2024
Cost-Effectiveness of Temporary Financial Assistance for Veterans Experiencing Housing Instability
Nelson R, Chapman A, Byrne T, Chaiyakunapruk N, Suo Y, Effiong A, Pettey W, Gelberg L, Kertesz S, Tsai J, Montgomery A. Cost-Effectiveness of Temporary Financial Assistance for Veterans Experiencing Housing Instability. JAMA Network Open 2024, 7: e2443396. PMID: 39499512, PMCID: PMC11539017, DOI: 10.1001/jamanetworkopen.2024.43396.Peer-Reviewed Original ResearchMeSH KeywordsAdultCost-Benefit AnalysisFemaleHousingHumansIll-Housed PersonsMaleMarkov ChainsMiddle AgedQuality-Adjusted Life YearsUnited StatesUnited States Department of Veterans AffairsVeteransConceptsSupportive Services for Veteran FamiliesTemporary financial assistanceHousing insecurityHousing-related expensesIncremental cost-effectiveness ratioQuality-adjusted life yearsMonte Carlo simulationsProbabilistic sensitivity analysesFinancial assistanceHomelessness prevention servicesHousing outcomesHomelessness preventionLoss of housingCarlo simulationsPrevent homelessnessTime horizonCombination of inputsHousing instabilityHousing interventionsEconomic evaluationVulnerable VeteransHousingHomelessnessVeteran familiesVeterans AffairsTransportation As A Determinant Of Health: Evaluating The Veterans Affairs Rideshare Program For Homeless Patients
Tsai J, Szymkowiak D, Beydoun H, Dasilva L. Transportation As A Determinant Of Health: Evaluating The Veterans Affairs Rideshare Program For Homeless Patients. Health Affairs 2024, 43: 1090-1099. PMID: 39102601, DOI: 10.1377/hlthaff.2023.01332.Peer-Reviewed Original ResearchMeSH KeywordsAdultFemaleHealth Services AccessibilityHumansIll-Housed PersonsMaleMiddle AgedProgram EvaluationSocial Determinants of HealthTransportationTransportation of PatientsUnited StatesUnited States Department of Veterans AffairsVeteransConceptsHomeless service usersService usersService useVeterans AffairsAssociated with greater useHomeless patientsNational pilotMedical appointmentsAdministrative dataDepartment of Veterans AffairsVA administrative dataVA service useAttend medical appointmentsRidesharing programUrgent care visitsGreater useHealth systemInpatient servicesNationwide health systemCare visitsHomelessnessVulnerable patientsPatient transportIndex dateServicesShallow Subsidies for Veterans Facing Housing Barriers in the VA Supportive Services for Veteran Families Program.
Nelson R, Byrne T, Suo Y, Effiong A, Pettey W, Zickmund S, Galyean P, Kimball E, Gelberg L, Kertesz S, Tsai J, Montgomery A. Shallow Subsidies for Veterans Facing Housing Barriers in the VA Supportive Services for Veteran Families Program. Journal Of Health Care For The Poor And Underserved 2024, 35: 532-544. PMID: 38828580, DOI: 10.1353/hpu.2024.a928631.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedFemaleHousingHumansIll-Housed PersonsMaleMiddle AgedRetrospective StudiesSocioeconomic FactorsUnited StatesUnited States Department of Veterans AffairsVeteransConceptsPermanent supportive housingMultivariable two-part regression modelTwo-part regression modelHousing instabilityHousing barriersSupportive housingFamilies ProgramQualitative interviewsSocioeconomic stabilityAllocation decisionsCharacteristics of veteransSubsidiesHigher incomeDepartment of Veterans AffairsIncomeHousingInterviewsVeterans AffairsMethod findingsHomelessnessRetrospective cohort studyOutpatient costsVeteransOlder ageCohort studyLegal Services for Veterans (LSV): Protocol for evaluating the grant-based LSV initiative supporting community organizations’ delivery of legal services to veterans
