Primary Care for Homeless Veterans: A Narrative Review of Current Evidence

Abstract

Context: There is a high burden of homelessness among veterans. Primary care can be an important mitigating factor of poor health outcomes such as duration of homelessness and control of chronic medical conditions. However, traditional primary care models have not met the unique needs of homeless individuals. The VA has addressed this by adopting a homeless-tailored primary care model for homeless veterans. However, there are no reviews on homeless-tailored primary care or primary care for homeless veterans. Objective: To evaluate and identify gaps in the existing knowledge on primary care for homeless veterans to facilitate ongoing program development and direct further research. Methods: Systematic literature search to identify relevant articles on primary care for homeless veterans. Two authors independently screened and reviewed full text of articles that met inclusion criteria. Data was extracted then analyzed using a narrative synthesis methodology. Results: 8 articles were included in this review. Health care utilization patterns of increased primary care use and decreased emergency services use were linked to homeless-tailored care. Homeless-tailored care also conferred improved patient satisfaction and provider trust. There were not conclusive data on health outcomes or housing related to primary care. Conclusions: Homeless-tailored care is a productive care model within the VA. However, further investigation is needed to maximize the potential of primary care for reaching and caring for this vulnerable population.