2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

326467
Medical and emergency medical service use by people experiencing homelessness before and after placement in supportive housing


Tuesday, November 3, 2015 : 3:30 p.m. - 3:50 p.m.

James Petrovich, PhD, MSSW, Department of Social Work, Texas Christian University, Fort Worth, TX
Emily Spence-Almaguer, PhD, MSW, School of Public Health, Department of Health Systems and Health Behaviors, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX
Subhash Aryal, PhD, MS, School of Public Health, Department of Biostatistics, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX
Kwynn Gonzalez-Pons, College of Public Health, University of North Texas Health Science Center, Fort Worth, TX
  
Audio (mp3) recording Recorded Presentation (mp4)
Research indicates that permanent supportive housing (housing with accompanying supportive services) for people who are homeless not only benefits individuals receiving housing, but also the communities where it is situated (Culhane et al., 2007). To provide a local assessment of a municipally-funded, scattered site supportive housing program, 100 program participants allowed access to administrative records documenting their use of medical (emergency room, psychiatric emergency room, outpatient clinic, urgent care clinic, and inpatient care) and emergency medical services (emergency transports) for the 18-month periods before and after housing.

Results indicate that participants used fewer medical and emergency medical services after housing placement, with medical service use decreasing 25% and emergency medical service use decreasing 29%. The largest specific subservice decreases were for ER (61%), inpatient (56%), and psychiatric ER (41%) use. Post-housing charges were just over one million dollars less than pre-housing charges. Additional analyses (yet to be completed) will assess the nature of service use using diagnostic data for each service episode, evaluating how the nature of service use may have changed after placement, including a determination of the appropriateness of service use.

The findings of this study provide continued support for permanent supportive housing as an effective intervention to address homelessness. While the study did not include a control group, the consistency of its findings with studies conducted elsewhere continues to support the assertion that permanent supportive housing positively impacts communities through decreased use of critical services and decreased costs associated with this service use. The study also sheds light on the trajectories of health and mental health care as participants transition from states of homelessness to housing stability.

Learning Areas:

Advocacy for health and health education
Public health or related public policy
Public health or related research

Learning Objectives:
Discuss changes in medical and emergency medical service use by formerly homeless individuals after placement in permanent supportive housing.

Keyword(s): Homelessness, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted a number of studies evaluating the use of critical service systems by people who are homeless. I have published the results of these studies in professional, peer-reviewed journals and presented at professional conferences.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4301.0: Permanent Supportive Housing: Can We Treat Housing as a Healthcare Intervention?