Kim B, Petrakis B, Griesemer I, Sliwinski S, Midboe A, Raciborski R, Byrne T, Gingell M, Blue-Howells J, Clark S, Tsai J, Harvey K, McInnes D. Legal Services for Veterans (LSV): Protocol for evaluating the grant-based LSV initiative supporting community organizations’ delivery of legal services to veterans. PLOS ONE 2024, 19: e0297424. PMID: 38625878, PMCID: PMC11020365, DOI: 10.1371/journal.pone.0297424.Peer-Reviewed Original ResearchMeSH KeywordsDriveHumansLegal ServicesObservational Studies as TopicProspective StudiesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsLegal servicesRE-AIMReach Effectiveness Adoption Implementation MaintenanceMixed-methods observational studyLegal needsIntegrated Promoting ActionLegal assistance programsLegal service providersSocial determinantsImplementation outcomesHealth servicesImplementation barriersResearch implementationImplementation MaintenanceLegal assistancePublic lawMeasures designVeteransPrimary outcomePromoting actionEconomic evaluationObservational studyVeterans' benefitsAssistance programsReporting requirementsTemporary Financial Assistance Reduced The Probability Of Unstable Housing Among Veterans For More Than 1 Year
Chapman A, Scharfstein D, Byrne T, Montgomery A, Suo Y, Effiong A, Velasquez T, Pettey W, Dalrymple R, Tsai J, Nelson R. Temporary Financial Assistance Reduced The Probability Of Unstable Housing Among Veterans For More Than 1 Year. Health Affairs 2024, 43: 250-259. PMID: 38315929, DOI: 10.1377/hlthaff.2023.00730.Peer-Reviewed Original ResearchMeSH KeywordsHousingHumansIll-Housed PersonsProbabilityUnited StatesUnited States Department of Veterans AffairsVeteransConceptsSupportive Services for Veteran FamiliesTemporary financial assistanceFinancial assistanceUnstable housingHousing outcomesHousing instabilityReduce homelessnessHousing stabilityVeterans AffairsVeteran familiesElectronic health record systemsDepartment of Veterans AffairsHealth record systemsHousingTemporaryAssistanceVeteransLanguage processingClinical notesHomelessnessLong-term effectsRecording systemAffairsProbabilityOutcomes
2023
Chronically homeless veterans with gambling disorder: Epidemiology, clinical correlates, and traumatic experiences
Stefanovics E, Potenza M, Szymkowiak D, Tsai J. Chronically homeless veterans with gambling disorder: Epidemiology, clinical correlates, and traumatic experiences. Journal Of Psychiatric Research 2023, 164: 118-124. PMID: 37339548, DOI: 10.1016/j.jpsychires.2023.05.062.Peer-Reviewed Original ResearchMeSH KeywordsGamblingHumansIll-Housed PersonsMaleMilitary PersonnelSubstance-Related DisordersUnited StatesUnited States Department of Veterans AffairsVeteransConceptsPsychiatric treatmentGambling disorderChi-square testChronic homelessnessClinical correlatesDescriptive epidemiologyLow educational attainmentElevated oddsSuicidal thoughtsLogistic regressionTraumatic experiencesMental healthSubstance useHomeless veteransHomeless ProgramVeteransTreatmentLower ratesEpidemiologyBehavioral concernsDisordersStudy of factorsCorrelatesAnalysis of varianceEducational attainmentEvaluating Veterans Response Teams and Police Interventions on Veterans' Health Care Utilization
Tsai J, Gonzalez C, Szymkowiak D, Stewart K, Dillard D, Whittle T, Woodland P. Evaluating Veterans Response Teams and Police Interventions on Veterans' Health Care Utilization. Journal Of Public Health Management And Practice 2023, 29: 387-391. PMID: 36867527, DOI: 10.1097/phh.0000000000001718.Peer-Reviewed Original ResearchMeSH KeywordsDelivery of Health CareHumansPatient Acceptance of Health CarePoliceUnited StatesUnited States Department of Veterans AffairsVeteransConceptsHealth care utilizationCare servicesCare utilizationVA health care servicesUse of outpatientSubstance abuse treatment servicesInpatient mental healthVA health careUrgent care servicesAncillary care servicesHealth care servicesResponse teamsTreatment servicesRehabilitation servicesMental healthHealth careHomeless ProgramSimilar increaseInterventionVeteransDepartmentOutpatientsMonthsCareEpidemiology and psychiatric correlates of cancer among homeless and unstably housed veterans in the VA healthcare system
