This literature review examines the challenges homeless persons encounter in accessing primary health care.

Homeless persons are numerous, carry a significant burden of illness and face challenges in accessing care. A search of the literature revealed insufficient emperical sources to permit the use of standard systematic review methodology to determine the most effective way to deliver point-of-first contact healthcare to homeless people. Instead we use a policy analysis approach. We found that the dominant model of primary care in Canada performs poorly when assessed on three evaluation criteria. While there is variable performance on individual measures, the three alternative models - targeted standard facility/clinic site, fixed outreach site, and mobile outreach service - all perform well. Our findings suggest that some factor other than performance on the specified measures, such as costs, feasibility, geographical fit or local preferences, should be used to chose a specific model. Our analysis clearly indicates that the status quo model of primary care is inadequate to meet the needs of homeless people (Authors).

View the policy analysis: Delivering Care to Homeless Persons: A Policy Analysis Approach to Evaluating the Options.