Background: People experiencing homelessness (PEH) face barriers to accessing regular ambulatory care, which increases their risk of having poorly controlled chronic medical conditions and contributes to high acute care utilization. The role of field-based homeless healthcare teams in improving hypertension and diabetes control and reducing acute care utilization (e.g., emergency department [ED] visits, inpatient hospitalizations) [...]

Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Demand for healthcare value has driven renewed attention to HaH, including from the Centers for Medicare and Medicaid Services. The COVID-19 pandemic has only magnified consideration of alternative sites of care. Where studied, HaH models have had desirable [...]

Background: Ambulatory care sensitive conditions (ACSCs) are a set of diagnoses that if not recognized and addressed properly in the ambulatory setting can lead to preventable hospitalizations. People experiencing homelessness (PEH) often have barriers to access of ambulatory care services and chronic disease self-management. These place them at high risk for having ACSCs, and contribute [...]

Background: Academic medical centers and other quaternary hospitals struggle with capacity challenges that manifest in longer ED wait times, delayed or cancelled elective surgical procedures, and delayed transfers from community hospitals[1]. The Hospital at Home model is an obvious and elegant solution to increase capacity[2], but its nationwide implementation has been limited due to lack [...]

Background: Patients experiencing unsheltered homelessness are at extreme risk for worse outcomes, including increased mortality 10 times that of the general population and an average life expectancy of 53 (over 20 yrs less than general population). Transitions of care pose unique difficulties for this vulnerable population, with numerous barriers to ongoing care and resulting readmission [...]

Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Demand for healthcare value, advances in relevant technologies, and the ongoing global pandemic have driven renewed attention to HaH models, by way of policy-based and academic pilot programs – and even commercialization attempts. Where studied, these models have [...]

Background: Lack of stable housing adversely affects health outcomes, increases healthcare utilization, and increases mortality. Few studies have assessed the prevalence of homelessness and housing insecurity in hospitalized patients. To address this gap, we conducted a hospital point-in-time study to determine the prevalence of housing insecurity and homelessness among hospitalized patients at two academic medical [...]

Background: “Hospital at Home” (HaH) models of care have existed for over 20 years in the U.S. Recent demand for healthcare value, advances in relevant technologies, and the ongoing global pandemic have driven renewed attention to HaH models, including from the Center for Medicare and Medicaid Services (CMS), and have spawned several pilots within the [...]

Background: Hospital at home (HaH) programs have shown efficacy as substitutes for high-cost, traditional hospitalization in patients who are primarily low-acuity and with a range of medical conditions, including community-acquired pneumonia (CAP) and urinary tract infection (UTI). However, wide-spread adoption is minimal as providers and patients are challenged to consider HaH at the time of [...]

Background: Patients experiencing homelessness have unique healthcare needs due to barriers of care, lack of access to food and safety, and limited social services. Patients can be experiencing homelessness temporarily or chronically. They experience high rates of substance abuse, mental illness and other health problems like HIV. These unique circumstances make patients experiencing homeless unique [...]