National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, West Haven, CT, USA.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
J Gen Intern Med. 2019 Sep;34(9):1703-1708. doi: 10.1007/s11606-019-05070-y. Epub 2019 Jun 3.
The permanent supported housing model is known to improve housing outcomes, but there has been sparse research on the effects of supported housing on physical health. Various organizations including the National Academy of Sciences have called for research in this area.
This observational multi-site outcome study examined changes in physical health among chronically homeless adults participating in a comprehensive supported housing program and the associations between changes in physical health, housing status, and trust in primary care providers.
Data are presented from an observational outcome study analyzed with mixed linear modeling and regression analyses.
A total of 756 chronically homeless adults across 11 sites were assessed every 3 months for 1 year.
The Collaborative Initiative to End Chronic Homelessness provided adults who were chronically homeless with permanent housing and supportive primary healthcare and mental health services.
Days housed, physical health-related quality of life (HRQOL) measured by the Short Form-12 health survey, number of medical conditions, number of treated medical conditions, and number of preventive medical procedures received.
Participants showed reduced number of medical problems and receipt of more preventive procedures over time, but there was no statistically significant change in physical HRQOL. Changes in housing were not significantly associated with changes in any physical health outcomes. Over time, participants' trust in primary care providers was positively associated with increased numbers of reported medical problems and preventive procedures received but not with physical HRQOL.
Entry into supported housing with linked primary care services was not associated with improvements in physical HRQOL. Improvement in other medical outcome measures was not specifically associated with improved housing status.
已知永久性保障性住房模式可改善住房状况，但有关保障性住房对身体健康影响的研究却很少。包括美国国家科学院在内的各种组织都呼吁在这一领域开展研究。
本观察性多地点结局研究考察了参与综合性保障性住房计划的慢性无家可归成年人的身体健康状况变化，以及身体健康变化、住房状况和对初级保健提供者的信任之间的关联。
本研究为观察性结局研究，采用混合线性模型和回归分析进行数据分析。
共有 11 个地点的 756 名慢性无家可归成年人接受了为期 1 年、每 3 个月评估 1 次的研究。
“合作结束慢性 homelessness 倡议”为慢性无家可归的成年人提供了永久性住房以及支持性的初级医疗保健和精神卫生服务。
居住天数、使用 SF-12 健康调查量表测量的与身体健康相关的生活质量、医疗条件数量、已治疗的医疗条件数量和接受的预防性医疗程序数量。
参与者的医疗问题数量随着时间的推移而减少，接受的预防性程序数量也有所增加，但身体健康的生活质量没有统计学意义上的显著变化。住房变化与任何身体健康结果的变化均无显著关联。随着时间的推移，参与者对初级保健提供者的信任与报告的医疗问题数量和接受的预防性程序数量的增加呈正相关，但与身体健康的生活质量无关。
参与保障性住房与相关初级保健服务的项目并不与身体健康的生活质量改善相关。其他医疗结局指标的改善与改善的住房状况没有特定关联。
