Supportive Housing and Its Relationship With Diabetes Diagnosis and Management Among Homeless Persons in New York City
Supportive Housing and Its Relationship With Diabetes Diagnosis and Management Among Homeless Persons in New York City
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DOI：
10.1093/aje/kwz057
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发表时间：
2019-06-01
影响因子：
5
通讯作者：
Gould, L. Hannah
中科院分区：
文献类型：
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作者：
Lim, Sungwoo;Miller-Archie, Sara A.;Gould, L. Hannah
支持性住房解决了无家可归者的基本生存需求，这可以降低患糖尿病的风险并改善糖尿病护理。我们在 2007 年至 2012 年有资格参加纽约市支持性住房计划的无家可归成年人中测试了支持性住房与糖尿病结局之间的关联。我们使用多个管理数据源，确定了 7,525 名符合医疗补助资格的成年人。结果包括接受医疗评估和管理服务、血红蛋白 A(1C) 和血脂检测（n = 1,489 名基线糖尿病患者），以及基线后 2 年内新诊断糖尿病的发生率（n = 6,036 名无基线糖尿病患者）。使用逆治疗概率加权来估计这些结果按安置的差异。安置人员比未安置人员更有可能接受评估和管理服务（相对风险（RR）= 1.03，95％置信区间（CI）：1.01，1.04）。对于基线糖尿病患者，安置者更有可能接受血红蛋白 A(1C) 测试（RR = 1.10，95% CI：1.02，1.19）和血脂测试（RR = 1.09，95% CI：1.02，1.17）。对于那些没有基线糖尿病的人来说，安置也与降低新诊断糖尿病的风险相关（RR = 0.87，95% CI：0.76，0.99）。这些发现表明，支持性住房的好处可能会扩展到糖尿病的护理和预防。
Supportive housing addresses a fundamental survival need among homeless persons, which can lead to reduced risk of diabetes mellitus and improved diabetes care. We tested the association between supportive housing and diabetes outcomes among homeless adults who were eligible for New York City's supportive housing program in 2007-2012. We used multiple administrative data sources, identifying 7,525 Medicaid-eligible adults. The outcomes included receiving medical evaluation and management services, hemoglobin A(1C) and lipid testing (n = 1,489 persons with baseline diabetes), and incidence of new diabetes diagnoses (n = 6,036 persons without baseline diabetes) in the 2 years postbaseline. Differences in these outcomes by placement were estimated using inverse-probability-of-treatment weighting. Placed persons were more likely to receive evaluation and management services (relative risk (RR) = 1.03, 95% confidence interval (CI): 1.01, 1.04) than unplaced persons. For those with baseline diabetes, placed persons were more likely to receive hemoglobin A(1C) tests (RR = 1.10, 95% CI: 1.02, 1.19) and lipid tests (RR = 1.09, 95% CI: 1.02, 1.17). For those without baseline diabetes, placement was also associated with lower risk of new diabetes diagnoses (RR = 0.87, 95% CI: 0.76, 0.99). These findings show that benefits of supportive housing may be extended to diabetes care and prevention.