Program Outcomes and Health Care Utilization of People Experiencing Homelessness and Substance Use Disorder after...

Area of Science:

• Public Health
• Health Services Research
• Addiction Medicine

Background:

• People experiencing homelessness (PEH) face significant health challenges, including high rates of mental illness and substance use disorder (SUD).
• Transitional care and medical respite programs are crucial for managing acute and chronic conditions in PEH, enabling safe transitions to community settings.
• Harm reduction strategies within these programs can enhance positive outcomes for PEH with SUD.

Purpose of the Study:

• To evaluate program outcomes, healthcare utilization, and comorbidities in PEH with and without SUD participating in a transitional care and medical respite program.
• To assess the impact of the program on acute care utilization for PEH with and without SUD.
• To identify opportunities for integrating harm reduction strategies to improve social and clinical outcomes.

Main Methods:

• Comparative analysis of program outcomes between PEH with and without SUD.
• Evaluation of healthcare utilization patterns before and after program engagement.
• Assessment of comorbid conditions, including trimorbidity, within the PEH population.

Main Results:

• PEH with SUD experienced similar program outcomes compared to those without SUD.
• Both groups demonstrated decreased acute care utilization following participation in the program.
• A high prevalence of trimorbidity was observed, a condition linked to increased mortality risk.

Conclusions:

• Transitional care and medical respite programs are effective in improving outcomes and reducing acute care utilization for PEH, irrespective of SUD status.
• The high prevalence of trimorbidity highlights the critical need for comprehensive care strategies.
• Integrating harm reduction approaches offers significant potential to enhance both social and clinical outcomes for PEH, particularly those with SUD.