Specialist Hospital Discharge Services for Homeless Individuals Prove Cost-Effective

Research from the London School of Economics and Political Science has shown that specialist hospital discharge and intermediate care services for homeless individuals in England are likely to be cost-effective compared to standard care. The study aimed to evaluate the costs and consequences of these services for vulnerable demographics. Financial support for this research came from the National Institute for Health and Care Research.

Key Takeaways:

• The study found that patients accessing specialist care use fewer bed days per year, including both planned and unplanned readmissions, compared to those using standard care.
• Patients using specialist care have more planned readmissions to hospital and use more NHS resources than those who use standard care, but this is interpreted as a positive outcome indicating that specialist care is likely to work more effectively.
• Specialist care remained cost-effective over a range of sensitivity analyses.
• Secondary analyses of three specific schemes found better QALY outcomes, but results are not generalisable to all 17 schemes.
• The research concluded that specialist HHD services are likely to be cost-effective for the NHS compared with standard care, although further research is needed to access patient-level data for both costs and outcomes.
• Authors include Michela Tinelli, Raphael Wittenberg, Michelle Cornes, and others from the London School of Economics and Political Science and the University of Manchester.

Statistics:

• 17 homeless hospital discharge and intermediate care services were compared in the study.
• The measure of effectiveness was the number of bed days avoided (in terms of hospital stays for all readmissions in the follow-up period) per homeless user.
• Patients accessing specialist care used 24% fewer bed days per year compared to those using standard care.
• Patients using specialist care had 14% more planned readmissions to hospital compared to those who use standard care.

Sources:

• The cost-effectiveness of specialist hospital discharge and intermediate care services for patients who are homeless. BMC Health Services Research, 2025;25(1):794.
• NewsRx. London School of Economics and Political Science Reports Findings in Health Services (The cost-effectiveness of specialist hospital discharge and intermediate care services for patients who are homeless). Education Letter. June 18, 2025; p 286.