The Impact of Supportive Housing on Liver-Related Outcomes Among Persons With Hepatitis C Virus Infection.
Medicaid
hepatitis C virus
homelessness
housing
supportive housing
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
07 10 2022
07 10 2022
Historique:
received:
18
04
2022
accepted:
08
07
2022
entrez:
8
10
2022
pubmed:
9
10
2022
medline:
12
10
2022
Statut:
ppublish
Résumé
Hepatitis C virus (HCV) infection disproportionately impacts people experiencing homelessness. Hepatitis C virus can lead to negative health outcomes, including mortality. We evaluated the impact of a permanent supportive housing (PSH) program (ie, "treatment") on liver-related morbidity and mortality among persons with chronic homelessness and HCV infection. We matched records for persons eligible for a New York City PSH program (2007-2014) with Heath Department HCV and Vital Statistics registries and Medicaid claims. Among persons diagnosed with HCV before or 2 years posteligibility, we added stabilized inverse probability of treatment weights to negative binomial regression models to compare rates for liver disease-related emergency department visits and hospitalizations, and hazard ratios for mortality, by program placement 2 and 5 years posteligibility. We identified 1158 of 8783 placed and 1952 of 19 019 unplaced persons with laboratory-confirmed HCV infection. Permanent supportive housing placement was associated with significantly reduced liver-related emergency department visits (adjusted rate ratio [aRR] = 0.76, 95% confidence interval [CI] = .61-.95), hospitalizations (aRR = 0.62, 95% CI = .54-.71), and all-cause (adjusted hazard ratio [aHR] = 0.65, 95% CI = .46-.92) and liver-related mortality (aHR = 0.72, 95% CI = .09-.83) within 2 years. The reduction remained significant for hospitalizations after 5 years. Placement into PSH was associated with reduced liver-related morbidity and mortality among persons with HCV infection and chronic homelessness.
Sections du résumé
BACKGROUND
Hepatitis C virus (HCV) infection disproportionately impacts people experiencing homelessness. Hepatitis C virus can lead to negative health outcomes, including mortality. We evaluated the impact of a permanent supportive housing (PSH) program (ie, "treatment") on liver-related morbidity and mortality among persons with chronic homelessness and HCV infection.
METHODS
We matched records for persons eligible for a New York City PSH program (2007-2014) with Heath Department HCV and Vital Statistics registries and Medicaid claims. Among persons diagnosed with HCV before or 2 years posteligibility, we added stabilized inverse probability of treatment weights to negative binomial regression models to compare rates for liver disease-related emergency department visits and hospitalizations, and hazard ratios for mortality, by program placement 2 and 5 years posteligibility.
RESULTS
We identified 1158 of 8783 placed and 1952 of 19 019 unplaced persons with laboratory-confirmed HCV infection. Permanent supportive housing placement was associated with significantly reduced liver-related emergency department visits (adjusted rate ratio [aRR] = 0.76, 95% confidence interval [CI] = .61-.95), hospitalizations (aRR = 0.62, 95% CI = .54-.71), and all-cause (adjusted hazard ratio [aHR] = 0.65, 95% CI = .46-.92) and liver-related mortality (aHR = 0.72, 95% CI = .09-.83) within 2 years. The reduction remained significant for hospitalizations after 5 years.
CONCLUSIONS
Placement into PSH was associated with reduced liver-related morbidity and mortality among persons with HCV infection and chronic homelessness.
Identifiants
pubmed: 36208165
pii: 6752599
doi: 10.1093/infdis/jiac292
pmc: PMC9547527
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
S363-S371Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
Déclaration de conflit d'intérêts
Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
Références
Am J Public Health. 2020 Jul;110(7):1068-1075
pubmed: 32437285
AIDS Behav. 2019 Mar;23(3):776-783
pubmed: 30684098
Stat Med. 2009 Nov 10;28(25):3083-107
pubmed: 19757444
Prehosp Emerg Care. 2014 Oct-Dec;18(4):476-82
pubmed: 24878364
Am J Gastroenterol. 2015 Aug;110(8):1169-77; quiz 1178
pubmed: 26215529
Health Serv Res. 2018 Oct;53(5):3437-3454
pubmed: 29532478
Am J Epidemiol. 2011 Apr 1;173(7):761-7
pubmed: 21385832
Lancet Infect Dis. 2012 Nov;12(11):859-70
pubmed: 22914343
Clin Infect Dis. 2014 Apr;58(8):1047-54
pubmed: 24523215
Ann Epidemiol. 2019 Apr;32:1-6.e1
pubmed: 30846275
Am J Public Health. 2005 Jul;95(7):1259-65
pubmed: 15983278
Eur J Public Health. 2019 Apr 1;29(2):242-247
pubmed: 30085011
Drug Alcohol Depend. 2018 Oct 1;191:63-69
pubmed: 30086424
BMC Health Serv Res. 2018 Jan 10;18(1):15
pubmed: 29316920
Lancet. 2000 Nov 25;356(9244):1800-5
pubmed: 11117912
JAMA. 2009 Apr 1;301(13):1349-57
pubmed: 19336710
Epidemiol Infect. 2018 Sep;146(12):1537-1542
pubmed: 29932040
Ann Intern Med. 2016 Sep 6;165(5):ITC33-ITC48
pubmed: 27595226
Subst Abus. 2020;41(1):70-76
pubmed: 29528786
Public Health Rep. 2015 Nov-Dec;130(6):693-703
pubmed: 26556941
J Public Health Manag Pract. 2018 Nov/Dec;24(6):526-532
pubmed: 29227418
Psychiatr Serv. 2014 Nov 1;65(11):1318-24
pubmed: 25022344
PLoS One. 2015 Apr 23;10(4):e0124552
pubmed: 25906394
Clin Infect Dis. 2019 Mar 19;68(7):1152-1159
pubmed: 30321289
Clin Infect Dis. 2017 Jul 15;65(2):252-258
pubmed: 28379316
Community Ment Health J. 2011 Apr;47(2):227-32
pubmed: 20063061
Clin Infect Dis. 2018 May 2;66(10):1618-1620
pubmed: 29206910
Hepatology. 2019 Mar;69(3):1020-1031
pubmed: 30398671
Am J Public Health. 2012 Mar;102(3):511-9
pubmed: 22390516
Am J Public Health. 2013 Dec;103 Suppl 2:S188-92
pubmed: 24148031
Clin Infect Dis. 2011 Jul 15;53(2):150-7
pubmed: 21665867
Am J Epidemiol. 2019 Jun 1;188(6):1120-1129
pubmed: 30834432
Lancet Public Health. 2022 Feb;7(2):e136-e145
pubmed: 35012711
Am J Public Health. 2016 Jul;106(7):1276-7
pubmed: 27196656
Public Health Rep. 2019 Mar/Apr;134(2):126-131
pubmed: 30699304
Hepatology. 2004 Mar;39(3):826-34
pubmed: 14999703
Am J Epidemiol. 2017 Aug 1;186(3):297-304
pubmed: 28472264
AIDS Behav. 2018 Sep;22(9):3083-3090
pubmed: 29737441
Clin Infect Dis. 2006 Jul 15;43(2):234-42
pubmed: 16779752
Am J Public Health. 2009 Nov;99 Suppl 3:S675-80
pubmed: 19372524
Med Care. 2021 Apr 1;59(Suppl 2):S199-S205
pubmed: 33710096