Access to primary care services among the homeless: a synthesis of the literature using the equity of access to medical care framework

J Prim Care Community Health. 2015 Apr;6(2):77-87. doi: 10.1177/2150131914556122. Epub 2014 Nov 11.


Objective: To identify barriers and facilitators to primary care access among the homeless using the Equity of Access to Medical Care Framework and to provide recommendations for medical and public health practitioners to improve health among this underserved population.

Methods: A quasi-systematic review of the literature was conducted using the PubMed, CINAHL, and PsycINFO databases. Study elements from articles in the final analysis were extracted and categorized into dimensions of access from the Framework.

Results: The review identified multiple barriers to primary care access for the homeless. This included lack of insurance coverage and competing priorities. Facilitators to access included tailored health care delivery systems and having a regular source of care.

Conclusion: This review provides evidence that health policy initiatives, patient-centered care, and targeted interventions can assist with improving primary care access among the homeless.

Keywords: access to care; homeless; primary care.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Health Services Accessibility / standards*
  • Healthcare Disparities
  • Homeless Persons*
  • Humans
  • Patient-Centered Care
  • Primary Health Care*