ArticleJournal of general internal medicine2024
Characteristics of Veterans Experiencing Homelessness using Telehealth for Primary Care Before and After COVID-19 Pandemic Onset.
Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Patient perspectives on telehealth access among people experiencing homelessness: a rapid review.International journal for equity in health · 2026Pooled it
- A scoping review of studies on secure messaging through patient portals: persistent challenges and potential solutions.npj health systems · 2026Article
- Risk for Acute Care Utilization in Housing-Insecure Adults: A National Study of a Hot Spotter Program in the US Veterans Health Administration.Medical care · 2026Article
- Primary Care by Telehealth and Care Quality in the Veterans Health Administration.JAMA network open · 2026Article
- Pathways into homelessness and perspectives on prevention: A qualitative study of army veterans.PloS one · 2026Article
- Telehealth for Patients Experiencing Homelessness-An Unexpected Opportunity.JAMA internal medicine · 2025Article
- Comparing major comorbidity indices as predictors of all-cause mortality in the Veterans Affairs health care system.Journal of clinical epidemiology · 2025Article
- Realizing Virtual Care in VA: Supporting the Healthcare System's Journey Towards Enhanced Access, Engagement, and Outcomes.Journal of general internal medicine · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundThe COVID-19 pandemic expanded telehealth use across healthcare systems, including the Veterans Health Administration (VA). Little is known about how large-scale telehealth rollout affected access to primary care for patients experiencing homelessness.
objectiveTo examine the extent to which homeless-experienced veterans used telehealth services in primary care and to characterize users before and after the onset of the COVID-19 pandemic.
designRetrospective cohort study, 3/16/2019-3/15/2022.
participants394,731 veterans with homelessness diagnoses nationally using 4,068,109 primary care visits. MAIN MEASURES: The outcomes were use of 1 + telehealth visits (video, phone, secure messaging) for primary care during each year. Through multivariable regression models, we examined associations between telehealth use, patient characteristics (e.g., age, sex, race-ethnicity, comorbidity), and VA homeless services use (e.g., homeless-tailored primary care (HPACT), permanent supportive housing). KEY
resultsCompared to pre-pandemic, telehealth in primary care among homeless-experienced veterans increased substantially 2 years post-pandemic (video: 1.37% versus 20.56%, phone: 60.74% versus 76.58%). Secure messaging was low over time (1.57-2.63%). In adjusted models, video users were more likely to be young (65 + years: OR = 0.43, CI: 0.42-0.44), women (OR = 1.74, CI: 1.70-1.78), Black (OR = 1.14, CI: 1.12-1.16), Hispanic (OR = 1.34, CI: 1.30-1.38), and with more comorbidities (2 + on the Charlson Comorbidity Index; OR = 1.16, CI: 1.14-1.19), compared to video non-users. HPACT patients were less likely to use video (OR = 0.68, CI: 0.66-0.71) than other primary care patients. This was not observed among users of other VA homeless services.
conclusionsDespite decreased access to health information technology and low pre-pandemic telehealth use, veterans experiencing homelessness still sustained high use of telehealth in primary care post-pandemic. Women and racial-ethnic minorities had higher video uptake proportionately, suggesting that telehealth may address access disparities among these homeless-experienced patient groups. Identifying and targeting organizational characteristics (e.g., HPACT users) that predict telehealth use for improvement may be key to increasing adoption among VA primary care patients experiencing homelessness.
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