TY - JOUR
T1 - Correlates of Hospital Use in Homeless and Unstably Housed Women
T2 - The Role of Physical Health and Pain
AU - Doran, Kelly M.
AU - Shumway, Martha
AU - Hoff, Rani A.
AU - Blackstock, Oni J.
AU - Dilworth, Samantha E.
AU - Riley, Elise D.
N1 - Publisher Copyright:
© 2014 Jacobs Institute of Women's Health.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Purpose: To examine correlates of emergency department (ED) use and hospitalizations in a community-based cohort of homeless and unstably housed women, with a focus on the role of physical health and pain. Methods: We conducted a cross-sectional analysis of baseline survey results from a study of homeless and unstably housed women in San Francisco. Primary outcomes were any self-reported ED visit and inpatient hospitalization over the prior 6months. Primary independent variables of interest were self-reported physical health status, as measured by the Short Form-12 (SF-12), and bodily pain. Other potential covariates were organized using the Gelberg-Andersen Behavioral Model for Vulnerable Populations. Standard bivariate and multivariable logistic regression techniques were used. Results: Three hundred homeless and unstably housed women were included in the study, of whom 37.7% reported having an ED visit and 23.0% reported being hospitalized in the prior 6months. Mean SF-12 physical health scores indicated poorer than average health compared with the U.S. norm. Most women (79.3%) reported at least some limitation in their daily activities owing to pain. In adjusted analyses, moderate and high levels of bodily pain were significantly correlated with ED visits (odds ratio [OR],2.92 and OR,2.57) and hospitalizations (OR,6.13 and OR,2.49). As SF-12 physical health scores decreased, indicating worse health, the odds of ED use increased. Predisposing, enabling, and additional need factors did not mediate these associations. Conclusions: Physical health and bodily pain are important correlates of ED visits and hospitalizations among homeless and unstably housed women. Interventions to reduce ED use among women who are homeless should address the high levels of pain in this population.
AB - Purpose: To examine correlates of emergency department (ED) use and hospitalizations in a community-based cohort of homeless and unstably housed women, with a focus on the role of physical health and pain. Methods: We conducted a cross-sectional analysis of baseline survey results from a study of homeless and unstably housed women in San Francisco. Primary outcomes were any self-reported ED visit and inpatient hospitalization over the prior 6months. Primary independent variables of interest were self-reported physical health status, as measured by the Short Form-12 (SF-12), and bodily pain. Other potential covariates were organized using the Gelberg-Andersen Behavioral Model for Vulnerable Populations. Standard bivariate and multivariable logistic regression techniques were used. Results: Three hundred homeless and unstably housed women were included in the study, of whom 37.7% reported having an ED visit and 23.0% reported being hospitalized in the prior 6months. Mean SF-12 physical health scores indicated poorer than average health compared with the U.S. norm. Most women (79.3%) reported at least some limitation in their daily activities owing to pain. In adjusted analyses, moderate and high levels of bodily pain were significantly correlated with ED visits (odds ratio [OR],2.92 and OR,2.57) and hospitalizations (OR,6.13 and OR,2.49). As SF-12 physical health scores decreased, indicating worse health, the odds of ED use increased. Predisposing, enabling, and additional need factors did not mediate these associations. Conclusions: Physical health and bodily pain are important correlates of ED visits and hospitalizations among homeless and unstably housed women. Interventions to reduce ED use among women who are homeless should address the high levels of pain in this population.
UR - http://www.scopus.com/inward/record.url?scp=84908046309&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84908046309&partnerID=8YFLogxK
U2 - 10.1016/j.whi.2014.06.003
DO - 10.1016/j.whi.2014.06.003
M3 - Article
C2 - 25213745
AN - SCOPUS:84908046309
SN - 1049-3867
VL - 24
SP - 535
EP - 541
JO - Women's Health Issues
JF - Women's Health Issues
IS - 5
ER -