HealthWare Systems Blog
on Wednesday, August 8, 2018
Hospitals can significantly improve the health of patients suffering from housing instability by actively addressing patient housing needs. A patient’s living situation, conditions, and location affect many aspects of health. Poor housing quality increases the risk of infectious disease, injury, chronic illness, pest and mold problems, and indoor air pollution. Neighborhood conditions are related to rates of violence, crime, noise, and opportunities for physical activity.
Improving patient housing situations can result in better health outcomes and quality of life for patients and their families. Plus, there are financial incentives for addressing patient housing needs. According to the American Hospital Association’s Social Determinants of Health Series:
“The economic benefits for hospitals can be significant, since homeless or unstably housed individuals are more likely to be uninsured, be hospitalized more frequently, have longer lengths of stay in the hospital, be readmitted within 30 days and use more high-cost services. Reducing homelessness and other forms of housing instability—through case management, supportive housing (supportive services combined with housing), housing subsidies or neighborhood revitalization—improves health outcomes, connects individuals with primary care and reduces these high levels of utilization. When hospitals and health systems focus their resources on housing supports and case management, the cost savings can offset the expenditures by between $9,000 and $30,000 per person per year.” (p. 8)
Here are a few ways hospitals can address patient housing needs:
Contribute to neighborhood improvement projects. Collaborate with your local government and other organizations that hold a shared interest in the state of your community. Get involved or make monetary donations to make a difference.
Provide home assessments and patient education for vulnerable populations. For example, the Seattle-King County Healthy Homes Project targeted low-income households with asthmatic children. The initiative sent a nurse and community health workers to patients’ homes to educate the families about asthma and self-management and to identify and address environmental triggers (with resources like bedding covers, vacuums, and cleaning supplies). The goal was to improve health outcomes for patients with asthma and to reduce the use of healthcare services such as urgent care.
Set up a home repair referral program. Don’t stop at simply assessing patients’ homes for health and safety risks; refer them to a local business that can take care of necessary home renovations for them. Establish partnerships with businesses who will offer their services at a reduced rate to your referrals or find charitable organizations like veterans’ clubs and churches that may have volunteers who could do the work for free. The One Touch e-referral program has seen success in linking government and nonprofit groups like Habitat for Humanity to create healthier homes.
Bring care to homeless patients via a mobile health center. Visit shelters, churches, and community centers and offer primary and preventive health services to at-risk patients. (Take a virtual tour of the Calvert Health System Mobile Health Center.)
Create a transitional arrangement for homeless patients whose conditions require they be discharged from the hospital, but who are not yet well enough to go back to a shelter or live on the street. St. Joseph Health created a Medical Respite Program consisting of 15 beds set at three different locations to meet this need. As its website explains, these beds are for homeless patients “who are being discharged from the hospital, and who need the opportunity to rest in a safe, healing environment while accessing medical care and other supportive services post-hospitalization.”
Invest in your own affordable patient housing. According to its website, Bon Secours Baltimore “has developed and now owns and operates more than 720 apartment units for low- and moderate-income seniors, families and people with disabilities.” The heath system has committed to “revitalize West Baltimore.”
Compile a list of affordable patient housing options near your facility. UW Medicine created a list of both short-term and long-term housing options to help patients, as well as their family members and caregivers, find lodging. Some of their local hotels even offer a discount to patients’ families and a shuttle service to and from the hospital.
Many of the above ideas for addressing patient housing needs are suggested by and discussed in further detail in the AHA’s guide, “Housing and the Role of Hospitals.” This guide also outlines steps hospitals should take when determining which method(s) would best address the patient housing needs in their own communities (p. 10-11).
Ensuring patients go home to safe, clean environments is critical in helping to reduce hospital readmission rates, which is crucial to reimbursement.
Patient housing instability is one of multiple interconnected social factors that affect health outcomes and healthcare costs. Along with patient housing needs, health systems should attend to other social determinants of health by, for example, addressing patient transportation needs and working to reduce patient malnutrition.