The Effects of Respite Care for Homeless Patients

Homeless people suffer from a higher level of physical and mental illness than the general population, resulting in more frequent hospital admissions and reduced longevity. Homeless shelters and public hospital outreach are often not equipped to meet the needs of homeless people suffering from acute illness. Without a stable base and access to services, homeless people are less likely to attend follow-up appointments, take prescribed medication or manage addiction issues. Respite care offers homeless patients a place to live and access to services upon discharge, so that they can better manage their health conditions. An influential study has measured some of the benefits of providing respite care for homeless patients.

Measuring the Benefits of Respite Care

• The benefits of respite care were measured in a study carried out between Oct. 1, 1998. and Dec. 30, 2000, in Chicago, Ill. Two groups of homeless patients, discharged from Cook County Hospital, were monitored and their overall hospital days, emergency room visits, outpatient appointments and mortality recorded over the year following the patient's initial hospitalization. The first group of 164 homeless patients was comprised of those successfully referred to Interfaith House for respite following discharge. The second group of 64 patients was drawn from those who met the criteria for admission to Interfaith House, but were not given a place, due to lack of resources.

Criteria of Eligibility to Interfaith House, Provider of Respite Care

• Criteria of eligibility to Interfaith House included: the patient was suffering from an acute illness; was capable of carrying out daily living activities independently; and was capable of living in a group environment and remaining drug-and-alcohol free throughout his stay. Interfaith House, the only provider of respite care in Chicago, was very oversubscribed, so that many homeless patients assessed as eligible for respite care had to be turned away for lack of beds.

The Results of the Study

• For patients in both groups, the most common causes of their initial hospitalization were trauma, HIV/AIDS and other infections. The study showed that, while attendance at outpatient clinics and the emergency room was not statistically different between the two groups, in the succeeding year, the number of inpatient hospital days was 58 percent lower for those who had had the benefit of respite care. Patients with HIV/Aids appeared to benefit most from respite care, with the greatest reduction in hospital days. No mortalities were recorded for either group in the 12-month follow-up period.

The Implications of the Study for the Provision of Respite Care

• The results of the study indicate that the wider provision of respite care would not only significantly improve outcomes for homeless patients in the longer term, but would also bring significant savings to public hospitals. The average daily cost of respite care was estimated at $79 per day, while the costs of a hospital day were estimated at $1,500 by the Agency for Healthcare Research and Quality for the United States. The contributors to the study, however, acknowledge that further studies need to be undertaken to confirm and expand upon these findings.