Cost-Savings Associated with Reductions in Public Service Utilization with Provision of Permanent Supported Housing in M
- PDF / 251,631 Bytes
- 9 Pages / 439.37 x 666.142 pts Page_size
- 49 Downloads / 171 Views
Cost-Savings Associated with Reductions in Public Service Utilization with Provision of Permanent Supported Housing in Midsized City in the United States Kathy Dobbins 1 & Carey Addison 2 & Autumn Roque 3 & Peggy L. El-Mallakh 4 & Rif S. El-Mallakh 5
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
Severe and persistent mental illnesses are frequently associated with homelessness and extensive use of public services. Cost savings after the provision of permanent supportive housing (PSH) have been examined in large metropolitan areas but not in medium-sized communities. Administrative and clinical data were collected to determine use of public services, such as use of emergency services, inpatient psychiatric and medical services, and correctional facilities, in the year preceding and the year subsequent to placement in PSH. Costs of the housing and the utilized services were also calculated. Ninety-one subjects were in housing first (HF) programs and 19 were in treatment first (TF) programs. Overall there was a net cost savings of over $1.2 million or $6134/consumer/year of PSH. Nearly all cost savings were in reduced service utilization which implies prevention of both medical and psychiatric morbidity. In HF the average per patient cost savings ($21,082.12) was not significantly greater than TF ($12,907.29; p = 0.33). Provision of PSH in a mid-sized city provides significant cost savings. Keywords Cost . Cost-savings . Savings . Homelessness . Permanent supportedhousing . Housing first . Emergency services . Public services Individuals with severe and persistent mental illness frequently experience severe social stressors, particularly homelessness. The US Department of Housing and Urban Development (HUD) estimated that in 2010, up to 46% of homeless adults living in shelters had a diagnosis of a serious mental illness and/or a substance use disorder [1]. In a study of 500 homeless individuals in 3 urban settings in Canada, almost 93% met diagnostic criteria for a psychiatric disorder; of these, 27.2% were diagnosed with schizophrenia or psychosis, and 70% reported drug dependence [2].
* Rif S. El-Mallakh [email protected] Extended author information available on the last page of the article
Psychiatric Quarterly
The impact of homelessness among vulnerable individuals with serious mental illnesses (SMI) is a major public health concern [2]. Access and use of psychiatric and medical outpatient services are severely limited in this population due to lack of connection to a healthcare system and issues related to homelessness, such as lack of a telephone [2]. As a result, homeless individuals with SMIs rely on costly emergency and inpatient services to obtain needed healthcare [3]. Lam and colleagues [3] reviewed all emergency department visits during 2012 in an urban “safety net” hospital (p. 608), and found that among people with psychiatric disorders, homelessness contributed to a 28% increase in the likelihood of an ED revisit, and a 38.2% increase in likelihood of hospit
Data Loading...
