David Buchanan ^1*, Bruce Doblin ², Theophilus Sai ³, Pablo Garcia ⁴

¹ John Stroger Hospital of Cook County / Rush University
² Northwestern University
³ John Stroger Hospital of Cook County and Rush University
⁴ St. Vincent's Hospital, New York, NY

^* To whom correspondence should be addressed. E-mail: david_buchanan{at}rush.edu.

	Abstract

Objectives. Homeless individuals experience high rates of physical and mental illness, increased mortality, and frequent hospitalizations. Respite care provides homeless individuals with housing and services allowing more complete recovery from illnesses and stabilization of chronic conditions.

Methods. We investigated respite care's impact on 225 hospitalized homeless adults consecutively referred from an urban public hospital during a 26-month period. The cohort was separated into 2 groups: (1) patients referred and accepted into the respite center and (2) patients referred but denied admission because beds were unavailable. All patients met the center's predefined eligibility criteria. Main outcome measures were inpatient days, emergency department visits, and outpatient clinic visits.

Results. The 2 groups had similar demographic characteristics, admitting diagnoses, and patterns of medical care use at baseline. During 12 months of follow-up, the respite care group required fewer hospital days than the usual care group (3.7 vs 8.3 days; P=.002), with no differences in emergency department or outpatient clinic visits. Individuals with HIV/AIDS experienced the greatest reduction in hospital days.

Conclusions. Respite care after hospital discharge reduces homeless patients' future hospitalizations.

Key Words: Health Care Facilities/Services, Health Service Delivery, Homelessness, Socioeconomic Factors, Mortality, Urban Health

This article has been cited by other articles:

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				L. S. Sadowski, R. A. Kee, T. J. VanderWeele, and D. Buchanan Effect of a Housing and Case Management Program on Emergency Department Visits and Hospitalizations Among Chronically Ill Homeless Adults: A Randomized Trial JAMA, May 6, 2009; 301(17): 1771 - 1778. [Abstract] [Full Text] [PDF]

				S. G. Kertesz and S. J. Weiner Housing the Chronically Homeless: High Hopes, Complex Realities JAMA, May 6, 2009; 301(17): 1822 - 1824. [Full Text] [PDF]

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