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. 1997 Feb;87(2):217-20.
doi: 10.2105/ajph.87.2.217.

Competing Priorities as a Barrier to Medical Care Among Homeless Adults in Los Angeles

Free PMC article

Competing Priorities as a Barrier to Medical Care Among Homeless Adults in Los Angeles

L Gelberg et al. Am J Public Health. .
Free PMC article


Objectives: The role of competing priorities as a barrier to the utilization of physical health services was assessed in a subset (n = 363) of a probability sample of homeless adults in Los Angeles.

Methods: Unadjusted odds of four measures of health services utilization were calculated for those with frequent difficulty in meeting their subsistence needs. These odds were then adjusted for a range of characteristics assumed to affect the utilization of health services among the homeless.

Results: Before and after adjustment, those with frequent subsistence difficulty were less likely to have a regular source of care (odds ratio [OR] = 0.30, 95% confidence interval [CI] = 0.16, 0.53) and more likely to have gone without needed medical care (OR = 1.77, 95% CI = 1.04, 3.00). Subsistence difficulty had no impact on the likelihood of having an outpatient visit or having been hospitalized. Conclusions remained the same after adjustment.

Conclusions: Frequent subsistence difficulty appears to be an important nonfinancial barrier to the utilization of health services perceived as discretionary among homeless adults.

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