Dental Care in Homeless Veterans: Associations with Positive Outcomes in Housing Intervention Programs

This retrospective longitudinal cohort study examined the impact of dental care on outcomes for homeless veterans who were discharged from VA homeless intervention programs from Aug 1, 08 thru Sept 30, 2009. Primary outcomes of interest were intervention program completion, employment or stable financial status upon program discharge, and transition to housing. The dataset for final analysis consisted of the records of 9,870 veterans, 4,482 of whom received dental care and 5,388 who did not. The sample was predominantly non-Hispanic Caucasian (49.9%) and African-American (39.9%) and was comprised almost exclusively of unmarried (95.2%) males (95.6%) with a mean age of 50.1±9.5 years. Univariate analyses revealed highly significant differences in intervention program length of stay and all outcome measures. Veterans receiving dental care had a mean length of stay of 236.7±154.8 days, while veterans not receiving care had a mean length of stay of only 176±139.2 days. Veterans who received dental care had an approximate 30% increase in the probability of completing the program successfully (dental care, 62.9%; no dental care, 47.8%), a 14% increase in employment or stable financial status (dental care, 72.1%; no dental care, 63.1%), and a 15% increase in obtaining residential housing (dental care, 82.8%; no dental care, 72.0%). Logistic regression models were examined to provide more detailed analyses of pre-intervention factors that may serve as moderators or mediators of these outcomes. Overall, the results were supportive in showing that dental care had a substantial impact in improving outcomes in housing intervention programs for homeless veterans.