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M94A1989.TXT
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Document 1989
DOCN M94A1989
TI Unstable housing and its impact on hospital utilization.
DT 9412
AU Goldstone IL; Hogg RS; Schilder A; Patullo AL; Sussel R; O'Shaughnessy
MV; UBC & BC Centre for Excellence in HIV/AIDS, Vancouver, Canada.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):405 (abstract no. PD0227). Unique
Identifier : AIDSLINE ICA10/94370586
AB OBJECTIVE: To assess the sociodemographic determinants of unstable
housing and its impact on hospital utilization through a survey
conducted jointly by PWA Society of BC (PWA) and Centre for Excellence.
METHODS: All participants were voting members of PWA (i.e. HIV
positive), residents of BC, and had previously agreed that the PWA send
them unsolicited material. Self-administered questionnaires were mailed
out to 829 full-members. Information on sociodemographic
characteristics, hospital utilization, and clinical status was obtained.
Persons with unstable housing were defined a priori as those who had
incomes less than $20,000 and were uncertain if they could remain in
their present housing throughout their illness. RESULTS: A total of 300
(36%) questionnaires were returned. As defined above, 115 (38%) persons
out of 300 lived in unstable housing. Persons in unstable housing were
more likely to be under 35 years of age (42 vs 27%; p = 0.030), have a
self reported CD4 count above 500 cells (20 vs 11%; p = 0.046), unable
to work (OR = 2.5; 95% CI 1.6, 4.1) and less likely to have an
university education (OR = 0.5; 95% CI 0.28, 0.77), own or mortgage
their residence (OR = 0.2; 95% CI 0.1, 0.5) than those who do not live
in unstable housing. In terms of hospitalization, persons in unstable
housing were more likely to be hospitalized in the prior year (OR = 1.8;
95% CI 1.2, 3.0) and at a tertiary AIDS care facility in 1992/93 (OR =
2.0; 95% CI 1.2, 3.4) as day or in patient. Persons in unstable housing
were also more likely to be hospitalized when their CD4 counts were less
than 500 and greater than 200 (50 vs 34%) and under 200 (61% vs 45%).
Logistic analysis indicates that not having an university education (p =
0.0378) not owning or mortgaging a residence (p = 0.008), being unable
to work (p = 0.0034), having a high CD4 count (p = 0.0075) and
hospitalization at an AIDS tertiary care facility in 1992/93 (p =
0.0104) were predictors of unstable housing. CONCLUSIONS: This analysis
demonstrates, albeit cross-sectionally, a clear association between
housing and hospital utilization. Our findings demonstrate that secure
housing is an important health issue and is key to the rational use of
hospital beds. The impact of HIV/AIDS is underestimated due to greater
under reporting of HIV/AIDS relative to other causes of death.
DE *Acquired Immunodeficiency Syndrome/IMMUNOLOGY/PHYSIOPATHOLOGY Adult
Age Factors British Columbia Demography Education Employment
Hospitals/*UTILIZATION *Housing Human *HIV
Infections/IMMUNOLOGY/PHYSIOPATHOLOGY Income Questionnaires
Socioeconomic Factors T4 Lymphocytes MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).