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Cost-Effectiveness of a Homeless Care Transition Program: Durham Homeless Care Transitions.

Publication ,  Journal Article
Biederman, DJ; Harker, M; Schmid, L; Sloane, R; Langan, E; Taylor, DH
Published in: North Carolina medical journal
November 2022

BACKGROUND Transitional care and medical respite programs provide assistance to people experiencing homelessness as they move from acute care into community settings. These programs can address issues that may fall outside the reach of traditional medical care yet have a profound impact on the health of vulnerable populations. This article focuses on the cost-effectiveness of the Durham Homeless Care Transitions (DHCT) program.METHOD This intervention study of the DHCT program uses a comparison group of people experiencing homelessness who were referred but did not participate. Encounter-level data, aggregated by quarterly segments of charges and reimbursements, were abstracted for all persons referred. Descriptive statistics were computed and models of charges and reimbursements were created using ordinary least squares (OLS) regression to compare utilization for 12 months pre- and post-referral.RESULTS Patients referred to the DHCT program (N = 485) were primarily non-Hispanic Black (62.5%), male (68.4%), uninsured (35.5%), and had an average of 5.3 chronic conditions and an average age of 50.0 years (SD = 11.3). There was variability among charges and reimbursement based on health care visit type but a negative association between treatment and charges, indicating that being part of the DHCT program led to lower charges post-referral.LIMITATIONS The study is limited by lack of access to line-item details of charges, reimbursement, and payer mix.CONCLUSION There is evidence of benefit to patients from transitional care and medical respite programs that does not substantially increase the overall societal cost of care; however, health systems commonly require evidence of cost savings and benefit as a return on investment.

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Published In

North Carolina medical journal

DOI

ISSN

0029-2559

Publication Date

November 2022

Volume

83

Issue

6

Start / End Page

454 / 460

Related Subject Headings

  • Referral and Consultation
  • Patient Transfer
  • Middle Aged
  • Male
  • Ill-Housed Persons
  • Humans
  • Cost-Benefit Analysis
  • Chronic Disease
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Biederman, D. J., Harker, M., Schmid, L., Sloane, R., Langan, E., & Taylor, D. H. (2022). Cost-Effectiveness of a Homeless Care Transition Program: Durham Homeless Care Transitions. North Carolina Medical Journal, 83(6), 454–460. https://doi.org/10.18043/ncm.83.6.454
Biederman, Donna J., Matthew Harker, Lorrie Schmid, Richard Sloane, Erica Langan, and Donald H. Taylor. “Cost-Effectiveness of a Homeless Care Transition Program: Durham Homeless Care Transitions.North Carolina Medical Journal 83, no. 6 (November 2022): 454–60. https://doi.org/10.18043/ncm.83.6.454.
Biederman DJ, Harker M, Schmid L, Sloane R, Langan E, Taylor DH. Cost-Effectiveness of a Homeless Care Transition Program: Durham Homeless Care Transitions. North Carolina medical journal. 2022 Nov;83(6):454–60.
Biederman, Donna J., et al. “Cost-Effectiveness of a Homeless Care Transition Program: Durham Homeless Care Transitions.North Carolina Medical Journal, vol. 83, no. 6, Nov. 2022, pp. 454–60. Epmc, doi:10.18043/ncm.83.6.454.
Biederman DJ, Harker M, Schmid L, Sloane R, Langan E, Taylor DH. Cost-Effectiveness of a Homeless Care Transition Program: Durham Homeless Care Transitions. North Carolina medical journal. 2022 Nov;83(6):454–460.

Published In

North Carolina medical journal

DOI

ISSN

0029-2559

Publication Date

November 2022

Volume

83

Issue

6

Start / End Page

454 / 460

Related Subject Headings

  • Referral and Consultation
  • Patient Transfer
  • Middle Aged
  • Male
  • Ill-Housed Persons
  • Humans
  • Cost-Benefit Analysis
  • Chronic Disease
  • 42 Health sciences
  • 32 Biomedical and clinical sciences