Trial reportHealth services research2020
A randomized trial of permanent supportive housing for chronically homeless persons with high use of publicly funded services.
Trial report in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07587073 (A Pragmatic Cluster-Randomized Evaluation of Enhanced Care Management With Community Supports, Transitional Care, and Residential Care Coordination for High-Risk Medi-Cal Members Under CalAIM in California), which is not on this map. Cited by 32 papers, 1 of them a synthesis 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.
A Pragmatic Cluster-Randomized Evaluation of Enhanced Care Management With Community Supports, Transitional Care, and Residential Care Coordination for High-Risk Medi-Cal Members Under CalAIM in California
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Targeted interventions to improve the social and economic circumstances of people with mental ill-health from marginalised communities: a systematic review.Psychological medicine · 2025Pooled it
- Housing and Support Intervention and Mortality Among Homeless Adults With Mental Illnesses: A Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2025Trial
- The Effect of a Housing First Intervention on Acute Health Care Utilization among Homeless Adults with Mental Illness: Long-term Outcomes of the At Home/Chez-Soi Randomized Pragmatic Trial.Journal of urban health : bulletin of the New York Academy of Medicine · 2021Trial
- A randomized trial of permanent supportive housing for chronically homeless persons with high use of publicly funded services.Health services research · 2020Trial
- Risk for Acute Care Utilization in Housing-Insecure Adults: A National Study of a Hot Spotter Program in the US Veterans Health Administration.Medical care · 2026Article
- Mortality among individuals living in permanent supportive housing: A retrospective cohort study.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Understanding overdose risk and response in permanent supportive housing: results of focus groups with tenants, staff, and leaders.Addiction science & clinical practice · 2025Article
- Factors Associated With Exits From and Returns to Homelessness Among Older Homeless Adults: Results From the HOPE HOME Study.Housing policy debate · 2025Article
- COVID-19 response and the unhoused communities in Sacramento: a mixed methods study with policy implications.BMC public health · 2025Article
- Modeling Health and Economic Outcomes of Providing Stable Housing to Homeless Adults With OUD.JAMA network open · 2025Article
- Staff views on overdose prevention in permanent supportive housing.Harm reduction journal · 2025Article
- Article
- Becoming Housed During Palliative Care Enrollment: Identifying Drivers, Deterrents, and Directions for Future Care.International journal of environmental research and public health · 2024Article
- Association of Homelessness and Unstable Housing With Cardiovascular Care Utilization Among Veterans.Circulation. Cardiovascular quality and outcomes · 2024Article
- Strategies to Reduce Frequent Emergency Department Use among Persons Experiencing Homelessness with Mental Health Conditions: a Scoping Review.Journal of urban health : bulletin of the New York Academy of Medicine · 2024Article
- Evaluating Intensity, Complexity, and Potential for Causal Inference in Social Needs Interventions: A Review of a Scoping Review.JAMA network open · 2024Article
- Variables Associated with Quality of Life Among Individuals Living in Permanent Supportive Housing.Community mental health journal · 2024Article
- PRELIMINARY IMPACT OF SUPPORTIVE HOUSING ON HOSPITAL UTILIZATION FOR INDIVIDUALS EXPERIENCING HOMELESSNESS.Transactions of the American Clinical and Climatological Association · 2024Article
- Permanent Supportive Housing Receipt and Health Care Use Among Adults With Disabilities.Medical care research and review : MCRR · 2023Article
- Changes in Health Care Utilization and Associated Costs After Supportive Housing Placement by an Urban Community Mental Health Center.Community mental health journal · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
objectiveTo examine whether randomization to permanent supportive housing (PSH) versus usual care reduces the use of acute health care and other services among chronically homeless high users of county-funded services. DATA SOURCES: Between 2015 and 2019, we assessed service use from Santa Clara County, CA, administrative claims data for all county-funded health care, jail and shelter, and mortality. STUDY
designWe conducted a randomized controlled trial among chronically homeless high users of multiple systems. We compared postrandomization outcomes from county-funded systems using multivariate regression analysis. DATA COLLECTION: We extracted encounter data from an integrated database capturing health care at county-funded facilities, shelter and jails, county housing placement, and death certificates. PRINCIPAL
findingsWe enrolled 423 participants (199 intervention; 224 control). Eighty-six percent of those randomized to PSH received housing compared with 36 percent in usual care. On average, the 169 individuals housed by the PSH intervention have remained housed for 28.8 months (92.9 percent of the study follow-up period). Intervention group members had lower rates of psychiatric ED visits IRR 0.62; 95% CI [0.43, 0.91] and shelter days IRR 0.30; 95% CI [0.17, 0.53], and higher rates of ambulatory mental health services use IRR 1.84; 95% CI [1.43, 2.37] compared to controls. We found no differences in total ED or inpatient use, or jail. Seventy (37 treatment; 33 control) participants died.
conclusionsThe intervention placed and retained frequent user, chronically homeless individuals in housing. It decreased psychiatric ED visits and shelter use, and increased outpatient mental health care, but not medical ED visits or hospitalizations. Limitations included more than one-third of usual care participants received another form of subsidized housing, potentially biasing results to the null, and loss of power due to high death rates. PSH can house high-risk individuals and reduce emergent psychiatric services and shelter use. Reductions in hospitalizations may be more difficult to realize.
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Registered trials
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