269770 Health Care Cost Analysis of a Frequent User's Program in New York City

Monday, October 29, 2012 : 9:00 AM - 9:15 AM

Marionette Holmes, PhD , Department of Economics, Spelman College, Atlanta, GA
Angela A. Aidala, PhD , Mailman School of Pubic Health, Columbia University, New York, NY
Background: The right to housing has been actively enforced by local laws in New York City and supported by Federal Housing policies. Programs providing housing supports for high risk adults with multiple jail stays and homeless shelter experiences can help mitigate the increased risk for HIV and STD's, and for the infected, suboptimal care and access to treatments associated with homelessness.

Methods: We perform a cost-benefit study of the Frequent Users Services Enhancement (FUSE) program, taking into account the averted costs of HIV, other STDs, emergency room use and substance abuse treatment costs. We compare the costs and health care resource utilization rates between our intervention group (n=67) and comparison group (n=90). We use propensity score matching to ensure that comparisons are made between persons with similar socioeconomic and health status. A rigorous sensitivity analysis is conducted to verify the robustness of the results.

Results: Preliminary results demonstrate ‘frequent users' of jail and homeless shelters report behaviors placing them at high risk for HIV and STD infection. Approximately 13% had 3 or more partners in the six months prior to study enrollment, and 42% reported not using a condom during last vaginal or anal intercourse. Participants report an average of 3.5 nights in inpatient care, 3.8 days in detox or residential treatment and 45% had visited the emergency room.

Conclusions: Preliminary results suggest that providing housing and supportive services for formerly incarcerated persons with histories of homelessness can avert significant health care costs and reduce the risk of HIV/STD infection.

Learning Areas:
Public health or related research

Learning Objectives:
Evaluate the impact of a housing program for high risk adults with multiple jail stays and homeless shelter on selected local health care costs.

Keywords: Homelessness, Cost Issues

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a PhD in Agricultural and Applied Economics with Post-doctoral training in Prevention Effectiveness Methods (such as Cost-Benefit, Cost-Effectiveness and Costing analysis)from the Centers for Disease Control and Comparative Effectiveness research From Columbia University's School of Medicine. I have been the principal investigator for a project on the Economic Evaluation of an HIV Prevention Program. I additionally have been the co-investigator on projects focusing on the economic evaluation of AIDS treatment.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.