Grant: Project Grant

People with lived experience of homelessness (PWLEH) have poor health and complex medical and social needs. They frequently present to hospital to meet these needs. Unfortunately, while hospitals can treat acute medical conditions, they are not well-equipped to address social barriers (such as housing) that are frequently the root causes of ill-health. PWLEH are therefore discharged back to the street, with no real change in either their long-term trajectory in health or social conditions. Medical respite programs (MRPs) are an innovation that bridges hospital-based medical care with shelter-based housing and social support. They are designed for patients too well for acute care, but too sick to be discharged to the street. In Calgary, an MRP was recently created as a transitional unit (based within a homeless shelter) that provides nursing care, while simultaneously focusing on expediting housing. There are only three other MRPs in Canada. It is unknown how effective they are in improving health and well-being. We will conduct a mixed methods evaluation to assess the effectiveness of the Calgary MRP. Our study will follow a group of PWLEH before and after attending the MRP, to determine whether the MRP reduces rates of hospital admission, hospital length of stay, and visits to the emergency department. We will also explore whether the MRP changes patterns of drug and alcohol use, and whether it improves quality of life and time to stable housing. Lastly, in-depth interviews with MRP patients will be conducted to better understand how the MRP has (or has not) affected their social circumstances, support network, engagement with the health system and ultimately their well-being. Our findings will inform other jurisdictions on the effect of this innovation for a particularly underserved population.