Wednesday, May 13, 2009
Housing for the chronically ill homeless
Last week, JAMA published a study on a housing and case management program aimed at reducing ED visits and hospital stays in the chronically ill homeless. Researchers in Chicago randomly assigned 407 homeless adults with ailments like diabetes and congestive heart failure to the intervention group, which received additional support after hospital discharge, or the usual care group, which received standard discharge planning. Patients in the intervention group were offered postdischarge case management and help finding long-term housing. Over 18 months, intervention group patients were less likely to return to the hospital for care, with a relative reduction of 29% in hospitalizations (95% CI, 10% to 44%) and 24% in emergency department visits (95% CI, 3% to 40%).
The study findings are encouraging, but at the same time it's hard to avoid wondering how these kinds of interventions would work on a larger or longer-term scale. The title of the accompanying editorial says it all: "Housing the chronically homeless: High hopes, complex realities". The real challenge, the editorialists write, is determining which subgroups are most likely to benefit.
posted by Jennifer Kearney-Strouse at
3:06 PM
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