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The Use of High-Risk Criteria to Assess Mortality Risk among Unsheltered Homeless Persons.
- Source :
- Journal of Health Care for the Poor & Underserved; Feb2020, Vol. 31 Issue 1, p441-454, 14p
- Publication Year :
- 2020
-
Abstract
- We assessed the ability of high-risk criteria developed by Boston Health Care for the Homeless Program to identify increased mortality during a 10-year cohort study (January 2000–December 2009) of 445 unsheltered adults. To qualify as high-risk for mortality, an individual slept unsheltered for six consecutive months or longer plus had one or more of the following characteristics: tri-morbidity, defined as co-occurring medical, psychiatric, and addiction diagnoses; one or more inpatient or respite admissions; three or more emergency department visits; 60 years old or older; HIV/AIDS; cirrhosis; renal failure; frostbite, hypothermia, or immersion foot. A total of 119 (26.7%) individuals met the high-risk criteria. The remaining 326 individuals in the cohort were considered lowerrisk. During the study, 134 deaths occurred; 52 (38.8%) were among high-risk individuals. Compared with sheltered individuals, the age-standardized mortality ratio for the high-risk group was 4.0 (95% confidence interval 3.0, 5.2) times higher and for the lower-risk group was 2.2 (1.8, 2.8) times higher. The hazard ratio, a measure of survival, for the high-risk group was 1.7 (1.2, 2.4) times that of the lower-risk group. High-risk criteria predicted an increased likelihood of mortality among unsheltered individuals. The lower-risk group also had high mortality rates compared with sheltered individuals. [ABSTRACT FROM AUTHOR]
- Subjects :
- MORTALITY risk factors
AGE distribution
AIDS
CONFIDENCE intervals
CAUSES of death
FROSTBITE
HIV infections
HOMELESSNESS
HOSPITAL care
HYPOTHERMIA
LIVER failure
LONGITUDINAL method
MEDICAL records
KIDNEY failure
RISK assessment
COMORBIDITY
PROPORTIONAL hazards models
DATA analysis software
DESCRIPTIVE statistics
ACQUISITION of data methodology
Subjects
Details
- Language :
- English
- ISSN :
- 10492089
- Volume :
- 31
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Journal of Health Care for the Poor & Underserved
- Publication Type :
- Academic Journal
- Accession number :
- 141624880
- Full Text :
- https://doi.org/10.1353/hpu.2020.0032