Background: Housing First (HF)-based interventions have been implemented in North America and beyond to help people exit homelessness.The effect of these interventions on access to primary and specialist care services is not well-defined.This study assesses the long-term effects of an HF intervention for homeless adults with mental illness on ice blue graphic tee primary care physician (PCP) and non-primary care physician (non-PCP) visits.Methods: This is a secondary analysis of the At Home/Chez Soi study, a randomized trial of HF for homeless adults with mental illness in Toronto, copyright.
High-need (HN) participants were randomized to HF with assertive community treatment (HF-ACT) or treatment as usual (TAU).Moderate needs (MN) participants were randomized to HF with intensive case management (HF-ICM) or TAU.The primary outcomes were the incidence and the number of visits to a PCP and non-PCP over 7-years post-randomization, compared to the 1-year pre-randomization.Results: Of 575 enrolled participants, 527 (80 HN and 347 MN) participants were included in the analyses.
HN participants who received HF-ACT had a significant reduction in the number of visits to a PCP compared to TAU participants (ratio of rate ratios (RRR): 0.66, 95% CI: 0.48-0.93) and a significant reduction in the number of non-PCP visits compared with TAU echofix spring reverb participants (RRR: 0.
64, 95% CI: 0.42-0.97) in the 7-years post-randomization compared to the 1-year pre-randomization.MN participants who received HF-ICM had a significant increase in incident visits to a PCP compared to TAU participants (RRR: 1.
66, 95% CI: 1.10-2.50).No effect of HF-ICM was observed on the incidence or number of non-PCP visits.
Conclusion: HF has differing effects on visits to PCPs and non-PCPs among homeless people with high and moderate needs for mental health supports.HF does not result in a consistent increase in PCP and non-PCP visits over a 7-year follow-up period.The At Home/Chez Soi study is registered with ISRCTN (ISRCTN, ISRCTN42520374).