Using data from a local health system’s electronic medical record and the Indiana Health Information Exchange, we conducted a retrospective chart review of the 95 individuals who accessed the HF shelter and participated in the SM outreach during the outreach’s first year of operations. ED visits and hospitalization days were compared one year before and after the first date of housing and the first SM encounter using a one-sided paired t-test. We hypothesized that both interventions would reduce ED visits and hospitalization days.

ED visits decreased by 30% (322 to 226, p=0.01) following HF shelter entry and by 35% (437 to 284) after initial SM engagement. Hospitalization days also declined (259 to 146 post-HF shelter, p=0.07; 324 to 148 post-SM encounter, p=0.05), though declines were not statistically significant.

These findings highlight that low-barrier shelter and low-barrier healthcare initiatives significantly reduce ED utilization and may also decrease hospitalization. Expanding and integrating these interventions could maximize benefits for IEH and the communities they live in. HF approaches to shelter and SM approaches to medical care allow for IEH, a disproportionately disadvantaged population, to have basic human needs met in a way that benefits not only these individuals but also potentially many others, generating significant downstream positive economic and social benefits for broader communities. While these low-barrier initiatives can be justified based on their humanitarian benefit alone, this research suggests that they are also pragmatic and have potentially cost-saving consequences.