Using evidence to impact policy change: How transforming healthcare utilization of a chronic homeless population reduces costs, increases the quality of care, and improves patient outcomes
Methods: This study used local hospital billing and medic data to examine healthcare utilization chronically homeless individuals (N=54) living in a PSH program in Charlotte, North Carolina. Local hospital billing data was collected for the two years prior and two year following each consenting tenant’s move into the PSH program.
Results: In the two years after moving into PSH, the average number of tenant ED visits decreased from 16.1 (SD=39.1) to 3.1 (SD=5.3) visits; t(49)=2.606, p=.012. The average length of hospitalizations originating from those visits decreased from 9.4 (SD=17.7) to 3.6 (SD=11.6) days; t(49)=2.039, p=.047. The average participant outpatient utilization increased from 7.2 (SD 11.70) to 10.9(SD 8.6) visits; t(53) p=.008.
Discussion: Study findings underscore the effectiveness of PSH in interrupting frequent utilization of EDs and changing healthcare utilization to a lower-cost outpatient setting. The results provide evidence for policy changes for care management in a PSH setting by Medicaid for the chronically homeless population to improve patient outcomes, improve the quality of care, and lower the overall costs of healthcare.
Learning Areas:Administer health education strategies, interventions and programs
Administration, management, leadership
Public health administration or related administration
Demonstrate how to reduce healthcare utilization and reduce costs for a chronically homeless population
Keyword(s): Homelessness, Health Care Access
Qualified on the content I am responsible for because: I have conducted research around changing healthcare utilization, improving healthcare outcomes, and lowering healthcare costs for Carolina's Healthcare System, the public hospital authority for Mecklenburg County for 7 years. I have worked on grant-funded projects targeting at-risk populations such as the Hispanic/Latino immigrant community around access to healthcare and the chronic homeless.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.