Onsite primary care to address medical needs among permanent supportive housing tenants: A feasibility demonstration project

BACKGROUND: There is limited evidence on interventions to address the health needs of vulnerable patients in permanent supportive housing (PSH). 

AIM, SETTING, PARTICIPANTS: Evaluate the feasibility of Project HOPE, a weekly onsite primary care pilot intervention for tenants of a single-site PSH program. 

PROGRAM DESCRIPTION: Physicians, nursing, and pharmacy providers work with existing case managers to provide onsite routine and acute care, outreach, and care coordination. Operations began in November 2020. 

PROGRAM EVALUATION: Chart review (n = 26) of electronic health records assessed primary care engagement during the 180 days pre- and post-implementation using paired t tests and McNemar's exact tests, alongside formative observations from site visits and monthly meetings. Compared to the pre period, there was a 50% increase in the proportion of tenants with any primary care engagement (95% CI, 0.24, 0.76), and 84.6% of tenants had at least one visit with Project HOPE. Tenants averaged 2.65 more PCP visits during the post period compared to the pre period (95% CI, 1.60, 3.71). Housing staff perceived improvements in care continuity, chronic disease management, and access to care for tenants. 

DISCUSSION: An onsite primary care delivery model led to increases in primary care engagement for high-acuity PSH tenants.