In our application, Aligning Resources for the Care of Homeless Veterans (ARCH) we propose studying ways to best organize and deliver primary care for homeless Veterans. We will assess 4 different adaptations of the PACT primary care model in a multi-center, randomized-controlled 2x2 comparative effectiveness study to determine optimal care approaches measured by reductions in avoidable emergency departments and preventable hospitalizations, increased patient satisfaction, improved chronic disease management and earlier transitions out of homelessness. Findings from this study will substantively add to our understanding and advance the fields of health seeking behavior, care of vulnerable/high-risk veteran populations and clinical systems design. Second, it reflects a true field-based study employing study sites in a methodologically rigorous manner that both advances our knowledge in this area as well as identifies optimal and feasible approaches to patient care within our current VHA system. Finally, it will help inform pressing policy issues relevant to two identified T-21 priority areas: Ending Veteran Homelessness in 5 Years and Transforming to a Patient Centered Primary Care model.
Homeless Veterans have greater medical and mental health needs and use emergency departments and inpatient care at much higher rates than other Veteran populations. Primary care provides a unique opportunity to address some of the service gaps and needs of homeless Veterans while providing the platform on which to engage them in an array of services needed to exit homelessness. Unfortunately, the current approach to primary care within most VA facilities is not organized with this focus and little is known about what model of care will work best within the VA system. This study will help determine the best way to organize primary care within VA in order to provide optimal care to homeless Veterans that improves their health, health care and helps them access services necessary to leave homelessness.
| Van Voorhees, Elizabeth E; Resnik, Linda; Johnson, Erin et al. (2018) Posttraumatic Stress Disorder and Interpersonal Process in Homeless Veterans Participating in a Peer Mentoring Intervention: Associations With Program Benefit. Psychol Serv : |
