Primary-care based housing program decreased outpatient visits and increased health and happiness

Primary care can help health of the unhoused: ©Sewcreamstudio - stock.adobe.com

Researchers from Brigham and Women’s Hospital, part of the Mass General Brigham health care system, conducted a study examining the effects of a housing program on patients’ health outcomes and health care utilization. Published in Health Affairs, the study focuses on addressing the issue of housing insecurity in the United States. Initiated in 2018, the program aimed to tackle social determinants of health through its primary care clinics by providing support to patients experiencing homelessness, eviction threats, or residing in unsafe housing conditions.

Lead author Dr. MaryCatherine Arbour and her team conducted a retrospective cohort evaluation study involving 1,139 patients enrolled in the program between October 2018 and March 2021. Employing a mixed-method approach, the evaluation combined quantitative analysis of health care utilization data with qualitative insights gathered through patient interviews.

The study found that participation in the housing program was associated with a reduction in outpatient visits. Patients attending the program reported attending 2.5 fewer primary care visits and 3.6 fewer outpatient visits annually. This decrease encompassed a decline in urgent care, behavioral health, psychiatry, and social work utilization, suggesting a positive impact on mental health and well-being.

Moreover, patients reported tangible improvements in both physical and mental health following their engagement with the program. The provision of stable housing not only alleviated stressors associated with homelessness but also fostered a deeper sense of connection with their primary care clinics and healthcare teams.

Central to the program’s success was the integration of a multidisciplinary care team, comprising housing advocates, clinicians, and community resource specialists. These professionals collaborated closely to address patients’ social needs, facilitate housing solutions, and provide ongoing support and guidance throughout the process.

Arbour emphasized the significance of patient narratives, which highlighted not only the health benefits derived from stable housing but also the profound sense of belonging and care experienced within the primary care setting.

While the study acknowledges its limitations, including sample size constraints and short-term follow-up, researchers underscore the need for further exploration into the program's long-term impact and its implications for clinical staff well-being.