In:
American Journal of Public Health, American Public Health Association, Vol. 103, No. S2 ( 2013-12), p. S331-S339
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.
Type of Medium:
Online Resource
ISSN:
0090-0036
,
1541-0048
DOI:
10.2105/AJPH.2013.301481
Language:
English
Publisher:
American Public Health Association
Publication Date:
2013
detail.hit.zdb_id:
2054583-6
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