Utilization of health care services among subgroups of urban homeless and housed poor

Thomas P. O'Toole, Jeanette L. Gibbon, Barbara H. Hanusa, Michael J. Fine

Research output: Contribution to journalArticle

Abstract

The objective of this study was to describe health services utilization by homeless and housed poor adults stratified by six-month primary sheltering arrangements. The primary method used in this study was a cross-sectional survey of 373 homeless adults. Interviews at twenty-four community-based sites (in Allegheny County, Pennsylvania) assessed demographic and clinical characteristics, reasons for homelessness, functional status and social support networks, and health services utilization during the previous six months. Multivariate logistic regression analysis identified factors independently associated with health services utilization. Subjects were classified as unsheltered, emergency-sheltered, bridge-housed, doubled-up, and housed-poor. The median age of the subjects was 38.4 years; 78.6 percent were African American and 69.9 percent had health insurance. Overall, 62.7 percent reported health services use in the past six months, with significantly more use among emergency-sheltered and bridge-housed subjects than among unsheltered subjects. The study concludes that health services use among the homeless is substantial and is independently associated with sheltering arrangement, comorbid illness, race, health insurance, and social support.

Original languageEnglish (US)
Pages (from-to)91-114
Number of pages24
JournalJournal of Health Politics, Policy and Law
Volume24
Issue number1
StatePublished - Feb 1999
Externally publishedYes

Fingerprint

health care services
Health Services
health service
utilization
Social Support
Health Insurance
health insurance
social support
Emergencies
Homeless Persons
homelessness
African Americans
regression analysis
illness
Cross-Sectional Studies
Logistic Models
logistics
Regression Analysis
Demography
Interviews

ASJC Scopus subject areas

  • Law
  • Health Professions(all)
  • Health(social science)
  • Health Policy
  • Medicine (miscellaneous)
  • Social Sciences (miscellaneous)
  • Nursing(all)

Cite this

O'Toole, T. P., Gibbon, J. L., Hanusa, B. H., & Fine, M. J. (1999). Utilization of health care services among subgroups of urban homeless and housed poor. Journal of Health Politics, Policy and Law, 24(1), 91-114.

Utilization of health care services among subgroups of urban homeless and housed poor. / O'Toole, Thomas P.; Gibbon, Jeanette L.; Hanusa, Barbara H.; Fine, Michael J.

In: Journal of Health Politics, Policy and Law, Vol. 24, No. 1, 02.1999, p. 91-114.

Research output: Contribution to journalArticle

O'Toole, TP, Gibbon, JL, Hanusa, BH & Fine, MJ 1999, 'Utilization of health care services among subgroups of urban homeless and housed poor', Journal of Health Politics, Policy and Law, vol. 24, no. 1, pp. 91-114.
O'Toole, Thomas P. ; Gibbon, Jeanette L. ; Hanusa, Barbara H. ; Fine, Michael J. / Utilization of health care services among subgroups of urban homeless and housed poor. In: Journal of Health Politics, Policy and Law. 1999 ; Vol. 24, No. 1. pp. 91-114.
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