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曾经无家可归的人在搬进支持性住房后,总体医疗保健支出较低。

Formerly Homeless People Had Lower Overall Health Care Expenditures After Moving Into Supportive Housing.

作者信息

Wright Bill J, Vartanian Keri B, Li Hsin-Fang, Royal Natalie, Matson Jennifer K

机构信息

Bill J. Wright (

Keri B. Vartanian is an associate research scientist at CORE.

出版信息

Health Aff (Millwood). 2016 Jan;35(1):20-7. doi: 10.1377/hlthaff.2015.0393.

Abstract

The provision of supportive housing is often recognized as important public policy, but it also plays a role in health care reform. Health care costs for the homeless reflect both their medical complexity and psychosocial risk factors. Supportive housing attempts to moderate both by providing stable places to live along with on-site integrated health services. In this pilot study we used a mixture of survey and administrative claims data to evaluate outcomes for formerly homeless people who were living in a supportive housing facility in Oregon between 2010 and 2014. Results from the claims analysis showed significantly lower overall health care expenditures for the people after they moved into supportive housing. Expenditure changes were driven primarily by reductions in emergency and inpatient care. Survey data suggest that the savings were not at the expense of quality: Respondents reported improved access to care, stronger primary care connections, and better subjective health outcomes. Together, these results indicate a potential association between supportive housing and reduced health care costs that warrants deeper consideration as part of ongoing health care reforms.

摘要

提供支持性住房通常被视为一项重要的公共政策,但它在医疗改革中也发挥着作用。无家可归者的医疗费用既反映了他们病情的复杂性,也反映了心理社会风险因素。支持性住房试图通过提供稳定的居住场所和现场综合医疗服务来缓解这两个问题。在这项试点研究中,我们使用了调查数据和行政索赔数据的组合,来评估2010年至2014年期间居住在俄勒冈州一个支持性住房设施中的前无家可归者的情况。索赔分析结果显示,这些人搬进支持性住房后,总体医疗费用显著降低。支出变化主要是由急诊和住院护理费用的减少推动的。调查数据表明,节省费用并没有以牺牲质量为代价:受访者报告说,获得医疗服务的机会有所改善,与初级医疗的联系更加紧密,主观健康结果也更好。这些结果共同表明,支持性住房与降低医疗费用之间可能存在关联,这作为正在进行的医疗改革的一部分,值得深入考虑。

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