SynthesisCanadian journal of psychiatry. Revue canadienne de psychiatrie2015
Housing First Impact on Costs and Associated Cost Offsets: A Review of the Literature.
Synthesis in Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Homelessness and health-related outcomes: an umbrella review of observational studies and randomized controlled trials.BMC medicine · 2022Pooled it
- The Impact of Housing First on Criminal Justice Outcomes among Homeless People with Mental Illness: A Systematic Review.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2019Pooled it
- Effects of Housing First approaches on health and well-being of adults who are homeless or at risk of homelessness: systematic review and meta-analysis of randomised controlled trials.Journal of epidemiology and community health · 2019Pooled it
- A randomized trial of permanent supportive housing for chronically homeless persons with high use of publicly funded services.Health services research · 2020Trial
- Cost-effectiveness of Housing First Intervention With Intensive Case Management Compared With Treatment as Usual for Homeless Adults With Mental Illness: Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2019Trial
- Health Care Outcomes of Homelessness Prevention Programs in Veterans Experiencing Housing Instability.JAMA health forum · 2026Observational
- Do Medicaid Expenditures Increase After Adults Exit Permanent Supportive Housing?Housing policy debate · 2024Article
- Lessons learned from housing first, rapid rehousing trials with youth experiencing homelessness.Addiction science & clinical practice · 2023Review
- An Australian aged care home for people subject to homelessness: health, wellbeing and cost-benefit.BMC geriatrics · 2023Article
- Women sleeping rough: The health, social and economic costs of homelessness.Health & social care in the community · 2022Article
- Association of Coded Housing Instability and Hospitalization in the US.JAMA network open · 2022Article
- Cost and Utilization Impacts of a Medicaid Managed Care Organization's Behavioral Health Wraparound Program.Administration and policy in mental health · 2022Observational
- Health risk associated with residential relocation among people who inject drugs in Los Angeles and San Francisco, CA: a cross sectional study.BMC public health · 2022Article
- Stakeholder perspectives on sustainment of Housing First in a VA permanent supportive housing program.Health services research · 2022Article
- Evidence-Based Analysis of Social Impact Bonds for Homelessness: A Scoping Review.Frontiers in psychology · 2022Article
- Psychiatric Crisis Care and the More is Less Paradox.Community mental health journal · 2021Article
- Permanent Supportive Housing Design Characteristics Associated with the Mental Health of Formerly Homeless Adults in the U.S. and Canada: An Integrative Review.International journal of environmental research and public health · 2021Review
- A Community Partnership to House and Care for Complex Patients with Unstable Housing.NEJM catalyst innovations in care delivery · 2021Article
- Article
- Housing First: A housing model rooted in harm reduction with potential to transform health care access for highly marginalized Canadians.Canadian family physician Medecin de famille canadien · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveHousing First (HF) programs for people who are chronically or episodically homeless, combining rapid access to permanent housing with community-based, integrated treatment, rehabilitation and support services, are rapidly expanding in North America and Europe. Overall costs of services use by homeless people can be considerable, suggesting the potential for significant cost offsets with HF programs. Our purpose was to provide an updated literature review, from 2007 to the present, focusing specifically on the cost offsets of HF programs.
methodA systematic review was performed on MEDLINE and PsycINFO as well as Google and the Homeless Hub for grey literature. Study characteristics and key findings were extracted from identified studies. Where available, impact on service cost associated with HF (increase or decrease) and net impact on overall costs, taking into account the cost of HF intervention, were noted.
resultsTwelve published studies (4 randomized studies and 8 quasi-experimental) and 22 unpublished studies were retained. Shelter and emergency department costs decreased with HF, while impacts on hospitalization and justice costs are more ambiguous. Studies using a pre-post design reported a net decrease in overall costs with HF. In contrast, experimental studies reported a net increase in overall costs with HF.
conclusionsWhile our review casts doubt on whether HF programs can be expected to pay for themselves, the certainty of significant cost offsets, combined with their benefits for participants, means that they represent a more efficient allocation of resources than traditional services.
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