Introduction

Addressing the health needs of the homeless population is a challenge to physicians, health institutions, and federal, state, and local governments. Homelessness is pervasive in the United States, and an estimated 3.5 million individuals are likely to experience homelessness in a given year. To address this problem, 860 cities and counties have enacted 10-year plans to end homelessness, and 49 states have created Interagency Councils on Homelessness.

Rates of chronic medical illness are high among homeless adults. With the exception of obesity, stroke, and cancer, homeless adults are far more likely to have a chronic medical illness such as human immunodeficiency virus (HIV), hypertension, and diabetes mellitus and more likely to experience a complication from the illness because they lack adequate housing and regular, uninterrupted treatment. Homeless adults are frequent users of costly emergency department and hospital services, largely paid for by public dollars. The combination of chronic medical illnesses and poor access to primary health care has substantial health and economic consequences.

Prior intervention research has focused on subgroups of the homeless population, particularly those with severe mental illness, substance abuse disorders, veterans, or those with HIV. Few studies of these subgroups have found any positive effect of housing and case management on health or health service use, although most compared 2 active interventions without a comparison group receiving usual care. Missing are intervention studies of homeless individuals with any chronic medical illness. This study sought to determine whether an intervention that provided housing and case management for homeless adults with chronic medical illness would reduce hospitalizations and visits to the emergency department.

Read the full study on the JAMA website:

Watch "Housing The Homeless After Hospitalization Cuts Readmissions" from MedPage Today: