A survey of the nation's homeless in 30 cities has found that more than one in five visited the emergency department or was hospitalized over three times in the last year, nearly 40% had no health coverage such as Medicaid and more than one in five were living with triple diagnoses.
That's the finding of the 100,000 Homes Campaign, a private and government funded outreach project that is seeking to, in part, reach out to hospitals and doctors to remedy the situation.
"Hospitals have a whole lot of ways they can be a part of this," says Catherine Craig, director of Health Integration for Community Solutions, the national campaign's parent organization. "Unfortunately, we see that solving the problem is not necessarily on every hospital's list of priorities."
The survey also found that 44% of the 18,778 homeless individuals surveyed face at least one health condition that puts them at risk of dying in the street, 45% have been diagnosed with mental illness. And 11.8% had sought care in a hospital emergency room in the last three months.
Of those surveyed, 22% acknowledged three health conditions: they have substance abuse issues, a mental illness diagnosis, and a chronic physical condition such as a disease. About 2,000 volunteers asked the questions – part of what they called a "vulnerability index" assessment in areas where homeless people congregate.
At least one in 10 reported asthma, diabetes, hepatitis C, or a heart condition. About 5% said they had been diagnosed with emphysema or cancer. More than half – 57% reported a history of substance abuse and 45% had symptoms of mental illness.
The organization's goal is to encourage partnerships between community organizations, physicians, and hospitals to find housing for homeless individuals, without which treatment for the other conditions a homeless person faces will more likely fail, Craig said.
Hospitals may have a greater incentive to participate in such community programs as they will soon face penalties in federal reimbursement – under provisions of the Affordable Care Act – if they have higher risk-adjusted rates of readmissions than other hospitals.
Craig said that programs launched by Bellevue Hospital Center and Woodhull Medical Center in New York City and Thomas Jefferson University Hospitals in Philadelphia have reported that their involvement in housing projects helped keep homeless people off the street, and out of the hospital.
And a collaboration of hospitals in Los Angeles has developed housing programs in nearby Bell where homeless patients can be discharged – after their acute care needs are met – so that hospitals can avoid releasing them to the street, in violation of city laws. Before that project was started, hospitals were forced to keep homeless patients in a hospital bed even if they were well enough to go home, if they had one.