Clinical Report: Inequities in Extended Hospital Stays for Individuals Facing Homelessness
Overview
This study investigates the prevalence of Alternate Level of Care (ALC) designations among hospitalized individuals experiencing homelessness in Ontario, Canada. It highlights significant disparities in ALC rates compared to matched patients from low-resource neighborhoods, with ALC designation rates of 9.1% for patients with recent homelessness versus 2.0% for matched comparators.
Background
Transitions from hospital to community care are crucial for patient recovery, yet individuals experiencing homelessness encounter specific barriers that complicate timely discharge. These barriers include a lack of stable housing, complex medical and social needs, and systemic factors that delay discharge. Understanding these challenges is essential for improving health outcomes and resource utilization in healthcare settings.
Data Highlights
Group
ALC Designation Rate
Patients with recent homelessness
9.1%
Matched comparators from low-resource neighborhoods
2.0%
Key Findings
Individuals experiencing homelessness are more likely to receive ALC designations compared to matched low-resource neighborhood patients.
The rate of ALC designation among homeless patients is 4.51 times higher than that of their matched counterparts.
Delays in discharge for homeless patients are linked to increased lengths of hospital stays and higher healthcare costs.
Barriers to discharge include lack of stable housing and access to follow-up care.
Systemic factors, such as limited transitional housing, contribute to these delays.
Clinical Implications
Healthcare providers should recognize the unique challenges faced by homeless patients during hospital discharge.
Conclusion
The findings indicate a need for targeted interventions to support timely hospital discharges for individuals experiencing homelessness.
