296 | wileyonlinelibrary.com/journal/phn Public Health Nurs. 2019;36:296–302. © 2019 Wiley Periodicals, Inc. 1 | INTRODUCTION Health correlates of homelessness are well‐documented. In compar‐ ison with the general population, homeless individuals demonstrate higher rates of mental health issues including psychiatric disorders and substance abuse, infectious diseases, unintentional injuries, and early mortality (Fazel, Geddes, & Kushel, 2014). Increased morbidity leads to increased health system utilization, particularly emergency department (ED) visits (Wang et al., 2015). More hospital admissions and longer (Hwang et al., 2013) and more expensive (Hwang, Weaver, Aubry, & Hoch, 2011) inpatient stays are also common for homeless individuals in need of health care. Medical respite programs began to emerge in the early 1980s to provide a safe and clean place for individuals experiencing home‐ lessness to recover from illness, injury, and medical procedures and during prolonged treatments such as chemotherapy or intravenous Received: 18 July 2018 | Revised: 1 January 2019 | Accepted: 17 January 2019 DOI: 10.1111/phn.12589 POPULATIONS AT RISK ACROSS THE LIFESPAN–PROGRAM EVALUATIONS Health care utilization following a homeless medical respite pilot program Donna J. Biederman 1 | Julia Gamble 2 | Sally Wilson 3 | Christian Douglas 1 | Jacob Feigal 4,5 1 School of Nursing, Duke University, Durham, North Carolina 2 Duke Outpatient Clinic, Duke University Health System, Durham, North Carolina 3 Project Access of Durham County, Durham, North Carolina 4 Departments of Psychiatry and Internal Medicine, Duke University Medical School, Durham, North Carolina 5 Healthcare for the Homeless Clinic, Lincoln Community Health Center, Durham, North Carolina Correspondence Donna J. Biederman, School of Nursing, Duke University, Durham, NC. Email: donna.biederman@duke.edu Abstract Objective: The purpose of this study was to evaluate a homeless medical respite pilot program to determine if program participants had health care utilization pattern changes and improved connection to income, housing, and health care resources post program. Design: This is a quantitative descriptive pre‐/post‐program evaluation. Sample: A total of 29 patients experiencing homelessness and discharged from an acute care hospital in the southeastern United States were provided with housing and nursing case management. Measurements: Demographics including age, sex, race, and ethnicity were collected. Connection to primary care, mental health, substance abuse services, income, insurance, and housing were assessed at program entry and completion. Health care utilization and charge and payment data were collected 1 year prior and 1 year post‐respite stay. Results: Participants demonstrated reduced hospital admissions (−36.7%) and when admitted, fewer inpatient days (−70.2%) and increased outpatient provider visits (+192.6%). Health care charges for the cohort decreased by 48.6% from the year prior to the program. Housing and income improved. Conclusions: The medical respite pilot program was successful in guiding patients to community resources for more appropriate health care at a demonstrated cost sav‐ ings. Participants also derived benefits in the form of improved housing and income. KEYWORDS health care utilization, homelessness, medical respite, pilot study