Hospitalization in an urban homeless population: the Honolulu Urban Homeless Project.
ABSTRACT To determine the rate and estimate the cost of hospitalization in a defined urban homeless population.
Retrospective chart review.
Kalihi-Palama Health Clinic Health Care for the Homeless Project, Hawaii State Hospital and seven acute care hospitals in Honolulu, Hawaii.
A total of 1751 homeless clients contacted between 1 December 1988 and 30 November 1990.
A total of 1751 individuals were studied for an aggregate of 871.3 person-years. Five hundred sixty-four hospitalizations were identified: ninety-two to the state psychiatric hospital and 472 to acute care hospitals. The age- and sex-adjusted hospitalization rate for acute care hospitals was 542/1000 person-years (compared with the state rate of 96/1000 person-years). Homeless persons were admitted to acute care hospitals for 4766 days compared with a predicted 640 days. The age- and sex-adjusted rate of admission to the state psychiatric hospital was 105/1000 person-years (compared with the state rate of 0.8/1000 person-years). Homeless persons were admitted to the state psychiatric hospital for 3837 days compared with a predicted 139 days.
Homeless individuals in this study were hospitalized in acute care and psychiatric hospitals far more frequently than were members of the general population.
- SourceAvailable from: James J O'Connell[Show abstract] [Hide abstract]
ABSTRACT: Medical respite programs offer medical, nursing, and other care as well as accommodation for homeless persons discharged from acute hospital stays. They represent a community-based adaptation of urban health systems to the specific needs of homeless persons. This article examines whether post-hospital discharge to a homeless medical respite program was associated with a reduced chance of 90-day readmission compared to other disposition options. Adjusting for imbalances in patient characteristics using propensity scores, respite patients were the only group that was significantly less likely to be readmitted within 90 days compared to those released to Own Care. Respite programs merit attention as a potentially efficacious service for homeless persons leaving the hospital.Journal of Prevention & Intervention Community 02/2009; 37(2):129-42. DOI:10.1080/10852350902735734