Bridging the Gap Between Research and Health Policy – Insights From Robert Wood Johnson Foundation Clinical Scholars
Comparative Cost Analysis of Housing and Case Management Program for Chronically Ill Homeless Adults Compared to Usual Care
Version of Record online: 18 NOV 2011
© Health Research and Educational Trust
Health Services Research
Volume 47, Issue 1pt2, pages 523–543, February 2012
How to Cite
Basu, A., Kee, R., Buchanan, D. and Sadowski, L. S. (2012), Comparative Cost Analysis of Housing and Case Management Program for Chronically Ill Homeless Adults Compared to Usual Care. Health Services Research, 47: 523–543. doi: 10.1111/j.1475-6773.2011.01350.x
- Issue online: 12 JAN 2012
- Version of Record online: 18 NOV 2011
- Michael Reese Health Trust
- National Institute of Mental Health Research Grant. Grant Number: R01MH083706
- housing and case management;
- chronic illnesses;
To assess the costs of a housing and case management program in a novel sample—homeless adults with chronic medical illnesses.
The study used data from multiple sources: (1) electronic medical records for hospital, emergency room, and ambulatory medical and mental health visits; (2) institutional and regional databases for days in respite centers, jails, or prisons; and (3) interviews for days in nursing homes, shelters, substance abuse treatment centers, and case manager visits. Total costs were estimated using unit costs for each service.
Randomized controlled trial of 407 homeless adults with chronic medical illnesses enrolled at two hospitals in Chicago, Illinois, and followed for 18 months.
Compared to usual care, the intervention group generated an average annual cost savings of (−)$6,307 per person (95 percent CI: −16,616, 4,002; p = .23). Subgroup analyses of chronically homeless and those with HIV showed higher per person, annual cost savings of (−)$9,809 and (−)$6,622, respectively. Results were robust to sensitivity analysis using unit costs.
The findings of this comprehensive, comparative cost analyses demonstrated an important average annual savings, though in this underpowered study these savings did not achieve statistical significance.