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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Mayur M. Desai, PhD, MPH, NEPEC/182, VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT 06516, 203-937-3850, mayur.desai@yale.edu, Robert A. Rosenheck, MD, Northeast Administration Evaluation Center (NEPEC), Veterans Administration Medical Center, 950 Campbell Avenue, West Haven, CT 06516, and Wesley J Kasprow, PhD, MPH, NEPEC / 182, Department of Veterans Affairs, VA CT Healthcare System, 950 Campbell Ave., West Haven, CT 06443.
Homeless persons face substantial barriers to obtaining needed medical services. The aim of this prospective study is to identify individual- and facility-level predictors of receiving outpatient medical care within 6 months of initial contact with a national homeless veterans outreach program aimed at linking clients with Department of Veterans Affairs (VA) services. Data from structured interviews conducted at the time of program intake for fiscal year 1999 were merged with VA administrative database records, which were used to track subsequent medical service use (N=25,887). Overall, 60.5% of homeless veterans had a medical visit following program intake. Across the 71 program sites nationally, the proportion of subjects who received follow-up care ranged from 39.7% to 92.9%. Multiple logistic regression modeling using generalized estimating equation techniques revealed that the likelihood of receiving follow-up care increased with age and medical comorbidity; decreased with time spent homeless; and was higher among those who were female, not married, not employed in the past 30 days, mentally ill, receiving VA benefits, and referred/self-referred into the homeless program as opposed to contacted through outreach. In addition, the lowest rates of medical follow-up were found at the largest facilities and at those that spent the greatest proportion of funds on mental health versus general health care. Nationally, a substantial proportion of homeless veterans did not receive medical care following program intake. More work is needed to improve access to medical services in this vulnerable population.
Learning Objectives:
Keywords: Homeless Health Care, Veterans
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.