From 2007 to 2013, hospitalizations among homeless individuals increased and were most frequently for mental illness and substance use disorder, according to a study published in the January issue of Medical Care.

Rishi K. Wadhera, M.D., from Beth Israel Deaconess Medical and Harvard Medical School in Boston, and colleagues compared 185,292 hospitalizations for homeless individuals and 32,322,569 hospitalizations for demographics-standardized nonhomeless individuals in Massachusetts, Florida, and California from 2007 to 2013.

The researchers observed an increase in hospitalizations for the homeless from 2007 to 2013 in Massachusetts, Florida, and California (294 to 420, 161 to 240, and 133 to 164 hospitalizations per 1,000 homeless residents, respectively). Compared with demographics-standardized nonhomeless individuals, hospitalizations for homeless persons were more often for mental illness and substance use disorder (52 versus 18 percent). Compared with risk-standardized nonhomeless individuals, homeless individuals had lower in-hospital mortality rates (0.9 to 1.2 percent), longer mean length of stay (6.5 versus 5.9 days), and lower mean costs per day ($1,535 versus $1,834).

"These data reinforce that there is an urgent need to reduce financial and nonfinancial barriers to the use of ambulatory care, for behavioral health services in particular, to improve long-term management of physical and mental illness for homeless individuals," the authors write.

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