Primary care-based housing intervention is associated with fewer visits, better health outcomes

Primary care-based housing intervention is associated with fewer visits, better health outcomes

February 8, 2024

2 min reading


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Key relationships:

  • Program enrollees had 2.5 fewer primary care visits and 3.6 fewer outpatient visits per year.
  • The program also helped build a stronger bond between patients and their PCPs.

A primary care-based housing program helped reduce the number of annual primary care and outpatient visits among participants while improving mental and physical health, researchers found.

“It’s very difficult to keep a patient’s blood pressure under control if they’re worried about where they’re going to sleep.” MaryCatherine Arbour, MD, MPH, medical director of the social care team at Brigham and Women’s Hospital Primary Care Center, said in a press release. “A person’s health is extremely at risk if their housing is unstable. And since the pandemic, there has been a huge increase in housing needs.”

PC0224Arbour_Graphic_01_WEB
Data extracted from: Arbor M, et al. Health Aff. 2024; doi:10.1377/hlthaff.2023.01046.

In 2018, Brigham and Women’s Hospital began screening for social determinants of health and hired two housing advocates — community workers specializing in housing needs — after 20% of patients were screened for unsafe or unstable housing.

These housing advocates supported patients by assisting them for 6 months with housing placement, housing applications, landlord or property management negotiations and other services.

Arbor and colleagues conducted a mixed-methods study of the program, including 1,139 patients aged 18 and older who participated between October 2018 and March 2021. Their findings were published in Health issues.

The group consisted mostly of non-English speaking, Hispanic, and younger women who had more chronic conditions and higher ED use than a control population (n = 5,524) that was matched for age, sex, insurance type, primary care location and appointment date.

Overall, patients who participated in the program had 2.5 (95% CI, 2.9 to 2.2) fewer primary care visits and 3.6 (95% CI, 4.8 to 2.4) fewer outpatient visits per year compared with those who did not. were registered.

“The reduction in outpatient care was driven primarily by less urgent care, behavioral health, and social work utilization, suggesting that the program has significant effects on mental health and behavioral health,” Arbor said.

Additionally, patients reported mental and physical health benefits and a stronger bond with their primary care providers.

The study was limited by the sample size and the 1-year follow-up period, which “may be insufficient to detect effects on health care utilization and indicators of chronic disease,” the researchers wrote.

“What makes this program special is that it’s involved in primary care and uses a triaged approach to identify the types of housing that are most likely to affect someone’s health,” Arbor said. “It is a unique, integrated approach that partners community resource specialists and community health workers with the primary care team and partners the primary care team with community-based partners, including legal partners.”

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