title: A Taxonomy of medical comorbidity for veterans who are homeless.
abstract: Homeless veterans have numerous medical and behavioral health problems. Grouping homeless people based on comorbidity patterns may assist in determining severity of illness and triaging health care more effectively. We sought to determine if a finite number of profiles could be identified related to demographic characteristics, living situation, length of homelessness, and referral areas using interview data from 2,733 veterans who were presently or recently homeless. We considered 12 disorders: eye problems, hypertension, cardiovascular problems, COPD/emphysema, tuberculosis, gastrointestinal problems, hepatic disease, neurologic disorders, orthopedic problems, skin problems, and trauma. Ratings were evaluated using cluster analysis. Comparison statistics were used to compare intercluster differences in demographics, homeless situation, and referral recommendations. A four-cluster solution is proposed: generalized illness, hepatic disease, lung disease, and neurologic disorder. Medical health problems are common and heterogeneous in homeless individuals. Classifications of these problems may be useful in planning treatment and predicting outcome.
authors.affiliation: Mental Illness and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA. ggold@nb.net
authors.forename: Gerald
authors.initials: G
authors.lastname: Goldstein
authors.forename: James F
authors.initials: JF
authors.lastname: Luther
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Jacoby
authors.forename: Gretchen L
authors.initials: GL
authors.lastname: Haas
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Gordon
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000145:classification / Q000453:epidemiology*; D016000:Cluster Analysis; D015897:Comorbidity; D005260:Female; D006305:Health Status Indicators; D006703:Ill-Housed Persons / Q000145:classification* / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000453:epidemiology*; D008873:Mid-Atlantic Region / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000145:classification* / Q000706:statistics & numerical data