Barriers to medical care for homeless families compared with housed poor families
D. Wood and R. B. Valdez
RAND/UCLA Center for Health Policy Study.
To evaluate health access and health services utilization of homeless
families we selected a systematic sample of 194 homeless families from 10
shelters in Los Angeles and 196 housed poor families from the same
geographic regions of Los Angeles selected from welfare offices. Both
samples relied primarily on Medicaid for their health insurance (61% and
96%). However, more homeless families than housed poor families were
currently uninsured (26% vs 2%), had lost health insurance over the past
year (50% vs 21%), and had spent a greater percentage of the past year
uncovered by health insurance (22% vs 6%). Homeless families were much less
likely to report a regular provider for preventive care (81% vs 94%) or for
sick care (72% vs 95%). Moreover, of those reporting a regular provider,
homeless families were more likely than housed poor families to use
emergency departments or clinics rather than private offices for both
preventive care (35% vs 15%) and sick care (37% vs 26%). Barriers to health
care more frequently prevented homeless families from obtaining care (38%
vs 28%). These findings suggest that homeless families have greater
problems of access to health care than other poor families, related to lack
of insurance, lack of a regular primary care provider, and other barriers.
Programs to address these barriers for homeless families are presented.
