Provider Perspectives on Delivering Primary Care to Homeless in Philadelphia

Studies have shown that the homeless population nationwide suffers from higher rates of illness than the general population. This is also true of the 25,000 homeless in Philadelphia. Most homeless prioritize finding food and safe shelter before their health. While home placement is a critical first step to ending an individual's homelessness, action is required to address gaps in their healthcare needs. Currently, there are four main access points for care for the homeless: emergency departments, community clinics, shelters fostering outreach and mobile outreach.

This study was a key-informant survey that sought to determine the scope of issues surrounding primary healthcare for the homeless from the providers' perspectives and to elucidate calls to action to address these issues. The study consisted of open-ended interviews with primary care providers at eight locations throughout Philadelphia. Because of the small size of the provider population, random selection was not an option for determining who to interview.

Three main action items were identified: expansion of insurance and accessibility of healthcare services, connection of existing systems to create an integrated system of care and increased dialogue and initiative about homelessness as a social issue. Within these three categories we have suggested calls to action including expanding insurance coverage, increasing the minimum wage, and broadening the services provided by existing care access points.

Eradicating homelessness will take significant time, money, resources and paradigm shifts in policy. However, our study suggests that minor changes can be made to greatly affect healthcare access for the homeless in Philadelphia.