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Medical respite programs offer medical, nursing, and other care as well as accommodation for homeless persons discharged from acute hospital stays. They represent a community-based adaptation of urban health systems to the specific needs of homeless persons. This article examines whether post-hospital discharge to a homeless medical respite program was associated with a reduced chance of 90-day readmission compared to other disposition options. Adjusting for imbalances in patient characteristics using propensity scores, respite patients were the only group that was significantly less likely to be readmitted within 90 days compared to those released to Own Care. Respite programs merit attention as a potentially efficacious service for homeless persons leaving the hospital.
This report is dedicated to the memories of Nurse Barbara McInnis of Pine Street Inn and Ms. Ellen Dailey, whose longstanding advocacy on behalf of Boston's homeless spurred the development of novel models of service to this population. The authors acknowledge the kind assistance of Mr. Walter Ferranti of Boston Medical Center, and Teresa Everson in the conduct of this study. The Lister Hill Center on Health Policy (University of Alabama at Birmingham), the National Institute on Drug Abuse (K23-DA-15487), and Boston Health Care for the Homeless Program supported this work. These entities had no role in the collection, analysis, or interpretation of the data or in the decision to submit the manuscript for publication. Professor Ash is associated with the company that licenses the software to implement Diagnostic Cost Group (DCG)–based casemix adjustment (Versick Health, lnc.).