Marcel Slockers

31 Health status of homeless people measured by mortality rates Based on the lists provided by the care facilities in 2001, homeless persons were classified as “only day care”, “convalescence care” and “other” (i.e. sleeping rough, only night care, day and night care). Day care is a walk-in facility for social support, medical care, activities, etc. Convalescence care is a medical care unit providing 24-h care where homeless people stay for a shorter or longer period with an indication for somatic care; however, homeless persons with psychiatric and/or addiction problems are also admitted. Night care is a service that provides a ‘bed and bread’ for one night for persons with no place to stay; each day, homeless people have to register for the following night. ‘Sleeping rough’ indicates persons who, during the whole year, sleep several times per month outside. This includes people sleeping in squats, or shacks/garden houses/sheds, etc. without gas, electricity and water. Risk time was calculated from the number of days between study entry in 2001 and date of mortality, or 1 December 2010, or date of loss-to-follow up, whichever came first. Study entry was assumed to be on July 1 2001 (i.e. halfway 2001). Only for people who died in the first six months of 2001 was follow-up time assumed to have started halfway between January 1 2001 and the date of mortality. In the municipal population registries, 242 persons were classified as ‘emigrated’, which is an administrative term for ‘loss to follow-up in the administration’. Of these, 90 could be traced in other registers (i.e. the GP register “microHIS”, Health insurance system, or Municipal OGGZ system) and were included in the follow-up time until the last date they were present in at least one register. The remaining persons were assumed to have been at risk until halfway the follow-up period. General population of Rotterdam Data for our homeless cohort were compared with the general population of Rotterdam region, aged 20 years and over. Data on the mid-year population and mortality rates by sex, and 5-year age groups were derived from Statline (http://statline.cbs.nl/statweb/ , accessed March 29, 2011) for the period 2001–2009. Statistical methods Poisson regression was used to assess the association of mortality among homeless with age and sex and their interaction, and with the type of service used corrected for age and sex. For this purpose, follow-up time of the homeless people was split into one-year periods of follow-up time by age (in complete single-years), and individual characteristics (sex, type of service use) were added. Poisson regression estimates the observed mortality rates by a multiplication of person years and a mortality rate that is the exponent of a linear predictor (alpha + beta_1×_1+ beta_2×_2+ beta_3×_3…). For a model with age and gender the