Housing Homeless Hospital Patients Reduces Public Costs

A new report, Getting Home: Outcomes from Housing High Cost Homeless Hospital Patients, published by the Economic Roundtable, shows that placing high cost homeless hospital patients into permanent supportive housing can significantly reduce annual public and hospital costs. According to the report, for every $1 spent to house and support homeless patients with chronic illnesses, $2 in public costs can be avoided in the first year after the patient is housed, and $6 in subsequent years. This study examined the outcomes of 163 hospital patients screened by the 10th Decile Project in Los Angeles between April 2011 and May 2013. The 10th Decile Project works with hospitals to identify the 10% of chronically homeless patients associated with the highest public hospital costs and offers housing, social, and health assistance. Of the 10th Decile patients studied, 71% were men; 43% were African-American, and 68% were over the age of 46. Nearly a third (29%) reported a jail or probation record. Most (90%) patients had at least one chronic physical disorder, while 78% had a mental illness. During the prior 24 months before referral, each patient had on average of 18 emergency room visits, seven hospital admissions, and 31 hospital inpatient days. After 10th Decile patients obtained permanent housing, total annual average public and hospital costs per person decreased from $63,808 to $16,913, not including housing subsidy costs. After a patient is housed, the public costs avoided amount to $31,736 in the first year, and $40,377 in subsequent years, even after accounting for housing subsidy costs. The authors of this report argue that a limited supply of permanent housing poses the greatest challenge to the efficacy of this program. In order to address this issue, the authors recommend making 10th Decile patients a top priority for tenant-based housing subsidies and creating an ongoing funding source for new affordable housing development. The report, Getting Home: Outcomes from Housing High Cost Homeless Hospital Patients, can be found on The Economic Roundtable’s webpage at: http://bit.ly/19YEWPR