{"version":"sf-edc-qaly-decision-v2","reviewedAt":"2026-09-07","status":"exploratory-judgmental-health-bridge","confidence":"very-low","denominator":"10 incremental QALYs","central":{"costPerCaseUsd":6300,"additionalRetainedPossessionProbability":0.05,"affectedAdults":1,"healthRelevantDisplacementShare":0.25,"utilityGain":0.04,"durationYears":1,"donorAdditionality":1},"scenarios":[{"name":"Favorable positive","costPerOutcomeUsd":42000,"healthRelevantDisplacementShare":1,"utilityGain":0.1,"durationYears":2,"affectedAdults":1,"donorAdditionality":1},{"name":"Central analyst estimate","costPerOutcomeUsd":126000,"healthRelevantDisplacementShare":0.25,"utilityGain":0.04,"durationYears":1,"affectedAdults":1,"donorAdditionality":1},{"name":"Unfavorable positive","costPerOutcomeUsd":630000,"healthRelevantDisplacementShare":0.1,"utilityGain":0.01,"durationYears":0.5,"affectedAdults":1,"donorAdditionality":0.5}],"formula":"10 * costPerOutcomeUsd / (affectedAdults * healthRelevantDisplacementShare * utilityGain * durationYears * donorAdditionality)","publishedPriceUsd":126000000,"judgments":[{"label":"Health-relevant displacement share","best":"25%","range":"10%–100%","basis":"Subjective transfer: a legal outcome may delay or alter a move without preventing health-relevant displacement. The July2026 Memphis trial found no effect on ultimate residential stability, so the central scenario credits only a minority. This is not a measured fraction."},{"label":"Utility gain among affected adults","best":"0.04","range":"0.01–0.10","basis":"Subjective modest health-improvement scenario, not an eviction-specific preference-based study estimate. The search did not identify a measured coefficient; adjacent housing utility studies are often null."},{"label":"Duration","best":"1 year","range":"0.5–2 years","basis":"One-year window limits extrapolation. Judge-assignment evidence supports some first-year acute-health effects but not a persistent second-year utilization effect."},{"label":"Affected adults","best":"1","range":"1","basis":"One adult avoids unsupported household/child multipliers; it does not imply that other household members receive no benefit."},{"label":"Donor additionality","best":"100%, conditional","range":"0%–100%","basis":"Central assumes the gift funds additional full-scope cases, not replacement of public funding. This is unverified. Zero additionality produces no finite price."}],"bottomLine":"Our best guess for the narrow adult-health pathway is $126 million per 10 QALYs, conditional on extra cases and a positive legal effect. We would not prioritize this program on the present QALY estimate; justice, voice, financial protection and other non-health benefits are not fully represented. This is not evidence that legal assistance has no value.","nullBoundary":"Zero legal effect, zero health effect or zero donor additionality means no finite cost per QALY; harm remains possible. Positive scenarios are not confidence intervals.","sources":[{"publisher":"Caspi and Rafkin","title":"Legal Assistance for Evictions","url":"https://www.charlierafkin.com/docs/cr_rtc.pdf","published":"July 2026 revision","retrieved":"2026-09-07","sourceType":"Memphis randomized trial; court outcomes differ from residential stability"},{"publisher":"Collinson et al.","title":"Eviction and Poverty in American Cities","url":"https://academic.oup.com/qje/article/139/1/57/7276608","published":"2024","retrieved":"2026-09-07","sourceType":"Judge-assignment study; health pathway, not utility coefficient"},{"publisher":"Collinson et al.","title":"Eviction and Poverty in American Cities, working paper Table8","url":"https://humcap.uchicago.edu/RePEc/hka/wpaper/Djik_Collinson_Humphries_Mader_Reed_Tannenbaum_2022_Eviction-Poverty.pdf","published":"2022 working paper","retrieved":"2026-09-07","sourceType":"Versioned hospital-use estimates; not QALYs"}],"evaluatedScenarios":[{"name":"Favorable positive","costPerOutcomeUsd":42000,"healthRelevantDisplacementShare":1,"utilityGain":0.1,"durationYears":2,"affectedAdults":1,"donorAdditionality":1,"qalysPerOutcome":0.2,"costPerTenQalys":2100000},{"name":"Central analyst estimate","costPerOutcomeUsd":126000,"healthRelevantDisplacementShare":0.25,"utilityGain":0.04,"durationYears":1,"affectedAdults":1,"donorAdditionality":1,"qalysPerOutcome":0.01,"costPerTenQalys":126000000},{"name":"Unfavorable positive","costPerOutcomeUsd":630000,"healthRelevantDisplacementShare":0.1,"utilityGain":0.01,"durationYears":0.5,"affectedAdults":1,"donorAdditionality":0.5,"qalysPerOutcome":0.00025,"costPerTenQalys":25200000000}]}