@article {Himsworthbjgp20X710141, author = {Catherine Himsworth and Priyamvada Paudyal and Christopher Sargeant}, title = {Risk factors for unplanned hospital admission in a specialist homeless general practice population: case{\textendash}control study to investigate the relationship with tri-morbidity}, elocation-id = {bjgp20X710141}, year = {2020}, doi = {10.3399/bjgp20X710141}, publisher = {Royal College of General Practitioners}, abstract = {Background {\textquoteleft}Tri-morbidity{\textquoteright} describes the complex comorbidity of chronic physical illness, mental illness, and alcohol and/or drug misuse within the homeless population. Poor health outcomes of homeless people are reflected by the higher rate of unplanned hospital admissions compared with the non-homeless population.Aim To identify whether tri-morbidity is a risk factor for unplanned hospital admissions in the homeless population.Design and setting A case{\textendash}control study of patients who were registered with a specialist homeless GP surgery in Brighton (72 cases and 72 controls).Method Cases were defined as those who had >=1 overnight hospital admission within a 12-month period. Controls were matched for demographics but with no hospital admission. The primary care record was analysed, and tri-morbidity entered into binomial logistic regression with admission as the dichotomous dependent variable.Results The logistic regression analysis demonstrated that other enduring mental health disorders and/or personality disorder (odds ratio [OR] 3.84, 95\% confidence interval [CI] = 1.56 to 9.44), alcohol use (OR 2.92, 95\% CI = 1.42 to 5.98), and gastrointestinal disorder (OR 2.90, 95\% CI = 1.06 to 7.98) were independent risk factors for admission. Tri-morbidity increased odds of admission by more than four-fold (OR 4.19, 95\% CI = 1.90 to 9.27).Conclusion This study shows that tri-morbidity is an important risk factor for unplanned hospital admissions among the homeless population, and provides an interesting starting point for the development of a risk stratification tool to identify those at risk of unplanned admission in this population.}, issn = {0960-1643}, URL = {https://bjgp.org/content/early/2020/05/18/bjgp20X710141}, eprint = {https://bjgp.org/content/early/2020/05/18/bjgp20X710141.full.pdf}, journal = {British Journal of General Practice} }