MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Inner City Health Associates, Toronto, Ontario, Canada.
PLoS One. 2021 Feb 11;16(2):e0246859. doi: 10.1371/journal.pone.0246859. eCollection 2021.
Primary care retention, defined as ongoing periodic contact with a consistent primary care provider, is beneficial for people with serious chronic illnesses. This study examined the effect of a Housing First intervention on primary care retention among homeless individuals with mental illness.
Two hundred individuals enrolled in the Toronto site of the At Home Project and randomized to Housing First or Treatment As Usual were studied. Medical records were reviewed to determine if participants were retained in primary care, defined as having at least one visit with the same primary care provider in each of two consecutive six-month periods during the 12 month period preceding and following randomization.
Medical records were obtained for 47 individuals randomized to Housing First and 40 individuals randomized to Treatment As Usual. During the one year period following randomization, the proportion of Housing First and Treatment As Usual participants retained in primary care was not significantly different (38.3% vs. 47.5%, p = 0.39). The change in primary care retention rates from the year preceding randomization to the year following randomization was +10.6% in the Housing First group and -5.0% in the Treatment As Usual group.
Among homeless individuals with mental illness, Housing First did not significantly affect primary care retention over the follow-up period. These findings suggest Housing First interventions may need to place greater emphasis on connecting clients with primary care providers.
初级保健保留，定义为与一致的初级保健提供者进行持续定期接触，对患有严重慢性疾病的人有益。本研究考察了住房优先干预对无家可归的精神病患者初级保健保留的影响。
对参加多伦多住房第一项目的 200 名参与者进行研究，并随机分为住房第一组或常规治疗组。审查医疗记录以确定参与者是否保留在初级保健中，定义为在随机分组前和后 12 个月内的两个连续六个月期间，至少与同一名初级保健提供者进行一次就诊。
为随机分配到住房第一组的 47 名参与者和随机分配到常规治疗组的 40 名参与者获得了医疗记录。在随机分组后的一年期间，住房第一组和常规治疗组保留在初级保健中的参与者比例没有显著差异（38.3%与 47.5%，p = 0.39）。从随机分组前一年到随机分组后一年，住房第一组的初级保健保留率变化为+10.6%，常规治疗组为-5.0%。
在患有精神疾病的无家可归者中，住房第一干预措施在随访期间对初级保健保留率没有显著影响。这些发现表明，住房第一干预措施可能需要更加重视将客户与初级保健提供者联系起来。
