Medstar Health Research Institute, Hyattsville, MD.
Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, Washington, DC.
Med Care. 2021 Apr 1;59(Suppl 2):S199-S205. doi: 10.1097/MLR.0000000000001443.
Permanent supportive housing (PSH) programs have the potential to improve health and reduce Medicaid expenditures for beneficiaries experiencing homelessness. However, most research on PSH has been limited to small samples of narrowly defined populations.
To evaluate the effects of PSH on Medicaid enrollees across New Jersey.
Linked data from the Medicaid Management Information System and the Homeless Management Information System were used to compare PSH-placed Medicaid enrollees with a matched sample of other Medicaid enrollees experiencing homelessness. Comparisons of Medicaid-financed health care utilization and spending measures were made in a difference-in-differences framework 6 quarters before and after PSH placement.
A total of 1442 Medicaid beneficiaries enrolled in PSH and 6064 Medicaid-enrolled homeless individuals not in PSH in 2013-2014.
PSH placement is associated with a 14.3% reduction in emergency department visits (P<0.001) and a 25.2% reduction in associated spending (P<0.001). PSH also appears to reduce inpatient utilization and increase pharmacy spending with neutral effects on primary care visits and total costs of care (TCOC).
Placement in PSH is associated with lower hospital utilization and spending. No relationship was found, however, between PSH placement and TCOC, likely due to increased pharmacy spending in the PSH group. Greater access to prescription drugs may have improved the health of PSH-placed individuals in a way that reduced hospital episodes with neutral effects on TCOC.
永久性支持性住房（PSH）计划有可能改善无家可归的受益人的健康状况并降低医疗补助支出。然而，大多数关于 PSH 的研究仅限于对狭义定义的人群的小样本研究。
评估新泽西州 PSH 对医疗补助受保人的影响。
使用医疗补助管理信息系统和无家可归管理信息系统的关联数据，将 PSH 安置的医疗补助受保人与其他经历无家可归的医疗补助受保人进行匹配样本进行比较。在 PSH 安置前后的 6 个季度内，采用差异中的差异框架比较 Medicaid 资助的医疗保健利用和支出措施。
2013-2014 年共有 1442 名参加 PSH 的医疗补助受保人和 6064 名未参加 PSH 的参加医疗补助的无家可归者。
PSH 安置与急诊就诊减少 14.3%（P<0.001）和相关支出减少 25.2%（P<0.001）相关。PSH 似乎还减少了住院利用，并增加了药房支出，对初级保健就诊和总护理成本（TCOC）没有影响。
PSH 的安置与较低的医院利用率和支出相关。然而，PSH 安置与 TCOC 之间没有关系，可能是由于 PSH 组的药房支出增加。更多获得处方药物的机会可能以对 TCOC 没有影响的方式改善了 PSH 安置者的健康状况，从而减少了医院发病次数。
