Leaving before discharge from a homeless Medical Respite program: predisposing factors and impact on selected outcomes.

Background: Medical Respite addresses care needs of homeless patients post-hospital discharge and is linked to reduced rehospitalization compared with standard discharge. However, outcomes may differ for Respite patients who exit before completing post-acute treatment and discharge plans.

Methods: Using administrative data from a San Francisco Medical Respite center (2007-2010), this retrospective study compares patient characteristics, post-Respite connections to community services, and likelihood of rehospitalization within 90 days of Respite exit between patients who choose to leave before discharge and all other Respite patients (logistic regression, odds ratio).

How health care setting affects prenatal providers' risk reduction practices: a qualitative comparison of settings.

Background: We sought to understand how systemic factors might facilitate or impede providers' ability to screen for and intervene on prenatal behavioral risks.

Methods: We convened eight focus groups of 60 prenatal care providers to explore methods for assessing and counseling pregnant women about tobacco, alcohol, and illicit drug use. Because practice setting was often mentioned as either an inducement or barrier to risk prevention, we conducted a re-analysis of focus group transcripts to examine systemic factors.