Health Affairs最新文献_第10页

Mortal Systemic Exclusion Yielded Steep Mortality-Rate Increases In People Experiencing Homelessness, 2011-20. 2011-20年，系统性排斥导致无家可归者死亡率急剧上升》（Mortal Systemic Exclusion Yielded Steep Mortality-Rate Increases In People Experiencing Homelessness，2011-20）。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01039

Matthew Z Fowle, Giselle Routhier

引用次数: 0

Temporary Financial Assistance Reduced The Probability Of Unstable Housing Among Veterans For More Than 1 Year. 临时经济援助降低了退伍军人一年以上住房不稳定的可能性。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.00730

Alec B Chapman, Daniel Scharfstein, Thomas H Byrne, Ann Elizabeth Montgomery, Ying Suo, Atim Effiong, Tania Velasquez, Warren Pettey, Rachel Dalrymple, Jack Tsai, Richard E Nelson

{"title":"Temporary Financial Assistance Reduced The Probability Of Unstable Housing Among Veterans For More Than 1 Year.","authors":"Alec B Chapman, Daniel Scharfstein, Thomas H Byrne, Ann Elizabeth Montgomery, Ying Suo, Atim Effiong, Tania Velasquez, Warren Pettey, Rachel Dalrymple, Jack Tsai, Richard E Nelson","doi":"10.1377/hlthaff.2023.00730","DOIUrl":"10.1377/hlthaff.2023.00730","url":null,"abstract":"The Department of Veterans Affairs (VA) aims to reduce homelessness among veterans through programs such as Supportive Services for Veteran Families (SSVF). An important component of SSVF is temporary financial assistance. Previous research has demonstrated the effectiveness of temporary financial assistance in reducing short-term housing instability, but studies have not examined its long-term effect on housing outcomes. Using data from the VA's electronic health record system, we analyzed the effect of temporary financial assistance on veterans' housing instability for three years after entry into SSVF. We extracted housing outcomes from clinical notes, using natural language processing, and compared the probability of unstable housing among veterans who did and did not receive temporary financial assistance. We found that temporary financial assistance rapidly reduced the probability of unstable housing, but the effect attenuated after forty-five days. Our findings suggest that to maintain long-term housing stability for veterans who have exited SSVF, additional interventions may be needed.","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Finding A Place To Be Somebody. 寻找成为某人的地方

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01007

Lawrence Lincoln

引用次数: 0

Higher Rates Of Homelessness Are Associated With Increases In Mortality From Accidental Drug And Alcohol Poisonings. 更高的无家可归率与意外药物和酒精中毒死亡率的增加有关。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.00951

W David Bradford, Felipe Lozano-Rojas

引用次数: 0

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

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 Epub Date: 2024-01-24 DOI: 10.1377/hlthaff.2023.01041

Devlin Hanson, Sarah Gillespie

{"title":"'Housing First' Increased Psychiatric Care Office Visits And Prescriptions While Reducing Emergency Visits.","authors":"Devlin Hanson, Sarah Gillespie","doi":"10.1377/hlthaff.2023.01041","DOIUrl":"10.1377/hlthaff.2023.01041","url":null,"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.","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Primary Care-Based Housing Program Reduced Outpatient Visits; Patients Reported Mental And Physical Health Benefits. 以初级保健为基础的住房计划减少了门诊就诊次数；患者表示心理和身体健康都得到了改善。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01046

MaryCatherine Arbour, Placidina Fico, Sidney Atwood, Na Yu, Lynn Hur, Maahika Srinivasan, Richard Gitomer

{"title":"Primary Care-Based Housing Program Reduced Outpatient Visits; Patients Reported Mental And Physical Health Benefits.","authors":"MaryCatherine Arbour, Placidina Fico, Sidney Atwood, Na Yu, Lynn Hur, Maahika Srinivasan, Richard Gitomer","doi":"10.1377/hlthaff.2023.01046","DOIUrl":"10.1377/hlthaff.2023.01046","url":null,"abstract":"Screening for housing instability has increased as health systems move toward value-based care, but evidence on how health care-based housing interventions affect patient outcomes comes mostly from interventions that address homelessness. In this mixed-methods evaluation of a primary care-based housing program in Boston, Massachusetts, for 1,139 patients with housing-related needs that extend beyond homelessness, we found associations between program participation and health care use. Patients enrolled in the program between October 2018 and March 2021 had 2.5 fewer primary care visits and 3.6 fewer outpatient visits per year compared with those who were not enrolled, including fewer social work, behavioral health, psychiatry, and urgent care visits. Patients in the program who obtained new housing reported mental and physical health benefits, and some expressed having stronger connections to their health care providers. Many patients attributed improvements in mental health to compassionate support provided by the program's housing advocates. Health care-based housing interventions should address the needs of patients facing imminent housing crises. Such interventions hold promise for redressing health inequities and restoring dignity to the connections between historically marginalized patient populations and health care institutions.","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

TennCare Disenrollment Led To Increased Eviction Filings And Evictions In Tennessee Relative To Other Southern States. 与南部其他州相比，田纳西州取消 TennCare 导致驱逐申请和驱逐数量增加。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.00973

