Comparison of Primary Care Experiences and Outpatient Health Service Utilization Among Black and Latino Homeless-Experienced Veterans: An Analysis of Patient-Centered Medical Homes.

Chinchilla M, Jones AL, DeRussy A, Green MF, Gelberg L, Young AS, Tsai J, Gabrielian SE, Kertesz SG. Comparison of Primary Care Experiences and Outpatient Health Service Utilization Among Black and Latino Homeless-Experienced Veterans: An Analysis of Patient-Centered Medical Homes. Journal of primary care & community health. 2025 Nov 9; 16:21501319251382520, DOI: 10.1177/21501319251382520.

Related HSR&D Project(s)

• IIR 15-095 – Primary Care Quality and Homeless Service Tailoring

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Abstract:

OBJECTIVES: To examine whether, among persons with recent homeless experience, minoritized clients rate primary care differently from non-minoritized clients in Veterans Affairs (VA) mainstream and homeless tailored clinics, through the largest survey of homeless-experienced Black, White, and Latino Veterans to date. METHODS: Surveys were collected from HEVs in Homeless-tailored Patient-Aligned Care Teams (HPACTs) and mainstream Patient Aligned Care Teams (PACTs; n? = 4894). We tested multivariable associations between race/ethnicity, clinic (HPACT vs mainstream-PACT), and their interaction, on care experience ratings and service utilization. RESULTS: There were no major differences in care ratings by race/ethnicity; medical and social vulnerability factors were associated with worse ratings. Black HEVs rated team Cooperation and Access/Coordination modestly better compared to White HEVs, while being Latino was nonsignificant. HPACTs were rated higher than mainstream-PACTs. Better Access/Coordination ratings were associated with more primary care (+1.12 additional visits per point increase) and mental health outpatient visits (+4.37 additional visits per point increase). CONCLUSIONS: In VA primary care, homeless-tailored clinics outperformed mainstream ones while racial/ethnic differences in ratings were minor. Optimizing perceived Access/Coordination of services may offer a path to increased service use.