Title |
Outcomes of specialist discharge coordination and intermediate care schemes for patients who are homeless: analysis protocol for a population-based historical cohort
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Published in |
BMJ Open, December 2017
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DOI | 10.1136/bmjopen-2017-019282 |
Pubmed ID | |
Authors |
Ruth M Blackburn, Andrew Hayward, Michelle Cornes, Martin McKee, Dan Lewer, Martin Whiteford, Dee Menezes, Serena Luchenski, Alistair Story, Spiros Denaxas, Michela Tinelli, Fatima B Wurie, Richard Byng, Michael C Clark, James Fuller, Mark Gabbay, Nigel Hewett, Alan Kilmister, Jill Manthorpe, Joanne Neale, Robert W Aldridge |
Abstract |
People who are homeless often experience poor hospital discharge arrangements, reflecting ongoing care and housing needs. Specialist integrated homeless health and care provision (SIHHC) schemes have been developed and implemented to facilitate the safe and timely discharge of homeless patients from hospital. Our study aims to investigate the health outcomes of patients who were homeless and seen by a selection of SIHHC services. Our study will employ a historical population-based cohort in England. We will examine health outcomes among three groups of adults: (1) homeless patients seen by specialist discharge schemes during their hospital admission; (2) homeless patients not seen by a specialist scheme and (3) admitted patients who live in deprived neighbourhoods and were not recorded as being homeless. Primary outcomes will be: time from discharge to next hospital inpatient admission; time from discharge to next accident and emergency attendance and 28-day emergency readmission. Outcome data will be generated through linkage to hospital admissions data (Hospital Episode Statistics) and mortality data for November 2013 to November 2016. Multivariable regression will be used to model the relationship between the study comparison groups and each of the outcomes. Approval has been obtained from the National Health Service (NHS) Confidentiality Advisory Group (reference 16/CAG/0021) to undertake this work using unconsented identifiable data. Health Research Authority Research Ethics approval (REC 16/EE/0018) has been obtained in addition to local research and development approvals for data collection at NHS sites. We will feedback the results of our study to our advisory group of people who have lived experience of homelessness and seek their suggestions on ways to improve or take this work further for their benefit. We will disseminate our findings to SIHHC schemes through a series of regional workshops. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 9 | 47% |
Ireland | 1 | 5% |
Korea, Democratic People's Republic of | 1 | 5% |
United States | 1 | 5% |
Unknown | 7 | 37% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 9 | 47% |
Scientists | 6 | 32% |
Members of the public | 3 | 16% |
Science communicators (journalists, bloggers, editors) | 1 | 5% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 76 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 14 | 18% |
Student > Bachelor | 9 | 12% |
Student > Doctoral Student | 5 | 7% |
Professor | 4 | 5% |
Student > Postgraduate | 4 | 5% |
Other | 15 | 20% |
Unknown | 25 | 33% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 16 | 21% |
Nursing and Health Professions | 7 | 9% |
Social Sciences | 7 | 9% |
Business, Management and Accounting | 2 | 3% |
Agricultural and Biological Sciences | 2 | 3% |
Other | 12 | 16% |
Unknown | 30 | 39% |