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.
journal_name
J Health Care Poor Underservedjournal_title
Journal of health care for the poor and underservedauthors
O'Toole TP,Johnson EE,Redihan S,Borgia M,Rose Jdoi
10.1353/hpu.2015.0077subject
Has Abstractpub_date
2015-08-01 00:00:00pages
1019-31issue
3eissn
1049-2089issn
1548-6869pii
S1548686915300334journal_volume
26pub_type
杂志文章,多中心研究,随机对照试验abstract::Poor communication of medical information during care transitions can lead to medication errors, adverse drug events, and increased health care costs. The crucial pharmacist's role sometimes requires efforts to improve documentation. Here, we describe our experience integrating a pharmacist into a medical team at a fe...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2013.0045
更新日期:2013-02-01 00:00:00
abstract::This case study describes how we are translating a diabetes care quality improvement initiative from an insured (HMO) setting into federally qualified health centers (FQHCs). We outline the innovative collaborative processes whereby researchers and FQHC providers adapted this initiative, which includes health informat...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章,随机对照试验
doi:10.1353/hpu.2012.0132
更新日期:2012-08-01 00:00:00
abstract::This study seeks to understand the perspective of Black and Hispanic/Latino residents of the South Bronx, New York, on the causes of persistent racial and ethnic disparities in health outcomes. In particular, it focuses on how people who live in this community perceive and interact with the health care system. Finding...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2006.0026
更新日期:2006-02-01 00:00:00
abstract::This commentary examines Genesee County (Flint) Michigan to explore whether a well-structured safety net system is able to provide low-income uninsured people adequate access to care at a reasonable cost. Genessee County is one of the more economically challenged communities in the country. This commentary explores th...
journal_title:Journal of health care for the poor and underserved
pub_type: 评论,杂志文章
doi:10.1353/hpu.2012.0025
更新日期:2012-02-01 00:00:00
abstract::Many observers explain the prevalence of inadequate prenatal care in the United States by citing demographic or psychosocial factors. But few have evaluated the barriers faced by women with different health insurance status and socioeconomic backgrounds. In this study of 149 women at six hospitals in Minneapolis, insu...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2010.0472
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:The Dominican Republic (DR) has provided free antiretrovirals (ARVs) since 2004. Little is known about adherence to ARV regimens in the DR. METHODS:We audio-recorded 53 HIV care visits at a hospital-based clinic in the DR, conducted post-visit interviews with each patient, and observed clinic policies and p...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2014.0190
更新日期:2014-11-01 00:00:00
abstract::Implementing and evaluating smoking cessation interventions in underserved populations has been found difficult due to high rates of non-adherence to the prescribed protocol. To understand better the barriers to cessation participation, we studied low-income inner-city pregnant women who were enrolled in either a stan...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章,随机对照试验
doi:10.1353/hpu.2012.0096
更新日期:2012-08-01 00:00:00
abstract::Perceived discrimination has been shown to be related to health screening behavior. The present study examines the effect of discrimination on cancer screening among women in the Black Women's Health Study. Five self-report items measured discrimination in everyday life and three items measured experiences of major di...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.0.0273
更新日期:2010-02-01 00:00:00
abstract::The Affordable Care Act expanded health insurance for low-income, uninsured individuals. Few longitudinal analyses have investigated how insurance expansion influences cost and utilization among adults with chronic conditions. This study conducted longitudinal analysis investigating time trends in utilization and cost...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2017.0119
更新日期:2017-01-01 00:00:00
abstract::The documented high incidence of mental health disorders among individuals in substance abuse treatment argues for the importance of studying the provision of mental health services to this population. This survey documents how the Linkage Programs assembled an array of mental health services based on the assessed hea...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章,多中心研究
doi:10.1353/hpu.2010.0377
更新日期:1995-01-01 00:00:00
abstract::This study examines travel patterns for hospitalization among elderly patients to address whether there are differences by age and race/ethnicity, and whether the differences persist even when a severe illness occurs. Using the Healthcare Cost and Utilization Project (HCUP) State Inpatient database (SID) of the Agency...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2005.0023
更新日期:2005-05-01 00:00:00
abstract::We examined ethnic identity in relation to hazardous alcohol use, illicit drug use, and risky sexual behavior in 266 college students recruited on the campus of a historically Black college/university (HBCU). Participants were primarily African American students participating in HIV education and prevention outreach e...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2017.0058
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:Study occurrence and consequences of deductibles and medical debt among privately insured under the Affordable Care Act. METHODS:Analysis of 2012-2016 National Health Interview Survey data on privately insured adults younger than age 65 on the effect of deductibles on medical debt, deferred medical care, and...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2020.0031
更新日期:2020-01-01 00:00:00
abstract::Teaching clinics are an important source of care for urban, minority, underserved communities and face great challenges to improve quality of care for diabetics. This study examined the impact of continuity with the same primary care provider on health care process and outcome measures for patients with diabetes treat...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2012.0193
更新日期:2012-11-01 00:00:00
