Homelessness is associated with significantly higher 30- and 90-day readmission rates even when adjusting for other demographic and clinical factors, according to a study recently published in the Journal of General Internal Medicine.
Sameed Ahmed M. Khatana, M.D., from University of Pennsylvania in Philadelphia, and colleagues evaluated the association of homelessness with 30-day and 90-day readmission rates using administrative claims for all inpatient hospitalizations in Florida, Massachusetts, and New York from January 2010 to October 2015.
The researchers report that of a total of 23,103,125 index hospitalizations, 515,737 were for patients who were identified as homeless at the time of discharge. Both 30-day and 90-day readmission rates were higher for index hospitalizations in the homeless group versus the housed group when adjusting for cause of index hospitalization, state, demographics, and comorbidities. In Florida, the difference in 30-day readmission rates between homeless and housed groups was largest (30.4 versus 19.3 percent), followed by Massachusetts (23.5 versus 15.2 percent) and New York (15.7 versus 13.4 percent; combined 17.3 versus 14 percent). Thirty-day readmission rates for the homeless group were higher across the most common causes of hospitalization: 4.1 percentage points higher for mental illness, 4.9 percentage points higher for diseases of the circulatory system, and 2.4 percentage points higher for diseases of the digestive system.
“Differences across states point to the potential of certain public policies to impact health outcomes for individuals experiencing homelessness,” the authors write.