Table 5 Mixed methods
Author, year Country | Title | Objective | Population/Setting | Exposure | Patient Experience Measure | Key findings related to patient experience measures and/or outcomes |
|---|---|---|---|---|---|---|
Bennet-Daly, 2021 [59] Australia | Development and Initial Evaluation of a Nurse-Led Healthcare Clinic for Homeless and At-Risk Populations in Tasmania, Australia: A Collaborative Initiative | To examine barriers to healthcare access amongst individuals who experience homelessness, client and staff perceptions of the MHNC services and explored opportunities for service expansion | PEH administrative case reviews n = 174 PEH Interviews n = 10 Mission Health Nurse-led Clinic (MHNC) | Mission Health Nurse-led Clinic Primary Healthcare | FTF interviews | The MHNC services were reported to be highly appreciated by all clients. Three themes emerged from the findings: personal vulnerability (client level), disconnectedness (system level) and the acceptability of the MHNC (service level). Subthemes of hardship and adversity, homelessness, lack of empowerment, lived experiences and wellbeing, gaps in or between services, social stigma and societal expectations, expense of health services, rapport and trust, continuity of care, drop-in and fee-free service, client advocacy and health promotion were identified. An expansion of services, extra operating hours and maintenance of flexible appointments were suggested as a means to increase engagement for improved health outcomes. A collaborative model of nurse-led healthcare service can mitigate the challenges of disconnectedness with other primary healthcare services, such as improved access and equity |
Chrystal, 2015 [38], US | Experience of primary care among homeless individuals with mental health conditions | To inform healthcare improvement, studied predictors of favourable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring | PEH with mental health conditions N = 366 Primary Care Clinics (VA and Non-VA, tailored and non-tailored) | Comparison of homeless specific tailored versus non-tailored Primary Care Clinics Primary Healthcare | The Primary Care Quality-Homeless (PCQ-H) questionnaire | Significant predictors of a positive experience included: a site offering tailored service design, perceived choice among providers, currently domiciled status. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favourable primary care experience |
Greysen, 2012 [28], US | Understanding Transitions in Care from Hospital to Homeless Shelter: a Mixed-Methods, Community-Based Participatory Approach | To understand patients’ experiences of transitions from hospital to a homeless shelter, and determine aspects of these experiences associated with perceived quality of these transitions | PEH N = 98 Columbus House (Homeless shelter) | Yale-New Haven Hospital (YNHH) Acute Care | F2F semi-structured interviews Survey instrumenta | Patients perceived an overall lack of coordination between the hospital and shelter at the time of discharge. Expectations of suboptimal coordination exacerbate delays in seeking care. Patients made three recommendations for improvement: 1) Hospital providers should consider housing a health concern; 2) Hospital and shelter providers should communicate during discharge planning; 3) Discharge planning should include safe transportation. 44% of participants reported that housing status was assessed and 42% reported that transportation was discussed. 27% reported discharge occurred after dark; 11% reported staying on the streets with no shelter on first night after discharge |