QUINCY -- To some, it seemed like a disaster in the making: Take people who have flitted in and out of shelters and emergency rooms for months or years -- people who have mental illness and substance abuse problems, people who just can't seem to get their lives together -- and give them a home without curfews or constant surveillance.

But a year after Father Bill's Place in Quincy moved a dozen homeless women into rooms of their own as part of a nationwide push toward housing the homeless instead of sheltering them, even the most skeptical have been impressed with the results.

``No one is more shocked than I am," a shelter staff member said of the early success of the ``housing first" initiative in an interim report written by Tatjana Meschede, a senior research associate at the Center for Social Policy at the University of Massachusetts at Boston. ``When we had a meeting before, I was pessimistic -- thought, from a medical standpoint, this is not going to work; we are going to have the ambulance over there every day, a lot of drama -- and that hasn't happened."

Indeed, since the women were moved into their own rooms, hospital stays and emergency room visits have dropped, people are using daily living skills like cooking and budgeting, some have reconnected with family, and almost all have an income, according to the report.

The difference is palpable. A year and a half ago, when the Globe visited the women before they moved into Claremont House, Lois Spencer, then 58, said matter-of-factly that she thought she would die in the shelter. But today, Spencer calls herself a ``hot-dog freak," raves about Derek Jeter the Yankee, and is recovering from surgery to treat a cancer that she did not even know she had back then, when all she could think about was her rattling cough.

Since spring 2005, when Spencer and her housemates were first moved from Father Bill's, ``housing first" initiatives have sprung up across the state -- part of a paradigm shift about the best and most economical way to help the homeless, who often rack up whopping emergency medical bills.

More and more case studies have found that a few homeless people may be responsible for significant emergency medical costs: For example, in Reno, Nev., Murray Barr, nicknamed ``Million-dollar Murray," singlehandedly racked up $1 million in medical costs and other public services over a 10-year period, according to an article by Malcolm Gladwell, author of ``The Tipping Point." And over a year and a half, 15 homeless men in San Diego cost the city $1.5 million in medical costs and other public services, according to Dr. James V. Dunford, medical director of the San Diego Emergency Medical Service.

In Boston, too, the health care costs are high. Dr. James O'Connell, president of Boston Health Care for the Homeless, began following 119 people who were living on the streets in Boston six years ago. The average annual healthcare cost was $28,436, he said. In contrast, the average annual cost for people who have moved into housing dropped to $6,056.

The costs are so great that researchers are now trying to prove, with pilot programs like the one in Quincy, that it makes more sense to give people housing, while also giving them a better life.

A 2002 report in the Housing Policy Debate journal followed 4,679 homeless, mentally ill people in New York who were given housing. Each person cost on average $40,449 of publicly funded services over a year before they moved in. After they were given housing, those costs dropped by $12,145 per year -- enough to pay for 95 percent of the costs of building and operating supportive housing.

In Quincy, the economic analysis won't be complete until next year, but at the one-year point, the raw cost of housing the women is about $2,000 less than caring for them in the shelter, according to John Yazwinski , executive director of Father Bill's Place.

And that doesn't include the decrease in expensive emergency medical care. In the year before the women moved into their new homes, they collectively racked up 44 days of hospital stays. The year after they moved into rooms, there were only four days of hospital stays. Emergency room visits have been cut in half.

While the analysis will be crucial in justifying the program to taxpayers, O'Connell said what is most disturbing are the health effects of living on the street, where doctors can only treat episodic problems like frostbite, pneumonia, or other maladies that may mask deeper troubles. About a third of the people he studied, whose average age is in the mid-40s, have died over the past six years.

``I can't imagine a more important and necessary condition for good health than having a safe place to live," O'Connell said. ``I often wish I could write a prescription: one studio apartment, 30 days, refill for six months. I think it's the only way they'll get better."

The idea, at once straightforward and revolutionary, is catching on. Traditionally, homeless people have been required to earn housing by getting a job, going back to school, and following strict rules -- a difficult feat for people who were often struggling with medical, mental health, and drug abuse problems. Add to that the social stigma of not having an address, waiting in line to get a bed every day, and having to carry all their belongings, and recovery becomes even harder.

But last August housing programs began to move people off the streets in Worcester, Springfield, Boston, and on Cape Cod. The state budget for fiscal year 2007 included a line item for $600,000 to create about 130 units for chronically homeless people across the state. Quincy itself has set up a second house for homeless men.

And the women of Claremont House have gotten some national attention since the Globe's visit last year: At a Washington conference on housing, one of them found herself speaking before more than a thousand of people about the benefits of moving into a home.

Meschede's interim report on the housing efforts in Quincy acknowledges a few lapses -- one woman was evicted from the house, and a man had to leave to go to a substance abuse treatment program. But people felt greater self-esteem; they felt better; most had income.

``Moving here saved my life. It really did. I never ever thought that I would be homeless ever in my life," one woman said in the report.

During a recent visit at Claremont House, the four women who were around clearly felt at home, talking and teasing one another with little of the bitter reticence that marked the first visit when they lived in the shelter. There was no chore list, but the common kitchen and bathroom areas were clean. Each room had been decorated with pride -- with houseplants, dried flowers, knick-knacks, or even just a bed piled with pillows.

Spencer hadn't been to the emergency room since she moved in.

Her housemate, Nancy Carroll , had filled her room with books and an old typewriter and was working on writing a mystery novel, planning on taking a class in creative writing, and worked at Father Bill's Place doing laundry and cleaning during the week.
Bonnie Brooker, 50, who went from working part-time at a school and a Blockbuster store to living in her car in Mansfield four years ago, said the house has done miracles for everyone.

``Everyone here knows everybody has an issue, situation, whatever it might be," she said. There are ``a couple women who have come so far outside of their shell, doing more, being out. This has got to be one of the biggest ideas ever."