Comparing the utilization and cost of health services between veterans experiencing brief and ongoing episodes of housing instability

Date Issued
2017-02Publisher Version
10.1007/s11524-016-0110-5Author(s)
Byrne, Thomas H.
Nelson, Richard E.
Montgomery, Ann Elizabeth
Brignone, Emily
Gundlapalli, Adi V.
Fargo, Jamison D.
Metadata
Show full item recordPermanent Link
https://hdl.handle.net/2144/22770Citation (published version)
Thomas Byrne, Richard E Nelson, Ann Elizabeth Montgomery, Emily Brignone, Adi V Gundlapalli, Jamison D Fargo. 2017. "Comparing the Utilization and Cost of Health Services between Veterans Experiencing Brief and Ongoing Episodes of Housing Instability.." J Urban Health, Volume 94, Issue 1, pp. 54 - 63.Abstract
Housing instability is associated with costly patterns of health and behavioral health service use. However, little prior research has examined patterns of service use associated with higher costs among those experiencing ongoing housing instability. To address this gap, we compared inpatient and outpatient medical and behavioral health service utilization and costs between veterans experiencing brief and ongoing episodes of housing instability. We used data from a brief screening instrument for homelessness and housing instability that has been implemented throughout the US Department of Veterans Affairs (VA) health care system to identify a national sample of veterans experiencing housing instability. Veterans were classified as experiencing either brief or ongoing housing instability, based on two consecutive responses to the instrument, and we used a series of two-part regression models to conduct adjusted comparisons of costs between veterans experiencing brief and ongoing episodes of housing instability. Among 5794 veterans screening positive for housing instability, 4934 (85%) were experiencing brief and 860 (15%) ongoing instability. The average total annual incremental cost associated with ongoing versus brief episodes of housing instability was estimated at $7573, with the bulk of this difference found in inpatient services. Cost differences resulted more from a higher probability of service use among those experiencing ongoing episodes of housing instability than from higher costs among service users. Our findings suggest that VA programmatic efforts aimed at preventing extended episodes of housing instability could potentially result in substantial cost offsets for the VA health care system.
Collections
- BU Open Access Articles [4833]
- SSW Scholarly Papers [124]
Related items
Showing items related by title, author, creator and subject.
-
Factors influencing the underutilization of mental health services among Asian American women with a history of depression and suicide.
Augsberger, Astraea; Yeung, Albert; Dougher, Meaghan; Hahm, Hyeouk Chris (2015-12-08)BACKGROUND: Despite the substantially high prevalence of depression, suicidal ideation and suicide attempts among Asian American women who are children of immigrants, little is known about the prevalence of mental health ... -
The association of recreational space with youth smoking in low-socioeconomic status neighborhoods in Santiago, Chile
Lee, Wonhyung; Grogan-Kaylor, Andrew; Sanhueza, Guillermo; Andrade, Fernando; Delva, Jorge (SPRINGER BASEL AG, 2014-02-01)OBJECTIVES: This study examines the relationship of neighborhood recreational space with youth smoking in mid- to low-income areas in the capital of Chile, Santiago. METHODS: A unique data set of adolescents (n = 779, ... -
Health implications of an immigration raid: findings from a Latino community in the midwestern United States.
Delva, Jorge; Llanes, Mikel; Ledón, Charo; Waller, Adreanne; Harner, Melanie; Martinez, Ramiro; Sanders, Laura; Harner, Margaret; Israel, Barbara; Lopez, William D.; Kruger, Daniel J.Immigration raids exemplify the reach of immigration law enforcement into the lives of Latino community members, yet little research characterizes the health effects of these raids. We examined the health implications of ...