{"version":"sf-openhouse-companionship-cea-v1","reviewedAt":"2026-09-07","organization":"Openhouse","program":"Six-month Friendly Visitor match","confidence":"very-low","denominator":"10 incremental QALYs","formula":"10 * costPerPlace / (utilityGain * effectiveYears * engagement * additionality)","scope":"Proposed additional six-month companionship match for an LGBTQ older adult; not housing construction, rent assistance or all intergenerational services.","scenarios":[{"name":"Favorable positive","costPerPlace":600,"utilityGain":0.03,"effectiveYears":0.5,"engagement":0.9,"additionality":0.75,"horizonYears":0.5},{"name":"Central analyst estimate","costPerPlace":1000,"utilityGain":0.01,"effectiveYears":0.5,"engagement":0.75,"additionality":0.5,"horizonYears":0.5},{"name":"Unfavorable positive","costPerPlace":2000,"utilityGain":0.002,"effectiveYears":0.25,"engagement":0.5,"additionality":0.25,"horizonYears":0.5}],"judgments":[{"key":"costPerPlace","label":"Cash cost per new match","basis":"Assumed $1,000: ten staff hours at a $60 loaded hourly cost plus $400 screening, training, transport and administration. Not an Openhouse quote. Volunteer time is an additional in-kind resource, not free societal capacity."},{"key":"utilityGain","label":"Incremental health utility while engaged","basis":"Subjective .01 utility gain, not a measured Openhouse effect. External befriending evidence supports investigating depression/loneliness, but neither those scales nor local satisfaction scores are converted numerically into QALYs."},{"key":"effectiveYears","label":"Effective benefit duration","basis":"Half a year at the assumed effect in the central scenario; unfavorable .25 equivalent years allows later onset or fading. No lifetime extrapolation."},{"key":"engagement","label":"Sustained effective engagement","basis":"75% analyst assumption for proposed matches sustaining useful contact, not a completion rate inferred from 80 active pairs or incomplete local follow-up."},{"key":"additionality","label":"Added funding capacity","basis":"50% judgment for new effective matches versus replacement funding. Marginal capacity and actual funding room are unverified."}],"nullBoundary":"Zero added contact, zero health improvement or fully replacement funding means no finite positive-benefit price. Signed negative utility retains possible harm. The positive scenarios are stress cases, not confidence intervals.","fundingRoom":{"verifiedUsd":null,"status":"unverified","nextEvidence":"A priced marginal-match plan, volunteer/staff capacity, retention and comparative preference-based health measurement."},"excluded":["Housing construction and rent assistance","Volunteer health benefits","Mortality or dementia prevention","Loneliness and satisfaction points directly relabeled as QALYs"],"sources":[{"publisher":"Openhouse development manager / SF Bay Times","title":"Fighting Ageism: LGBTQ Seniors and Friendly Visitors Connect","url":"https://sfbaytimes.com/fighting-ageism-lgbtq-seniors-and-friendly-visitors-connect-for-life-affirming-companionship-and-support/","published":"2025-11-06","retrieved":"2026-09-07","sourceType":"Organization-authored description: 80 current pairs; not a causal outcome or full-year cohort"},{"publisher":"San Francisco Human Services Agency","title":"2023–2027 intergenerational program grants","url":"https://www.sfhsa.org/sites/default/files/media/document/2023-07/f_multiple_grantees_intergenerational_program.pdf","published":"2023-07","retrieved":"2026-09-07","sourceType":"Pages44–54: mixed-program annual budget, not marginal Friendly Visitor cost"},{"publisher":"Openhouse / California Reducing Disparities Project","title":"Local evaluation final report","url":"https://cultureishealth.org/wp-content/uploads/2024/05/Openhouse_Final-Report_2021-11-30.pdf","published":"2021-11-30","retrieved":"2026-09-07","sourceType":"Uncontrolled multi-program evaluation; incomplete FVP follow-up; satisfaction is not health utility"},{"publisher":"BEFRIENDAS researchers / PubMed","title":"Befriending intervention randomized trial","url":"https://pubmed.ncbi.nlm.nih.gov/41161295/","published":"2025","retrieved":"2026-09-07","sourceType":"Australian aged-care trial; depression/loneliness effects, not a transferable QALY estimate"},{"publisher":"NIHR / PLINY researchers","title":"Telephone friendship groups for older people","url":"https://www.ncbi.nlm.nih.gov/books/NBK264029/","published":"2014","retrieved":"2026-09-07","sourceType":"Volunteer recruitment/retention and delivery failure; incomplete planned economics: capacity warning"}],"evaluatedScenarios":[{"name":"Favorable positive","costPerPlace":600,"utilityGain":0.03,"effectiveYears":0.5,"engagement":0.9,"additionality":0.75,"horizonYears":0.5,"qalysPerPlace":0.010125,"costPerTenQalys":592592.5925925926,"additionalQalys":1.6875},{"name":"Central analyst estimate","costPerPlace":1000,"utilityGain":0.01,"effectiveYears":0.5,"engagement":0.75,"additionality":0.5,"horizonYears":0.5,"qalysPerPlace":0.001875,"costPerTenQalys":5333333.333333334,"additionalQalys":0.1875},{"name":"Unfavorable positive","costPerPlace":2000,"utilityGain":0.002,"effectiveYears":0.25,"engagement":0.5,"additionality":0.25,"horizonYears":0.5,"qalysPerPlace":0.0000625,"costPerTenQalys":320000000,"additionalQalys":0.003125}]}