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Changes in healthcare use among individuals who move into public housing: a population-based investigation
BACKGROUND: Residence in public housing, a subsidized and managed government program, may affect health and healthcare utilization. We compared healthcare use in the year before individuals moved into public housing with usage during their first year of tenancy. We also described trends in use. METH...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989341/ https://www.ncbi.nlm.nih.gov/pubmed/29871635 http://dx.doi.org/10.1186/s12913-018-3109-7 |
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author | Hinds, Aynslie M. Bechtel, Brian Distasio, Jino Roos, Leslie L. Lix, Lisa M. |
author_facet | Hinds, Aynslie M. Bechtel, Brian Distasio, Jino Roos, Leslie L. Lix, Lisa M. |
author_sort | Hinds, Aynslie M. |
collection | PubMed |
description | BACKGROUND: Residence in public housing, a subsidized and managed government program, may affect health and healthcare utilization. We compared healthcare use in the year before individuals moved into public housing with usage during their first year of tenancy. We also described trends in use. METHODS: We used linked population-based administrative data housed in the Population Research Data Repository at the Manitoba Centre for Health Policy. The cohort consisted of individuals who moved into public housing in 2009 and 2010. We counted the number of hospitalizations, general practitioner (GP) visits, specialist visits, emergency department visits, and prescriptions drugs dispensed in the twelve 30-day intervals (i.e., months) immediately preceding and following the public housing move-in date. Generalized linear models with generalized estimating equations tested for a period (pre/post-move-in) by month interaction. Odds ratios (ORs), incident rate ratios (IRRs), and means are reported along with 95% confidence intervals (95% CIs). RESULTS: The cohort included 1942 individuals; the majority were female (73.4%) who lived in low income areas and received government assistance (68.1%). On average, the cohort had more than four health conditions. Over the 24 30-day intervals, the percentage of the cohort that visited a GP, specialist, and an emergency department ranged between 37.0% and 43.0%, 10.0% and 14.0%, and 6.0% and 10.0%, respectively, while the percentage of the cohort hospitalized ranged from 1.0% to 5.0%. Generally, these percentages were highest in the few months before the move-in date and lowest in the few months after the move-in date. The period by month interaction was statistically significant for hospitalizations, GP visits, and prescription drug use. The average change in the odds, rate, or mean was smaller in the post-move-in period than in the pre-move-in period. CONCLUSIONS: Use of some healthcare services declined after people moved into public housing; however, the decrease was only observed in the first few months and utilization rebounded. Knowledge of healthcare trends before individuals move in are informative for ensuring the appropriate supports are available to new public housing residents. Further study is needed to determine if decreased healthcare utilization following a move is attributable to decreased access. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3109-7) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5989341 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-59893412018-06-20 Changes in healthcare use among individuals who move into public housing: a population-based investigation Hinds, Aynslie M. Bechtel, Brian Distasio, Jino Roos, Leslie L. Lix, Lisa M. BMC Health Serv Res Research Article BACKGROUND: Residence in public housing, a subsidized and managed government program, may affect health and healthcare utilization. We compared healthcare use in the year before individuals moved into public housing with usage during their first year of tenancy. We also described trends in use. METHODS: We used linked population-based administrative data housed in the Population Research Data Repository at the Manitoba Centre for Health Policy. The cohort consisted of individuals who moved into public housing in 2009 and 2010. We counted the number of hospitalizations, general practitioner (GP) visits, specialist visits, emergency department visits, and prescriptions drugs dispensed in the twelve 30-day intervals (i.e., months) immediately preceding and following the public housing move-in date. Generalized linear models with generalized estimating equations tested for a period (pre/post-move-in) by month interaction. Odds ratios (ORs), incident rate ratios (IRRs), and means are reported along with 95% confidence intervals (95% CIs). RESULTS: The cohort included 1942 individuals; the majority were female (73.4%) who lived in low income areas and received government assistance (68.1%). On average, the cohort had more than four health conditions. Over the 24 30-day intervals, the percentage of the cohort that visited a GP, specialist, and an emergency department ranged between 37.0% and 43.0%, 10.0% and 14.0%, and 6.0% and 10.0%, respectively, while the percentage of the cohort hospitalized ranged from 1.0% to 5.0%. Generally, these percentages were highest in the few months before the move-in date and lowest in the few months after the move-in date. The period by month interaction was statistically significant for hospitalizations, GP visits, and prescription drug use. The average change in the odds, rate, or mean was smaller in the post-move-in period than in the pre-move-in period. CONCLUSIONS: Use of some healthcare services declined after people moved into public housing; however, the decrease was only observed in the first few months and utilization rebounded. Knowledge of healthcare trends before individuals move in are informative for ensuring the appropriate supports are available to new public housing residents. Further study is needed to determine if decreased healthcare utilization following a move is attributable to decreased access. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12913-018-3109-7) contains supplementary material, which is available to authorized users. BioMed Central 2018-06-05 /pmc/articles/PMC5989341/ /pubmed/29871635 http://dx.doi.org/10.1186/s12913-018-3109-7 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Hinds, Aynslie M. Bechtel, Brian Distasio, Jino Roos, Leslie L. Lix, Lisa M. Changes in healthcare use among individuals who move into public housing: a population-based investigation |
title | Changes in healthcare use among individuals who move into public housing: a population-based investigation |
title_full | Changes in healthcare use among individuals who move into public housing: a population-based investigation |
title_fullStr | Changes in healthcare use among individuals who move into public housing: a population-based investigation |
title_full_unstemmed | Changes in healthcare use among individuals who move into public housing: a population-based investigation |
title_short | Changes in healthcare use among individuals who move into public housing: a population-based investigation |
title_sort | changes in healthcare use among individuals who move into public housing: a population-based investigation |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989341/ https://www.ncbi.nlm.nih.gov/pubmed/29871635 http://dx.doi.org/10.1186/s12913-018-3109-7 |
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