Having somewhere to call ‘home’ is an important component of integrated health care
It wouldn’t come as a surprise to most health professionals that people experiencing homelessness are less likely to access primary care. Consequently, they’re much more likely to engage with the acute and more costly end of the health service spectrum.
New research released by the UWA Centre for Social Impact has demonstrated that there are enormous savings for the health system when people struggling with homelessness are provided with public housing. The study, undertaken with colleagues Professor Paul Flatau and Shannen Vallesi, is the first in Australia to link hospital and health service data with public housing and homelessness statistics.
Within just one year of their entry into public housing, the 3383 participants in the study who were previously homeless showed a marked reduction in ED presentations, hospital admissions and length of stay coupled with a reduced number of bed-days in psychiatric units and ICU. This equated to a combined annual cost-saving of $16.4m for the WA health system.
The most dramatic reduction in the use of health services was observed among people who received support from a National Partnership Agreement on Homelessness (NPAH) program. This is a joint federal and state/territory government initiative that couples access to public housing with targeted support. Unfortunately, it’s only funded until 2017.
There were nearly 1000 study participants in the NPAH program and the average reduction in health service use equated to a potential saving of $13,273 a year for each individual. An even larger cost saving was observed among those public housing tenants who had been part of a NPAH program where housing support workers provide assistance to people exiting a mental health service.
The cost saving in the latter case equated to an average of $84,135 per person, largely attributable to the significant drop in psychiatric admissions once people were established in stable housing.
The study also surveyed some of the public housing tenants and the results reinforced a strong relationship between housing and health. It was obvious that precarious housing circumstances exacerbate stress and mental health issues for many people, making it more difficult for them to commit to health-related behaviour changes. Conversely, there were reports of positive changes in mental and physical health among surveyed tenants once they were living in a place they called ‘home’.
These are compelling findings for the health and medical sectors. They reinforce the fact that the revolving door between homelessness and poor health can actually be addressed, and that doing so can save the health system money.
Most critically, the health sector savings far outweigh the cost of providing support for homeless people to access public housing. This confirms the merits of prevention and early intervention, a public health policy much espoused at the moment. Just as importantly, the study findings support the merits of more fully integrated models of health care.