Outcomes of specialist discharge coordination and intermediate care schemes for patients who are homeless: analysis protocol for a population-based historical cohort

Blackburn, Ruth Marion, Hayward, Andrew, Cornes, Michelle, McKee, Martin, Lewer, D., Whiteford, Martin, Menezes, Dee, Luchenski, Serena, Story, Alistair, Denaxas, Spiros, Tinelli, Michela ORCID: 0000-0002-8816-4389, Wurie, Fatima B, Byng, Richard, Clark, Michael ORCID: 0000-0003-4964-5005, Fuller, James, Gabbay, Mark, Hewett, Nigel, Kilmister, Alan, Manthorpe, Jill, Neale, Joanne and Aldridge, Robert W (2017) Outcomes of specialist discharge coordination and intermediate care schemes for patients who are homeless: analysis protocol for a population-based historical cohort. BMJ Open, 7 (12). ISSN 2044-6055

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Abstract

Introduction 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. Methods and analysis 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. Ethics and dissemination 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.

Item Type:	Article
Official URL:	http://bmjopen.bmj.com/
Additional Information:	© 2017 The Authors CC BY 4.0
Divisions:	Care Policy and Evaluation Centre LSE Health
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited:	07 Nov 2017 14:55
Last Modified:	15 Nov 2024 02:30
Projects:	13/156/10, MR/K006584/1, 206602/Z/17/Z
Funders:	National Institute for Health Research (NIHR), Medical Research Council, Wellcome Trust, Economic and Social Research Council, Engineering and Physical Sciences Research Council
URI:	http://eprints.lse.ac.uk/id/eprint/85128

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