Objective. The Boston Health Care for the Homeless Program (BHCHP) provides medical respite care for homeless persons in two freestanding facilities with a total of 90 beds. Sub-acute, post-acute, recuperative care, and hospice care were provided to 734 homeless individuals during 1998. Admissions are designed as an alternative to acute care hospitalizations, either directly through emergency room diversion or by shortening lengths of hospital admissions for those who require medical and nursing services and are too ill or frail to withstand the rigors of the shelters and streets without substantial health risks. Methods. To understand the morbidity and describe the primary diagnoses of homeless individuals admitted for respite care, the medical records were reviewed of a random sample of 276 (24%) of the 1138 admissions during CY98. Results: Orthopedic problems accounted for one-quarter of admissions, with 21 (31%) of those 67 due to injury and trauma. 64 (23%) admissions were due to infectious diseases, including 25 (39%) for HIV/AIDS-related illnesses and 16 (25%) for cellulitis. 21 (8%) persons were admitted with endocrine diagnoses, with 19 for diabetes. Conclusion. Domiciled individuals can be discharged from emergency departments and hospitals with family, visiting nurse, home health aide, and other home supports. The lack of such supports for homeless persons can result in more acute care hospitalizations and prolonged lengths of stay. BHCHP’s respite care program is an example of a growing number of innovative alternatives to costly acute care hospitalization for homeless persons.
Learning Objectives: 1. Understand the role of a respite program in the in the continuum of care for homeless persons. 2. Assess the morbidity of a cohort of homeless persons with complex and chronic medical problems. 3. Discuss the utilization of respite care facilities in providing cost-effective alternatives to acute care hospitalization for homeless persons
Keywords: Homeless Health Care, Access and Services
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.