Discharge into homelessness

In Austria and the entire European Union, the number of homeless people has been increasing for years. This issue is particularly pressing in winter, as homeless people are confronted not only with harsh weather conditions but also with inadequate care structures. A new study conducted by Konrad Zenczak, a graduate of the master degree programme “Management von Gesundheitsunternehmen” (management of healthcare institutions) at IMC Krems, together with Manfred Pferzinger and Christine Bachner, shows for the first time how precarious discharge conditions can lead to repeated hospitalisations and a continuous solidification of homelessness. The publication “Die Entlassung in die Obdachlosigkeit” (discharge into homelessness) examines the conditions of admission, treatment and discharge of homeless patients, and which factors can reduce the rate of readmission.

An unsolved problem in the healthcare system

The study reveals serious deficiencies in the aftercare and discharge planning of homeless patients. In Austria, there is hardly any data on the care of this patient group to date, although homeless people are particularly often admitted to hospitals with complex diagnoses and a variety of illnesses. Zenczak’s study fills an important gap by analysing in detail the conditions for discharge from healthcare facilities and by identifying the structural problems that lead to a high readmission rate.

A key finding of the study is the interconnection between addiction and mental illness, which are particularly common among homeless patients, and the gaps in care for people who are uninsured or immobilised. These problem areas increase the risk of homeless patients being released back onto the streets without adequate care. A lack of aftercare structures means that many of those affected soon have to be readmitted to hospital.
“The multiple crises in recent years have exacerbated the economic situation for many people and thus also increased the risk of homelessness,” Zenczak explains. “However, the issue is often ignored by political decision-makers in Austria. Therefore, I consider it my responsibility to raise awareness and demand action in this respect.”

Recommendations for improving discharge management

Zenczak and his research team advocate targeted measures to improve discharge management. They call for the preventive treatment of addictions and mental illnesses, as well as the expansion of social care services and the sustainable creation of prospects. In particular, easy and low-threshold access to care and insurance services is important, as is the closer integration of social services to ensure the transition to stable aftercare and secure housing. In order to reduce the risk of homelessness recurring, a preventive approach is particularly important.
The study shows that structural adjustments are urgently needed to sustainably improve the care situation of homeless people and to promote their integration. Targeted measures could not only reduce the readmission rate at hospitals, but also pave the way to a secure living situation.

Perspectives for fairer care

Zenczak regards the publication as a first step towards a more comprehensive approach to homelessness in Austria: “The study is a milestone, as there has been little research on the care of homeless people in the context of the Austrian health system to date.” According to Zenczak, the qualitative methodology provides a deep insight into the discharge conditions of these patients and the network of influencing factors that hinders their recovery for the first time.

The publication “Die Entlassung in die Obdachlosigkeit” sends a strong message to the healthcare system and to policymakers. The findings call for a rethink in order to design discharge practices in such a way that homeless people receive the best possible support. In the long term, this could not only reduce the rate of readmission, but also lay the foundation for better social integration.