Houston Outreach Medicine, Education, and Social Services' (HOMES) homeless population demographics, descriptions and barriers to care

Background: Houston Outreach Medicine, Education, and Social Services (HOMES) is a multi-institutional, inter-professional, student-run free clinic serving the homeless of Houston. We sought to determine the demographic and health characteristics, barriers to healthcare, and community resources needed among HOMES Clinic patients. Methods: Subjects were enrolled by random selection of willing homeless persons at a soup kitchen that is the primary source of HOMES Clinic patients. Interviews were conducted by trained students. Question formats included yes/no, categorical, and open-ended questions. Data collection was 4/2/06-5/12/06 (N=91). Results: Two-thirds of participants were homeless for <1year and were more likely to be first time homeless compared to the homeless for >1 year (OR=4.63; 95% CI=1.45-16.27). The most common self-reported conditions were hypertension (40%), depression (37.36%) and hepatitis C (17%). Seventy percent sought medical care within six months of the study. Twenty percent felt they were unable to access medical care. Reported barriers were lack of money, insurance, and time. Open-ended questions on barriers revealed themes including difficulty of fulfilling procedural requirements, social stigmatization, and prioritization of survival needs. Forty percent of respondents reported not having health insurance but the majority (75%) applied for insurance within the last six months. The community resources most needed by this population were rent/utility assistance and clothing. Conclusions: The most common health problems were chronic conditions that needed long-term care resources. An intervention decreasing the steps involved in obtaining healthcare and focusing on the recently homeless is recommended.