Experience of Primary Care among Homeless Individuals with Mental Health Conditions

dc.contributor.authorChrystal, Joya G.
dc.contributor.authorGlover, Dawn L.
dc.contributor.authorYoung, Alexander S.
dc.contributor.authorWhelan, Fiona
dc.contributor.authorAustin, Erika L.
dc.contributor.authorJohnson, Nancy K.
dc.contributor.authorPollio, David E.
dc.contributor.authorHolt, Cheryl L.
dc.contributor.authorStringfellow, Erin
dc.contributor.authorGordon, Adam J.
dc.contributor.authorKim, Theresa A.
dc.contributor.authorDaigle, Shanette G.
dc.contributor.authorSteward, Jocelyn L.
dc.contributor.authorKertesz, Stefan G.
dc.contributor.otherUS Department of Veterans Affairs
dc.contributor.otherVeterans Health Administration (VHA)
dc.contributor.otherVA Greater Los Angeles Healthcare System
dc.contributor.otherUniversity of California Los Angeles
dc.contributor.otherVeterans Affairs Medical Center - Birmingham
dc.contributor.otherUniversity of Alabama Tuscaloosa
dc.contributor.otherUniversity of Maryland College Park
dc.contributor.otherVA Pittsburgh Healthcare System
dc.contributor.otherUniversity of Pittsburgh
dc.contributor.otherBoston University
dc.contributor.otherUniversity of Alabama Birmingham
dc.date.accessioned2023-09-28T21:10:59Z
dc.date.available2023-09-28T21:10:59Z
dc.date.issued2015
dc.description.abstractThe delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA), one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366) were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005), with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H) questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score). Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons' needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers.en_US
dc.format.mediumelectronic
dc.format.mimetypeapplication/pdf
dc.identifier.citationChrystal, J. G., Glover, D. L., Young, A. S., Whelan, F., Austin, E. L., Johnson, N. K., Pollio, D. E., Holt, C. L., Stringfellow, E., Gordon, A. J., Kim, T. A., Daigle, S. G., Steward, J. L., & Kertesz, S. G. (2015). Experience of Primary Care among Homeless Individuals with Mental Health Conditions. In U. Macleod (Ed.), PLOS ONE (Vol. 10, Issue 2, p. e0117395). Public Library of Science (PLoS). https://doi.org/10.1371/journal.pone.0117395
dc.identifier.doi10.1371/journal.pone.0117395
dc.identifier.orcidhttps://orcid.org/0000-0002-9367-9213
dc.identifier.orcidhttps://orcid.org/0000-0002-2453-8871
dc.identifier.orcidhttps://orcid.org/0000-0002-2286-1448
dc.identifier.orcidhttps://orcid.org/0000-0002-2261-7875
dc.identifier.orcidhttps://orcid.org/0000-0001-6101-8421
dc.identifier.orcidhttps://orcid.org/0000-0001-6043-0721
dc.identifier.urihttps://ir.ua.edu/handle/123456789/12058
dc.languageEnglish
dc.language.isoen_US
dc.publisherPLOS
dc.rights.licenseCC0 1.0 Universal (CC0 1.0) Public Domain Dedication
dc.rights.urihttps://creativecommons.org/publicdomain/zero/1.0/
dc.subjectMEDICAL-CARE
dc.subjectPROSPECTIVE COHORT
dc.subjectLOS-ANGELES
dc.subjectADULTS
dc.subjectQUALITY
dc.subjectILLNESS
dc.subjectVETERANS
dc.subjectSERVICES
dc.subjectACCESS
dc.subjectDETOXIFICATION
dc.subjectMultidisciplinary Sciences
dc.titleExperience of Primary Care among Homeless Individuals with Mental Health Conditionsen_US
dc.typeArticle
dc.typetext
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