The Revolving Hospital Door

Hospital inpatient 30-day readmission rates among homeless patients reached almost 51 percent during this study's period.

The Issue

Little is known about hospital readmission rates among patients who are homeless. Understanding the readmission rates for homeless patients can provide communities with important information on caring for the homeless population and reducing hospital use.

Key Findings

• The 30-day inpatient hospital readmission rate among homeless patients was 50.8 percent.

   

• Among hospitalizations included in the study, 70 percent resulted in inpatient readmission, observation status stay, or emergency department visit within 30 days of hospital discharge.

   

• Most readmissions occurred within one week (53.9%) or two weeks (74.8%) of hospital discharge.

   

• Risk for readmission increased with discharge to the streets or shelter as compared to other living situations, like to a motel, a site of planned future care, or with friends or family.

   

Conclusion

The hospital readmissions rate among homeless patients is high, indicating that communities should focus on this problem by screening for homelessness and improving discharge planning. Further studies should examine multiple hospitals, including those with medical respite program or other specialized post-discharge programs.

About the Study

This retrospective chart review of homeless and hospitalized patients at a hospital in an urban setting from May to August 2012 included 113 unique patients who were admitted to the hospital a total of 266 times during the study period.