Mir M Ali, Ashley C Bradford, Johanna Catherine Maclean

{"title":"TennCare Disenrollment Led To Increased Eviction Filings And Evictions In Tennessee Relative To Other Southern States.","authors":"Mir M Ali, Ashley C Bradford, Johanna Catherine Maclean","doi":"10.1377/hlthaff.2023.00973","DOIUrl":"10.1377/hlthaff.2023.00973","url":null,"abstract":"Previous research suggests that enrolling in Medicaid reduces evictions by improving health and providing financial protection. However, previous studies have not examined whether the loss of Medicaid affects eviction outcomes. We analyzed eviction filings and completed evictions after a large, mandatory Medicaid disenrollment in Tennessee in 2005. We conducted a difference-in-differences analysis using data from the Eviction Lab at Princeton University and found that relative to other southern states, the TennCare disenrollment led to a 27.6 percent greater increase in the average annual number of eviction filings at the county level during the period 2005-09 and a 24.5 percent greater increase in the average annual number of completed evictions at the county level during that same period. Our findings have implications for the housing stability of Medicaid recipients today, many of whom are being disenrolled because of the unwinding of the Medicaid continuous enrollment provision that is occurring across the country. To protect housing stability for people disenrolled from Medicaid, policy makers may wish to consider new initiatives aimed at preventing an increase in eviction.","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Encampment Clearings And Transitional Housing: A Qualitative Analysis Of Resident Perspectives. 营地清理与过渡性住房：对居民观点的定性分析。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01040

Michael Mayer, Yesenia Mejia Urieta, Linda S Martinez, Miriam Komaromy, Ursel Hughes, Avik Chatterjee

{"title":"Encampment Clearings And Transitional Housing: A Qualitative Analysis Of Resident Perspectives.","authors":"Michael Mayer, Yesenia Mejia Urieta, Linda S Martinez, Miriam Komaromy, Ursel Hughes, Avik Chatterjee","doi":"10.1377/hlthaff.2023.01040","DOIUrl":"10.1377/hlthaff.2023.01040","url":null,"abstract":"The number of people experiencing homelessness in tent encampments in the US has increased significantly. Citing concerns over health and safety, many cities have pursued highly visible encampment removals. In January 2022, a major tent encampment in Boston, Massachusetts, was cleared using a unique approach: Most encampment residents were placed in transitional harm reduction housing. We conducted interviews between July 2022 and February 2023 with thirty former encampment residents to explore how the encampment clearing affected their health and sense of safety. We also explored participants' perspectives on harm reduction housing. Of those interviewed, fourteen people had been placed in such housing. Among those not placed, the encampment clearing tended to exacerbate health and safety concerns, especially those related to mental health conditions and risk for violence. Among people successfully placed, harm reduction housing improved health and safety and allowed participants to make meaningful progress toward long-term goals such as addiction recovery, management of chronic health conditions, and permanent housing. Our findings suggest that encampments can have safety-promoting characteristics, but if encampment removal is pursued, offering harm reduction housing after removal can be beneficial.","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Homelessness And Health: Factors, Evidence, Innovations That Work, And Policy Recommendations. 无家可归与健康：因素、证据、有效创新和政策建议。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01049

Cheyenne Garcia, Kelly Doran, Margot Kushel

{"title":"Homelessness And Health: Factors, Evidence, Innovations That Work, And Policy Recommendations.","authors":"Cheyenne Garcia, Kelly Doran, Margot Kushel","doi":"10.1377/hlthaff.2023.01049","DOIUrl":"10.1377/hlthaff.2023.01049","url":null,"abstract":"On a single night in 2023, more than 653,000 people experienced homelessness in the United States. In this overview, we highlight structural and individual risk factors that can lead to homelessness, explore evidence on the relationship between homelessness and health, discuss programmatic and policy innovations, and provide policy recommendations. Health system efforts to address homelessness and improve the health of homeless populations have included interventions such as screening for social needs and medical respite programs. Initiatives using the Housing First approach to permanent supportive housing have a strong track record of success. Health care financing innovations using Medicaid Section 1115 waivers offer promising new approaches to improving health and housing for people experiencing homelessness. To substantially reduce homelessness and its many adverse health impacts, changes are needed to increase the supply of affordable housing for households with very low incomes. Health care providers and systems should leverage their political power to advocate for policies that scale durable, evidence-based solutions to reduce homelessness, including increased funding to expand housing choice vouchers and greater investment in the creation and preservation of affordable housing.","PeriodicalId":50411,"journal":{"name":"Health Affairs","volume":null,"pages":null},"PeriodicalIF":8.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A History Of The Impacts Of Discriminatory Policies On Housing And Maternal And Infant Health In An Ohio Neighborhood. 俄亥俄州一个社区歧视性政策对住房和母婴健康影响的历史。

IF 8.6 1区医学

Health Affairs Pub Date : 2024-02-01 DOI: 10.1377/hlthaff.2023.01045

Kierra S Barnett, Jason Reece, Brittany M Mosley, Mikyung Baek, Ayaz Hyder, Kelly Kelleher, Shawnita Sealy-Jefferson, Deena J Chisolm

引用次数: 0