Table 4.
Characteristics Associated with Underreporting and Overreporting of Use of Three Types of Health Care Services in the Past 12 Months among Homeless Adults
| Characteristics | Ambulatory Care Visits | Emergency Department Encounters | Hospitalizations | |||
|---|---|---|---|---|---|---|
| Underreport† (N = 398) | Overreport† (N = 404) | Underreport‡ (N = 321) | Overreport‡ (N = 200) | Underreport§ (N = 83) | Overreport§ (N = 107) | |
| AOR (95% CI) | AOR (95% CI) | AOR (95% CI) | AOR (95% CI) | AOR (95% CI) | AOR (95% CI) | |
| Predisposing factors | ||||||
| Demographic group | ||||||
| Single adult male (ref) | 1.00 | ns | ns | ns | ns | ns |
| Single adult female | 1.28 (0.88–1.86) | |||||
| Family adult | 1.82 (1.25–2.64)** | |||||
| Age (years) | ns | ns | ns | ns | ns | ns |
| Lifetime duration of homelessness ≥2 years | ns | ns | 1.37 (1.02–1.84)* | ns | ns | 1.84 (1.17–2.90)** |
| Race/ethnicity | ||||||
| White (ref) | ns | ns | ns | ns | ns | ns |
| Black | ||||||
| Aboriginal | ||||||
| Other visible minority | ||||||
| Born in Canada | ns | ns | 1.68 (1.21–2.33)** | ns | ns | ns |
| Highest level of education | ||||||
| Less than high school | ns | ns | ns | ns | ns | ns |
| High school or equivalent | ||||||
| College/vocational training | ||||||
| History of traumatic brain injury | ns | ns | ns | ns | ns | ns |
| Physical assault in past 12 months | ns | ns | 1.68 (1.22–2.30)** | 2.67 (1.86–3.83)** | ns | 1.98 (1.26–3.13)** |
| Sexual assault in past 12 months | ns | ns | ns | ns | ns | 3.06 (1.59–5.90)** |
| Alcohol problem in past 30 days | ns | ns | ns | ns | 0.55 (0.31–0.97)* | ns |
| Drug problem in past 30 days | ns | ns | ns | ns | ns | ns |
| Mental health problem in past 30 days | 1.55 (1.13–2.14)** | 1.60 (1.16–2.20)** | ns | ns | ns | 1.94 (1.24–3.02)** |
| Propensity to underseek care score | ns | ns | ns | ns | ns | ns |
| Enabling factors | ||||||
| Monthly income | ||||||
| <$500 | ns | ns | ns | ns | ns | ns |
| $500–999 | ||||||
| ≥$1,000 | ||||||
| Has a primary care provider | 1.45 (1.03–2.03)* | 1.77 (1.26–2.49)** | ns | ns | ns | ns |
| Self‐perceived unmet needs for health care | ns | ns | ns | ns | ns | ns |
| Self‐perceived unmet needs for mental health care | ns | ns | ns | ns | ns | ns |
| Has competing priorities for subsistence needs | 3.48 (1.55–7.81)** | ns | ns | ns | ns | ns |
| Need factors | ||||||
| SF‐12 physical component summary score | ns | 0.98 (0.97–1.00)* | 0.96 (0.95–0.98)** | 0.96 (0.94–0.97)** | 0.97 (0.95–0.99)** | ns |
| SF‐12 mental component summary score | ns | ns | 0.99 (0.98–1.00)* | 0.99 (0.97–1.00)* | ns | ns |
| No. of chronic health conditions | ||||||
| None (ref) | 1.00 | 1.00 | ns | ns | ns | 1.00 |
| 1 | 1.77 (1.23–2.55)** | 1.73 (1.20–2.49)** | 0.76 (0.41–1.40) | |||
| 2 | 2.65 (1.69–4.18)** | 2.25 (1.40–3.63)** | 1.04 (0.55–1.98) | |||
| 3 or more | 2.52 (1.54–4.13)** | 2.04 (1.19–3.51)** | 2.51 (1.42–4.44)** | |||
†As compared to reference group of homeless participants who accurately reported number of ambulatory care visits (n = 361).
‡As compared to reference group of homeless participants who accurately reported number of emergency department encounters (n = 641); one participant had missing data on the self‐reported number of emergency department encounters and was excluded from logistic regression analyses.
§As compared to reference group of homeless participants who accurately reported number of hospitalizations (n = 972); one participant had missing data on the self‐reported number of hospitalization and was excluded from logistic regression analyses.
AOR = adjusted odds ratio; ns = not significant (p > .05) in final multivariable logistic regression model.
*p < .05; **p < .01.