title: Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria.
abstract: Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.
authors.affiliation: Salt Lake Informatics, Decision-enhancement and Analytic Sciences (IDEAS 2.0) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America; Department of Psychology, Utah State University, Logan, Utah, United States of America.
authors.forename: Rachel
authors.initials: R
authors.lastname: Peterson
authors.affiliation: Salt Lake Informatics, Decision-enhancement and Analytic Sciences (IDEAS 2.0) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America; Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States of America.
authors.forename: Adi V
authors.initials: AV
authors.lastname: Gundlapalli
authors.affiliation: National Center on Homelessness Among Veterans, Philadelphia, Pennsylvania, United States of America; Health Policy and Public Education, University of the Sciences, Philadelphia, Pennsylvania, United States of America.
authors.forename: Stephen
authors.initials: S
authors.lastname: Metraux
authors.affiliation: Salt Lake Informatics, Decision-enhancement and Analytic Sciences (IDEAS 2.0) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America; Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States of America.
authors.forename: Marjorie E
authors.initials: ME
authors.lastname: Carter
authors.affiliation: Salt Lake Informatics, Decision-enhancement and Analytic Sciences (IDEAS 2.0) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America; Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States of America.
authors.forename: Miland
authors.initials: M
authors.lastname: Palmer
authors.affiliation: Salt Lake Informatics, Decision-enhancement and Analytic Sciences (IDEAS 2.0) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America; Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States of America.
authors.forename: Andrew
authors.initials: A
authors.lastname: Redd
authors.affiliation: Salt Lake Informatics, Decision-enhancement and Analytic Sciences (IDEAS 2.0) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America; Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States of America.
authors.forename: Matthew H
authors.initials: MH
authors.lastname: Samore
authors.affiliation: Salt Lake Informatics, Decision-enhancement and Analytic Sciences (IDEAS 2.0) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, United States of America; Department of Psychology, Utah State University, Logan, Utah, United States of America; National Center on Homelessness Among Veterans, Philadelphia, Pennsylvania, United States of America.
authors.forename: Jamison D
authors.initials: JD
authors.lastname: Fargo
mesh_terms: D015331:Cohort Studies; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006703:Ill-Housed Persons / Q000145:classification / Q000706:statistics & numerical data; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000706:statistics & numerical data; D058014:Veterans Health / Q000145:classification / Q000706:statistics & numerical data