A program that delivers health outcomes for chronically homeless people while saving taxpayers more than $8000 per person over two years by preventing expensive hospital presentations and admissions, should be rolled out to other parts of the country to help prevent homelessness among vulnerable people exiting hospital, according to St Vincent’s Health Australia.
Tierney House, which was established at St Vincent’s Hospital Sydney in 2012 and is the only program of its type in NSW, provides accommodation and health care to chronically homeless people as they convalesce from illness or receive treatment for chronic health conditions.
St Vincent’s Health Australia’s CEO, Toby Hall, said Tierney House was a response to rough sleepers in Sydney’s inner city presenting, and re-presenting, to the hospital’s Emergency Department (ED) – one of the most expensive areas of the health care system – for often routine treatment.
“Tierney House is an antidote to a significant problem inner city hospitals face across Australia: vulnerable rough sleepers – without any ongoing health care co-ordination – presenting at hospital EDs, sometimes on multiple occasions in the space of a few days or weeks, for non-emergency care,” said Mr Hall.
“Partly funded by NSW Health, but also by private donations, Tierney House provides 12 beds where chronically homeless people can stay for short-to-medium periods while they convalesce or receive the ongoing, integrated care they might need to stabilise a chronic health condition.
“The care provided by Tierney House is flexible depending on a person’s health needs, and it also provides help on a range of other important non-health issues, such as housing, Centrelink, legal, financial or social needs.”
A team of academics from the University of Western Sydney, the University of NSW and University of Western Australia independently evaluated Tierney House’s effectiveness and found that in addition to its health advantages, it delivered a net cost-benefit to NSW taxpayers of $8,276 per person over two years by reducing ED and other hospital presentations and admissions.
Mr Hall said, based on its effectiveness and cost savings, state governments should roll out the Tierney House model for areas with large homeless populations both to improve care but also save money in the long-term. He said it was a model of care that could be translated into other areas, such as mental health.
“What Tierney House does is very straightforward but effective. It diverts people from EDs while providing the stability they need to address their health concerns,” Mr Hall.
“Around 7000 Australians become homeless each year after leaving state-provided care – hospitals, prisons, and foster care for young people – despite governments committing themselves to stopping people exiting into homelessness.
“The provision of stable, short-to-medium term accommodation for homeless people leaving hospital allows us to monitor their ongoing treatment and provides a central point for the co-ordination and integration of a range of health and non-health services.
“The health system is a scary place for many homeless people. But Tierney House’s staff make the experience less frightening by accompanying residents to medical appointments and by acting as ‘interpreters’ – deciphering the often complex medical advice of specialists.
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