Supporting Primary Care Access and Use among Homeless Persons.

Area of Science:

• Health Services Research
• Public Health Policy
• Health Equity Studies

Background:

• The Affordable Care Act (ACA) aimed to increase health insurance coverage for uninsured populations.
• Homeless individuals historically face significant barriers to accessing healthcare services.
• Understanding the impact of the ACA on healthcare access for the homeless is crucial for health equity.

Purpose of the Study:

• To explore the experiences of homeless individuals in accessing and utilizing primary care services after the ACA's implementation.
• To identify factors influencing primary care access and use patterns among the homeless population.
• To determine strategies that can promote consistent primary care utilization within this demographic.

Main Methods:

• Conducted 26 semi-structured interviews with homeless individuals and primary care providers/staff.
• Employed thematic analysis to identify key themes related to primary care access and use.
• Focused on understanding facilitators and barriers to consistent healthcare engagement.

Main Results:

• Post-ACA implementation, many homeless individuals gained health insurance, facilitating primary care access.
• Identified key factors influencing access, including insurance status and system-level support.
• Highlighted the importance of provider/staff engagement in facilitating care continuity.
• Reported on strategies that can enhance consistent primary care use among homeless persons.

Conclusions:

• Maintaining health insurance is a critical factor for homeless individuals' primary care access and use.
• Systems-based strategies are essential to support consistent primary care engagement for the homeless population.
• Addressing these factors can help reduce health disparities and promote health equity for vulnerable populations.