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Cited by 452Homelessness and Social IssuesFood Security and Health in Diverse PopulationsHealthcare Policy and Management

Competing priorities as a barrier to medical care among homeless adults in Los Angeles.

Open access
Gelberg, L, Gallagher, T C, Andersen, R M, Koegel, P·1997·American Journal of Public Health
DOI 10.2105/ajph.87.2.217PMC PMC1380797
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Abstract

OBJECTIVES: The role of competing priorities as a barrier to the utilization of physical health services was assessed in a subset (n = 363) of a probability sample of homeless adults in Los Angeles. METHODS: Unadjusted odds of four measures of health services utilization were calculated for those with frequent difficulty in meeting their subsistence needs. These odds were then adjusted for a range of characteristics assumed to affect the utilization of health services among the homeless. RESULTS: Before and after adjustment, those with frequent subsistence difficulty were less likely to have a regular source of care (odds ratio [OR] = 0.30, 95% confidence interval [CI] = 0.16, 0.53) and more likely to have gone without needed medical care (OR = 1.77, 95% CI = 1.04, 3.00). Subsistence difficulty had no impact on the likelihood of having an outpatient visit or having been hospitalized. Conclusions remained the same after adjustment. CONCLUSIONS: Frequent subsistence difficulty appears to be an important nonfinancial barrier to the utilization of health services perceived as discretionary among homeless adults.

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  • This population has difficulty accessing routine and preventive care.

    “Unfortunately, this population has difficulty accessing routine and preventive care. Many homeless individuals lack health insurance, have difficulty accessing transportation, must attend to immediate survival demands (e.g., food and shelter), and struggle to keep track of healthcare appointments.13”

    From Housing first is associated with reduced use of emergency medical services (2014) · cites this paper as [13]

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Research works printed but not linked: 6

  1. Elvy A. Access to care. In: Brickner PW, Scharer LK, Conanan B, et al., eds. Health Care of Homeless People. New York, NY: Springer Publishing Co; 1985.
  2. Koegel P, Gelberg L. Patient-oriented approach to providing care to homeless persons. In: Wood, D, ed. Delivering Health Care to Homeless Persons: The Diagnosis and Management of Medical and Mental Health Conditions. New York, NY: Springer Publishing Co; 1992.
  3. Stark LR. Barriers to health care for homeless people. In: Jahiel RI, ed. Home- lessness: A Prevention-OrientedApproach. Baltimore, Md: Johns Hopkins University Press; 1992.
  4. Jahiel RI. Services for homeless people: An overview. In: Jahiel RI, ed. Homeless- ness: A Prevention-Oriented Approach. Baltimore, Md: Johns Hopkins University Press; 1992.
  5. Koegel P, Bumnam MA. The Course of February 1997, Vol. 87, No. 2 Homelessness Study: aims and designs. Presented at the 119th Annual Meeting of the American Public Health Association; November 1991; Atlanta, Ga.
  6. Liebow E. Tell Them Who l Am: The Lives of Homeless Women. New York: The Free Press; 1993.

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Authors
Gelberg, L., Gallagher, T. C., Andersen, R. M., & Koegel, P.
Affiliations
  • University of California, Los Angeles (US)
  • RAND Corporation (US)
ORCID
Gelberg, L
Venue
American Journal of Public Health
Publisher
American Public Health Association
Published
1997-02
Volume
87
Issue
2
Pages
217-220
ISSN
  • 0090-0036 (ISSN-L)
  • 1541-0048
DOI
10.2105/ajph.87.2.217
PMC
PMC1380797
OpenAlex
W2072073623
Cited by
452
References
16
Citations by year
2026: 9 · 2025: 18 · 2024: 13 · 2023: 20 · 2022: 23 · 2021: 23 · 2020: 23 · 2019: 22 · 2018: 22 · 2017: 22 · 2016: 17 · 2015: 29 · 2014: 21 · 2013: 20 · 2012: 19
FWCI
13.19
Type
journal article
Language
en
Open access
Locations
  • American Journal of Public Health (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Agency for Healthcare Research and Quality (1T32 HS 00046-01, R01 HS06696)
  • National Institute of Mental Health (1 R01 MH64121)
Topics
  • Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
  • Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Keywords
homeless adults, barriers to care, competing priorities, subsistence needs, health care utilization, usual source of care, outpatient visits, hospitalization, Los Angeles
MeSH terms
Adolescent, Adult, Female, Health Priorities, Health Services, Health Status, Ill-Housed Persons, Humans, Male, Patient Acceptance of Health Care, Probability, Los Angeles

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