Health Care Outcomes of Homelessness Prevention Programs in Veterans Experiencing Housing Instability

Area of Science:

• Health Services Research
• Public Health Policy
• Veterans Affairs

Background:

• Homelessness among veterans is linked to adverse health outcomes and elevated healthcare expenditures.
• The VA's Supportive Services for Veteran Families (SSVF) program offers financial aid and support for housing instability.
• Limited data exists on the short-term, prevention-focused impacts of such interventions.

Purpose of the Study:

• To assess the 3-year impact of the SSVF program on veteran mortality and healthcare costs.
• To evaluate the effectiveness of a federal homelessness prevention initiative.

Main Methods:

• Observational study comparing SSVF enrollees with non-enrollees from October 2015 to December 2018.
• Propensity score weighting (inverse probability of treatment weighting) used to balance covariates.
• Cox proportional hazards regression for mortality and generalized linear model for healthcare costs.

Main Results:

• The study included over 693,000 veteran patient-trials, with 3.8% enrolled in SSVF.
• SSVF enrollment was associated with a significant decrease in mortality risk (HR, 0.87; 95% CI, 0.82-0.92).
• SSVF enrollment showed increased outpatient costs but decreased inpatient costs, resulting in an overall cost shift.

Conclusions:

• Federal homelessness prevention programs like SSVF are associated with improved veteran health outcomes.
• The SSVF program demonstrates potential for reducing inpatient healthcare costs.
• Findings support the integration of such programs into national policy discussions for veteran support.