Predicting health services utilization among homeless adults: A prospective analysis

This study expands on the Andersen-Newman health services utilization (HSU) model. In a community-based homeless sample (n = 363) baseline predisposin g, enabling, and needs-based variables predicted hospitalization and ambula tory outpatient service utilization within I year after baseline. Standard predisposing and enabling variables were supplemented with latent construct s representing substance use, mental illness, poor housing status, social s upport, community support, and barriers to health care. Need is represented by baseline health status. Poor physical health, move barriers, drug use, African American ethnicity, less community support, and less education pred icted hospitalization, the least desirable form of HSU. Poor health, female gender, a regular source of care, community support, drug use, and fewer a lcohol problems predicted an office visit. Because outpatient visits for ac ute conditions provide an opportunity for generally neglected preventive se rvices and health screenings, this study suggests convenient multiservice h ealth-related programs for the homeless that include drug and alcohol treat ment.