Homelessness is a pervasive public health problem in the United States (U.S.). Under the U.S. Affordable Care Act, the nation's public health insurance program (Medicaid) was expanded to serve more individuals, including those experiencing homelessness. Coupled with changes in financial incentives designed to reduce healthcare costs, health plans, hospitals and large health systems have started to operate permanent supportive housing (PSH) programmes as a healthcare benefit. To better understand patient perceptions of care coordination in a PSH programme operated by a large health plan in Southern California, we conducted 22 semi-structured in-depth patient interviews between October and November 2019. Two coders analysed these data inductively and deductively, using pre-identified domains and open coding. Coding reliability and thematic saturation were also assessed. Findings indicated positive experiences with care coordination for physical health and social supports, such as food distribution and transportation. Identified service gaps included mental health support and help securing public assistance (e.g., cash benefits). Opportunities to enhance PSH care coordination were also identified, such as the need for a simplified approach. Hospitals, health plans and systems considering PSH programmes may look to these results for implementation guidance.

中文翻译：

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永久性支持性住房参与者之间的感知护理协调：来自美国管理式护理计划的证据

无家可归是美国 (US) 普遍存在的公共卫生问题。根据美国平价医疗法案，美国的公共医疗保险计划 (Medicaid) 扩大到为更多人提供服务，包括那些无家可归的人。再加上旨在降低医疗保健成本的财政激励措施的变化，医疗保健计划、医院和大型医疗系统已开始运营永久支持性住房 (PSH) 计划作为医疗保健福利。为了更好地了解南加州一家大型健康计划运营的 PSH 计划中患者对护理协调的看法，我们在 2019 年 10 月至 11 月期间进行了 22 次半结构化的患者深度访谈。两名编码员使用预- 识别域和开放编码。还评估了编码可靠性和主题饱和度。调查结果表明，在协调身体健康和社会支持方面的积极经验，例如食品分配和运输。确定的服务差距包括心理健康支持和帮助确保公共援助（例如，现金福利）。还确定了加强 PSH 护理协调的机会，例如需要简化方法。考虑 PSH 计划的医院、健康计划和系统可以将这些结果作为实施指南。还确定了加强 PSH 护理协调的机会，例如需要简化方法。考虑 PSH 计划的医院、健康计划和系统可以将这些结果作为实施指南。还确定了加强 PSH 护理协调的机会，例如需要简化方法。考虑 PSH 计划的医院、健康计划和系统可以将这些结果作为实施指南。