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

Med Care Res Rev. 2023 Dec;80(6):596-607. doi: 10.1177/10775587231183192. Epub 2023 Jun 27.


This study assessed whether permanent supportive housing (PSH) participation is associated with health service use among a population of adults with disabilities, including people transitioning into PSH from community and institutional settings. Our primary data sources were 2014 to 2018 secondary data from a PSH program in North Carolina linked to Medicaid claims. We used propensity score weighting to estimate the average treatment effect on the treated of PSH participation. All models were stratified by whether individuals were in institutional or community settings prior to PSH. In weighted analyses, among individuals who were institutionalized prior to PSH, PSH participation was associated with greater hospitalizations and emergency department (ED) visits and fewer primary care visits during the follow-up period, compared with similar individuals who largely remained institutionalized. Individuals who entered PSH from community settings did not have significantly different health service use from similar comparison group members during the 12-month follow-up period.

Keywords: Medicaid; access/demand/utilization of services; administrative data; determinants of health; disability; observational data.

MeSH terms

  • Adult
  • Delivery of Health Care
  • Disabled Persons*
  • Health Services
  • Hospitalization
  • Housing
  • Humans
  • Ill-Housed Persons*
  • United States