having a primary care provider, higher perceived external health locus of control, and lower health status. Independent predictors of psychiatric hospitalization included being a current smoker, having a recent mental health problem, and having a lower perceived internal health locus of control. Being accompanied by a partner or dependent children was protective for hospitalization. CONCLUSIONS: Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services.
Authors: Stefan G Kertesz; Mary Jo Larson; Nicholas J Horton; Michael Winter; Richard Saitz; Jeffrey H Samet Journal: Med Care Date: 2005-06 Impact factor: 2.983
Authors: Stephen W Hwang; Joanna J M Ueng; Shirley Chiu; Alex Kiss; George Tolomiczenko; Laura Cowan; Wendy Levinson; Donald A Redelmeier Journal: Am J Public Health Date: 2010-06-17 Impact factor: 9.308
Authors: Stephen W Hwang; Maritt J Kirst; Shirley Chiu; George Tolomiczenko; Alex Kiss; Laura Cowan; Wendy Levinson Journal: J Urban Health Date: 2009-07-23 Impact factor: 3.671
Authors: Stephen W Hwang; Catharine Chambers; Shirley Chiu; Marko Katic; Alex Kiss; Donald A Redelmeier; Wendy Levinson Journal: Am J Public Health Date: 2013-10-22 Impact factor: 9.308
Authors: Catharine Chambers; Shirley Chiu; Marko Katic; Alex Kiss; Donald A Redelmeier; Wendy Levinson; Stephen W Hwang Journal: Am J Public Health Date: 2013-10-22 Impact factor: 9.308
Authors: Anne M Gadermann; Mohammad Ehsanul Karim; Monica Norena; Scott D Emerson; Anita M Hubley; Lara B Russell; Rosane Nisenbaum; Stephen W Hwang; Tim Aubry; Anita Palepu Journal: J Urban Health Date: 2020-04 Impact factor: 3.671
Authors: Wen-Chieh Lin; Monica Bharel; Jianying Zhang; Elizabeth O'Connell; Robin E Clark Journal: Am J Public Health Date: 2015-10-08 Impact factor: 9.308
Authors: Andrea Wang; Katherine Francombe Pridham; Rosane Nisenbaum; Cheryl Pedersen; Rebecca Brown; Stephen W Hwang Journal: J Gen Intern Med Date: 2021-01-29 Impact factor: 6.473
Authors: Joshua W Elder; Evan F Wu; James A Chenoweth; James F Holmes; Aman K Parikh; Aimee K Moulin; Tommie G Trevino; John R Richards Journal: Emerg Med Int Date: 2020-07-17 Impact factor: 1.112
Authors: Thomas P O'Toole; Erin E Johnson; Matthew Borgia; Amy Noack; Jean Yoon; Elizabeth Gehlert; Jeanie Lo Journal: Prev Chronic Dis Date: 2018-02-15 Impact factor: 2.830