Comparative Cost Analysis of Housing and Case Management Program for Chronically Ill Homeless Adults Compared to Usual Care

The cost analysis of a housing and case management program for chronically ill homeless adults demonstrated an average annual savings for care. The study, however, was underpowered for the findings to reach statistical significance.

Participants of this study included 407 homeless adults with chronic medical illnesses who were randomly assigned to the usual care group (n=206) or the intervention group (n=201). The intervention included: interim housing at a respite center after hospital discharge, stable housing after recovery from hospitalizations, and case management based in study hospital, respite, and housing sites. Homeless adults were enrolled from two Chicago hospitals and were followed for 18 months. Using data from medical records, respite centers, jails, or prisons, interviews for days in nursing homes, shelters, substance abuse treatment centers, and case manager visits, total cost of care was assessed.

Key Findings:

  • The intervention group had an average cost savings of $6,307 per person annually.
  • Further analysis showed that those who were chronically homeless had an average cost savings of $9,809 per person annually. Those with HIV had an average cost savings of $6,622 per person annually.

This study is the first cost analyses from a randomized controlled trial of homeless adults with chronic medical illness.