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Randomized Controlled Trial
. 2016 Feb 17:16:60.
doi: 10.1186/s12913-016-1316-7.

A 10-year retrospective analysis of hospital admissions and length of stay among a cohort of homeless adults in Vancouver, Canada

Angela Russolillo  1 , Akm Moniruzzaman  2 , Milad Parpouchi  3 , Lauren B Currie  4 , Julian M Somers  5
Affiliations
Randomized Controlled Trial

A 10-year retrospective analysis of hospital admissions and length of stay among a cohort of homeless adults in Vancouver, Canada

Angela Russolillo et al. BMC Health Serv Res. .

Abstract

Background: Homelessness is associated with a very high prevalence of substance use and mental disorders and elevated levels of acute health service use. Among the homeless, little is known regarding the relative impact of specific mental disorders on healthcare utilization. The aim of the present study was to examine the association between different categories of diagnosed mental disorders with hospital admission and length of stay (LOS) in a cohort of homeless adults in Vancouver, Canada.

Methods: Participants were recruited as part of an experimental trial in which participants met criteria for both homelessness and mental illness. Administrative data were obtained (with separate consent) including comprehensive records of acute hospitalizations during the 10 years prior to recruitment and while participants where experiencing homelessness. Generalized Estimating Equations were used to estimate the associations between outcome variables (acute hospital admissions and LOS) and predictor variables (specific disorders).

Results: Among the eligible sample (n = 433) 80 % were hospitalized, with an average of 6.0 hospital admissions and 71.4 days per person during the 10-year observation period. Of a combined total 2601 admissions to hospital, 1982 were psychiatric and 619 were non-psychiatric. Significant (p <0.001) independent predictors of hospital admission and LOS included a diagnosis of schizophrenia or bipolar disorder, as well as high (≥32 service contacts) non-psychiatric medical service use in the community.

Conclusions: Our results demonstrate that specific mental disorders alongside high non-psychiatric service use were significantly associated with hospital admission and LOS. These findings suggest the importance of screening within the homeless population to identify individuals who may be at risk for acute illness and the implementation of services to promote recovery and prevent repeated hospitalization.

Trial registration: ISRCTN57595077 ; ISRCTN66721740.

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Figures

Fig. 1
Fig. 1
Acute hospitalization before recruitment for ‘At Home’ participants (n = 433)
Fig. 2
Fig. 2
Hospital days before recruitment for ‘At Home’ participants (n = 433)
See this image and copyright information in PMC

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