Homelessness and the high cost of medical care

I’ve blogged repeatedly about the relationship between our medical system and homelessness–direct discharge from hospitals to homeless shelters for example. Here in Madison, we’re working to find solutions that could involve creating respite care for homeless individuals and families, a place to come after they’ve been discharged where they can receive the care they need as they recover from surgery or illness. But that’s only part of the problem.

A study in Chicago shows the effects of providing supporting housing for homeless people with chronic illnesses:

A beautiful randomized trial conducted here in Chicago supports Bendixen’s claims. That study found that placing homeless people with chronic illnesses in supportive housing reduces emergency department visits, residential substance abuse treatment, hospital inpatient admissions and nursing home use. Researchers also observed average annual cost savings of $6,307, with greater average savings among the chronically homeless ($6,607) and among those living with HIV ($9,809). The sample size of 407 was too small to establish statistically significant savings, but the results were obviously promising, especially when housing services are focused on men and women with high expected medical costs.

In Illinois, 3.2% of patients accounted for half of all Medicaid spending; the top.15% (4500 of a total 3.2 million enrollees), had required annual spending of $285,000 each.

The article points out that in addition to housing, chronically ill people need help with medications, reminders to keep appointments, and case managers. There are profiles of two people who are in the supportive housing program.


The full story is here.

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