       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).

