67% of homeless patients surveyed spent their first night after hospital discharge at a shelter; and
11% spent the night on the street.
She poses a question.
“ … key set of questions (that) has not been asked often enough: What is “home” for our patients? Is it a comfortable house with adequate family support? Is it a fifth-floor walk-up apartment with bad heating? Is it a homeless shelter? Is it the streets?”
She writes that
“Ignoring the issue simply creates more expensive problems in the future. Patients who leave the hospital and are homeless cycle through a revolving door of costly, inefficient and dangerous care from the hospital to the streets or shelter and then back again. Homeless individuals visit the emergency department and are hospitalized at rates up to 10 times higher than low-income-housed patients. Once in the hospital, homeless patients have longer stays and cost on average $2,500 more per hospitalization than housed patients.”
And urges hospitals to be part of the solution and to help break the cycle of chronic homelessness. Instead she suggests that:
Previous to discharge, hospital staff can ask about a patient’s housing status; and
Discharge patients to supportive housing or medical respite programs.
We all know that there is a shortage of supportive housing and more advocacy work needs to be done to address the lack of funding but the steps above can reduce recidivism rates and future hospital days.