abstract::Lack of health insurance and a regular source of care (RSOC) are associated with suboptimal health care. This study examined the impact of a statewide program called the Community Healthcare Access Program (CHAP), which provided a RSOC for uninsured persons in Delaware. This cohort study used survey data to compare he...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2005.0050
更新日期:2005-08-01 00:00:00
abstract::Several characteristics associated with patient trust are identified. To determine the level of trust patients from disadvantaged circumstances have in their primary care resident physician, and to determine patient and physician characteristics that predict trust, we administered a survey to randomly selected primary...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2004.0018
更新日期:2004-05-01 00:00:00
abstract::This study examined factors associated with the use of the Health Care for the Homeless Program and other health care services by homeless adults. A total of 941 homeless adults were identified in 52 soup kitchens in U.S. communities. Descriptive statistics and logistic regression models were applied. Among homeless a...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:
更新日期:2003-02-01 00:00:00
abstract::Type 2 diabetes disproportionately affects Latinos increasing their risk of diabetes-related complications. This study used a randomized controlled design with a community-based approach to evaluate the impact of a culturally tailored pharmacist intervention on clinical outcomes in Latino diabetics. The intervention i...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章,随机对照试验
doi:10.1353/hpu.2014.0003
更新日期:2013-11-01 00:00:00
abstract::Previous studies show that many physicians do not accept new patients with Medicaid coverage, but no study has examined Medicaid enrollees' actual experience of provider refusal of their coverage and its implications. Using the 2012 National Health Interview Survey, we estimate provider refusal of health insurance cov...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2016.0096
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:Asylum seekers have poor access to health care. Qualitative data portraying their experience is lacking. METHODS:We conducted focus groups and comprehensive interviews with 35 asylum seekers and 15 expert providers/advocacy organization representatives. Purposive sampling was used to recruit subgroups. Inter...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2011.0047
更新日期:2011-05-01 00:00:00
abstract::We sought to describe the prevalence and predictors of tuberculin skin test (TST) reactors in a high-risk sample of urban Aboriginal people, and to evaluate adherence to medical evaluation and latent tuberculosis infection (LTBI) treatment among those with TST reactivity. Of the 164 participants tested, 86% returned f...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.0.0029
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:We describe body mass index (BMI) trajectories over 20 months in newly settled refugees in the United States. METHODS:Growth curves were modeled in in hierarchical linear modeling for cohorts from Southeast Asia, Africa, and the Middle East. RESULTS:For refugees from Southeast Asia and Africa, coefficients...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2015.0046
更新日期:2015-05-01 00:00:00
abstract::Despite substantial asthma prevalence and morbidity, children from Spanish-speaking families are at high risk of inadequate maintenance therapy. The reasons for this remain unclear. The objective of this study was to compare patterns of asthma morbidity and access to care of children with asthma from Spanish-speaking ...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2005.0005
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Health care costs are often a hindrance to seeking health care. Community-based health care insurance schemes (CBHIS) is a suitable alternative to conventional health insurance schemes which are often beyond the budget of majority of rural residents in Africa. Following establishment of a model CBHIS in the ...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2014.0023
更新日期:2014-02-01 00:00:00
abstract::Nationally, a higher proportion of the medically underserved than of the general population suffer from hypertension. Poorer adherence to recommended therapies (including medication regimens, salt intake reduction, and regular visits with provider) has been linked to poorer blood pressure control. To identify whether ...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.0.0259
更新日期:2010-02-01 00:00:00
abstract:INTRODUCTION:This study analyzed the impact of sociodemographic characteristics, patient comorbidities, risk factors for critical limb ischemia and hospital characteristics on racial disparities in amputation rates for Native American patients with peripheral artery disease (PAD). METHODS:The study used the Healthcare...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2018.0058
更新日期:2018-01-01 00:00:00
abstract::While smoking has declined, rates remain alarmingly high for people of low socioeconomic status. Funding community-based organizations to link low socioeconomic status smokers to cessation services holds promise for reaching this population. This approach also shows potential for elevating addressing tobacco use as a ...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2019.0065
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:More effective treatment for hepatitis C virus (HCV) creates an opportunity to improve health outcomes. OBJECTIVE:To use Centers for Medicare and Medicaid Services (CMS)-defined HCV quality indicators (QI) as a framework to assess the quality of care at an urban safety net hospital. DESIGN:Retrospective co...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2014.0093
更新日期:2014-05-01 00:00:00
abstract::Age-related hearing loss is highly prevalent and only 20% of adults with hearing loss report using hearing aids. A major barrier to increased hearing aid use is the high out-of-pocket costs associated with hearing aids. The objective of this brief report is to estimate the numbers of millions of Americans 60 years or ...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2016.0164
更新日期:2016-01-01 00:00:00
abstract::Grassroots level health care workers provided insights into rural women's health concerns at a program development workshop held at Sundarban Islands in West Bengal, India. This report describes these narratives and identifies strategies for potential intervention plans. The narratives suggest layers of disenfranchise...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2013.0069
更新日期:2013-05-01 00:00:00