Ensuring that 退伍军人 have stable housing not only reduces homelessness but also slashes the cost of providing them with publicly funded 健康 care, 根据一项由 大发娱乐 科学家们. The researchers found that 退伍军人 who received temporary financial assistance (TFA) from the Department of Veterans Affairs (VA) to acquire or retain housing had fewer hospital visits and an average reduction in 健康 care costs of $2,800 over a two-year period than 退伍军人 who did not receive this benefit.
The researchers say this model could help non-profit organizations and other federal, 状态, and local governments better serve homeless Americans who are not 退伍军人.
"Getting 退伍军人 experiencing homelessness into stable housing is desirable for a whole host of social, 健康, 经济, 道德原因,” 理查德E. 纳尔逊,Ph值.D., the study's lead author and a research associate professor of 内科医学 at U of U Health. 在这种情况下, the overarching finding of our research is that providing 退伍军人 with temporary financial assistance helps them get into stable housing and reduces 健康 care costs—particularly inpatient 健康 care costs. This should be seen as a ‘win-win' for the average person or taxpayer."
这项研究发表在《大发娱乐》杂志的5月刊上 卫生事务.
On any given night, about 40,000 American 退伍军人 are homeless, according to the U.S. 住房和城市发展部. Thousands more are at risk of losing their homes every day, 纳尔逊 says.
无家可归与无数的医疗保健问题有关, 包括艾滋病毒/艾滋病, 营养不良, 皮肤感染, 肺结核和肺炎, 药物滥用. 结果是, VA's specialized homelessness programs provide 健康 care to almost 150,每年有1000名无家可归的退伍军人.
在之前的研究中, 纳尔逊 and his colleagues found that homeless 退伍军人 or those at risk of becoming homeless who received TFA provided by VA's Supportive 服务 for Veteran Families (SSVF) program were more likely to have stable housing 90 days after enrolling in the program than those who didn't receive the program's short-term subsidies.
VA's specialized homelessness programs provide 健康 care to almost 150,每年有1000名无家可归的退伍军人.
基于这一发现, the 科学家们 sought to determine if TFA also had an impact on utilization of VA 健康 care facilities by these 退伍军人. 他们确定了29个,184 退伍军人 who had received TFA through the SSFA program in 49 状态s as well as 11,229 who participated in other aspects of SSFA but did not receive TFA.
The researchers analyzed data on these 退伍军人 from two years prior to SSVF enrollment to two years after in quarterly increments. Overall, 健康 care costs increased sharply in the eight quarters prior to SSVF enrollment. 然而, 健康 care costs decreased an average of $352 per quarter for SSVF 退伍军人 receiving TFA following enrollment compared to those who didn't receive this benefit. This decrease was consistent regardless of the amount of TFA received, 哪一个的平均价格是6美元,在SSVF的参与过程中, 平均三个月.
The magnitude of the decrease was larger for those who were homeless at enrollment compared to those who were on the brink of it but remained in their homes because of their TFA allocation. 这种差异是由于, 在某种程度上, to the fact that homeless 退伍军人 are more likely to be hospitalized.
在某些情况下, the decrease in 健康 care costs offset the total TFA amount VA allotted to these 退伍军人, potentially reducing the overall outlay for their care and well-being. The researchers say this finding could have implications for efforts to alleviate homelessness and its accompanying 健康 care issues among other populations.
"Historically, housing and 健康 care have been considered separate things," 纳尔逊 says. "By showing that they are linked––that improving somebody's housing situation might also improve their 健康 status––this finding could have a big impact on how we approach these challenges among 退伍军人 and other citizens in the future."
在这项研究的局限性中, 健康 care costs for 退伍军人 who use non-VA providers were not included in the analysis. Veterans are also more likely than the general population to be male and have a higher risk of substance abuse and mental illness, 两种情况通常与无家可归有关.
前进, the researchers plan to examine whether other SSVF services such as legal assistance, 信贷咨询, and obtaining VA benefits can improve housing and 健康 care outcomes for 退伍军人 who are homeless or at risk of it. 除了, since reduced 健康 care spending doesn't necessarily improve 健康, 他们将探讨更直接的措施, 比如死亡率.
"There has been a huge shift over the past 10 to 15 years in homeless assistance policies toward interventions like the one we studied,托马斯·H说. 伯恩,Ph值.D., 该研究的资深作者, 贝德福德VA Bedford医疗保健系统的调查员, 麻萨诸塞州, 波士顿大学社会工作助理教授. “然而，迄今为止，关于它们的有效性的证据有限. Our findings help provide some much-needed evidence about the impact of such interventions."
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除了博士. 纳尔逊, 犹他大学健康研究人员Ying Suo说, 詹姆斯·库克, 沃伦Pettey, 汤姆·格林也参与了这项研究. Other contributors included 科学家们 from the University of Alabama at Birmingham, 圣母大学, 加州大学洛杉矶分校, 波士顿大学, 以及位于圣安东尼奥的德克萨斯大学健康科学中心.
这项研究, "Temporary Financial Assistance Decreased Health Care Costs ForVeterans Experiencing Housing Instability,出现在《大发娱乐》. It was supported by the Department of Veterans Affairs (VA) Health 服务 研究 and Development Service.