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Cityscape: Volume 17 Number 2 | Article 11


The goal of Cityscape is to bring high-quality original research on housing and community development issues to scholars, government officials, and practitioners. Cityscape is open to all relevant disciplines, including architecture, consumer research, demography, economics, engineering, ethnography, finance, geography, law, planning, political science, public policy, regional science, sociology, statistics, and urban studies.

Cityscape is published three times a year by the Office of Policy Development and Research (PD&R) of the U.S. Department of Housing and Urban Development.

Affordable, Accessible, Efficient Communities

Volume 17, Number 2

Mark D. Shroder

Michelle P. Matuga

A Research Note: Long-Term Cost Effectiveness of Placing Homeless Seniors in Permanent Supportive Housing

Joshua D. Bamberger
University of California, San Francisco; Mercy Housing

Sarah K. Dobbins
San Francisco Department of Public Health


A recently developed body of evidence shows that housing chronically homeless adults improves health outcomes and prevents unnecessary, high-cost, institutional-based medical care. In this study, we report changes in the healthcare costs of homeless seniors who were placed in housing from a skilled nursing facility (SNF) and the costs for those placed in housing from the general community. Cost and utilization data from 1 year before move-in were compared with data from the 7 years subsequent to moving into a new permanent, supportive housing facility. During the 7 years after placement, the total hospital-based costs for the 51 seniors who moved into the facility was $1.46 million less than the costs incurred in the year before moving in. Permanent supportive housing may be a cost-effective placement option for homeless seniors exiting SNFs, particularly as they approach the end of life.

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