科研之友
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摘要
Objectives. We examined changes in service use in a Housing First (HF) pilot program for adults who were homeless with medical illnesses and high prior acute-care use relative to a similar comparison group. Methods. We used a 1-year pre-post comparison group design. The 29 participants and 31 comparison group members were adults who were homeless with inpatient claims of at least $10 000 or at least 60 sobering "sleep off" center contacts in the prior year. Results. Participants showed a significantly greater reduction in emergency department and sobering center use relative to the comparison group. At a trend level, participants had greater reductions in hospital admissions and jail bookings. Reductions in estimated costs for participants and comparison group members were $62504 and $25925 per person per year a difference of $36579, far outweighing program costs of $18600 per person per year. Conclusions. HF participants showed striking reductions in acute-care use relative to the comparison group, demonstrating that HF can be a successful model for people with complex medical conditions and high prior acute-care use. Despite notable methodological limitations, these findings could be used to inform a larger multisite study that would establish greater generalizability. (Am J Public Health. 2013;103:316-321. doi:10.2105/AJPH.2012.300867)
- 出版日期2013-2
