Primary care-based housing intervention reduces hospital visits and improves health outcomes

Primary care-based housing intervention reduces hospital visits and improves health outcomes

February 8, 2024

2 min read


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Key points:

  • Plan participants had 2.5 fewer primary care visits per year and 3.6 fewer outpatient visits per year.
  • The program also helps build stronger connections between patients and their PCPs.

Researchers found that primary care-based housing programs helped reduce participants’ annual primary care and outpatient visits while improving physical and mental health.

“It’s difficult to control patients’ blood pressure if they’re worried about where they’re going to sleep.” Mary Catherine Arbour, MD, MPH, said in a press release. “If a person’s housing is unstable, their health is at great risk. The need for housing has increased significantly since the pandemic.”

PC0224Arbour_Graphic_01_WEB
Data from: Arbor M et al. health affairs. 2024;doi:10.1377/hlthaff.2023.01046.

In 2018, Brigham and Women’s Hospital began screening for social determinants of health and, after screening 20% ​​of its patients for unsafe or unstable housing, hired two housing advocates—who specialize in housing needs. community worker.

These housing advocates provide patients with six-month assistance with housing placement, housing applications, landlord or property management negotiations, and other services.

Arbor and colleagues conducted a mixed-methods study of the project, involving 1,139 patients aged 18 and older who participated between October 2018 and March 2021.Their findings were published in Health Affairs.

The cohort consisted primarily of non-English-speaking, Hispanic, and younger women who had more chronic conditions and used the emergency room more often than a control population (n = 5,524), who were stratified by age, Matches were made by gender, insurance type, primary care location, and emergency department. Date of encounter.

Overall, patients who participated in the program had 2.5 fewer primary care visits (95% CI, 2.9 to 2.2) and 3.6 fewer outpatient visits (95% CI) per year compared with patients who did not participate in the program. ,4.8 to 2.4).

“The decrease in ambulatory care was primarily due to decreases in urgent care, behavioral health and social work utilization, indicating the program’s significant impact on mental health and behavioral health,” Arbor said.

Additionally, patients reported mental and physical health benefits, as well as closer connections with primary care providers.

The study was limited by its sample size and one-year follow-up period and “may be underpowered to detect effects on health care use and chronic disease indicators,” the researchers wrote.

“What’s special about this program is that it’s embedded in primary care and uses a triage approach to identify the types of housing that are more likely to impact someone’s health,” Arbor said. “This is a unique, integrated approach that partners community resource specialists and community health workers with primary care teams, and primary care teams with community partners, including legal partners.”

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