Seng Jun Jie Benjamin, Lim Vanessa Zi Kun, Kwan Yu Heng, Thumboo Julian, Low Lian Leng
Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
BMC Health Serv Res. 2019 Apr 15;19(1):227. doi: 10.1186/s12913-019-4047-8.
Globally, public housing is utilized to provide affordable housing for low-income households. Studies have shown an association between public housing and negative health outcomes. There is paucity of data pertaining to outpatient primary and tertiary healthcare resources utilization among public rental housing residents in Singapore.
A retrospective cohort study was performed, involving patients under the care of SingHealth Regional Health System (SHRS) in Year 2012. Healthcare utilization outcomes evaluated included number of outpatient primary and specialist care clinic visits, emergency department visits and hospitalization in Year 2011. Multivariate logistical analyses were used to examine the association between public rental housing and healthcare utilization.
Of 147,105 patients, 10,400 (7.1%) patients stayed in public rental housing. There were more elderly (54.8 ± 18.0 vs 49.8 ± 17.1, p < 0.001) and male patients [5279 (50.8%) vs 56,892 (41.6%), p < 0.001] residing in public rental housing. Co-morbidities such as hypertension and hyperlipidemia were more prevalent among public rental housing patients. (p < 0.05). After adjustment for covariates, public rental housing was not associated with frequent outpatient primary care clinic or specialist outpatient clinic attendances (p > 0.05). However, it was associated with increased number of emergency department visits (OR: 2.41, 95% CI: 2.12-2.74) and frequent hospitalization (OR: 1.56, 95% CI: 1.33-1.83).
Residing in public rental housing was not associated with increased utilization of outpatient healthcare resources despite patients' higher disease burden and frequency of emergency department visits and hospitalizations. Further research is required to elucidate their health seeking behaviours.
在全球范围内，公共住房被用于为低收入家庭提供经济适用房。研究表明，公共住房与负面健康结果之间存在关联。关于新加坡公共租赁住房居民门诊初级和三级医疗资源利用的数据很少。
进行了一项回顾性队列研究，涉及2012年新加坡健康集团区域卫生系统（SHRS）护理下的患者。评估的医疗利用结果包括2011年门诊初级和专科护理诊所就诊次数、急诊科就诊次数和住院次数。采用多变量逻辑分析来检验公共租赁住房与医疗利用之间的关联。
在147,105名患者中，有10,400名（7.1%）患者居住在公共租赁住房中。居住在公共租赁住房中的老年患者（54.8±18.0岁 vs 49.8±17.1岁，p<0.001）和男性患者[5279名（50.8%） vs 56,892名（41.6%），p<0.001]更多。高血压和高脂血症等合并症在公共租赁住房患者中更为普遍（p<0.05）。在对协变量进行调整后，公共租赁住房与频繁的门诊初级护理诊所或专科门诊就诊无关（p>0.05）。然而，它与急诊科就诊次数增加（OR：2.41，95%CI：2.12 - 2.74）和频繁住院（OR：1.56，95%CI：1.33 - 1.83）有关。
尽管患者疾病负担较重，急诊科就诊和住院频率较高，但居住在公共租赁住房与门诊医疗资源利用增加无关。需要进一步研究以阐明他们的就医行为。
