Homelessness
| Autor: | Catherine Leda Seibyl, Robert A. Rosenheck |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Mental Health Services medicine.medical_specialty Hospitals Veterans Safety net Social Welfare Psychiatric Department Hospital Residence Characteristics Environmental health Health care medicine Humans Hospital Costs Veterans Affairs health care economics and organizations Aged Veterans business.industry Public Health Environmental and Occupational Health Workload Middle Aged Mental illness medicine.disease Mental health United States Substance abuse United States Department of Veterans Affairs Socioeconomic Factors Health Care Surveys Family medicine Ill-Housed Persons Female Substance Abuse Treatment Centers business |
| Zdroj: | Medical Care. 36:1256-1264 |
| ISSN: | 0025-7079 |
| DOI: | 10.1097/00005650-199808000-00013 |
| Popis: | OBJECTIVES This study examines health service use and costs for homeless and domiciled veterans hospitalized in psychiatric and substance abuse units at Department of Veterans Affairs (VA) medical centers, nationwide. METHODS A national survey of residential status at the time of admission was conducted on all VA inpatients hospitalized in acute mental health care units on September 30, 1995. Survey data were merged with computerized workload data bases to assess service use and cost during the 6 months before and after the date of discharge from the index hospitalization. RESULTS Of 9,108 veterans with complete survey data, 1,797 (20%) had been literally homeless at the time of admission, and 1,380 (15%) were doubled up temporarily, for a total homelessness rate of 35%. Combining patients from general psychiatry and substance abuse programs, the average annual cost of care for homeless veterans, after adjusting for other factors, was $27,206; $3,196 (13.3%) higher than the cost of care for domiciled veterans (P < 0.0001). Approximately 26% of annual inpatient VA mental health expenditures ($404 million) are spent on the care of homeless persons. CONCLUSIONS Homelessness adds substantially to the cost of health care services for persons with mental illness in VA, and most likely, in other "safety net" systems that serve the poor. These high costs, along with the prospect of declining public funding for health and social welfare programs, and an anticipated increase in the numbers of homeless mentally ill persons, portend a difficult time ahead for both homeless patients and the organizations that care for them. |
| Databáze: | OpenAIRE |
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