Providing Positive Primary Care Experiences for Homeless Veterans Through Tailored Medical Homes
The Veterans Health Administration’s Homeless Patient Aligned Care Teams
Dados Bibliográficos
BACKGROUND: In 2012, select Veterans Health Administration (VHA) facilities implemented a homeless-tailored medical home model, called Homeless Patient Aligned Care Teams (H-PACT), to improve care processes and outcomes for homeless Veterans. OBJECTIVE: The main aim of this study was to determine whether H-PACT offers a better patient experience than standard VHA primary care. RESEARCH DESIGN: We used multivariable logistic regressions to estimate differences in the probability of reporting positive primary care experiences on a national survey. SUBJECTS: Homeless-experienced survey respondents enrolled in H-PACT (n=251) or standard primary care in facilities with H-PACT available (n=1527) and facilities without H-PACT (n=10,079). MEASURES: Patient experiences in 8 domains from the Consumer Assessment of Healthcare Provider and Systems surveys. Domain scores were categorized as positive versus nonpositive. RESULTS: H-PACT patients were less likely than standard primary care patients to be female, have 4-year college degrees, or to have served in recent military conflicts; they received more primary care visits and social services. H-PACT patients were more likely than standard primary care patients in the same facilities to report positive experiences with access [adjusted risk difference (RD)=17.4], communication (RD=13.9), office staff (RD=13.1), provider ratings (RD=11.0), and comprehensiveness (RD=9.3). Standard primary care patients in facilities with H-PACT available were more likely than those from facilities without H-PACT to report positive experiences with communication (RD=4.7) and self-management support (RD=4.6). CONCLUSIONS: Patient-centered medical homes designed to address the social determinants of health offer a better care experience for homeless patients, when compared with standard primary care approaches. The lessons learned from H-PACT can be applied throughout VHA and to other health care settings
Family medicine · Health care · Logistic regression · Medical home · Pact · Political science · Primary care · Veterans Affairs · Food Security and Health in Diverse Populations · Homelessness and Social Issues · Medicine · Nursing · Psychiatric care and mental health services
Centering Humanizing, Individualized Care Amid Systemic Barriers
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Impact of Health Insurance Status and a Diagnosis of Serious Mental Illness on Whether Chronically Homeless Individuals Engage in Primary Care
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New to Care
Development of the Primary Care Quality-Homeless (PCQ-H) Instrument
Patient-aligned Care Team Engagement to Connect Veterans Experiencing Homelessness With Appropriate Health Care
Patterns of Sex and Racial/Ethnic Differences in Patient Health Care Experiences in US Veterans Affairs Hospitals
Development of and Field Test Results for the CAHPS PCMH Survey
Differences in Experiences With Care Between Homeless and Nonhomeless Patients in Veterans Affairs Facilities With Tailored and Nontailored Primary Care Teams
Survey Response Style and Differential Use of CAHPS Rating Scales by Hispanics
Understanding Racial and Ethnic Differences in Patient Experiences With Outpatient Health Care in Veterans Affairs Medical Centers
| Obras citantes distintas | 8 |
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| Citações por ano | 1,33 |
| Intervalo de citações | 2020 - 2026 (7) |
| Velocidade de citação | current |
| Altamente citado | Não |
| Tipos de citação | Neutras: 8 |