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J Health Care Poor Underserved. 2008 Nov;19(4):1212-28. doi: 10.1353/hpu.0.0068.

Association between the level of housing instability, economic standing and health care access: a meta-regression.

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  • 1Division of General Internal Medicine, University of California-San Francisco, CA 94143, USA.

Abstract

INTRODUCTION:

To determine the relationship between housing instability, economic standing, and access to health care and use of acute care services.

METHODS:

We performed a meta-regression using four nationally representative surveys. The independent variable was an ordered measure of economic and housing instability: 1) the general population, 2) low-income population, 3) never homeless users-of-subsistence-services, 4) unstably housed, 5) formerly homeless, and 6) the actively homeless. Dependent variables were four measures of health care access and three measures of acute health care utilization.

RESULTS:

Worsening housing instability and economic standing was associated with poorer access: being uninsured (5.4% per unit increase, 95% CI 1.7-9.2%, p=.011), postponing needed care (3.3%, 95% CI 1.9-4.7%, p=.001), postponing medications (6.1%, 95% CI 1.5-10.6%, p=.035), and with one measure of acute health care utilization: higher hospitalization rates (2.9%, 95% CI 1.2-4.6%, p=.008).

DISCUSSION:

Economic and housing instability should be considered a graded risk factor for poor access to health care.

PMID:
19029747
[PubMed - indexed for MEDLINE]
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