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Hospitalization in an Urban Homeless Population: The Honolulu Urban Homeless Project

Jon V. Martell, MD; Rae S. Seitz, BA; Janice K. Harada, BS; Joel Kobayashi, BS; Vern K. Sasaki, MPH; and Clifford Wong, BS
[+] Article and Author Information

Requests for Reprints: Jon V. Martell, MD, 1587 Puolani Street, Honolulu, HI 96819.

Current Author Addresses: Dr. Martell: 1587 Puolani Street, Honolulu, HI 96819.

Ms. Seitz, Ms. Harada, Mr. Kobayashi, Mr. Sasaki, and Mr. Wong: Office of Student Affairs, University of Hawaii, John A. Burns School of Medicine, 1960 East-West Road, Honolulu, HI 96822.


©1992 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1992;116(4):299-303. doi:10.7326/0003-4819-116-4-299
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Objective: To determine the rate and estimate the cost of hospitalization in a defined urban homeless population.

Design: Retrospective chart review.

Setting: Kalihi-Palama Health Clinic Health Care for the Homeless Project, Hawaii State Hospital, and seven acute care hospitals in Honolulu, Hawaii.

Patients: A total of 1751 homeless clients contacted between 1 December 1988 and 30 November 1990.

Measurements and Main Results: A total of 1751 individuals were studied for an aggregate of 871.3 person-years. Five hundred sixty-four hospitalizations were identified: ninety-two to the state psychiatric hospital and 472 to acute care hospitals. The age- and sex-adjusted hospitalization rate for acute care hospitals was 542/1000 person-years (compared with the state rate of 96/1000 person-years). Homeless persons were admitted to acute care hospitals for 4766 days compared with a predicted 640 days. The age- and sex-adjusted rate of admission to the state psychiatric hospital was 105/1000 person-years (compared with the state rate of 0.8/1000 person-years). Homeless persons were admitted to the state psychiatric hospital for 3837 days compared with a predicted 139 days.

Conclusions: Homeless individuals in this study were hospitalized in acute care and psychiatric hospitals far more frequently than were members of the general population.

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