Health care utilization following a homeless medical respite pilot program

Abstract

Objective: The purpose of this study was to evaluate a homeless medical respite pilot program to determine if program participants had health care utilization pattern changes and improved connection to income, housing, and health care resources post program.

Design: This is a quantitative descriptive pre-/post-program evaluation.

Sample: A total of 29 patients experiencing homelessness and discharged from an acute care hospital in the southeastern United States were provided with housing and nursing case management.

Measurements: Demographics including age, sex, race, and ethnicity were collected. Connection to primary care, mental health, substance abuse services, income, insurance, and housing were assessed at program entry and completion. Health care utilization and charge and payment data were collected 1 year prior and 1 year post-respite stay.

Results: Participants demonstrated reduced hospital admissions (-36.7%) and when admitted, fewer inpatient days (-70.2%) and increased outpatient provider visits (+192.6%). Health care charges for the cohort decreased by 48.6% from the year prior to the program. Housing and income improved.

Conclusions: The medical respite pilot program was successful in guiding patients to community resources for more appropriate health care at a demonstrated cost savings. Participants also derived benefits in the form of improved housing and income.

Keywords: health care utilization; homelessness; medical respite; pilot study.