Document Type
Article
Publication Date
7-11-2026
Abstract
Objective
To evaluate the use of longitudinal Health Information Exchange data to assess changes in healthcare utilization and selected clinical outcomes associated with community-based organization interventions addressing housing instability and food insecurity.Methods
A retrospective pre-post study design was used to analyze two distinct community-based organization cohorts within a regional Health Information Exchange. The housing cohort included 228 individuals who received housing placement services, and the nutrition cohort included 786 individuals enrolled in a medically tailored meal program. Healthcare utilization and clinical outcomes were compared during the 365 days before and after program enrollment. Outcomes included inpatient admissions, emergency department visits, outpatient visits, length of stay, hemoglobin A1C, and body mass index. Paired t-tests were used to assess differences between pre- and post-enrollment periods.Results
Among housing program participants, emergency department visits decreased by 32% (p< 0.05), while outpatient visits increased by 92% (p< 0.001). Changes in inpatient admissions and length of stay were not statistically significant. Among nutrition program participants, inpatient admissions decreased by 20% (p< 0.01), emergency department visits decreased by 18% (p< 0.01), and length of stay decreased by 5% (p< 0.01). Significant improvements were also observed in hemoglobin HbA1c (5% decrease, p< 0.05) and body mass index (4% decrease, p< 0.01).Conclusions
Longitudinal Health Information Exchange data can be used to evaluate healthcare utilization and clinical outcomes associated with community-based organization interventions. Findings suggest that housing and medically tailored meal programs are associated with improvements in healthcare utilization and selected clinical measures, while demonstrating the value of Health Information Exchanges as data repositories supporting whole-person care and program evaluation.Recommended Citation
Kramer, Kevin; Scherpbier, Harm; and Marella, William, "Leveraging Health Information Exchange (HIE) Data to Demonstrate the Impact on Health Outcomes of Community Based Organization Interventions: Case Studies of Housing Placement and Medically Tailored Meal Program" (2026). College of Population Health Faculty Papers. Paper 254.
https://jdc.jefferson.edu/healthpolicyfaculty/254
Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Language
English
Included in
Health and Medical Administration Commons, Population Health Commons, Public Health Commons

Comments
This article is the author's final published version in Journal of Primary Care and Community Health, Volume 17, July 2026, Pages 1-7.
The published version is available at https://doi.org/10.1177/21501319261468517.
Copyright © The Author(s) 2026.