Deriving costs of service use among an urban homeless population.
The purpose of this study was to describe a novel approach to calculating service use costs across multiple domains of service for homeless populations. A randomly-selected sample of homeless persons was interviewed in St. Louis, MO and followed for 2 years. Service- and cost-related data were collected from homeless individuals and from the agencies serving them. Detailed interviews of study participants and of agency personnel in specific domains of service (medical, psychiatric, substance abuse, homeless maintenance, and homeless amelioration services) were conducted using a standardized approach. Service utilization data were obtained from agency records. Standardized service-related costs were derived and aggregated across multiple domains from agency-reported data. Housing status was not found to be significantly associated with costs. Although labor intensive, this approach to cost estimation allows costs to be accurately compared across domains. These methods could potentially be applied to other populations.
University of Florida Department of Psychiatry, PO Box 100383, Gainesville, FL 32610. Electronic address: fuehrlein@ufl.edu.
Brian S
BS
Fuehrlein
RTI International, 3040 Cornwallis Rd, PO Box 12194, Research Triangle Park, NC 27709-2194.
Alexander J
AJ
Cowell
University of Alabama, School of Social Work, 25 Little Hall, Tuscaloosa, AL 35487-0314.
David E
DE
Pollio
Washington University School of Medicine, Department of Psychiatry, 660S Euclid Ave. Campus Box 8134, St. Louis, MO 63011.
Lori Y
LY
Cupps
University of Texas Southwestern Medical Center, Department of Psychiatry, 5323 Harry Hines Blvd, Dallas, TX 75390.
Margaret E
ME
Balfour
VA North Texas Health Care System and University of Texas Southwestern Medical Center, 6363 Forest Park Rd., Suite 651, Dallas, TX 75390-8828.
Carol S
CS
North
D000328:Adult; D003153:Community Health Services / Q000191:economics* / Q000706:statistics & numerical data; D003625:Data Collection; D005260:Female; D005500:Follow-Up Studies; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008923:Missouri; D019966:Substance-Related Disorders / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D014505:Urban Population
Alcohol use disorders; Cost; Drug use disorders; Homeless; Longitudinal; Psychiatric disorders; Service use