Mares Alvin S, Kasprow Wesley J, Rosenheck Robert A
Northeast Program Evaluation Center of the Department of Veterans Affairs, VA Connecticut Healthcare System, Connecticut 06156, USA.
Ment Health Serv Res. 2004 Dec;6(4):199-211. doi: 10.1023/b:mhsr.0000044746.47589.06.
This study examines the effect of previous participation in time limited residential treatment and other factors on treatment outcomes among homeless veterans with serious mental illness placed into permanent supported housing. The sample consisted of 655 veterans placed into supported housing at 18 sites through the VA's Healthcare for Homeless Veterans (HCHV) Supported Housing Program during the period 1993-2000. Data on client and program characteristics, and treatment outcomes, were documented by HCHV case managers staffing these programs. Data on use of VA services, including time limited residential treatment received 6 months prior to entry into supported housing, were extracted from VA administrative files. The relationship of prior residential treatment, as well as other measures of client characteristics, service use, and program characteristics, to outcomes were assessed using both bivariate and multivariate Cox proportional hazards regression and logistic regression. After adjusting for client characteristics, service use, and program characteristics, no differences in outcomes were found between clients who had received prior residential treatment and those placed directly into permanent supported housing. Prior residential treatment appears to have little effect on treatment outcomes among formerly homeless veterans placed into permanent supported housing programs providing indirect support for the direct placement supported housing model.
本研究考察了先前参与限时住院治疗及其他因素对被安置到永久性支持性住房中的患有严重精神疾病的无家可归退伍军人治疗结果的影响。样本包括1993年至2000年期间通过退伍军人事务部(VA)的无家可归退伍军人医疗保健(HCHV)支持性住房项目在18个地点被安置到支持性住房中的655名退伍军人。这些项目的HCHV个案管理员记录了有关客户和项目特征以及治疗结果的数据。从VA行政档案中提取了有关VA服务使用情况的数据,包括进入支持性住房前6个月接受的限时住院治疗。使用双变量和多变量Cox比例风险回归以及逻辑回归评估先前住院治疗以及客户特征、服务使用和项目特征的其他指标与结果之间的关系。在对客户特征、服务使用和项目特征进行调整后,发现接受过先前住院治疗的客户与直接被安置到永久性支持性住房中的客户在结果上没有差异。先前住院治疗似乎对被安置到永久性支持性住房项目中的前无家可归退伍军人的治疗结果影响很小,这为直接安置支持性住房模式提供了间接支持。