Frequent Episodic Utilizers of Veterans Health Administration Homeless Programs Use: Background Characteristics and...

Area of Science:

• Health Services Research
• Veterans Affairs Studies
• Public Health

Background:

• Homelessness among veterans is a significant public health concern.
• Understanding patterns of service utilization is crucial for effective intervention.
• The Veterans Health Administration (VHA) provides targeted programs for homeless veterans.

Purpose of the Study:

• To identify sociodemographic, diagnostic, and service use factors associated with repeated, episodic use of VHA Homeless Programs.
• To assess the prevalence and predictors of frequent episodic utilization among veterans in VHA Homeless Programs.

Main Methods:

• Retrospective cohort study utilizing administrative data from VHA services.
• Stepwise multivariate logistic regression analysis.
• Sample of 31,098 veterans who completed VHA Homeless Program intake in 2013 and accessed services through 2016.

Main Results:

• Only 2.4% of veterans exhibited frequent episodic use (≥4 episodes).
• Key risk factors identified include military sexual trauma, history of incarceration, diagnoses of psychosis and substance use disorder, and acute care utilization.
• These factors highlight specific vulnerabilities among frequent users.

Conclusions:

• Targeting interventions for poverty, income support, and post-incarceration reintegration may reduce frequent episodic use of VHA Homeless Programs.
• Consideration of integrated care models within emergency departments and inpatient settings is recommended.
• These strategies aim to improve long-term housing stability and reduce reliance on episodic VHA services.