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. 2018 Jun 5;18(1):411.
doi: 10.1186/s12913-018-3109-7.

Changes in healthcare use among individuals who move into public housing: a population-based investigation

Aynslie M Hinds  1 , Brian Bechtel  2 , Jino Distasio  3 , Leslie L Roos  4 , Lisa M Lix  4
Affiliations

Changes in healthcare use among individuals who move into public housing: a population-based investigation

Aynslie M Hinds et al. BMC Health Serv Res. .

Abstract

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.

Keywords: Administrative data; Health services; Health status; Healthcare use; Public housing; Record linkage.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics approval was obtained from the University of Manitoba Health Research Ethics Board (H2014:381). Data access was approved by the Manitoba Health Information Privacy Committee (2014/15–29), the Winnipeg Regional Health Authority, and the Provincial Government Department of Families. This study used population-based administrative data. Due to the retrospective nature of the study design and the large cohort size and geographical distribution of the study members, it is not feasible to obtain consent to participate or consent to publish.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart for construction of the study cohort
Fig. 2
Fig. 2
Percentage of the study cohort who were hospitalized, visited an emergency department (Winnipeg residents), and saw a GP or a specialist in the year before and the year after the public housing move-in date. Note. N = 1942 for GP visits, specialist visits, and hospitalizations. The N for ED visits (Winnipeg residents) fluctuated between 1067 and 1089 depending on who resided in Winnipeg in any given period
Fig. 3
Fig. 3
Mean number of prescriptions per 30-day interval filled by the study cohort (N = 1942) in the year before and the year after the public housing move-in date
See this image and copyright information in PMC

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