The Cottage: providing medical respite care in a home-like environment for people experiencing homelessness

Research output: Contribution to journalArticle

Abstract

Purpose
Co-existing health conditions and frequent hospital usage are pervasive in homeless populations. Without a home to be discharged to, appropriate discharge care and treatment compliance are difficult. The Medical Respite Centre (MRC) model has gained traction in the USA, but other international examples are scant. The purpose of this paper is to address this void, presenting findings from an evaluation of The Cottage, a small short-stay respite facility for people experiencing homelessness attached to an inner-city hospital in Melbourne, Australia.

Design/methodology/approach
This mixed methods study uses case studies, qualitative interview data and hospital administrative data for clients admitted to The Cottage in 2015. Hospital inpatient admissions and emergency department presentations were compared for the 12-month period pre- and post-The Cottage.

Findings
Clients had multiple health conditions, often compounded by social isolation and homelessness or precarious housing. Qualitative data and case studies illustrate how The Cottage couples medical care and support in a home-like environment. The average stay was 8.8 days. There was a 7 per cent reduction in the number of unplanned inpatient days in the 12-months post support.

Research limitations/implications
The paper has some limitations including small sample size, data from one hospital only and lack of information on other services accessed by clients (e.g. housing support) limit attribution of causality.

Social implications
MRCs provide a safe environment for individuals to recuperate at a much lower cost than inpatient admissions.

Originality/value
There is limited evidence on the MRC model of care outside of the USA, and the findings demonstrate the benefits of even shorter-term respite post-discharge for people who are homeless.
Original languageEnglish
JournalHousing, Care and Support
DOIs
Publication statusPublished - 2018

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homelessness
medical care
housing
health
qualitative interview
causality
void
attribution
compliance
social isolation
hospital
methodology
lack
costs
evaluation
cost
evidence

Cite this

@article{40e564f57fa3427c84524001df58d350,
title = "The Cottage: providing medical respite care in a home-like environment for people experiencing homelessness",
abstract = "PurposeCo-existing health conditions and frequent hospital usage are pervasive in homeless populations. Without a home to be discharged to, appropriate discharge care and treatment compliance are difficult. The Medical Respite Centre (MRC) model has gained traction in the USA, but other international examples are scant. The purpose of this paper is to address this void, presenting findings from an evaluation of The Cottage, a small short-stay respite facility for people experiencing homelessness attached to an inner-city hospital in Melbourne, Australia.Design/methodology/approachThis mixed methods study uses case studies, qualitative interview data and hospital administrative data for clients admitted to The Cottage in 2015. Hospital inpatient admissions and emergency department presentations were compared for the 12-month period pre- and post-The Cottage.FindingsClients had multiple health conditions, often compounded by social isolation and homelessness or precarious housing. Qualitative data and case studies illustrate how The Cottage couples medical care and support in a home-like environment. The average stay was 8.8 days. There was a 7 per cent reduction in the number of unplanned inpatient days in the 12-months post support.Research limitations/implicationsThe paper has some limitations including small sample size, data from one hospital only and lack of information on other services accessed by clients (e.g. housing support) limit attribution of causality.Social implicationsMRCs provide a safe environment for individuals to recuperate at a much lower cost than inpatient admissions.Originality/valueThere is limited evidence on the MRC model of care outside of the USA, and the findings demonstrate the benefits of even shorter-term respite post-discharge for people who are homeless.",
keywords = "Homelessness, medical respite care, Emergency department, hospital use, medical respite centre",
author = "Angela Gazey and Shannen Vallesi and Karen Martin and Craig Cumming and Lisa Wood",
year = "2018",
doi = "10.1108/HCS-08-2018-0020",
language = "English",
journal = "Housing, Care and Support",
issn = "1460-8790",
publisher = "Emerald Group Publishing Limited",

}

TY - JOUR

T1 - The Cottage: providing medical respite care in a home-like environment for people experiencing homelessness

AU - Gazey, Angela

AU - Vallesi, Shannen

AU - Martin, Karen

AU - Cumming, Craig

AU - Wood, Lisa

PY - 2018

Y1 - 2018

N2 - PurposeCo-existing health conditions and frequent hospital usage are pervasive in homeless populations. Without a home to be discharged to, appropriate discharge care and treatment compliance are difficult. The Medical Respite Centre (MRC) model has gained traction in the USA, but other international examples are scant. The purpose of this paper is to address this void, presenting findings from an evaluation of The Cottage, a small short-stay respite facility for people experiencing homelessness attached to an inner-city hospital in Melbourne, Australia.Design/methodology/approachThis mixed methods study uses case studies, qualitative interview data and hospital administrative data for clients admitted to The Cottage in 2015. Hospital inpatient admissions and emergency department presentations were compared for the 12-month period pre- and post-The Cottage.FindingsClients had multiple health conditions, often compounded by social isolation and homelessness or precarious housing. Qualitative data and case studies illustrate how The Cottage couples medical care and support in a home-like environment. The average stay was 8.8 days. There was a 7 per cent reduction in the number of unplanned inpatient days in the 12-months post support.Research limitations/implicationsThe paper has some limitations including small sample size, data from one hospital only and lack of information on other services accessed by clients (e.g. housing support) limit attribution of causality.Social implicationsMRCs provide a safe environment for individuals to recuperate at a much lower cost than inpatient admissions.Originality/valueThere is limited evidence on the MRC model of care outside of the USA, and the findings demonstrate the benefits of even shorter-term respite post-discharge for people who are homeless.

AB - PurposeCo-existing health conditions and frequent hospital usage are pervasive in homeless populations. Without a home to be discharged to, appropriate discharge care and treatment compliance are difficult. The Medical Respite Centre (MRC) model has gained traction in the USA, but other international examples are scant. The purpose of this paper is to address this void, presenting findings from an evaluation of The Cottage, a small short-stay respite facility for people experiencing homelessness attached to an inner-city hospital in Melbourne, Australia.Design/methodology/approachThis mixed methods study uses case studies, qualitative interview data and hospital administrative data for clients admitted to The Cottage in 2015. Hospital inpatient admissions and emergency department presentations were compared for the 12-month period pre- and post-The Cottage.FindingsClients had multiple health conditions, often compounded by social isolation and homelessness or precarious housing. Qualitative data and case studies illustrate how The Cottage couples medical care and support in a home-like environment. The average stay was 8.8 days. There was a 7 per cent reduction in the number of unplanned inpatient days in the 12-months post support.Research limitations/implicationsThe paper has some limitations including small sample size, data from one hospital only and lack of information on other services accessed by clients (e.g. housing support) limit attribution of causality.Social implicationsMRCs provide a safe environment for individuals to recuperate at a much lower cost than inpatient admissions.Originality/valueThere is limited evidence on the MRC model of care outside of the USA, and the findings demonstrate the benefits of even shorter-term respite post-discharge for people who are homeless.

KW - Homelessness

KW - medical respite care

KW - Emergency department

KW - hospital use

KW - medical respite centre

U2 - 10.1108/HCS-08-2018-0020

DO - 10.1108/HCS-08-2018-0020

M3 - Article

JO - Housing, Care and Support

JF - Housing, Care and Support

SN - 1460-8790

ER -