Dispersed or clustered housing for adults with intellectual disabilities: a systematic review

Background This review evaluated research on the quality and costs of dispersed community-based housing compared to clustered housing. Methods Searches yielded 19 papers based on 10 studies comparing dispersed housing with some kind of clustered housing (village communities, residential campuses or clusters of houses). The studies reported the experience of nearly 2500 people from four different countries.Results In five of eight quality of life domains there were no studies reporting benefits of clustered settings. Clustered settings had some advantages in interpersonal relations, emotional and physical well-being. However, in many cases the better results refer only to village communities and not to campus or clustered housing. Clustered housing was usually less expensive but this was due to lower staffing levels. Conclusion Dispersed housing appears to be superior to clustered housing on the majority of quality indicators studied. The only exception to this is that village communities for people with less severe disabilities have some benefits; this is not however a model which can be feasibly provided for everyone. There is no evidence that clustered housing can deliver the same quality of life as dispersed housing at a lower cost.