Hospitals in Honolulu are facing a growing financial burden due to the increasing number of homeless patients, many of whom suffer from chronic illnesses. Fritzie Igno, from Queen Emma Clinics, recently examined Alexander Akuna, a former homeless patient who had heart and kidney problems. Despite being told his illnesses were terminal, he has managed to survive and now lives in federally subsidized housing. Homeless people often spend more time in jail or prison than other individuals, which is an expensive burden for the state and the town. Studies have shown that providing chronic homeless people with permanent supportive housing is not only more cost-effective than a shelter-based approach, but it is also more effective in the long term.
A study on the costs of rural homelessness conducted in Portland, Maine, found a significant reduction in costs by providing permanent supportive housing instead of caring for people while they remain homeless. According to a report published in the New England Journal of Medicine, homeless people spend an average of four more days per hospital visit than comparable homeless people. This extended stay is often due to laws specifically aimed at the homeless population, including regulations that prohibit loitering, sleeping in cars, and begging. Hawaii Pacific Health reported that in the past year there has been a 20 percent increase in the high-risk population, many of whom are homeless and tend to stay in the hospital more than two days longer than other patients due to the lack of adequate post-acute care centers. An Emergency Medical Service worker estimated that paramedics sometimes transport 12 homeless people to the hospital in 12 hours, often due to minor illnesses, refilling prescriptions and food.
This does not justify the use of ambulance services. Meanwhile, the city's homeless resource center is expected to start operating on the first floor sometime this month. The study specifically observed a 57 percent reduction in the cost of mental health services over a six-month period, partly due to a 79 percent decrease in the cost of psychiatric hospitalization. Many homeless people go to the emergency room with multiple medical conditions when their problem has worsened and they need high-level care. The average daily cost of food for a homeless individual in Honolulu is difficult to determine as it depends on many factors such as access to food banks or other sources of free food. However, it is estimated that it can range from $5-$10 per day for basic meals.
