housing homeless cheaper than increased health care costs FWD

Tom Boland (wgcp@earthlink.net)
Sun, 14 Jun 1998 14:56:48 -0700 (PDT)

See also New England Journal of Medicine
Hospitalization Costs Associated with Homelessness in New York City

FWD  Philadelphia Inquirer - June 13, 1998 - Opinion

     Lack of shelter drives up the cost of health care.
     Doctors won't send patients home to the streets.

As Philadelphians debate how to deal with homelessness without making it a
crime, they would do well to study the latest edition of the New England
Journal of Medicine.

In that prestigious weekly is a detailed study conducted in New York City
hospitals that gives a disturbing picture of the high health-care costs of
homelessness. It argues that prevention may indeed be much cheaper than

The study examined 19,000 admissions of homeless people to Big Apple
hospitals and compared their diagnosis and length of stay with those of
other low-income people in the city. The result: The homeless patients
stayed an average of 4.1 days, or 36 percent, longer than the other
patients -- a difference that was not explained by adjustments for poverty,
severity of illness, or demographic characteristics. This amounted to
"substantial excess costs" for the hospitals.

The study pointed to the lack of affordable housing as a key culprit in
this explosion of cost. Doctors were unwilling or unable to release
homeless patients because shelters were filled, and no other housing was
available. The problem was particularly acute for psychiatric patients
because their average stay in hospitals is longer. In fact, the study found
that just trimming the average hospital stay for a homeless psychiatric
patient would save more money than the annual cost of subsidized housing
for that person.

There's a clear message in this to those grappling with legislation now
before City Council to regulate "sidewalk behavior." The intent of the bill
sponsored by Council President John Street is sound: to ensure that public
spaces are safe and welcoming to residents, tourists and business owners,
and that aggressive panhandling is not to be tolerated.

But there's been a legitimate fear that penalizing those who make the
sidewalk their home will further marginalize the hundreds of hard-core
homeless who suffer from mental illness and other disabilities.

Mayor Rendell has thrown his support behind the bill by promising that he
will devote new money to homeless services. Providing more affordable
housing in a city loaded with vacant homes -- which advocates for the
homeless have been demanding -- must be high on the mayor's priority list.

The compassionate approach is also the cost-effective one. Read the New
England Journal.


See also: http://www.nejm.org/public/1998/0338/0024/1734/1.htm
Hospitalization Costs Associated with Homelessness in New York City

HOMELESS PEOPLE'S NETWORK  <http://aspin.asu.edu/hpn/>  Home Page
ARCHIVES  <http://aspin.asu.edu/hpn/archives.html>  read posts to HPN
TO JOIN  <http://aspin.asu.edu/hpn/join.html> or email Tom <wgcp@earthlink.net>