Vanessa Schick is with the University of Texas Health Science Center at Houston, School of Public Health, Houston. Lindsey Wiginton is with the Houston Health Department, Houston. Cathy Crouch and Ali Haider are with SEARCH Homeless Services, Houston. Frances Isbell is with Healthcare for the Homeless-Houston, Houston.
Am J Public Health. 2019 Feb;109(2):313-319. doi: 10.2105/AJPH.2018.304817.
To investigate the impact of an integrated care model on the health-related quality of life (HRQOL) of formerly chronically homeless individuals in permanent supportive housing.
From 2014 to 2017, eligible individuals in Houston, Texas (n = 323), were placed in 1 of 2 permanent supportive housing service delivery models. Both models included coordinated care teams. In the intervention group, teams had a single plan of care with the partnering clinic. The 9-item Patient Health Questionnaire and 36-item Short Form Survey were administered at baseline and every 6 months for 30 months. We assessed intervention group emergency department use at 2 years. We evaluated change by using hierarchical linear growth models.
There was a significant and clinically meaningful increase in HRQOL in the intervention group, with the intervention group reporting improvement over the comparison group. Intervention group emergency department use decreased by 70% (no comparison group).
Those in the intervention group with a single, coordinated plan of care reported significant and clinically meaningful increases in their HRQOL. Public Health Implications. Coordinated care models have potential to reduce societal costs and increase HRQOL, providing a financial and humanitarian justification for the continued investment in collaborative care in permanent supportive housing.
调查综合护理模式对永久性支持性住房中以前长期无家可归者的健康相关生活质量(HRQOL)的影响。
2014 年至 2017 年,德克萨斯州休斯顿的符合条件的个人(n=323)被安置在 2 种永久性支持性住房服务提供模式中的 1 种中。两种模式都包括协调护理团队。在干预组中,团队与合作诊所制定了单一的护理计划。在基线和 30 个月内每 6 个月进行一次 9 项患者健康问卷和 36 项简短表格调查。我们在 2 年内评估了干预组的急诊室使用情况。我们使用分层线性增长模型评估了变化。
干预组的 HRQOL 显著且具有临床意义的增加,干预组报告的改善优于对照组。干预组急诊室使用率下降了 70%(无对照组)。
那些接受单一协调护理计划的干预组报告说,他们的 HRQOL 有显著且具有临床意义的提高。公共卫生意义。协调护理模式有可能降低社会成本并提高 HRQOL,为在永久性支持性住房中持续投资协作护理提供了财务和人道主义理由。