Advancing social risk-informed care for people experiencing homelessness

Compared with their housed counterparts, people experiencing homelessness (PEH) are at greater risk of premature death, higher healthcare utilization and spending, and lower quality of care. They tend to describe their care as unaccommodating to their needs and stigmatizing. Further, hospitalization rates among the PEH population are rising. In this context, hospital-based clinicians and care teams must be equipped to deliver patient-centered care to these individuals despite pandemic-induced constraints in hospital capacity.

A 2019 National Academy of Sciences, Engineering, and Medicine (NASEM) report offers important guidance for clinicians and care teams caring for this population. The report describes health sector activities to integrate social care into healthcare delivery, with the goal of reducing preventable high-acuity care use and improving health outcomes. While some activities focus on how health systems should address social needs at the community level, three focus on supporting patients at the clinician level: awareness, adjustment, and assistance. From this perspective, we highlight a hypothetical clinical scenario involving challenges that can arise from homelessness that hospital-based clinicians and care teams often face. We then provide examples of how applying clinician-level NASEM activities to PEH may help clinicians and care teams deliver high-quality care to this population.