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Table 3 Unadjusted odds ratios for the predisposing, enabling, and need factors associated with higher cost use

From: Factors associated with higher healthcare costs in a cohort of homeless adults with a mental illness and a general cohort of adults with a history of homelessness

Study Odds Ratio (95%CI)
Cohort with a mental illness (n = 525) General homeless cohort (n = 655)
Cost category Top 11–50% (n = 219) Top 6–10% (n = 83) Top 5% (n = 160) Top 11–50% (n = 279) Top 6–10% (n = 79) Top 5% (n = 108)
Predisposing Factors
Age
  Per 1-year increase 1.00 (0.98, 1.03) 1.01 (0.98, 1.04) 1.01 (0.98, 1.03) 1.00 (0.98, 1.02) 1.00 (0.98, 1.03) 1.01 (0.99, 1.04)
Age Group 18 to 34 years (reference)
 35 to 49 1.87 (0.98, 3.57) 2.18 (1.02, 4.68) 1.88 (0.96, 3.69) 0.98 (0.61, 1.55) 1.23 (0.62, 2.42) 1.47 (0.78, 2.79)
 50+ 1.10 (0.53, 2.27) 1.42 (0.60, 3.37) 1.05 (0.49, 2.26) 0.90 (0.53, 1.52) 1.03 (0.48, 2.24) 1.47 (0.73, 2.97)
Gender a
 Female 1.68 (0.87, 3.24) 1.18 (0.55, 2.57) 1.68 (0.85, 3.32) 1.83 (1.19, 2.82) 2.35 (1.33, 4.18) 2.45 (1.45, 4.13)
Marital Status
 Single, never married 0.71 (0.37, 1.36) 0.55 (0.26, 1.14) 0.92 (0.46, 1.84) 0.66 (0.45, 0.97) 0.75 (0.43, 1.29) 0.69 (0.42, 1.12)
Race
 Black 0.68 (0.33, 1.40) 0.46 (0.20, 1.04) 0.43 (0.21, 0.92) 0.97 (0.56, 1.69) 0.55 (0.23, 1.35) 0.30 (0.11, 0.81)
 Other racialized groups 0.60 (0.29, 1.23) 0.32 (0.14, 0.75) 0.39 (0.19, 0.82) 1.02 (0.65, 1.62) 0.70 (0.35, 1.39) 1.09 (0.63, 1.92)
Place of Birth
 Outside Canada 1.26 (0.71, 2.23) 0.71 (0.36, 1.39) 0.86 (0.47, 1.57) 1.08 (0.68, 1.73) 0.99 (0.51, 1.93) 0.48 (0.23, 0.99)
Education
 Graduated high school 0.78 (0.44, 1.39) 0.92 (0.47, 1.79) 1.13 (0.62, 2.06) 0.75 (0.52, 1.10) 0.75 (0.44, 1.28) 0.62 (0.38, 1.00)
Employment
 Currently employed 0.31 (0.10, 0.95) 0.34 (0.08, 1.43) 0.31 (0.09, 1.07) 0.56 (0.32, 0.99) 0.62 (0.27, 1.42) 0.27 (0.10, 0.71)
Housing Status
 Homeless 0.67 (0.22, 2.05) 0.64 (0.18, 2.21) 1.48 (0.42, 5.25) 0.71 (0.49, 1.03) 0.75 (0.43, 1.29) 0.73 (0.45, 1.17)
Duration of homelessness
 Per 1-year increase 0.98 (0.94, 1.03) 1.00 (0.95, 1.05) 0.98 (0.93, 1.03) 0.99 (0.96, 1.03) 0.98 (0.94, 1.03) 1.03 (0.99, 1.06)
  ≥ 2 years spent homeless 1.02 (0.57, 1.82) 0.75 (0.38, 1.47) 0.89 (0.48, 1.62) 1.02 (0.70, 1.49) 0.90 (0.53, 1.53) 1.13 (0.70, 1.83)
Criminal behavior (past 6 to 12 months) 1.88 (0.98, 3.58) 2.86 (1.38, 5.91) 2.06 (1.05, 4.01) 1.45 (0.98, 2.15) 1.56 (0.91, 2.70) 1.67 (1.02, 2.73)
