{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:23:26Z","timestamp":1791638606647,"version":"4.3.4"},"reference-count":58,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2019,3,7]],"date-time":"2019-03-07T00:00:00Z","timestamp":1551916800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2020]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2045796019000052_sec_a1\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>A significant proportion of adults who are admitted to psychiatric hospitals are homeless, yet little is known about their outcomes after a psychiatric hospitalisation discharge. The aim of this study was to assess the impact of being homeless at the time of psychiatric hospitalisation discharge on psychiatric hospital readmission, mental health-related emergency department (ED) visits and physician-based outpatient care.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796019000052_sec_a2\" sec-type=\"methods\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>This was a population-based cohort study using health administrative databases. All patients discharged from a psychiatric hospitalisation in Ontario, Canada, between 1 April 2011 and 31 March 2014 (<jats:italic>N<\/jats:italic> = 91 028) were included and categorised as homeless or non-homeless at the time of discharge. Psychiatric hospitalisation readmission rates, mental health-related ED visits and physician-based outpatient care were measured within 30 days following hospital discharge.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796019000052_sec_a3\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>There were 2052 (2.3%) adults identified as homeless at discharge. Homeless individuals at discharge were significantly more likely to have a readmission within 30 days following discharge (17.1 <jats:italic>v.<\/jats:italic> 9.8%; aHR = 1.43 (95% CI 1.26\u20131.63)) and to have an ED visit (27.2 <jats:italic>v.<\/jats:italic> 11.6%; aHR = 1.87 (95% CI 1.68\u20132.0)). Homeless individuals were also over 50% less likely to have a psychiatrist visit (aHR = 0.46 (95% CI 0.40\u20130.53)).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796019000052_sec_a4\" sec-type=\"conclusion\">\n\t    <jats:title>Conclusion<\/jats:title>\n\t    <jats:p>Homeless adults are at higher risk of readmission and ED visits following discharge. They are also much less likely to receive post-discharge physician care. Efforts to improve access to services for this vulnerable population are required to reduce acute care service use and improve care continuity.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s2045796019000052","type":"journal-article","created":{"date-parts":[[2019,3,7]],"date-time":"2019-03-07T01:47:04Z","timestamp":1551923224000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":35,"title":["Homelessness at discharge and its impact on psychiatric readmission and physician follow-up: a population-based cohort study"],"prefix":"10.1017","volume":"29","author":[{"given":"V.","family":"Lalibert\u00e9","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Stergiopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Jacob","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Kurdyak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,3,7]]},"reference":[{"key":"S2045796019000052_ref59","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2014.12.003"},{"key":"S2045796019000052_ref55","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2005.0042"},{"key":"S2045796019000052_ref54","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2013.02.046"},{"key":"S2045796019000052_ref53","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201100468"},{"key":"S2045796019000052_ref52","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.87.2.256"},{"key":"S2045796019000052_ref51","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.1163"},{"key":"S2045796019000052_ref50","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2007.58.12.1563"},{"key":"S2045796019000052_ref49","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200410000-00004"},{"key":"S2045796019000052_ref48","first-page":"53","article-title":"Ambulatory care groups: a categorization of diagnoses for research and management","volume":"26","author":"Starfield","year":"1991","journal-title":"Health Services Research"},{"key":"S2045796019000052_ref13","doi-asserted-by":"publisher","DOI":"10.1177\/0706743717748926"},{"key":"S2045796019000052_ref57","unstructured":"University John Hopkins, Johns Hopkins ACG Case-Mix Adjustment System. 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