Tsai J, Szymkowiak D, Zullig L. Epidemiology and psychiatric correlates of cancer among homeless and unstably housed veterans in the VA healthcare system. Cancer Epidemiology Biomarkers & Prevention 2023, 32: 617-624. PMID: 36791363, DOI: 10.1158/1055-9965.epi-22-1154.Peer-Reviewed Original ResearchMeSH KeywordsDelivery of Health CareHousingHumansMaleNeoplasmsSubstance-Related DisordersUnited StatesUnited States Department of Veterans AffairsVeteransConceptsSuicidal ideation/behaviorSubstance use disordersUse disordersVA health care systemVeterans Affairs administrative dataCommon primary siteCancer diagnosisIntrahepatic bile ductsRisk of cancerVA healthcare systemAlcohol use disorderCorrelates of cancerTypes of cancerHealth care systemIncident cancerTreatment of cancerBile ductIncidence rateHigh prevalenceLower riskPsychiatric correlatesPsychiatric characteristicsPsychiatric disordersPrimary sitePsychiatric conditions
2022
Developing an operational definition of housing instability and homelessness in Veterans Health Administration’s medical records
Tsai J, Szymkowiak D, Jutkowitz E. Developing an operational definition of housing instability and homelessness in Veterans Health Administration’s medical records. PLOS ONE 2022, 17: e0279973. PMID: 36584201, PMCID: PMC9803152, DOI: 10.1371/journal.pone.0279973.Peer-Reviewed Original ResearchHousingHousing InstabilityHumansIll-Housed PersonsMedical RecordsUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthPrimary Care for Veterans Experiencing Homelessness: a Narrative Review of the Homeless Patient Aligned Care Team (HPACT) Model
Tsai J, Havlik J, Howell B, Johnson E, Rosenthal D. Primary Care for Veterans Experiencing Homelessness: a Narrative Review of the Homeless Patient Aligned Care Team (HPACT) Model. Journal Of General Internal Medicine 2022, 38: 765-783. PMID: 36443628, PMCID: PMC9971390, DOI: 10.1007/s11606-022-07970-y.Peer-Reviewed Original ResearchMeSH KeywordsHumansIll-Housed PersonsPatient Care TeamPatient-Centered CareUnited StatesUnited States Department of Veterans AffairsVeteransConceptsHomeless Patient Aligned Care TeamPrimary care medical home modelsVeterans' healthOnly original research studiesNarrative reviewPatient Aligned Care TeamsCare team modelPrimary care utilizationEmergency department utilizationMedical home modelDatabases Ovid MEDLINEPositive patient experienceVeterans Experiencing HomelessnessOriginal research studiesCare utilizationOvid EmbasePrimary careCare teamOvid MEDLINEInclusion criteriaPatient experiencePeer-reviewed studiesHome modelHealthcare outcomesVA systemIdentifying Graduation Rates and Practices in the U.S. Department of Housing and Urban Development-Veterans Affairs Supportive Housing Program
Tsai J, Byrne T, Hill L, Flatley B, Harelik N, Deal M. Identifying Graduation Rates and Practices in the U.S. Department of Housing and Urban Development-Veterans Affairs Supportive Housing Program. Community Mental Health Journal 2022, 59: 808-811. PMID: 36417137, DOI: 10.1007/s10597-022-01057-y.Peer-Reviewed Original ResearchMeSH KeywordsHousingHumansIll-Housed PersonsPublic HousingUnited StatesUnited States Department of Veterans AffairsUrban RenewalVeteransConceptsHousing programsSupportive housing programUrban Development-Veterans Affairs Supportive Housing (HUD-VASH) programGraduation ratesHUD-VASH programPSH programsKey themesClient independenceHUD-VASHTemplate analysis approachGraduation criteriaPolicyUnited StatesU.S. DepartmentLittle researchProgram managersPracticeGraduation practiceOnline surveyAdministrative dataThe Impact of Temporary Housing Assistance Expenditures on Subcategories of Health Care Cost for U.S. Veterans Facing Housing Instability.
