Providence Health System: Providence Health and Services, Portland, USA.
J Urban Health. 2022 Apr;99(2):260-267. doi: 10.1007/s11524-022-00609-7. Epub 2022 Mar 16.
While associations between obtaining affordable housing and improved health care are well documented, insufficient funding often forces housing authorities to prioritize limited housing vouchers to specific populations. We assessed the impact of obtaining housing on health care utilization at two urban housing authorities with different distribution policies: Housing Authority A prioritized seniors and people with disabilities, while Housing Authority B prioritized medically complex individuals and families with school-aged children. Both housing authorities used random selection to distribute vouchers, allowing us to conduct a randomized natural experiment of cases and waitlisted controls. No significant demographic differences were present between those receiving vouchers and waitlisted controls. Housing Authority A vouchers were associated with increased outpatient visits (OR = 1.19; P = 0.051). Housing Authority B vouchers decreased the likelihood of emergency department visits (OR = 0.61; P = 0.042). This study provides evidence that, while obtaining housing can result in better health care outcomes overall, local prioritization policies can influence that impact.
虽然获得经济适用房与改善医疗保健之间存在关联已得到充分证明，但资金不足常常迫使住房管理局将有限的住房券优先分配给特定人群。我们评估了在两个具有不同分配政策的城市住房管理局获得住房对医疗保健利用的影响：住房管理局 A 优先考虑老年人和残疾人士，而住房管理局 B 则优先考虑患有多种疾病的个人以及有学龄儿童的家庭。两个住房管理局都使用随机选择来分配券，这使我们能够对案例进行随机自然实验，并对候补对照组进行分配。获得券的人和候补对照组之间没有明显的人口统计学差异。住房管理局 A 的券与门诊就诊次数增加有关（OR=1.19；P=0.051）。住房管理局 B 的券降低了急诊就诊的可能性（OR=0.61；P=0.042）。这项研究提供了证据，表明虽然获得住房总体上可以带来更好的医疗保健结果，但地方优先政策可能会影响这种影响。
