'Housing First' Increased Psychiatric Care Office Visits And Prescriptions While Reducing Emergency Visits.

IF 8.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Health Affairs Pub Date : 2024-02-01 Epub Date: 2024-01-24 DOI:10.1377/hlthaff.2023.01041
Devlin Hanson, Sarah Gillespie
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引用次数: 0

Abstract

Housing First is an approach to ending homelessness that recognizes permanent housing as a platform for stability and engagement in health services. As part of a randomized controlled trial to test the effects of permanent supportive housing with the Housing First approach in Denver, Colorado, we analyzed the intervention's impact on health care use, Medicaid enrollment, and mortality among people experiencing chronic homelessness who had frequent arrests and jail stays. Two years after assignment to the Housing First intervention, participants had an average of eight more office-based visits for psychiatric diagnoses, three more prescription medications, and six fewer emergency department visits than the control group. Although enrollment in Medicaid increased over the course of the study for both the intervention group and the control group, the intervention group was 5 percentage points less likely to be enrolled in Medicaid. Supportive housing had no significant impact on mortality. When considering pathways to scale up supportive housing, policy makers should recognize the potential of Housing First to facilitate the use of office-based psychiatric care and medications in a population with many health care needs.

住房优先 "在减少急诊就诊次数的同时,也增加了精神科门诊就诊次数和处方数量。
住房优先 "是一种终止无家可归现象的方法,它将永久性住房视为稳定和参与医疗服务的平台。我们在科罗拉多州丹佛市开展了一项随机对照试验,以检验 "住房优先 "方法中的永久性支持性住房的效果,作为试验的一部分,我们分析了该干预措施对经常被捕和入狱的长期无家可归者使用医疗服务、加入医疗补助计划以及死亡率的影响。与对照组相比,"住房优先 "干预措施实施两年后,参与者因精神疾病就诊的次数平均增加了八次,处方药用量增加了三次,急诊就诊次数减少了六次。虽然在研究过程中,干预组和对照组加入医疗补助计划的人数都有所增加,但干预组加入医疗补助计划的可能性要低 5 个百分点。支持性住房对死亡率没有明显影响。在考虑扩大支持性住房规模的途径时,政策制定者应认识到 "住房优先 "在促进有多种医疗保健需求的人群使用诊室精神科护理和药物方面的潜力。
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来源期刊
Health Affairs
Health Affairs 医学-卫生保健
CiteScore
15.00
自引率
2.10%
发文量
246
审稿时长
3-6 weeks
期刊介绍: Health Affairs is a prestigious journal that aims to thoroughly examine significant health policy matters both domestically and globally. Our publication is committed to addressing issues that are relevant to both the private and public sectors. We are enthusiastic about inviting private and public decision-makers to contribute their innovative ideas in a publishable format. Health Affairs seeks to incorporate various perspectives from industry, labor, government, and academia, ensuring that our readers benefit from the diverse viewpoints within the healthcare field.
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