Abstract

We describe data from a multi-center community-based survey of homeless veterans who were not accessing available primary care to identify reasons for not getting this care as well as for not seeking health care when it was needed. Overall, 185 homeless veterans were interviewed: The average age was 48.7 years (SD 10.8), 94.6% were male, 43.2% were from a minority population. The majority identified a recent need for care and interest in having a primary care provider. Reasons for delaying care fell into three domains: 1) trust; 2) stigma; and 3) care processes. Identifying a place for care (OR 3.3; 95% CI: 1.4–7.7), having a medical condition (OR 5.5; 95% CI 1.9–15.4) and having depression (OR 3.4; 95% CI: 1.4–8.7) were associated with receiving care while not being involved in care decisions was associated with no care (OR 0.7; 95% CI 0.5–0.9). Our findings support the importance of considering health access within an expanded framework that includes perceived stigma, inflexible care systems and trust issues.

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Additional Information

ISSN
1548-6869
Print ISSN
1049-2089
Pages
pp. 1019-1031
Launched on MUSE
2015-08-27
Open Access
No
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