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