Patient-Centered Outcomes Following Project-Based and Scattered-Site Permanent Supportive Housing Among People Experiencing Homelessness

Abstract Permanent supportive housing (PSH) is widely used to address chronic homelessness, yet less is known about how different housing configurations may influence health and social outcomes. This study examined changes in patient-centered outcomes among people experiencing homelessness following placement into PSH and explored whether outcomes differed between project-based and scattered-site housing models. Participants were adults approved for PSH through the Los Angeles County Coordinated Entry System who completed baseline and monthly follow-up surveys after housing placement. Outcomes included housing stability, health status, health behaviors, and access to resources, and propensity score methods were used to adjust for baseline differences between individuals placed in project-based versus scattered-site housing. Among 329 participants, housing stability improved substantially during the first six months following housing placement, with declines in unsheltered homelessness and improvements in several health-related behaviors, including medication adherence and reductions in daily tobacco use. However, improvements in broader indicators of health and well-being were more modest, and food insecurity remained common. Comparisons between housing configurations revealed relatively few differences in outcomes after adjustment for baseline characteristics. These findings suggest that both project-based and scattered-site supportive housing models can support similar short-term outcomes for individuals exiting homelessness, while persistent challenges such as food insecurity and limited improvements in perceived health highlight the importance of integrating supportive housing programs with broader health and social service supports.