'Homeless navigators' help reduce ER use, readmissions

One of the key factors in preventing hospital readmissions is for health leaders to think of patients as their responsibility even after discharge. Some hospitals are extending this thinking to homeless patients, the Los Angeles Daily News reports.

Several hospitals rely on specialists known as "homeless navigators" to help indigent patients find housing or treatment centers after discharge. Homeless people who frequently use emergency departments often have drug or alcohol addictions that go untreated during their stays, which only increases the likelihood of readmission, according to Jonathan Lopez, homeless navigator for Woodland Hills (Calif.) Medical Center.

"When a frequent flyer returns to our ED my adrenalin gets going," Lopez told the Daily News. "I instantly start to process where I might be able to coordinate a placement. I get to relate to these individuals in an extraordinary way."

Lopez, with the aid of various caseworkers and nurses, tries to find transitional housing for homeless patients after discharge, or treatment centers or sober living environments for addicts. Lack of resources often complicated these efforts. Los Angeles County, for example, has 6,000 emergency beds in homeless shelters, but nearly 10 times as many homeless people, according to the article. Resource availability, Lopez told the Daily News, is the "greatest challenge" to his work.

"Frequent flyer" hospital stays at Woodland Hills result in an average of $1,500 a night in uncompensated care, the article notes, and nationwide uncompensated care costs reached $41 billion (although not all patients were homeless).

Elsewhere in the U.S., clinics and mobile medical homes are seeking to reduce readmissions by identifying "frequent flyers" and coordinating care for them. Research by St. Michael's Hospital in Toronto found homeless women use emergency departments at 13 times the rate of women in the general population, FierceHealthcare previously reported.

To learn more:
- read the Daily News article

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