Application Of The Frailty Framework Among Vulnerable Populations To Hospitalization Outcomes Of Individuals Experiencing Homelessness In Long Beach, California

Background: Individuals experiencing homelessness have a high prevalence of infectious diseases that may result in hospitalization.Objectives: This study uses risk factors at baseline to predict hospitalization at follow-up. This paper also presents the associations between reporting homelessness and selected infectious diseases.Research design: Longitudinal study of baseline and follow-up conducted August 2000 through July 2014.Subjects: 4916 Not experiencing homelessness mean age 37.9 years, 29% female, and 2692 experiencing homelessness age 42.1 years, 29% female received services from a research/service center in a low-income, high-crime area of Long Beach, CA.Measures: Risk Behavior Assessment, Risk Behavior Follow-up Assessment, laboratory testing for hepatitis A, hepatitis B, hepatitis C, syphilis, chlamydia, and gonorrhea.Results: Predictors of hospitalization at follow-up were ever use of crack cocaine, income from Social Security or disability, reporting homelessness, female, and those who identify as Black race/ethnicity.Conclusions: Income from the safety net of Social Security or disability provides participants with experience that transfers to being able to obtain healthcare. A higher proportion of those experiencing homelessness, compared to those not experiencing homelessness, appear to be hospitalized at follow-up. Our findings support use of the Frailty Framework when working with individuals experiencing both homelessness and hospitalization.