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

Authors

Melissa Chinchilla
Audrey L Jones
Aerin DeRussy
Michael F Green
Lillian Gelberg
Alexander S Young
Jack Tsai
Sonya E Gabrielian
Stefan G Kertesz

Language

English

Publication Date

1-1-2025

Journal

Journal of Primary Care & Community Health

DOI

10.1177/21501319251382520

PMID

41208152

PMCID

PMC12602919

PubMedCentral® Posted Date

11-9-2025

PubMedCentral® Full Text Version

Post-print

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.

Keywords

Humans, Ill-Housed Persons, Hispanic or Latino, Primary Health Care, Veterans, Patient-Centered Care, Male, Female, Black or African American, United States, Middle Aged, Ambulatory Care, Adult, United States Department of Veterans Affairs, Health Services Accessibility, White, healthcare, homelessness, needs and experiences of care, primary care, veterans

Published Open-Access

yes

Recommended Citation

Chinchilla, Melissa; Jones, Audrey L; DeRussy, Aerin; et al., "Comparison of Primary Care Experiences and Outpatient Health Service Utilization Among Black and Latino Homeless-Experienced Veterans: An Analysis of Patient-Centered Medical Homes" (2025). Faculty, Staff and Student Publications. 5771.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5771