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- Title
Comparing Homeless Persons' Care Experiences in Tailored Versus Nontailored Primary Care Programs.
- Authors
Kertesz, Stefan G.; Holt, Cheryl L.; Steward, Jocelyn L.; Jones, Richard N.; Roth, David L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa W.; Austin, Erika L.; Henry, Stephen Randal; Johnson, Kay; Granstaff, U. Shanette; O'Connell, James J.; Golden, Joya F.; Young, Alexander S.; Davis, Lori L.; Pollio, David E.
- 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.
- Subjects
UNITED States; RESEARCH; AMERICAN veterans; HYPOTHESIS; CHI-squared test; COMPARATIVE studies; CONFIDENCE intervals; EPIDEMIOLOGY; HEALTH services accessibility; HOMELESS persons; INTERPROFESSIONAL relations; MEDICAL cooperation; MEDICAL specialties &; specialists; PATIENT satisfaction; PHYSICIAN-patient relations; PRIMARY health care; QUESTIONNAIRES; RESEARCH funding; STATISTICAL sampling; SURVEYS; UNITED States. Dept. of Veterans Affairs; DATA analysis; MULTIPLE regression analysis; DESCRIPTIVE statistics
- Publication
American Journal of Public Health, 2013, Vol 103, Issue S2, pS331
- ISSN
0090-0036
- Publication type
Article
- DOI
10.2105/AJPH.2013.301481