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Modeling service access in a homeless population.
David E Pollio1, Carol S North, Karin M Eyrich
1George Warren Brown School of Social Work, Washington University, St. Louis, Missouri 63130-4899, USA. depollio@gwbmail.wustl.edu
Journal of Psychoactive Drugs
|February 28, 2004
Summary
Understanding service use among vulnerable populations is key. This study reveals complex interactions between demographics, homelessness, mental illness, and service utilization, highlighting the need for integrated care approaches.
Area of Science:
- Social Sciences
- Public Health
- Health Services Research
Background:
- Previous research links greater service use to positive outcomes.
- The interplay of demographics, homelessness, mental illness, and service use remains under-explored.
Purpose of the Study:
- To conceptualize and analyze the complex interactions among demographics, homelessness, mental illness, and service use.
- To identify key predictors of service utilization across four sectors.
Main Methods:
- Systematic sampling of 396 subjects.
- Logistic regression analysis of service use across homeless amelioration, homeless maintenance, mental health, and chemical dependency sectors.
- Evaluation of nested conceptual models to assess predictive improvements.
Main Results:
- The most comprehensive model, including need factors, comorbidity, demographics, and cross-sector service use, showed the greatest predictive advantage.
- Mental health and addiction service use were strongly predicted by diagnosis.
- Including all variables did not significantly improve model prediction beyond the third model.
Conclusions:
- Integrated service delivery facilitating cross-sector use is recommended.
- Homelessness service sectors must prioritize need factors.
- Service providers should address potential barriers to accessing multiple service types.