Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems
View abstract on PubMed
Summary
This summary is machine-generated.The Housing First intervention significantly reduced healthcare costs for chronically homeless individuals with severe alcohol problems. This cost reduction increased with longer housing retention, demonstrating the program's long-term economic benefits.
Area Of Science
- Public Health
- Health Services Research
- Addiction Medicine
Background
- Chronically homeless individuals with severe alcohol use disorders (AUDs) incur high healthcare and criminal justice costs due to co-occurring medical and psychiatric conditions.
- These individuals often exhibit high rates of service utilization across multiple systems.
Purpose Of The Study
- To assess the impact of a Housing First intervention on healthcare utilization and associated costs among chronically homeless individuals with severe alcohol problems.
- To evaluate the cost-effectiveness of providing housing as a primary intervention for this vulnerable population.
Main Methods
- A quasi-experimental design was employed, comparing 95 participants in a Housing First program (allowing continued drinking) with 39 wait-list control participants.
- Data on service use and costs, including jail, shelter, sobering centers, hospital services, detoxification, treatment, emergency services, and Medicaid, were collected.
- Propensity score adjustments were used in Poisson generalized estimating equation regressions to analyze cost differences.
Main Results
- Housing First participants incurred substantial costs prior to the study, with median monthly costs of $4066.
- After 6 and 12 months in housing, median monthly costs decreased to $1492 and $958, respectively.
- The intervention was associated with a 53% reduction in total costs over the first 6 months (rate ratio, 0.47) compared to controls, averaging $2449 per person per month in cost offsets.
Conclusions
- The Housing First program demonstrated a significant relative decrease in service costs for chronically homeless individuals with severe alcohol problems after 6 months.
- The cost-saving benefits of the Housing First intervention were found to increase with longer participant retention in housing.