Medical care for the homeless: Study finds that homes lessen need for emergency care
Group pairs those without homes with medical care, subsidized housing
What do homeless men and women with emphysema, hypertension, diabetes and congestive heart failure need to take better care of their health?
A home, Chicago researchers reported Tuesday in the Journal of the American Medical Association.
The report describes encouraging results for the Chicago Housing for Health Partnership, the first program in the country to link hospitals serving homeless, chronically ill patients with federally subsidized housing. The organization was formed in 2002 to deal with a common and unfortunate situation: Ill homeless people are discharged from hospitals and end up back on the streets without regular medical care. Inevitably, their health deteriorates.
If there were some way to stabilize these patients with ongoing help, then perhaps they would have fewer medical crises and not return to hospitals as often, members of the partnership reasoned.
Half were assigned to an intervention group. Social workers helped these patients find housing and worked with them for 18 months, providing help.
The others got "usual care" -- discharge to a shelter or a respite center.
The benefits of intervention were significant, the report stated: Homeless people who got assistance had 24 percent fewer emergency department visits and 29 percent fewer hospitalizations at the end of 18 months.
Put another way, the study shows that for every 100 homeless adults offered assistance, expected benefits include 49 fewer hospitalizations, 270 fewer hospital days and 116 fewer emergency department visits.
"With stable housing, people get linked up to primary care and are better able to follow medical advice," said Dr. Laura Sadowski, the lead researcher and a physician at Stroger Hospital.
"When people who are homeless have a place to sleep and eat and keep their medicine, they don't have to be in and out of hospitals and emergency rooms all the time," said Arturo Bendixen, the Chicago partnership's director.
That was true for Sam, 57, a formerly homeless man with gout, arthritis and cirrhosis of the liver who participated in the study.
Sam, who asked that his last name not be published, described waking up "dizzy and disoriented" several years ago and calling 911. "You're dying and you're an alcoholic," Sam said the paramedic told him.
But Sam kept drinking until he ended up at Stroger Hospital in 2006, where a social worker told him about the study and he signed on. "I didn't even imagine all the stuff that's happened since," Sam said. "I got taken care of. ... They got me an apartment. I'm not drinking anymore. It's a different lifestyle."
Mt. Sinai and other partnership members are continuing the program because "it makes such a dramatic difference," said Lori Pacura, vice president of patient care services at Mt. Sinai.
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