Thirty-Day Hospital Readmission Among Homeless Individuals with Medicaid in Massachusetts

Authors
Melanie W. Racine
David Munson
Jessie M. Gaeta
Travis P. Baggett
Peer-Reviewed Article
January 2020
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Headline

Discharge to medical respite care leads to lower hospital readmission rates among individuals who are frequently admitted to the hospital.

Context

Medical respite care has emerged as an evidence-based approach to improve outcomes for people experiencing homelessness following an illness, injury, or hospitalization. By providing short-term housing and access to medical, behavioral, and other critical services, medical respite programs can interrupt cycles of homelessness and hospitalizations. This study assesses the impact of discharge to medical respite care on readmission rates among a sample of Medicaid members in Massachusetts attributed to the Boston Health Care for the Homeless Program (BHCHP).

Findings

The authors use a retrospective observational cohort study design to compare hospital readmission rates among homeless individuals discharged from the hospital to a community-based medical respite care provider with people not discharged to medical respite care. When controlling for age, sex, race, and the presence of 3 or more chronic medical conditions, discharge to medical respite care was associated with a 51% lower likelihood of readmission among individuals who were previously frequently admitted to the hospital. However, discharge to medical respite care was not associated with a change in the overall rate of readmission among the study sample. Individuals with an assigned primary care provider at BHCHP were also less likely to be readmitted.

Takeaways

Medical respite care can improve health outcomes and reduce hospital readmissions among individuals who are frequently admitted to the hospital, potentially leading to overall cost savings. Given these benefits, hospitals, health systems, and other health care stakeholders should consider prioritizing medical respite care referrals for this population.

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