A pilot study of the impact of housing first-supported housing for intensive users of medical hospitalization and sobering services

D. Srebnik, T. Connor and L. Sylla

American Journal of Public Health, 2013, vol. 103, issue 2, 316-321

Abstract: Objectives. We examined changes in service use in a Housing First (HF) pilot program for adults who were homeless with medical illnesses and high prior acute-care use relative to a similar comparison group. Methods. We used a 1-year pre-post comparison group design. The 29 participants and 31 comparison group members were adults who were homeless with inpatient claims of at least $10 000 or at least 60 sobering "sleep off" center contacts in the prior year. Results. Participants showed a significantly greater reduction in emergency department and sobering center use relative to the comparison group. At a trend level, participants had greater reductions in hospital admissions and jail bookings. Reductions in estimated costs for participants and comparison group members were $62 504 and $25 925 per person per year-a difference of $36 579, far outweighing program costs of $18 600 per person per year. Conclusions. HF participants showed striking reductions in acute-care use relative to the comparison group, demonstrating that HF can be a successful model for people with complex medical conditions and high prior acute-care use. Despite notable methodological limitations, these findings could be used to inform a larger multisite study that would establish greater generalizability. Copyright © 2012 by the American Public Health Association®.

Keywords: adult; alcoholism; article; chronic disease; comparative study; economics; emergency health service; female; halfway house; homelessness; hospitalization; housing; human; male; middle aged; pilot study; statistics; United States; utilization review, Adult; Alcoholism; Chronic Disease; Emergency Service, Hospital; Female; Halfway Houses; Homeless Persons; Hospitalization; Humans; Male; Middle Aged; Pilot Projects; Public Housing; Washington (search for similar items in EconPapers)
Date: 2013
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Citations: View citations in EconPapers (8)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2012.300867_7

DOI: 10.2105/AJPH.2012.300867

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