Nelson R, Montgomery A, Suo Y, Cook J, Pettey W, Evans W, Greene T, Gelberg L, Kertesz S, Tsai J, Byrne T. The Impact of Temporary Housing Assistance Expenditures on Subcategories of Health Care Cost for U.S. Veterans Facing Housing Instability. Journal Of Health Care For The Poor And Underserved 2022, 33: 1821-1843. PMID: 36341665, DOI: 10.1353/hpu.2022.0140.Peer-Reviewed Original ResearchMeSH KeywordsHealth Care CostsHealth ExpendituresHousingHousing InstabilityHumansIll-Housed PersonsPublic HousingRetrospective StudiesSubstance-Related DisordersUnited StatesUnited States Department of Veterans AffairsVeteransConceptsHealth care costsCare costsOutpatient substance use disorder treatmentMental healthSubstance use disorder treatmentRetrospective cohort studyOutpatient mental healthDirect medical costsInpatient mental healthUse disorder treatmentHealth care encountersBehavioral health costsHealth care servicesCohort studyHousing instabilityMultivariable differenceCare encountersMedical costsCare servicesDisorder treatmentU.S. veteransVeterans AffairsVA systemHealth costsSupportive servicesProviders' reflections on infrastructure and improvements to promote access to care for Veterans experiencing housing instability in rural areas of the United States: A qualitative study
Cusack M, Montgomery AE, Harris T, Roncarati J, Brecht T, Antonellis C, Byrne T, Tsai J, True G. Providers' reflections on infrastructure and improvements to promote access to care for Veterans experiencing housing instability in rural areas of the United States: A qualitative study. Health & Social Care In The Community 2022, 30: e6356-e6365. PMID: 36250724, DOI: 10.1111/hsc.14077.Peer-Reviewed Original ResearchMeSH KeywordsCOVID-19Health Services AccessibilityHousingHousing InstabilityHumansUnited StatesUnited States Department of Veterans AffairsVeteransConceptsHousing instabilityRural areasHomeless service providersFederal infrastructure investmentUnited StatesConcerns of providersRecent legislative actsSemi-structured telephone interviewsService deliveryLegislative actsProviders’ reflectionsQualitative studyInfrastructure investmentTemplate analysisService accessService providersStaff workAnalysed transcriptsHealth disparitiesRelated servicesBroadband InternetU.S.AccessAdditional resourcesTelephone interviewsThe Most Important Resources to Prevent Homelessness According to Veterans: Results From the CHALENG Survey, 2019–2021
Tsai J, Gluff J, Blue-Howells J. The Most Important Resources to Prevent Homelessness According to Veterans: Results From the CHALENG Survey, 2019–2021. Psychiatric Services 2022, 73: 119-120. PMID: 34974745, DOI: 10.1176/appi.ps.202100604.Peer-Reviewed Original ResearchHumansIll-Housed PersonsSocial ProblemsSurveys and QuestionnairesUnited StatesUnited States Department of Veterans AffairsVeteransActuarial Prediction Versus Clinical Prediction of Exits From a National Supported Housing Program
Byrne T, Tsai J. Actuarial Prediction Versus Clinical Prediction of Exits From a National Supported Housing Program. American Journal Of Orthopsychiatry 2022, 92: 217-223. PMID: 35025573, PMCID: PMC10687831, DOI: 10.1037/ort0000603.Peer-Reviewed Original ResearchMeSH KeywordsHousingHumansIll-Housed PersonsPublic HousingUnited StatesUnited States Department of Veterans AffairsVeteransConceptsClinical judgmentLogistic regressionClinical predictionService utilization historiesBehavioral health diagnosesMultivariable prediction modelPositive predictive valueHUD-VASHSupported housing programsDevelopment cohortValidation cohortPredictive valueSociodemographic characteristicsClinician ratingsHealth diagnosisCohortSupportive housing programCase managersPermanent supportive housingCharacteristic curveVeteransSupportive housingPresent studyPremature exitUtilization historyRacial Differences in the Psychosocial Response to the COVID-19 Pandemic in Veterans With Psychosis or Recent Homelessness
Novacek DM, Wynn JK, McCleery A, Reavis EA, Senturk D, Sugar CA, Tsai J, Green MF. Racial Differences in the Psychosocial Response to the COVID-19 Pandemic in Veterans With Psychosis or Recent Homelessness. American Journal Of Orthopsychiatry 2022, 92: 590-598. PMID: 35737567, PMCID: PMC9958263, DOI: 10.1037/ort0000633.Peer-Reviewed Original ResearchMeSH KeywordsCOVID-19HumansIll-Housed PersonsPandemicsPsychotic DisordersRace FactorsRetrospective StudiesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsWhite veteransPsychosocial responsesControl groupBlack veteransRecent homelessnessSignificant differencesCOVID-19 pandemicVeterans Affairs (VA) healthcare servicesWorse psychosocial outcomesBaseline interviewClinical InterviewPsychosocial outcomesPsychosisRacial disparitiesTime pointsVulnerable populationsRacial differencesHealthcare servicesInitial responseVeteransSocial supportGlobal pandemic
2021
Effects of Electroconvulsive Therapy on Suicidal Behavior and Emergency Department Use Among Homeless Veterans: A Propensity Score-Matched Study.
