Comparing Homeless Persons' Care Experiences in Tailored Versus Nontailored Primary Care Programs.

• Autores: Stefan G. Kertesz, Cheryl Holt, Jocelyn L. Steward, Richard N. Jones, David L. Roth, Erin Stringfellow, Adam J. Gordon, Theresa W. Kim, Erika L. Austin, Stephen G Henry, Kay Johnson, U. Shanette Granstaff, James J. O'Connell, Joya F. Golden, Alexander S. Young, Lori L. Davis, David E. Pollio
• Localización: American journal of public health, ISSN 0090-0036, Vol. 103, Nº. 0, 2013, págs. 331-339
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • 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. [ABSTRACT FROM AUTHOR]