title: Homeless Veterans' Use of Peer Mentors and Effects on Costs and Utilization in VA Clinics.
abstract: OBJECTIVE
  The study compared health care utilization and costs among homeless veterans randomly assigned to peer mentors or usual care and described contacts with peer mentors.
  
  
  METHODS
  Homeless patients at four Department of Veterans Affairs clinics were randomly assigned to a peer mentor (N=195) or to usual care (N=180). Administrative data on utilization and costs over a six-month follow-up were combined with peer mentors' reports of patient contacts.
  
  
  RESULTS
  Most patients (87%) in the peer mentor group had at least one peer contact. Patients in this group spent the largest proportions of time discussing housing and health issues with peer mentors and had more outpatient encounters than those in usual care, although differences were not significant. No other between-group differences were found in utilization or costs.
  
  
  CONCLUSIONS
  Although significant impacts of peer mentors on health care patterns or costs were not detected, some patients had frequent contact with peer mentors.
authors.affiliation: Dr. Yoon, Ms. Lo, and Ms. Gehlert are with the Health Economics Resource Center, Department of Veterans Affairs (VA) Palo Alto Health Care System, Menlo Park, California (e-mail: jean.yoon@va.gov ). Dr. Yoon is also with the Department of Medicine, University of California, San Francisco. Ms. Johnson and Dr. O'Toole are with the National Center on Homelessness Among Veterans, Providence VA Medical Center, Providence, Rhode Island.
authors.forename: Jean
authors.initials: J
authors.lastname: Yoon
authors.affiliation: Dr. Yoon, Ms. Lo, and Ms. Gehlert are with the Health Economics Resource Center, Department of Veterans Affairs (VA) Palo Alto Health Care System, Menlo Park, California (e-mail: jean.yoon@va.gov ). Dr. Yoon is also with the Department of Medicine, University of California, San Francisco. Ms. Johnson and Dr. O'Toole are with the National Center on Homelessness Among Veterans, Providence VA Medical Center, Providence, Rhode Island.
authors.forename: Jeanie
authors.initials: J
authors.lastname: Lo
authors.affiliation: Dr. Yoon, Ms. Lo, and Ms. Gehlert are with the Health Economics Resource Center, Department of Veterans Affairs (VA) Palo Alto Health Care System, Menlo Park, California (e-mail: jean.yoon@va.gov ). Dr. Yoon is also with the Department of Medicine, University of California, San Francisco. Ms. Johnson and Dr. O'Toole are with the National Center on Homelessness Among Veterans, Providence VA Medical Center, Providence, Rhode Island.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gehlert
authors.affiliation: Dr. Yoon, Ms. Lo, and Ms. Gehlert are with the Health Economics Resource Center, Department of Veterans Affairs (VA) Palo Alto Health Care System, Menlo Park, California (e-mail: jean.yoon@va.gov ). Dr. Yoon is also with the Department of Medicine, University of California, San Francisco. Ms. Johnson and Dr. O'Toole are with the National Center on Homelessness Among Veterans, Providence VA Medical Center, Providence, Rhode Island.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Johnson
authors.affiliation: Dr. Yoon, Ms. Lo, and Ms. Gehlert are with the Health Economics Resource Center, Department of Veterans Affairs (VA) Palo Alto Health Care System, Menlo Park, California (e-mail: jean.yoon@va.gov ). Dr. Yoon is also with the Department of Medicine, University of California, San Francisco. Ms. Johnson and Dr. O'Toole are with the National Center on Homelessness Among Veterans, Providence VA Medical Center, Providence, Rhode Island.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: O'Toole
mesh_terms: D000328:Adult; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data*; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008611:Mentors; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010379:Peer Group; D014481:United States; D014728:Veterans / Q000523:psychology*
keywords: Homeless mentally ill; Homelessness; Peer support; Primary care; service delivery