Comparative Cost Analysis of Housing and Case Management Program for Chronically Ill Homeless Adults Compared to Usual Care
Comparative Cost Analysis of Housing and Case Management Program for Chronically Ill Homeless Adults Compared to Usual Care
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DOI：
10.1111/j.1475-6773.2011.01350.x
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发表时间：
2012-02-01
影响因子：
3.4
通讯作者：
Sadowski, Laura S.
中科院分区：
文献类型：
--
作者：
Basu, Anirban;Kee, Romina;Sadowski, Laura S.
Objective.评估住房和病例管理计划在一个新的样本中的成本-患有慢性疾病的无家可归的成年人。该研究使用了来自多个来源的数据：（1）医院，急诊室和门诊医疗和心理健康访问的电子医疗记录;（2）在喘息中心，监狱或监狱的机构和区域数据库;（3）在疗养院，庇护所，药物滥用治疗中心和个案经理访问的采访。总成本估计使用每项服务的单位成本。对407名患有慢性疾病的无家可归成年人进行随机对照试验，这些人在伊利诺斯州芝加哥的两家医院登记，并随访18个月。主要发现。与常规护理相比，干预组每人平均每年节省费用（-）6，307美元（95% CI：-16，616，4，002; p = 0.23）。对长期无家可归者和艾滋病毒感染者的亚组分析显示，每人每年节省的费用分别为（-）9,809美元和（-）6,622美元。结果稳健的敏感性分析使用单位成本。这项全面的比较成本分析的结果表明，每年平均节省了大量费用，尽管在这项动力不足的研究中，这些节省没有达到统计学意义。
Objective. To assess the costs of a housing and case management program in a novel sample-homeless adults with chronic medical illnesses.Data Source. The study used data from multiple sources: (1) electronic medical records for hospital, emergency room, and ambulatory medical and mental health visits; (2) institutional and regional databases for days in respite centers, jails, or prisons; and (3) interviews for days in nursing homes, shelters, substance abuse treatment centers, and case manager visits. Total costs were estimated using unit costs for each service.Study Design. Randomized controlled trial of 407 homeless adults with chronic medical illnesses enrolled at two hospitals in Chicago, Illinois, and followed for 18 months.Principal Findings. Compared to usual care, the intervention group generated an average annual cost savings of (-)$6,307 per person (95 percent CI: -16,616, 4,002; p = .23). Subgroup analyses of chronically homeless and those with HIV showed higher per person, annual cost savings of (-)$9,809 and (-)$6,622, respectively. Results were robust to sensitivity analysis using unit costs.Conclusion. The findings of this comprehensive, comparative cost analyses demonstrated an important average annual savings, though in this underpowered study these savings did not achieve statistical significance.