Previous Health Care Experiences' Influence on Health Care Perceptions Among Residents of Six Homeless Shelters in Seattle, Washington, July-October 2021.

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  • Additional Information
    • Source:
      Publisher: Advocate Aurora Health Country of Publication: United States NLM ID: 101646624 Publication Model: eCollection Cited Medium: Internet ISSN: 2330-0698 (Electronic) Linking ISSN: 2330068X NLM ISO Abbreviation: J Patient Cent Res Rev Subsets: PubMed not MEDLINE
    • Publication Information:
      Publication: [Milwaukee, WI] : Advocate Aurora Health
      Original Publication: Milwaukee, WI : Aurora Health Care, [2014]-
    • Abstract:
      Purpose: The study purpose was to learn and describe 1) where homeless shelter residents receive health care, 2) what contributes to positive or negative health care experiences among shelter residents, and 3) shelter resident perceptions toward health care.
      Methods: Semi-structured interviews (SSIs) utilizing purposive sampling and focus group discussions (FGDs) utilizing convenience sampling were conducted at 6 homeless shelters in Seattle-King County, Washington, during July-October 2021. All residents (age ≥18) were eligible to participate. SSIs were conducted with 25 residents, and 8 FGDs were held. Thematic analysis was conducted using Dedoose.
      Results: Participants received health care in settings ranging from no regular care to primary care providers. Four elements emerged as contributing positively and negatively to health care experiences: 1) ability to access health care financially, physically, and technologically; 2) clarity of communication from providers and staff about appointment logistics, diagnoses, and treatment options; 3) ease of securing timely follow-up services; and 4) respect versus stigma and discrimination from providers and staff. Participants who felt positively toward health care found low- or no-cost care to be widely available and encouraged others to seek care. However, some participants described health care in the United States as greedy, classist, discriminatory, and untrustworthy. Participants reported delaying care and self-medicating in anticipation of discrimination.
      Conclusions: Findings demonstrate that while people experiencing homelessness can have positive experiences with health care, many have faced negative interactions with health systems. Improving the patient experience for those experiencing homelessness can increase engagement and improve health outcomes.
      Competing Interests: Conflicts of Interest Dr. Chu reports consulting with Ellume, Abbvie, Pfizer, and The Bill and Melinda Gates Foundation. She has received research funding from Gates Ventures and Sanofi Pasteur and support and reagents from Ellume and Cepheid outside the submitted work. There are no other conflicts of interest to report.
      (© 2023 Advocate Aurora Health, Inc.)
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    • Grant Information:
      T32 AI007044 United States AI NIAID NIH HHS
    • Contributed Indexing:
      Keywords: access; health care disparities; homelessness; patient attitude; perceived discrimination
    • Publication Date:
      Date Created: 20230724 Latest Revision: 20240130
    • Publication Date:
      20240130
    • Accession Number:
      PMC10358972
    • Accession Number:
      10.17294/2330-0698.2012
    • Accession Number:
      37483554