HOW DO THE HOMELESS NEWLY DIAGNOSED WITH CANCER RECEIVE SAFE AND COST-EFFECTIVE HEALTHCARE DURING YEAR ONE FOLLOWING DIAGNOSIS?

Cancer is one of the most common causes of mortality in homeless adults. When a homeless person is hospitalized, they typically return to the streets, making recovery difficult. Conducting a needs assessment survey of homeless patients who are newly diagnosed with cancer was the first step towards evaluating how they can receive safe and cost-effective healthcare. Collection of information was from three perspectives: the patient, the oncology provider, and costs. Nine qualitative interviews with homeless individuals focused on concerns and barriers to care. Ten qualitative interviews with Medical Oncologists as well as a 20 question Survey Monkey was sent to all providers and focused on current treatment of their homeless patients. Lastly, a retrospective cost analysis examined costs of inpatient and outpatient care during chemotherapy. Two themes emerged from the patient interviews: Barriers to care and Someone to help. Three themes emerged from the oncology interviews: I worry about everything, Making decisions, and Care after chemotherapy. Half of the 19 providers who responded to the Survey Monkey questions indicated that they would revise treatment plans because of homelessness. All providers stated they would utilize a housing first option if available for their homeless patients. The retrospective cost analysis of 53 homeless patients with cancer over a 5-year period showed cost savings from inpatient vs outpatient treatment which totaled $9.0 million dollars. Drawing up a proposal to share with stakeholders is needed to develop a plan to help this population which may include a housing first/respite home as a solution.