Determinants of Regular Source of Care Among Homeless Adults in Los Angeles

Bibliographic Data

ID9099795
AuthorsTeresa C Gallagher (corresponding author), Ronald Andersen (0000-0003-4095-8259, corresponding author), Ronald M Andersen, Paul Koegel (RAND Corporation), Lillian Gelberg (0000-0001-9772-0116, University of California, Los Angeles)
Year1997
Volume35
Issue8
Pages814-830
Publication date1997-08-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199708000-00007
PMID9268254
OpenAlexW2055812521
LanguageEN
Citations received32
References cited22

OBJECTIVES: The authors explore the determinants of having a regular source of care in a community-based probability sample of homeless adults in Los Angeles. Results from this study should be more representative than those from previous studies of the homeless that are clinic- or shelter-based. In addition to those factors found to be barriers to regular sources of care in the general population, we hypothesized that psychosocial characteristics of the homeless and the homeless lifestyle would negatively impact their likelihood of having a regular source of care. METHODS: The authors conducted a multiple logistic regression to predict regular source of care among the homeless, using an adaptation of the Behavioral Model of health services utilization as an analytic framework. RESULTS: Fifty-seven percent of the sample reported that they had a regular source of care. Of those with a source of care, 30% reported a hospital outpatient department; 25% reported a community or homeless clinic; 23% reported a hospital emergency room; 14% reported a government clinic; and 9% reported a private physician's office as their source of care. Some factors found to be barriers to having a regular source of care in the general population (male, Hispanic, young age) also were barriers among homeless adults. Additional barriers in this sample included homelessness-related characteristics such as competing needs, long-term homelessness, and social isolation. Chronic mental illness and chronic substance dependence were not related to having a source of care among the homeless. Characteristics that increased the likelihood of having a regular source of care in the general population (poor health status, Medicaid) were not related to having a regular source of care among the homeless. CONCLUSIONS: In a context of limited resources, the distribution of regular source of care among the homeless appears to be highly inequitable. Although some of the characteristics identifying those with a regular source of care suggest differential patterns of behavior across subgroups, others suggest differential advantage in access to care and a lack of fit between the needs of the homeless and the organization of health services

Emergency department · Environmental health · Family medicine · Health care · Logistic regression · Population · Psychiatry · Psychosocial · Food Security and Health in Diverse Populations · Homelessness and Social Issues · Medicine · Psychiatric care and mental health services · Gerontology

Tools

Open DOI