Permanent Supportive Housing Receipt and Health Care Use Among Adults With Disabilities

Area of Science:

• Health Services Research
• Disability Studies
• Public Health Policy

Background:

• Understanding the impact of permanent supportive housing (PSH) on health service utilization is crucial for individuals with disabilities.
• Previous research has not fully elucidated the differential effects of PSH based on pre-transition living settings (institutional vs. community).

Purpose of the Study:

• To assess the association between permanent supportive housing (PSH) participation and health service use among adults with disabilities.
• To compare health service utilization patterns for individuals transitioning into PSH from institutional versus community settings.

Main Methods:

• Utilized secondary data from a North Carolina PSH program (2014-2018) linked to Medicaid claims.
• Employed propensity score weighting to estimate the average treatment effect on the treated of PSH participation.
• Stratified analyses based on pre-PSH setting (institutional or community).

Main Results:

• Among individuals institutionalized before PSH, PSH participation was linked to increased hospitalizations and emergency department (ED) visits, and decreased primary care visits.
• Individuals transitioning to PSH from community settings did not exhibit significantly different health service use compared to similar non-PSH individuals within 12 months.
• The findings highlight a complex relationship between PSH and healthcare utilization, varying by prior living situation.

Conclusions:

• Permanent supportive housing (PSH) may lead to increased acute care utilization (hospitalizations, ED visits) for formerly institutionalized individuals with disabilities.
• PSH does not appear to significantly alter health service use patterns for individuals transitioning from community settings.
• Further research is needed to understand the mechanisms driving these utilization changes and to optimize PSH models for diverse populations.