Victimization (past 6 to 12 months) 2.01 (1.02, 3.94) 2.02 (0.94, 4.33) 2.33 (1.16, 4.68) 1.71 (1.15, 2.54) 1.64 (0.95, 2.86) 1.99 (1.21, 3.28)
Diagnosed of mental illness
 Psychotic disorder 0.81 (0.41, 1.60) 1.16 (0.69, 1.94) 1.37 (0.80, 2.35) 0.92 (0.33, 2.56) 1.71 (0.57, 5.20) 2.51 (0.87, 7.21)
 Other disorder (reference)  
 No disorder 0.17 (0.09, 0.30) 0.11 (0.06, 0.23) 0.12 (0.06, 0.23)
Substance use
 Problematic alcohol use 1.32 (0.74, 2.34) 2.34 (1.20, 4.58) 1.14 (0.63, 2.07) 1.64 (0.99, 2.73) 1.85 (0.95, 3.61) 2.41 (1.34, 4.35)
 Problematic drug use 1.24 (0.71, 2.17) 1.75 (0.90, 3.40) 0.83 (0.46, 1.50) 3.10 (1.96, 4.91) 7.01 (3.88, 12.68) 5.92 (3.44, 10.20)
 Current daily smoker 0.97 (0.52, 1.79) 0.94 (0.46, 1.93) 0.67 (0.35, 1.26) 0.97 (0.63, 1.49) 1.01 (0.54, 1.86) 1.06 (0.61, 1.86)
Enabling Factors
Regular source of care
  Yes 2.85 (1.58, 5.13) 4.05 (1.97, 8.35) 2.30 (1.25, 4.24) 2.08 (1.43, 3.02) 4.11 (2.29, 7.36) 4.62 (2.71, 7.87)
  Perceived barrier to care (past 6 to 12 months) 1.18 (0.65, 2.12) 1.26 (0.64, 2.48) 0.90 (0.49, 1.68) 1.87 (1.24, 2.81) 2.57 (1.48, 4.47) 1.75 (1.04, 2.92)
  Food insecurity (not enough food) 1.37 (0.77, 2.43) 1.32 (0.68, 2.58) 1.10 (0.60, 2.00) 0.87 (0.58, 1.30) 1.64 (0.95, 2.82) 1.13 (0.68, 1.87)
  Acute mental health care (past 12 months) 4.27 (2.00, 9.08) 10.60 (4.60, 24.45) 20.67 (9.31, 45.87) 4.37 (2.09, 9.12) 6.33 (2.72, 14.75) 20.00 (9.27, 43.13)
  Acute non-mental health care (past 12 months) 2.26 (1.26, 4.04) 4.86 (2.40, 9.86) 6.42 (3.39, 12.14) 2.87 (1.92, 4.30) 5.99 (3.38, 10.61) 5.20 (3.12, 8.67)
Need Factors
Perceived general health
  Fair 1.04 (0.55, 1.96) 0.77 (0.36, 1.63) 0.73 (0.37, 1.43) 1.41 (0.91, 2.17) 2.89 (1.60, 5.20) 2.05 (1.17, 3.58)
  Poor 1.10 (0.49, 2.48) 1.01 (0.40, 2.56) 1.30 (0.57, 2.96) 1.85 (0.95, 3.60) 3.30 (1.40, 7.79) 5.26 (2.55, 10.87)
Diagnosed conditions (administrative records)
 1 1.62 (0.80, 3.27) 2.05 (0.91, 4.60) 2.24 (1.08, 4.65) 3.10 (1.89, 5.10) 5.67 (2.96, 10.87) 3.66 (1.94, 6.92)
 2+ 2.04 (0.67, 6.19) 4.27 (1.33, 13.77) 4.44 (1.48, 13.36) 3.39 (1.50, 7.63) 9.45 (3.74, 23.91) 14.84 (6.43, 34.21)
Self-reported conditions (survey data)
 1 1.58 (0.81, 3.09) 1.27 (0.57, 2.86) 1.21 (0.59, 2.46) 1.93 (1.25, 2.97) 2.28 (1.18, 4.39) 1.66 (0.89, 3.09)
 2+ 1.50 (0.70, 3.23) 2.38 (1.02, 5.57) 1.67 (0.76, 3.67) 3.28 (1.93, 5.57) 6.14 (3.07, 12.25) 7.34 (3.95, 13.66)
Missing Data 0.81 (0.36, 1.83) 0.73 (0.27, 1.96) 1.68 (0.76, 3.74) 0.69 (0.36, 1.33) 0.74 (0.28, 1.92) 0.62 (0.25, 1.53)