{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T21:39:07Z","timestamp":1778449147300,"version":"3.51.4"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T00:00:00Z","timestamp":1677801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100022897","name":"Mental Health Commission of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100022897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","award":["259"],"award-info":[{"award-number":["259"]}],"id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institute of Health Research","doi-asserted-by":"crossref","award":["MOP-130405"],"award-info":[{"award-number":["MOP-130405"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Ontario Ministry of Health"},{"name":"Ministry of Long-Term Care"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Continuity of primary care (CPC) is associated with reduced mortality and improved health status. This study assessed the level of CPC and changes in CPC over 6 years among adults with experience of homelessness and mental illness who received a Housing First intervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants were adults (\u226518 years old) with a serious mental disorder and experiencing chronic homelessness enrolled between October 2009 and June 2011 in the Toronto site of the Canadian At Home\/Chez Soi study and followed until March 2017. Participants were randomized to Housing First with intensive case management (HF-ICM), Housing First with assertive community treatment (HF-ACT), or treatment as usual. For this report, 280 intervention group participants (HF-ICM, n = 193 and HF-ACT, n = 87) were analysed using data from health records. The main outcome was CPC measured by the Continuity of Care Index as a continuous and categorical variable among participants during 3 consecutive 2-year periods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Most HF-ICM participants had low levels of CPC, with 68%\u201374% of this group having low CPC across all time periods. Similarly, most HF-ACT participants had low levels of CPC, with 63%\u201378% of this group having low CPC across all time periods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Among this group of individuals with mental illness who were experiencing homelessness, CPC remained low over 6 years of follow-up. This study highlights that housing and mental health interventions may need to place greater emphasis on improving CPC using effective strategies that are specifically geared towards this important goal among their clients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/fampra\/cmad023","type":"journal-article","created":{"date-parts":[[2023,3,4]],"date-time":"2023-03-04T12:18:25Z","timestamp":1677932305000},"page":"369-372","source":"Crossref","is-referenced-by-count":1,"title":["Continuity of primary care among homeless adults with mental illness who received a housing and mental health intervention"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1283-768X","authenticated-orcid":false,"given":"Matthew J","family":"To","sequence":"first","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital , Toronto , Canada"},{"name":"Department of Family and Community Medicine, University of Toronto , Toronto , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1131-8439","authenticated-orcid":false,"given":"Cilia","family":"Mejia-Lancheros","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital , Toronto , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8498-8922","authenticated-orcid":false,"given":"James","family":"Lachaud","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital , Toronto , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1276-1101","authenticated-orcid":false,"given":"Stephen W","family":"Hwang","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital , Toronto , Canada"},{"name":"Division of General Internal Medicine, Department of Medicine, University of Toronto , Toronto , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,3,3]]},"reference":[{"issue":"2","key":"2024061213163338700_CIT0001","first-page":"229","article-title":"Homelessness and health","volume":"164","author":"Hwang","year":"2001","journal-title":"CMAJ"},{"issue":"9","key":"2024061213163338700_CIT0002","first-page":"1","article-title":"Interventions to improve access to primary care for people who are homeless: a systematic review","volume":"16","author":"Health Quality Ontario","year":"2016","journal-title":"Ont Health Technol Assess Ser"},{"issue":"698","key":"2024061213163338700_CIT0003","doi-asserted-by":"crossref","first-page":"e600","DOI":"10.3399\/bjgp20X712289","article-title":"Primary medical care continuity and patient mortality: a 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housing and health outcomes of homeless adults with mental illness: outcomes of the extended At Home\/Chez Soi randomized controlled trial","volume":"6","author":"Stergiopoulos","year":"2019","journal-title":"Lancet Psychiatry"},{"issue":"1","key":"2024061213163338700_CIT0007","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1177\/1460458218824720","article-title":"Continuity of care and multiple chronic conditions impact frequent use of outpatient services","volume":"26","author":"Wang","year":"2020","journal-title":"Health Informatics J"},{"issue":"649","key":"2024061213163338700_CIT0008","doi-asserted-by":"crossref","first-page":"e531","DOI":"10.3399\/bjgp16X686101","article-title":"Continuity of care in primary care and association with survival in older people: a 17-year prospective cohort study","volume":"66","author":"Maarsingh","year":"2016","journal-title":"Br J Gen 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