Tsai J, Peltzman T, Watts BV, Shiner B. Effects of Electroconvulsive Therapy on Suicidal Behavior and Emergency Department Use Among Homeless Veterans: A Propensity Score-Matched Study. The Journal Of Clinical Psychiatry 2021, 82 PMID: 34705349, DOI: 10.4088/jcp.21m13935.Peer-Reviewed Original ResearchMeSH KeywordsDiagnostic and Statistical Manual of Mental DisordersElectroconvulsive TherapyEmergency Service, HospitalEmergency Services, PsychiatricFemaleHumansIll-Housed PersonsMaleMedical OveruseMental DisordersMiddle AgedPatient Acceptance of Health CarePatient DischargeSuicidal IdeationSuicide, AttemptedUnited StatesUnited States Department of Veterans AffairsVeteransConceptsElectroconvulsive therapyEmergency department useHomeless veteransDepartment useSuicidal ideationVeterans Affairs Health Care SystemNational VA administrative dataPropensity score-matched studySuicide attemptsFirst ECT sessionVA administrative dataPsychiatric inpatient unitHealth care systemECT sessionsED useAcute servicesInpatient unitTreatment engagementPsychiatric conditionsPropensity scoreSuicidal behaviorCare systemVeteransFurther studiesAdministrative dataTemporary Financial Assistance Decreased Health Care Costs For Veterans Experiencing Housing Instability
Nelson RE, Montgomery AE, Suo Y, Cook J, Pettey W, Gundlapalli A, Greene T, Evans W, Gelberg L, Kertesz SG, Tsai J, Byrne TH. Temporary Financial Assistance Decreased Health Care Costs For Veterans Experiencing Housing Instability. Health Affairs 2021, 40: 820-828. PMID: 33939508, DOI: 10.1377/hlthaff.2020.01796.Peer-Reviewed Original ResearchMeSH KeywordsHealth Care CostsHousingHumansIll-Housed PersonsPublic HousingUnited StatesUnited States Department of Veterans AffairsVeteransConceptsTemporary financial assistanceFinancial assistanceHousing instabilityFamilies ProgramNational policy debatesSupportive servicesStable housing situationsAffair partnersPolicy debatesHousing situationCommunity organizationsExpensive inpatientHomelessnessAssistancePeopleServicesDebateOrganizationProgramPartnersImminent riskClinical and functional effects of the COVID-19 pandemic and social distancing on vulnerable veterans with psychosis or recent homelessness
Wynn JK, McCleery A, Novacek D, Reavis EA, Tsai J, Green MF. Clinical and functional effects of the COVID-19 pandemic and social distancing on vulnerable veterans with psychosis or recent homelessness. Journal Of Psychiatric Research 2021, 138: 42-49. PMID: 33819876, PMCID: PMC9750189, DOI: 10.1016/j.jpsychires.2021.03.051.Peer-Reviewed Original ResearchMeSH KeywordsCOVID-19HumansIll-Housed PersonsPandemicsPhysical DistancingPsychotic DisordersRetrospective StudiesSARS-CoV-2United StatesUnited States Department of Veterans AffairsVeteransConceptsPsychotic disordersVulnerable veteransVeterans Affairs Healthcare SystemWorse clinical outcomesCOVID-19 pandemicMental health problemsCommunity Integration MeasureMental health issuesClinical factorsClinical outcomesMental health resilienceVA servicesHealth problemsRecent homelessnessHealth issuesElevated levelsPhone interviewsHealthcare systemFunctional effectsCOVID-19Health resilienceRHVVeteransVulnerable individualsVulnerable groupsPreventing Suicide Among Homeless Veterans: A Consensus Statement by the Veterans Affairs Suicide Prevention Among Veterans Experiencing Homelessness Workgroup.
Holliday R, Liu S, Brenner LA, Monteith LL, Cappelletti MM, Blosnich JR, Brostow DP, Gelberg L, Hooshyar D, Koget J, McInnes DK, Montgomery AE, O'Brien R, Rosenheck RA, Strickland S, Workman GM, Tsai J. Preventing Suicide Among Homeless Veterans: A Consensus Statement by the Veterans Affairs Suicide Prevention Among Veterans Experiencing Homelessness Workgroup. Medical Care 2021, 59: s103-s105. PMID: 33710080, PMCID: PMC7958976, DOI: 10.1097/mlr.0000000000001399.Peer-Reviewed Original ResearchMeSH KeywordsHumansIll-Housed PersonsSuicide PreventionUnited StatesUnited States Department of Veterans AffairsVeteransConceptsConsensus statement