Cost-Effectiveness of a Homeless Care Transition Program: Durham Homeless Care Transitions

Area of Science:

• Health Services Research
• Public Health
• Health Economics

Background:

• Transitional care and medical respite programs support homeless individuals transitioning from acute care to community settings.
• These programs address critical health determinants often unmet by traditional medical services.
• The Durham Homeless Care Transitions (DHCT) program's cost-effectiveness is examined.

Purpose of the Study:

• To evaluate the cost-effectiveness of the Durham Homeless Care Transitions (DHCT) program.
• To compare healthcare utilization and costs for homeless individuals participating in the DHCT program versus a control group.

Main Methods:

• An intervention study design comparing DHCT participants with a referred but non-participating group.
• Abstraction of encounter-level charges and reimbursements for 12 months pre- and post-referral.
• Ordinary least squares (OLS) regression models used to analyze utilization patterns.

Main Results:

• The study included 485 individuals, predominantly non-Hispanic Black (62.5%) and male (68.4%), with an average of 5.3 chronic conditions.
• Participation in the DHCT program was associated with lower healthcare charges post-referral.
• Variability in charges and reimbursement existed based on healthcare visit type.

Conclusions:

• Transitional care and medical respite programs benefit patients without substantially increasing overall societal care costs.
• Evidence suggests these programs can be valuable for vulnerable homeless populations.
• Health systems require demonstrated cost savings and return on investment for program adoption.