Assessment of a Hotel-Based Protective Housing Program for Incidence of SARS-CoV-2 Infection and Management of Chronic Illness Among Persons Experiencing Homelessness

Huggett, Thomas D.; Tung, Elizabeth L.; Cunningham, Megan; Ghinai, Isaac; Duncan, Heather; Detmer, Wayne M.

doi:10.1001/jamanetworkopen.2021.38464

Cited by 16 publications

(21 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, two trends suggest the value of direct elicitation of social needs information from patients. First, studies continue to show the value of eliciting social needs for outcomes important for patients, such as providing transportation to reduce missed medical appointments [14], providing housing to reduce COVID transmission [15], changing landlord behavior to reduce home health hazards [16], and using food prescriptions to address nutritional deficits [17]. Second, health care organizations and insurance plans are already acquiring social needs data by interrogating EHR records and geocoded public and proprietary databases.…”

Section: Discussionmentioning

confidence: 99%

Do patients want clinicians to ask about social needs and include this information in their medical record?

Albert

McCracken

Bui

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

Background Social needs screening in primary care may be valuable for addressing non-medical health-related factors, such as housing insecurity, that interfere with optimal medical care. Yet it is unclear if patients welcome such screening and how comfortable they are having this information included in electronic health records (EHR). Objective To assess patient attitudes toward inclusion of social needs information in the EHR and key correlates, such as sociodemographic status, self-rated health, and trust in health care. Design, participants, and main measures In a cross-sectional survey of patients attending a primary care clinic for annual or employment exams, 218/560 (38%) consented and completed a web survey or personal interview between 8/20/20-8/23/21. Patients provided social needs information using the Accountable Care Communities Screening Tool. For the primary outcome, patients were asked, “Would you be comfortable having these kinds of needs included in your health record (also known as your medical record or chart)?” Analyses Regression models were estimated to assess correlates of patient comfort with including social needs information in medical records. Key results The median age was 45, 68.8% were female, and 78% were white. Median income was $75,000 and 84% reported education beyond high school. 85% of patients reported they were very or somewhat comfortable with questions about social needs, including patients reporting social needs. Social need ranged from 5.5% (utilities) to 26.6% (housing), and nonwhite and gender-nonconforming patients reported greater need. 20% reported “some” or “complete” discomfort with social needs information included in the EHR. Adjusting for age, gender, race, education, trust, and self-rated health, each additional reported social need significantly increased discomfort with the EHR for documenting social needs. Conclusions People with greater social needs were more wary of having this information placed in the EHR. This is a concerning finding, since one rationale for collecting social need data is to use this information (presumably in the EHR) for addressing needs.

show abstract

Section: Discussionmentioning

confidence: 99%

Do patients want clinicians to ask about social needs and include this information in their medical record?

Albert

McCracken

Bui

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…It was often difficult to find a safe place to discharge the clients. Intriguingly, our average length of stay involved a shorter isolation/quarantine period compared to that noted by Huggett and colleagues in Chicago, IL, who reported an average stay of 59 days, ranging from 18 to 115 days [ 7 ]. In our cohort, the overall rate of successful contact for the student health teams was 72.4%, with 302 successful encounters in total.…”

Section: Discussionmentioning

confidence: 63%

Telehealth Monitoring for Individuals Experiencing Homelessness During the Early COVID-19 Pandemic: An Innovative Clinical and Medical Education Model

