Applying the Gelberg-Andersen Behavioral Model for Vulnerable Populations to Health Services Utilization in Homeless Women

University of California, USA.
Journal of Health Psychology (Impact Factor: 1.22). 10/2007; 12(5):791-804. DOI: 10.1177/1359105307080612
Source: PubMed


We applied the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict health services utilization (HSU) in 875 homeless US women. Structural models assessed the impact of predisposing (demographics, psychological distress, alcohol/drug problems, homelessness severity), enabling (health insurance, source of care, barriers) and need (illness) variables on HSU (preventive care, outpatient visits, hospitalizations). Homelessness severity predicted illness, barriers and less insurance. Distress predicted more barriers, illness and less outpatient HSU. Drug problems predicted hospitalizations. Barriers predicted more illness and less outpatient HSU. Health and homelessness indicators were worse for White women. Better housing, access to care and insurance would encourage appropriate HSU.

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    • "health insurance, income, competing needs, information about accessible local healthcare resources, available physicians, clinical, and treatment services), and need factors (i.e. perceived needs, medical comorbidities, and severity of illness for vulnerable population with STIs, SUDs, mental illness, and HIV/AIDS) (Gelberg et al., 2000; Stein et al., 2007). Measures of geographic access and spatial behavior (e.g. "
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    ABSTRACT: We mapped mobile medical clinic (MMC) clients for spatial distribution of their self-reported locations and travel behaviors to better understand health-seeking and utilization patterns of medically vulnerable populations in Connecticut. Contrary to distance decay literature, we found that a small but significant proportion of clients was traveling substantial distances to receive repeat care at the MMC. Of 8404 total clients, 90.2% lived within 5 miles of a MMC site, yet mean utilization was highest (5.3 visits per client) among those living 11-20 miles of MMCs, primarily for those with substance use disorders. Of clients making >20 visits, 15.0% traveled >10 miles, suggesting that a significant minority of clients traveled to MMC sites because of their need-specific healthcare services, which are not only free but available at an acceptable and accommodating environment. The findings of this study contribute to the important research on healthcare utilization among vulnerable population by focusing on broader dimensions of accessibility in a setting where both mobile and fixed healthcare services coexist.
    Health & Place 05/2014; 28C:153-166. DOI:10.1016/j.healthplace.2014.04.008 · 2.81 Impact Factor
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    • "While theoretically, the domains of the Andersen model capture an appropriate and broad conceptualization of factors associated with care utilization, it is how the components are operationalized that ultimately define how well it will predict preventive care utilization. The specific factors included in the model must reflect the unique contexts and experiences of the population under study [25,26]. While we operationalized all suggested model variables, and other known barriers were addressed as part of the care protocol, none of the currently known factors accounted for the non-participation of some women receiving free care nor do they explain the full participation (100%) of other women. "
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    BMC Public Health 02/2012; 12(1):93. DOI:10.1186/1471-2458-12-93 · 2.26 Impact Factor
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    • "This model was originally developed to explain health services use in terms of individual determinants; it has undergone several revisions since to include health system and societal factors (Aday & Andersen, 1974; Andersen, 1995; Gelberg, Andersen, & Leake, 2000). Its utility as a framework to study utilization of care has been demonstrated empirically by variety of studies (Coulter et al., 2000; Shiboski et al., 2005; Stein, Andersen, & Gelberg, 2007). As our study sample was recruited from primary care clinics and is homogenous in terms of access to primary care, the present study seeks to describe individual level characteristics associated with recent utilization of oral health services (within the past 24 months) among a cohort of HIV-positive patients who have accessed HIV primary care. "
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