Because of concern that results could be biased by the fact that 28% of clients were already living in independent housing at the time of the baseline assessment (Table 4), we examined differences in service use and outcomes by this criterion. Adjusting for the baseline value of each measure, for site, and for significant bivariate differences between those housed and not housed at baseline (i.e., veteran status, mental health functioning, and psychiatric symptom distress) (Table 5), the only significant difference in service use was in the proportion of core CICH services received (i.e. overall service integration Table 9, last row) (71-74% vs. 80-83% after 3 months of entering the program). It thus appears that clients housed before informed consent and baseline assessment were obtained were somewhat less engaged in full array of CICH services.
Significant differences between clients housed at baseline and others were observed on 7 of 30 outcome measures, primarily the 4 housing outcome measures (Table 10).
Clients housed at baseline also had more days of drinking to intoxication and more serious alcohol problems than those not housed at baseline, but also showed higher levels of physical functioning (Table 10). Alcohol problems increased more among clients housed at baseline than others, possibly suggesting that rapid placement into permanent housing without sobriety requirements may have facilitated continued abuse of alcohol during the first year in the program. It is also possible, however, that rapid placement allowed clients with more serious addiction problems to be served. Nevertheless, outcomes on these measures were no longer statistically different from 6-12 months.
Housing status at baseline thus appears not to be a seriously confounding influence on changes in service use patterns and outcomes over time. We nevertheless included the "housing status at baseline" indicator as a covariate in subsequent multivariate analyses.