Medical Respite as a Transitional Care Intervention to Improve Health and Housing Outcomes for Women Experiencing Homelessness

Abstract

People experiencing homelessness have high medical complexity and are at increased risk for poor post-acute outcomes after hospital discharge, yet evidence on medical respite programs for women is limited. We conducted a retrospective evaluation of a 10-bed medical respite program serving women experiencing homelessness in Northeast Ohio. Records of all women referred between March 2022 and May 2024 were reviewed to assess program implementation and resident outcomes, including health care utilization, health and health management improvement, and housing transitions at discharge. Among 226 referrals, 73 women were admitted. The median age was 56 years, and residents exhibited substantial medical, functional, and behavioral health complexity. At discharge, 45.2% transitioned to permanent housing and 19.2% to skilled nursing facilities. Most residents demonstrated improvements in primary diagnosis status, medication management, self-care ability, and health knowledge, along with reductions in hospitalizations and emergency department visits following admission. Substance use disorder, Medicare enrollment, and history of domestic violence were associated with lower odds of discharge to permanent housing. Medical respite appears to be an effective transitional care intervention for medically fragile women experiencing homelessness, supporting health stabilization, reduced acute care utilization, and housing transitions.