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dc.contributor.authorByrne, Thomas H.en_US
dc.contributor.authorNelson, Richard E.en_US
dc.contributor.authorMontgomery, Ann Elizabethen_US
dc.contributor.authorBrignone, Emilyen_US
dc.contributor.authorGundlapalli, Adi V.en_US
dc.contributor.authorFargo, Jamison D.en_US
dc.coverage.spatialUnited Statesen_US
dc.date.accessioned2017-07-06T20:00:36Z
dc.date.available2017-07-06T20:00:36Z
dc.date.issued2017-02
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/28116585
dc.identifier.citationThomas 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.
dc.identifier.issn1468-2869
dc.identifier.urihttps://hdl.handle.net/2144/22770
dc.description.abstractHousing 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.en_US
dc.description.sponsorshipThis study was supported by funding from the Department of Veterans Affairs (VA) Health Services Research & Development (HSR&D) grant IIR 13-334-3 and from the VA National Center on Homelessness Among Veterans.en_US
dc.format.extentp. 54 - 63en_US
dc.languageeng
dc.relation.ispartofJ Urban Health
dc.subjectHealth service useen_US
dc.subjectHomelessnessen_US
dc.subjectHousingen_US
dc.subjectVeteransen_US
dc.subjectPublic health and health servicesen_US
dc.subjectPublic healthen_US
dc.titleComparing the utilization and cost of health services between veterans experiencing brief and ongoing episodes of housing instabilityen_US
dc.typeArticleen_US
dc.identifier.doi10.1007/s11524-016-0110-5
dc.identifier.pmid28116585
dc.identifier.pmcidPMC5359170
pubs.elements-sourcepubmeden_US
pubs.notesEmbargo: Not knownen_US
pubs.organisational-groupBoston Universityen_US
pubs.organisational-groupBoston University, School of Social Worken_US
pubs.publication-statusPublisheden_US
dc.identifier.orcid0000-0003-4824-0284 (Byrne, Thomas)


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