Effectiveness and Cost-effectiveness of 'Usual Care' versus 'Specialist Integrated Care': A Comparative Study of Hospital Discharge Arrangements for Homeless People in England
To explore specialist services set up to improve homeless people’s experiences of leaving hospital. It is investigating different types of services; for example, some put patients in touch with a specially trained GP, others might employ a housing support worker to ensure people do not return to living on the streets after hospital discharge. We want to know what homeless people think of specialist services, how they help them tackle the range of problems they may have, and if this support prevents them returning to hospital. To compare effectiveness and costs we will also study hospital discharge arrangements where no specialist support for homeless people is in place.
2015 – 2018
Michelle Cornes and Jill Manthorpe (SCWRU); Martin Whiteford (University of Liverpool); Andrew Hayward, Rob Aldridge, Fatima Wurie (University College London); Michela Tinelli and Mike Clark (LSE); Graham Foster (Queen Mary’s); Jo Neale (King’s College London’s Institute of Psychiatry, Psychology & Neuroscience); Nigel Hewett (Pathway); James Fuller and Alan Kilmister (Peer Researchers)
National Institute for Health Research (NIHR) Health Services and Delivery Research
This research has two parts. The first is a realist evaluation designed to generate six case studies exploring the differences between sites with access to specialist discharge schemes and those without. The second will assess effectiveness and cost effectiveness in a further 14 sites. It will explore how specialist discharge schemes impact on outcomes and patterns of service use across the whole system (e.g. use of unplanned care) and the cost implications of this. This is methodologically innovative in its use of new approaches to data linkage.
The project is underway, and due to report in 2018.
Outputs and Impact
Reports, articles and presentations to different audiences are planned, with two published in 2017. The study will provide practical evidence for commissioners interested in developing hospital discharge schemes for homeless people and the workforces involved.
Whiteford, M. et al. (2016) Caring in hard times: A critical appraisal of the role of hospital discharge arrangements in preventing homelessness in England, European Network for Housing Research, Belfast, 28th June – 1st July
Cornes, M. et al. (2016) Effectiveness and Cost-effectiveness of ‘Usual Care’ versus ‘Specialist Integrated Care’: A Comparative Study of Hospital Discharge Arrangements for Homeless People in England. Regional Events: London 18th & 20th January 2016; Liverpool 11th January 2016; Crewe 10th February 2016; Cumbria (GP Forum) 23rd February.
Dr Michelle Cornes.
Social Care Workforce Research Unit
King’s College London