American journal of public health
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We identified predictors of emergency department (ED) use among a population-based prospective cohort of homeless adults in Toronto, Ontario. ⋯ Among homeless adults with universal health insurance, a small subgroup accounted for the majority of visits to emergency services. Frequent use was driven by multiple predisposing, enabling, and need factors.
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Randomized Controlled Trial
Housing first improves residential stability in homeless adults with concurrent substance dependence and mental disorders.
We examined the relationship between substance dependence and residential stability in homeless adults with current mental disorders 12 months after randomization to Housing First programs or treatment as usual (no housing or support through the study). ⋯ People with mental disorders might achieve similar levels of housing stability from Housing First regardless of whether they experience concurrent substance dependence.
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We examined the empirical link between money mismanagement and subsequent homelessness among veterans. ⋯ Money mismanagement, reported by a substantial number of veterans, was related to a higher rate of subsequent homelessness. The findings have implications for policymakers and clinicians, suggesting that financial education programs offered by the US Departments of Defense and Veterans Affairs may be targeted to effectively address veteran homelessness.
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We studied housing retention and its predictors in the single-site Housing First model. ⋯ We found that single-site Housing First programming fills a gap in housing options for chronically homeless people with severe alcohol problems.
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We examined the proportion of homeless veterans among users of Veterans Affairs (VA) emergency departments (EDs) and compared sociodemographic and clinical characteristics of homeless and nonhomeless VA emergency department users nationally. ⋯ In a national integrated health care system with no specific requirements for health insurance, the major differences found between homeless and nonhomeless ED users were high rates of psychiatric and substance abuse diagnoses. EDs may be an important location for specialized homeless outreach (or "in" reach) services to address mental health and addictive disorders.