Aug. 2, 2018
In 2012, select Veterans Health Administration (VHA) facilities began tailoring primary care services to the unique needs of homeless veterans through the Homeless Patient Aligned Care Team (HPACT) program. Located among standard VHA primary care services, HPACTs are structured to deliver accessible, well-coordinated, comprehensive services. While the exact features vary across facilities, HPACTs differ from standard primary care services in several regards. For example, HPACTs focus explicitly on the mission to reduce homelessness, provide access accommodations, train providers in homeless health care, and coordinate primary care with mental health, addiction, and social services. While there is evidence that HPACT improves primary care access, there is little information on patient perceptions of care in facilities with HPACTs among their services. The objective of this study, Do Tailored VA Primary Care Services Reduce Differences in Experiences with Care between Homeless and Non-Homeless Veterans?, is to compare the primary care experiences of homeless and non-homeless veterans in VHA facilities with HPACTs among their services, and in facilities without HPACTs.
This brief analyzes data from VHA’s ongoing national survey of patient experience to shed light on patient perspectives of care in facilities that have structured primary care services toward homeless patient needs. Whereas homeless patients tend to report more negative or less positive primary care experiences than non-homeless patients, these trends were reversed in facilities with HPACTs among their services. In these facilities patients enrolled in HPACT were much more likely to report positive care experiences than homeless patients receiving standard primary care.
The results suggest that VHA facilities with specific services and planning for homeless veterans foster a better care experience, with the greatest benefit for enrolled patients. These results are striking in light of prior literature documenting the role of negative health care experiences in preventing persons who are homeless from utilizing health services, and substantial patient and system benefits associated with positive care experiences. With evidence that homeless-tailoring of services relates to primary care engagement and satisfaction with care, VHA might wish to expand HPACT programs so that more patients may benefit from this care model.
To view the research brief, click here.