Evidence map›Paper›PMID 39499512›Full record

ArticleJAMA network open2024

Cost-Effectiveness of Temporary Financial Assistance for Veterans Experiencing Housing Instability.

Richard E Nelson, Alec Chapman, Thomas Byrne, Nathorn Chaiyakunapruk, Ying Suo, Atim Effiong, Warren Pettey, Lillian Gelberg, Stefan G Kertesz, Jack Tsai and 1 more

Abstract read
In one paragraph

Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. When Workforce Policy Meets Operational Reality: Reflections on the Veterans Health Administration's Contract Buyout Program.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Richard E NelsonInformatics, Decision-Enhancement and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah.
Alec ChapmanInformatics, Decision-Enhancement and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah.
Thomas ByrneNational Center on Homelessness Among Veterans, Washington, DC.
Nathorn ChaiyakunaprukInformatics, Decision-Enhancement and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah.
Ying SuoInformatics, Decision-Enhancement and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah.
Atim EffiongInformatics, Decision-Enhancement and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah.
Warren PetteyInformatics, Decision-Enhancement and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah.
Lillian GelbergNational Center on Homelessness Among Veterans, Washington, DC.
Stefan G KerteszNational Center on Homelessness Among Veterans, Washington, DC.
Jack TsaiNational Center on Homelessness Among Veterans, Washington, DC.
Ann Elizabeth MontgomeryNational Center on Homelessness Among Veterans, Washington, DC.

Funding

CTSA UM1 Program at University of UtahUM1TR004409 · NCATS · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI RACHEL HESS, Jennifer Juhl Majersik · 2023 to 2026
$21.9M
NCATS NIH HHS UM1 TR004409
6 · The paper itself

Abstract

Importance: The US Department of Veterans Affairs (VA) partners with community organizations (grantees) across the US to provide temporary financial assistance (TFA) to vulnerable veterans through the Supportive Services for Veteran Families (SSVF) program. The goal of TFA for housing-related expenses is to prevent homelessness or to quickly house those who have become homeless. Objective: To assess the cost-effectiveness of the SSVF program with TFA vs without TFA as an intervention for veterans who are experiencing housing insecurity. Design, Setting, and Participants: This study used a Markov simulation model to compare cost and housing outcomes in a hypothetical cohort of veterans enrolled in the SSVF program. Enrollees who are homeless receive rapid rehousing services, while those who are at risk of becoming homeless receive homelessness prevention services. Exposure: The SSVF program with TFA for veterans who are experiencing housing insecurity. Main Outcomes and Measures: The effectiveness measure was the incremental cost-effectiveness ratio (ICER) with quality-adjusted life-years (QALYs). The model was parameterized using a combination of inputs taken from published literature and internal VA data. The model had a 2-year time horizon and a 1-day cycle length. In addition, probabilistic sensitivity analyses were conducted using 10 000 Monte Carlo simulations. Results: The base case analyses found that the SSVF program with TFA was more costly ($35 814 vs $32 562) and yielded more QALYs (1.541 vs 1.398) than the SSVF program without TFA. The resulting ICER was $22 676 per QALY, indicating that TFA is the preferred strategy at a willingness-to-pay threshold of $150 000 per QALY. This ICER was $19 114 per QALY for veterans in the rapid rehousing component of the SSVF program and $29 751 per QALY for those in the homelessness prevention component of the SSVF program. At a willingness-to-pay threshold of $150 000 per QALY, probabilistic sensitivity analyses showed that TFA was cost-effective in 8972 of the 10 000 Monte Carlo simulations (89.7%) for rapid rehousing and in 8796 of the 10 000 Monte Carlo simulations (88.0%) for homelessness prevention only. Conclusions and Relevance: This economic evaluation suggests that TFA is a cost-effective approach (ie, yields improved health benefits at a reasonable cost) for addressing housing insecurity for veterans enrolling in the SSVF program. Future research could examine the cost effectiveness of large, nationwide housing interventions such as this one among subpopulations of veterans such as those with certain comorbidities including severe mental illness or substance use disorders, those with chronic diseases, or those experiencing long-term housing instability vs acute loss of housing.

Indexed as

Cost-Benefit AnalysisIll-Housed PersonsUnited States Department of Veterans AffairsVeteransAdultFemaleHousingHumansMaleMarkov ChainsMiddle AgedQuality-Adjusted Life YearsUnited States

Identifiers

PMID39499512
PMCPMC11539017

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.