Healthcare Mobility among United States Military Veterans with Experience of Housing Instability

Housing instability, generally, is associated with a lack of access to care. The present study explores healthcare mobility among Veterans experiencing housing instability to identify the magnitude of this phenomenon and whether it is associated with certain patient characteristics or needs. The sample included 486,675 Veterans with 4 or more healthcare visits during the year following identification of homelessness. Analyses compared (a) baseline characteristics of Veterans who did and did not experience high healthcare mobility (i.e., receipt of healthcare services at 4 or more U.S. Department of Veterans Affairs Medical Centers) and (b) services use during the observation period. Among the sample, 0.7% experienced high healthcare mobility. Veterans with a rural residence had 30% greater odds of high healthcare mobility; baseline use of primary care was associated with reduced odds. The findings represent the combined challenges of accessing healthcare when experiencing housing instability and while residing in a rural area and highlight the need to ensure that there is access to needed care. Future work should assess Veterans' access to community-based resources, particularly in rural areas and new ways of delivering care in these areas.