Meray¹,

Motorwala²,

Sellers³

et al. 2022

Cureus

View full text Add to dashboard Cite

Background: People experiencing homelessness (PEH) are recognized as members of a vulnerable population with significant health and social disparities. Due to the COVID-19 pandemic, these populations are at risk for increased morbidity and mortality. The Herbert Wertheim College of Medicine (HWCOM) of Florida International University (FIU) in collaboration with the Miami-Dade County Homeless Trust presents this case series based on the results of the Telemedicine Homeless Monitoring Project, launched in April 2020.Methods: Utilizing a faculty-student educational model, medical students at FIU HWCOM called PEH patients residing in isolation hotels on a daily basis to monitor their symptoms using a COVID-19 risk assessment template. Thirty-one PEH patients were followed for the duration of 12 weeks between April 2020 and August 2020. A retrospective chart review was then conducted, and four exemplar patients were chosen, highlighting common themes. Variables in the risk assessment included demographics, comorbidities, past medical history, indications for isolation or quarantine, length of stay, clinical and social needs identified, and qualitative data regarding barriers or successes of the telehealth platform.Results: Thirty-one patients, between the ages of 20 and 84 and with an average age of 50.74, were followed in the program. There were eight females and 23 males in the study. Four exemplar PEH patients were discussed, highlighting the common themes identified; the lack of basic necessities that PEH face, the burden of chronic medical illnesses, a lack of health literacy, the burden of mental illnesses, and the acute stress caused by COVID-19 itself.Conclusion: Our research identified numerous characteristics of the homeless population that providers should pay special attention to during the pandemic. The relationship between the Homeless Trust and FIU HWCOM provided medical students with an excellent learning opportunity by letting them participate in clinical care while under lockdown due to the COVID-19 outbreak. Based on the results of the study, we believe that models like this will be useful in the event of a future epidemic.

show abstract

“…A second potential contributor is that the unregulated drug supply may have continued to become more toxic as the pandemic progressed, resulting in more severe overdoses for which care could not be deferred [ 36 , 40 ]. One final potential contributor is the movement of individuals experiencing homelessness into temporary housing facilities during the pandemic given high risk of viral transmission in congregate shelters [ 52 ]. This may have reduced overdoses given the strong link between the experience of homelessness and drug overdoses [ 19 , 53 , 54 ].…”

Section: Discussionmentioning

confidence: 99%

Drug Overdoses During the COVID‐19 Pandemic Among Recently Homeless Individuals

Liu

Richard²,

Campitelli³

et al. 2022

Addiction

View full text Add to dashboard Cite

Aims To examine how weekly rates of emergency department (ED) visits for drug overdoses changed among individuals with a recent history of homelessness (IRHH) and their housed counterparts during the pre‐pandemic, peak, and re‐opening periods of the first wave of the COVID‐19 pandemic, using corresponding weeks in 2019 as a historical control. Design Population‐based retrospective cohort study conducted between September 30, 2018 and September 26, 2020. Setting Ontario, Canada. Participants A total of 38 617 IRHH, 15 022 369 housed individuals, and 186 858 low‐income housed individuals matched on age, sex, rurality, and comorbidity burden. Measurements ED visits for drug overdoses of accidental and undetermined intent. Findings Average rates of ED visits for drug overdoses between January and September 2020 were higher among IRHH compared with housed individuals (rate ratio [RR], 148.0; 95% CI, 142.7–153.5) and matched housed individuals (RR, 22.3; 95% CI, 20.7–24.0). ED visits for drug overdoses decreased across all groups by ~20% during the peak period (March 17 to June 16, 2020) compared with corresponding weeks in 2019. During the re‐opening period (June 17 to September 26, 2020), rates of ED visits for drug overdoses were significantly higher among IRHH (RR, 1.56; 95% CI, 1.44–1.69), matched housed individuals (RR, 1.25; 95% CI, 1.08–1.46), and housed individuals relative to equivalent weeks in 2019 (RR, 1.07; 95% CI, 1.02–1.11). The relative increase in drug overdose ED visits among IRHH was larger compared with both matched housed individuals (P = 0.01 for interaction between group and year) and housed individuals (P < 0.001) during this period. Conclusions Recently homeless individuals in Ontario, Canada experienced disproportionate increases in ED visits for drug overdoses during the re‐opening period of the COVID‐19 pandemic compared with housed people.

show abstract

Assessment of a Hotel-Based Protective Housing Program for Incidence of SARS-CoV-2 Infection and Management of Chronic Illness Among Persons Experiencing Homelessness

Cited by 16 publications

References 20 publications

Do patients want clinicians to ask about social needs and include this information in their medical record?

Do patients want clinicians to ask about social needs and include this information in their medical record?

Telehealth Monitoring for Individuals Experiencing Homelessness During the Early COVID-19 Pandemic: An Innovative Clinical and Medical Education Model

Drug Overdoses During the COVID‐19 Pandemic Among Recently Homeless Individuals

Contact Info

Product

Resources

About