Protocol of a mixed method research design to study medical respite programs for persons experiencing homelessness

Author/s

Timothy Daaleman, Joanne Johnson, Lillian Gelberg, Robert Agans, Donna Biederman

Abstract

Medical Respite Programs (MRPs) characterise a care model that has been developed to address the health care and social needs of persons experiencing homelessness by providing post-acute hospital care in a safe environment. Although this model has been shown to reduce hospitalisations, improve health outcomes and increase access to health services, prior studies of MRP programs and outcomes have been limited to individual sites and may not generalise to the population of individuals receiving MRP care.

This study protocol describes a mixed method design to collect organisational, provider, and patient-level data from a sample of MRPs.

Although we determined that our protocol was feasible in collecting multiple sources of data from MRP sites, we identified challenges in communicating with MRP patients, staff and providers due to fallout from the COVID-19 pandemic, burnout in health care staff, higher workloads and additional psychosocial stressors. The heaviest burden of care in MRPs falls on nursing assistants, medical assistants, social workers, and other direct care staff, who play key roles in providing care in MRP sites. We determined that staff shortages and burnout led to some MRP sites refusing participation or delaying data collection, which contributed to reduced response rates and missing data.

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