Community supports may significantly lower hospital admissions and length of stay

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Photo: Steven Martin via Flickr

Investing in affordable housing that offers supportive social services to older adults on Medicare may help reduce hospital admissions and length of stay for inpatient hospital care, according to a recent study in Health Affairs.

When comparing a group of older Medicare beneficiaries in a Queens, N.Y. neighborhood who received community-based supportive services with a similar group who did not, researchers found that hospital discharge rates were 32 percent lower, hospital lengths of stay were reduced by one day and ambulatory care-sensitive conditions (ACSC) were 30 percent lower in the first “intervention” group. ACSCs include acute conditions such as urinary tract infections or chronic conditions such as diabetes complications that are potentially preventable with appropriate primary and preventive care, according to CMS.

Researchers examined a housing program run by Selfhelp, a nonprofit that operates programs for older people in 27 sites across Manhattan, Brooklyn, Queens, the Bronx and Nassau counties. Programs include senior centers, naturally occurring retirement communities, case management programs, programs for Holocaust survivors, home health aide training and nine apartment buildings, primarily high rises.

While prior research has shown that housing conditions affect health outcomes of the elderly, the effect that support services – including physical and psychological assessments, counseling and advocacy, health education, wellness and physical activity and socialization programs – have on the well-being of seniors and costly hospital services for Medicare beneficiaries is still being analyzed.

The study results suggest that continued investment into housing with supportive social services can reduce costly hospital stays and decrease spending for vulnerable older adults, according to lead author Michael Gusmano, associate professor of health policy at Rutgers University. The term “housing with supportive social services” is used to distinguish the housing program examined in the study from supportive housing, which is provided specifically for the formerly homeless population.

“These findings are consistent with the claim that housing programs of this sort help people stay healthy and, perhaps more importantly, help them receive health and social services that allow them to manage their chronic conditions,” Gusmano said in a statement. “By receiving timely and appropriate support in the community, this vulnerable population may be able to avoid hospitalization or at least use it less often.”

The study appears in the Oct. 1 online version of Health Affairs. Here are some questions to consider in your reporting:

  • What programs are available in your community that link supportive services with housing for older adults?
  • How effective are they?
  • Will any be impacted by 2019 federal, state or city budgets?

Resources

  • The SASH Program in Vermont is one example of how to successfully integrate social supports and housing for older adults. S. News and World Report reported on the program in August.
  • This slide deck from a 2016 Community Catalyst presentation features background information, data and examples of other housing and health partnerships for older adults.
  • This issue brief from the Kaiser Family Foundation looks at Medicaid’s role of Medicaid in providing community-based support for seniors.
  • This report offers a more detailed look at the role of housing with supportive services in New York City.

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