Comparing homeless persons' care experiences in tailored versus nontailored primary care programs

Stefan G. Kertesz, Cheryl L. Holt, Jocelyn L. Steward, Richard N. Jones, David L. Roth, Erin Stringfellow, Adam J. Gordon, Theresa W. Kim, Erika L. Austin, Stephen Randal Henry, N. Kay Johnson, U. Shanette Granstaff, James J. O'Connell, Joya F. Golden, Alexander S. Young, Lori L. Davis, David E. Pollio

Research output: Contribution to journalArticle

Abstract

Objectives. We compared homeless patients' experiences of care in health care organizations that differed in their degree of primary care design service tailoring. Methods. We surveyed homeless-experienced patients (either recently or currently homeless) at 3 Veterans Affairs (VA) mainstream primary care settings in Pennsylvania and Alabama, a homeless-tailored VA clinic in California, and a highly tailored non-VA Health Care for the Homeless Program in Massachusetts (January 2011-March 2012). We developed a survey, the "Primary Care Quality- Homeless Survey," to reflect the concerns and aspirations of homeless patients. Results. Mean scores at the tailored non-VA site were superior to those from the 3 mainstream VA sites (P < .001). Adjusting for patient characteristics, these differences remained significant for subscales assessing the patient-clinician relationship (P < .001) and perceptions of cooperation among providers (P = .004). There were 1.5- to 3-fold increased odds of an unfavorable experience in the domains of the patient-clinician relationship, cooperation, and access or coordination for the mainstream VA sites compared with the tailored non-VA site; the tailored VA site attained intermediate results. Conclusions. Tailored primary care service design was associated with a superior service experience for patients who experienced homelessness.

Original languageEnglish (US)
Pages (from-to)S331-S339
JournalAmerican journal of public health
Volume103
Issue numberSUPPL. 2
DOIs
StatePublished - Dec 2013

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Kertesz, S. G., Holt, C. L., Steward, J. L., Jones, R. N., Roth, D. L., Stringfellow, E., Gordon, A. J., Kim, T. W., Austin, E. L., Henry, S. R., Johnson, N. K., Granstaff, U. S., O'Connell, J. J., Golden, J. F., Young, A. S., Davis, L. L., & Pollio, D. E. (2013). Comparing homeless persons' care experiences in tailored versus nontailored primary care programs. American journal of public health, 103(SUPPL. 2), S331-S339. https://doi.org/10.2105/AJPH.2013.301481