TABLE 3—
Comparison of Primary Care Quality-Homeless Scores by Site of Care in Tailored vs Nontailored Care Programs: January 2011–March 2012
| Tailored, Mean ±SD, Mean (SE), or OR (95% CI) |
Mainstream, Mean ±SD, Mean (SE), or OR (95% CI) |
||||||
| Scores | No. | Tailored Non-VA | Tailored VA | Mainstream VA A | Mainstream VA B | Mainstream VA C | Pa |
| Subscale scores, unadjusted | |||||||
| Relationship | 600 | 3.32 ±0.41 | 3.28 ±0.46 | 3.28 ±0.55 | 3.13 ±0.49 | 2.95 ±0.49 | < .001b |
| Cooperation | 566 | 2.97 ±0.52 | 2.85 ±0.82 | 2.81 ±0.82 | 2.75 ±0.70 | 2.43 ±0.62 | < .001b |
| Access/coordination | 600 | 3.17 ±0.40 | 3.10 ±0.48 | 3.15 ±0.53 | 3.12 ±0.44 | 2.90 ±0.39 | .024c |
| Homeless-specific needs | 596 | 3.17 ±0.46 | 3.17 ±0.49 | 3.05 ±0.60 | 3.05 ±0.51 | 2.96 ±0.50 | .033 |
| Subscale scores, adjustedd | |||||||
| Relationship | 551 | 3.45 (0.09) | 3.38 (0.10) | 3.37 (0.09) | 3.26 (0.09) | 3.07 (0.12) | < .001 |
| Cooperation | 522 | 3.15 (0.13) | 2.96 (0.15) | 2.93 (0.14) | 2.89 (0.14) | 2.71 (0.18) | .005 |
| Access/coordination | 551 | 3.29 (0.08) | 3.19 (0.10) | 3.24 (0.09) | 3.24 (0.09) | 3.03 (0.11) | .055 |
| Homeless-specific needs | 547 | 3.38 (0.09) | 3.38 (0.11) | 3.25 (0.10) | 3.31 (0.10) | 3.26 (0.13) | .209 |
| Unfavorable experiencede | |||||||
| Relationship | 551 | Ref | 1.84 (0.96, 3.54) | 2.60 (1.49, 4.56) | 2.57 (1.48, 4.47) | 2.38 (1.03, 5.48) | .005 |
| Cooperation | 522 | Ref | 1.87 (0.88, 4.00) | 2.73 (1.46, 5.09) | 2.73 (1.45, 5.14) | 2.70 (1.06, 6.84) | .01 |
| Access/coordination | 551 | Ref | 2.36 (1.22, 4.57) | 2.50 (1.42, 4.41) | 1.96 (1.11, 3.46) | 2.38 (1.02, 5.56) | .018 |
| Homeless-specific needs | 547 | Ref | 0.96 (0.51, 1.81) | 2.15 (1.27, 3.63) | 1.45 (0.87, 2.44) | 1.90 (0.85, 4.28) | .021 |
Note. CI = confidence interval; OR = odds ratio; VA = Veterans Affairs. Tailored non-VA refers to a 26-year old Health Care for the Homeless Program. Mainstream VA sites are non-tailored primary care sites in Pennsylvania (A), and Alabama (B and C). Tailored VA is a VA homeless-tailored primary care program (California).
In unadjusted comparisons, the P value is from an overall test for significant differences among the 5 included sites. In the 2 adjusted analysis, the P value reflects a test of whether the site (5 categories, degrees of freedom = 4) was significant after controlling for variables detailed under footnote b.
Post hoc tests revealed significant pairwise differences between tailored non-VA and mainstream VA B; tailored non-VA and mainstream VA C; tailored VA and mainstream VA C; and mainstream VA A and mainstream VA C.
Post hoc tests revealed significant pairwise differences between tailored non-VA and mainstream VA C; and mainstream VA A and mainstream VA C.
Adjusted analyses control for age, gender, Black race, having had one’s own domicile (apartment or house) in past 2 weeks, psychiatric symptoms (Colorado score), drug and alcohol risk scores on the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), general self-reported health, and low income status.
Unfavorable experience was defined based on the number of “frankly unfavorable” responses falling into the highest tertile observed for that particular scale (i.e., agree or strongly agree with a negatively worded item, or disagree or strongly disagree with a positively worded item). The highest tertile for unfavorable responses was found to be 2 or more unfavorable responses for the relationship, cooperation and access/coordination scales, and 1 or more unfavorable responses for the homeless-specific needs scale.