Comparison of Patient Experience Between Primary Care Settings Tailored for Homeless Clientele and Mainstream Care Settings

Background: More than 1 million Americans receive primary care from federal homeless health care programs yearly. Vulnerabilities that can make care challenging include pain, addiction, psychological distress, and a lack of shelter. Research on the effectiveness of tailoring services for this population is limited. Objective: The aim was to examine whether homeless-tailored primary care programs offer a superior patient experience compared with nontailored (“mainstream”) programs overall, and for highly vulnerable patients. Research Design: National patient survey comparing 26 US Department of Veterans Affairs (VA) Medical Centers’ homeless-tailored primary care (“H-PACT”s) to mainstream primary care (“mainstream PACT”s) at the same locations. Participants: A total of 5766 homeless-experienced veterans. Measures: Primary care experience on 4 scales: Patient-Clinician Relationship, Cooperation, Accessibility/Coordination, and Homeless-Specific Needs. Mean scores (range: 1–4) were calculated and dichotomized as unfavorable versus not. We counted key vulnerabilities (chronic pain, unsheltered homelessness, severe psychological distress, and history of overdose, 0–4), and categorized homeless-experienced veterans as having fewer (≤1) and more (≥2) vulnerabilities. Results: H-PACTs outscored mainstream PACTs on all scales (all P
Source: Medical Care - Category: Health Management Tags: Original Articles Source Type: research