Positive Results from Primary Care Housing Stability Program

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Access to safe and affordable housing is considered a growing determinant of health. As a result, institutions are taking more steps to support their patients. In 2018, the Brigham Primary Care Center of Excellence, located in Boston, created a social care team to help address the housing needs of 1,139 patients across their 15 primary care clinics.

To determine care teams’ effectiveness, researchers from Brigham Health, an academic medical center, began a two-year evaluation that lasted from October 2018 to March 2021. Three questions guided their research.

Researchers conducted patient interviews and read through Brigham Primary Care Center of Excellence records to see if patient involvement affected disease control, what types of housing problems patients reported, and what the overall patient experience was. Results were published Monday in Health Affairs.

“Patients enrolled in the program between October 2018 and March 2021 had 2.5 fewer primary care visits and 3.6 fewer outpatient visits per year compared with those not enrolled, including fewer social work, behavioral health, psychiatry, and urgent care visits,” the report reads.

Interviews were also conducted with 23 patients. Almost all patients reported improved mental health with one patient saying, “It took most stress off me, knowing I had help.”

Another patient said, “[My housing advocate] didn’t let me give up. Together, we definitely made them diamonds happen in my life again. …I love my hospital. I’m a hardcore, dedicated patient.”

Today, 14% of families in the United States spend at least half of their paychecks on housing. In households earning less than $30,000 a year, 51% of families spend at least half of their earnings, according to The State of Nation’s Housing Report in 2022.

Although this program was beneficial, the researchers say an even greater way for health systems to make a difference is to restructure the healthcare policies that create medical debt which exacerbates the housing crisis.