Study finds hotel shelters for unhoused people reduce emergency service use

A study conducted by researchers at UC Berkeley and UCSF has found that placing unhoused people in hotels leads to a reduction in emergency service usage.

According to campus researcher and study co-author Mark Fleming, the research team analyzed data tables to compare services used by houseless individuals in San Francisco during the COVID-19 pandemic. Fleming said unhoused people who were provided private hotel rooms, private bathrooms and on-site healthcare used emergency services at a lower rate than unhoused people without shelter.

Fleming speculated that improved conditions at the hotel-based shelters have led to better outcomes for the unhoused individuals.

“It’s very likely that people are more willing to stay sheltered when they have a private room because privacy is important for anybody,” Fleming said. “Having the embedded health services at the shelter-in-place hotel sites was beneficial at getting people connected to care before they progressed to an emergency.”

Fleming said the congregate shelters offered prior to the pandemic imposed greater risk of contracting COVID-19, which in turn forced San Francisco to move many people into non-congregate shelters like hotel rooms. People experiencing homelessness often have greater rates of chronic health conditions than other populations, according to Fleming, leading to greater health risks and dangers in contracting COVID-19.

Fleming also speculated that the privacy of the hotel shelters helped discharge unhoused people from hospitals at a faster rate than those without shelter, as the hotels provide a reliable and safe space upon return.

Maria Raven, co-author and chief of emergency medicine at UCSF Medical Center, speculated that since emergency departments are open 24/7, many houseless people use these services first rather than seeking treatment elsewhere. She said when shelter is provided, it is easier for these unhoused people to take care of themselves.

“What surprised me the most was that we actually did find these significant reductions in services,” Raven said. “Lots of studies have looked at the ability to reduce emergency department usage (among unhoused people), and it’s actually really hard to show.”

Fleming said he and the team compared emergency service usage among sheltered houseless people as opposed to those who were not placed in a hotel.

Though there were reductions in emergency service use for both groups, the reduction in the hotel group was much bigger than other groups.

“This provides evidence that this model of non-congregation shelter with onsite healthcare is good for their health, reduces their need for hospitalization and that this model should be a part of a broader toolkit for fighting houselessness,” Fleming said.

Contact Lance Roberts at [email protected], and follow him on Twitter at @lance_roberts.

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