ArticleBMC health services research2026
Associations between housing tenure and unscheduled hospital use in people of working age with multiple physical and mental long-term conditions: a retrospective cohort study using linked data from London.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIndividuals with physical and mental long-term conditions typically experience high levels of hospital use. Housing tenure - the arrangements under which individuals occupy their home - has been shown to be associated with the co-occurrence of physical and mental long-term conditions. However, the association between housing tenure and unplanned hospital use is not established. This study investigates the longitudinal relationship between housing tenure and unplanned hospital admissions among individuals of working age with co-occurring physical and mental long-term conditions.
methodsA longitudinal retrospective cohort study was undertaken, utilising the Care City Cohort, a dataset comprising healthcare, social care and wider determinants variables for residents in North East London. Two-part regression models with multiple imputation were used to estimate the odds of experiencing an unscheduled hospital admission and the associated length of stay among individuals with co-occurring physical and mental long-term conditions, by housing tenure. The models were adjusted for socio-demographic characteristics, health-related behaviours, and the number of physical and mental long-term conditions.
resultsAnalysis was conducted on the records of 45,399 individuals diagnosed with physical and mental long-term conditions before April 2016. The most common tenure was owner-occupied was 48%, followed by social renting (27.1%) and privately rented housing (24.9%). After adjusting for sociodemographic variables and health vulnerabilities, the odds of a non-elective admission were higher for social housing residents (OR 1.40; 95%CI: 1.21-1.61) than owner-occupied. There was no evidence of different lengths of stay between tenures.
conclusionsThis study highlights housing tenure as an important determinant of unscheduled hospital admissions amongst working age adults with a combination of physical and mental long-term conditions. Housing tenure status may be a useful indicator for local services to target secondary prevention strategies to reduce unscheduled hospital use.
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