Measuring the impact of the Supportive Services for Veteran Families (SSVF) on Veteran outcomes

衡量退伍军人家庭支持服务 (SSVF) 对退伍军人成果的影响

• 批准号: 10209954
• 负责人: Richard E. Nelson
• 金额: --
• 依托单位: VA SALT LAKE CITY HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-01 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10209954
• 关键词: Accident and Emergency department; Address; Attitude; Characteristics; Cohort Analysis; Communities; Community Healthcare; Country; Data; Economics; Effectiveness; Employee; Enrollment; Expenditure; Family; Financial Support; Geographic Locations; Goals; Health; Health Care Costs; Healthcare Systems; Heterogeneity; Homeless persons; Homelessness; Housing; Individual; Inpatients; Intervention; Interview; Investments; Literature; Management Information Systems; Measures; Methodology; Methods; Modeling; Nonprofit Organizations; Outcome; Outcome Assessment; Outpatients; Paper; Participant; Personal Satisfaction; Population; Privatization; Program Evaluation; Program Sustainability; Publishing; Quality-Adjusted Life Years; Reporting; Research; Resources; Retrospective cohort; Risk; Service provision; Services; Site; Societies; Source; Structure; Suicide; Suicide prevention; Variant; Veterans; Work; cost; cost effective; cost outcomes; economic evaluation; experience; geographic difference; health economics; housing instability; implementation strategy; improved; improved outcome; innovation; insight; models and simulation; mortality; mortality risk; operation; programs; satisfaction; service providers; structured data; treatment as usual; unstructured data

Background Through the Supportive Services for Veteran Families (SSVF) program, Veterans and their families who are experiencing homelessness or at risk of becoming homeless can receive of financial support and other services from private non-profit organizations with the goal of stabilizing their housing. The impact on Veteran housing, healthcare cost, and health outcomes as well as Veteran satisfaction with this program is not known. Specific aims Aim 1: Describe geographic variation in the amount of SSVF services provided and identify predictors of this variation for SSVF recipients for FY2012-FY2017 using data from the HMIS. Aim 2: Perform an outcome and economic assessment of the SSVF program. 2a: Measure the impact of the rapid re-housing component of SSVF on housing, health, and healthcare cost outcomes through retrospective cohort analyses for FY2012-FY2017. 2b: Conduct grantee-specific and overall economic evaluations of the SSVF program compared to usual care using input parameters from the published literature and from Aims 1 and 2a. Aim 3: Identify barriers and facilitators to SSVF use and Veterans' satisfaction with the program using semi- structured interviews with VA operations partners, SSVF grantee employees, VA homeless services providers, and Veterans using SSVF services. Significance of the proposed research and relevance to Veterans' health The loss of stable housing has a devastating effect on Veterans' health and well-being. In addition, homelessness can be costly both to the healthcare system and society as a whole. Solving the problem of Veteran homelessness is one of the most important initiatives the VA is currently pursuing. Unique features and innovation of the project Our study – comprising over 400 sites within the US – will be by far the largest study of a homeless intervention ever conducted in the US. In addition, we will use both structured and unstructured data and detailed, Veteran-level data on services and financial assistance received by Veterans enrolled in this program. Methodology to be used In Aim 1 we will construct multi-level regression models to identify both individual- and community-level predictors of SSVF services and expenditures. In Aim 2a, we will fit outcome models relating SSVF program initiation to the subsequent mortality, exit from homelessness, and cost outcomes in weighted populations defined by propensity scores. In Aim 2b, we will construct simulation models using input parameters from a variety of sources. And in Aim 3, we will conduct interviews with national VA stakeholders, SSVF grantee employees, VA homeless service providers, and Veterans who have enrolled in the SSVF program. Expected results In Aim 1, we expect to find considerable variation in services and expenditures across the country, which will be explained by observable Veteran- and community-level characteristics. We anticipate that our Aim 2a analyses will find that enrollment in SSVF will lead to increased rates of stable housing, lower mortality rates, and greater outpatient healthcare costs but lower emergency department and inpatient costs. in Aim 2b, our hypothesis is that the SSVF program will be cost-effective overall and yield a positive return on investment compared to usual care but these effects will vary substantially across SSVF sites. Finally, our qualitative data from Aim 3 will provide insight into ways to improve the SSVF program, enhance implementation strategies, and explore the experience of Veterans with housing instability.

背景

项目成果

Temporary Financial Assistance Decreased Health Care Costs For Veterans Experiencing Housing Instability.

临时财政援助降低了经历住房不稳定的退伍军人的医疗费用。

• DOI: 10.1377/hlthaff.2020.01796
• 发表时间: 2021
• 期刊: Health affairs (Project Hope)
• 作者: Nelson,RichardE;Montgomery,AnnElizabeth;Suo,Ying;Cook,James;Pettey,Warren;Gundlapalli,Adi;Greene,Tom;Evans,William;Gelberg,Lillian;Kertesz,StefanG;Tsai,Jack;Byrne,ThomasH
• 通讯作者: Byrne,ThomasH

Predictors of homeless service utilization and stable housing status among Veterans receiving services from a nationwide homelessness prevention and rapid rehousing program.

接受全国无家可归预防和快速安置计划服务的退伍军人中无家可归者服务利用和稳定住房状况的预测因素。

• DOI: 10.1016/j.evalprogplan.2022.102223
• 发表时间: 2023
• 期刊: Evaluation and program planning
• 影响因子: 1.6
• 作者: Byrne,Thomas;Montgomery,AnnElizabeth;Chapman,AlecB;Pettey,Warren;Effiong,Atim;Suo,Ying;Velasquez,Tania;Nelson,RichardE
• 通讯作者: Nelson,RichardE

The Impact of Temporary Housing Assistance Expenditures on Subcategories of Health Care Cost for U.S. Veterans Facing Housing Instability.

临时住房援助支出对面临住房不稳定的美国退伍军人医疗保健费用子类别的影响。

• DOI: 10.1353/hpu.2022.0140
• 发表时间: 2022
• 期刊: Journal of health care for the poor and underserved
• 影响因子: 1.4
• 作者: Nelson,RichardE;Montgomery,AnnElizabeth;Suo,Ying;Cook,James;Pettey,Warren;Evans,William;Greene,Tom;Gelberg,Lillian;Kertesz,Stefan;Tsai,Jack;Byrne,Thomas
• 通讯作者: Byrne,Thomas