[Hpn] Homelessness impacts HEALTH service use by HIV+ Medicaid recipients / J Gen Intern Med. 2000;15:731-738 recipients / J Gen Intern Med. 2000;15:731-738

Tom Boland wgcp@earthlink.net
Mon, 4 Dec 2000 08:54:47 -0800 (PST)


http://www.ama-assn.org/special/hiv/newsline/reuters/11288717.htm
FWD  Last Updated: 2000-11-27 18:32:03 EST (Reuters Health)

HOUSING STATUS IMPACTS HEALTH SERVICE USE BY HIV-INFECTED MEDICAID RECIPIENTS

By Sherry Kahn

WESTPORT, CT (Reuters Health) - HIV-infected Medicaid recipients with
unstable housing may be receiving less adequate health care than those who
are stably housed, New York researchers report in the October issue of the
"Journal of General Internal Medicine".

Dr Meredith Y. Smith of Mount Sinai School of Medicine in Manhattan and a
multicenter team interviewed 1526 HIV-infected adults who were receiving
Medicaid.  Although previous studies have shown a relationship between
residential instability and inadequate utilization of health services among
HIV-infected individuals, this study was the first to control for health
insurance coverage.

Study participants were recruited from social and health service agencies,
acute care facilities, and community-based medical clinics throughout New
York State.  Face-to-face interviews were conducted to gather data on
"sociodemographics, health status and health risk factors, quality of life,
and health care access and utilization."

The researchers found that homeless participants and those living in
"doubled-up" accommodations were less likely to be seeing a physician
regularly than those who were stably housed.  Compared to the stably housed
and doubled-up subjects, the homeless were less likely to see the same
physicians for outpatient care and were more likely to make hospital
visits.  The homeless were also less likely to be taking pneumonia
prophylaxis.

"Doubled-up participants were found to make more emergency room visits ...
and both the doubled-up and the homeless were shown to use slightly more
outpatient care than the stably housed," the authors write.

"Because those who are in unstable housing show the least appropriate
patterns of health service use, priority should be given to helping these
individuals maintain stable housing situations," Dr Smith told Reuters
Health.

"Other types of initiatives, including co-locating medical services at
single-room occupancy hotels or at low income housing programs or services
... can also assist the unstably housed in accessing health care," she
added.

J Gen Intern Med. 2000;15:731-738.

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