1 / 43

Using data to end homelessness

Using data to end homelessness. Joshua D. Bamberger, MD, MPH Josh.bamberger@sfdph.org San Francisco Department of Public Health University of California, San Francisco, Dept. of Family and Community Medicine. Housing and Homeless Studies. Cost Before and after studies

vui
Download Presentation

Using data to end homelessness

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Using data to end homelessness Joshua D. Bamberger, MD, MPH Josh.bamberger@sfdph.org San Francisco Department of Public Health University of California, San Francisco, Dept. of Family and Community Medicine

  2. Housing and Homeless Studies • Cost • Before and after studies • Randomized controlled trials • Mortality • Retrospective case control • Quality of Life • Retrospective cohort studies • Populations based homeless prevalence • Creating a Narrative

  3. Creating a Narrative • Housing is less expensive than homelessness • For people w/ homelessness and AIDS, ARVs are necessary but not sufficient to improve mortality • The right treatment for the condition

  4. SF Health Dept’s Housing • Direct Access to Housing- 1600 units in 40 buildings • Tailor housing to needs of individual • Initially SRO, now new buildings • Priority to people with multiple disabilities • 93% with Axis I mental illness • At least 18% HIV+

  5. DAH Portfolio

  6. Cost: Plaza Retrospective Before and After • 106 Chronically homeless adults • Cost year before housing: $3,132,856 • Cost year after housing: $906,228 • Reduction in healthcare costs: $2,226,568 • Cost of program: $1.1million/year • Reduction in public cost in first year: $1.1 million • More than 90% of reductionamong 15 tenants who cost more than $50,000/year prior to being housed • Regression to the mean

  7. Cost: KCC Random assignment trial • Brand new building with 174 units • Homeless, high users of a managed care system • Comprehensive healthcare utilization • Randomly assigned to treatment or regular care • Followed prospectively for 5 years • Outcomes included: Healthcare cost, mortality, jail

  8. Cost- 1811 Eastlake, Seattle • Compared to controls, housed Ps showed greater reductions in overall costs • Cost offsets of housing > $4m for 1st year • More time in housing associated with greater reduction in costs • 6-mo within-subjects reductions in typical alcohol use Figure and findings from Larimer et al. (2009)

  9. Mortality

  10. Quality of Housing and Outcome • Ranking of housing from worst to best housing • Private bath better than shared bath • New building better than renovated • Nursing better than no nursing • Senior better than non-senior

  11. The more beautiful the housing the better the outcome

  12. Population Snapshot

  13. Veteran PIT Counts, 2009-2012 * * CoCs only required to conduct a new count of unsheltered homelessness in odd numbered years; in 2012, only 32% of CoCs opted not to do a new unsheltered count, providing an incomplete picture of trends in the number of unsheltered homeless Veterans Source: PIT data, 2009 - 2012

  14. Number of Homeless Veterans in 5 Communities with Greater than 40% reduction 2010-2012

  15. Common aspects of “positive outliers” • Common values and philosophy of practice, strong leadership, housing first • Targeting • High level of communication (HIPPA busters) • Use of data to inform policy and measure success

  16. Creating a Narrative • Housing is less expensive than homelessness • For people w/ homelessness and AIDS, ARVs are necessary but not sufficient to improve mortality • The right treatment for the condition

  17. Using data to end homelessness Joshua D. Bamberger, MD, MPH Josh.bamberger@sfdph.org San Francisco Department of Public Health University of California, San Francisco, Dept. of Family and Community Medicine

More Related