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- Title
Risk factors for unplanned hospital admission in a specialist homeless general practice population: case-control study to investigate the relationship with tri-morbidity.
- Authors
Himsworth, Catherine; Paudyal, Priyamvada; Sargeant, Christopher
- Abstract
<bold>Background: </bold>'Tri-morbidity' describes the complex comorbidity of chronic physical illness, mental illness, and alcohol and/or drug misuse within the homeless population. Poor health outcomes of homeless people are reflected by the higher rate of unplanned hospital admissions compared with the non-homeless population.<bold>Aim: </bold>To identify whether tri-morbidity is a risk factor for unplanned hospital admissions in the homeless population.<bold>Design and Setting: </bold>A case-control study of patients who were registered with a specialist homeless GP surgery in Brighton (72 cases and 72 controls).<bold>Method: </bold>Cases were defined as those who had ≥1 overnight hospital admission within a 12-month period. Controls were matched for demographics but with no hospital admission. The primary care record was analysed, and tri-morbidity entered into binomial logistic regression with admission as the dichotomous dependent variable.<bold>Results: </bold>The logistic regression analysis demonstrated that other enduring mental health disorders and/or personality disorder (odds ratio [OR] 3.84, 95% confidence interval [CI] = 1.56 to 9.44), alcohol use (OR 2.92, 95% CI = 1.42 to 5.98), and gastrointestinal disorder (OR 2.90, 95% CI = 1.06 to 7.98) were independent risk factors for admission. Tri-morbidity increased odds of admission by more than four-fold (OR 4.19, 95% CI = 1.90 to 9.27).<bold>Conclusion: </bold>This study shows that tri-morbidity is an important risk factor for unplanned hospital admissions among the homeless population, and provides an interesting starting point for the development of a risk stratification tool to identify those at risk of unplanned admission in this population.
- Subjects
BRIGHTON (England); HOSPITAL admission &; discharge; CASE-control method; LOGISTIC regression analysis; ODDS ratio; ALCOHOL drinking; HOSPITALS; FAMILY medicine; DISEASES
- Publication
British Journal of General Practice, 2020, Vol 70, Issue 695, pe406
- ISSN
0960-1643
- Publication type
journal article
- DOI
10.3399/bjgp20X710141