The dissertation employs Andersen and Newman's conceptual framework of health service utilization to examine continuity of care among homeless people. The research context is the Health Care for the Homeless Program which provides free health and medical care to thousands of homeless people in 19 major U.S. cities. The study examines continuity of care for a common illness episode among homeless people, namely peripheral vascular disease of the lower limbs and related disorders. Continuity is modeled as a function of predisposing individual, illness level, and health service system characteristics. The analysis uses multiple regression statistical methods to assess whether and the extent to which individual and health system determinants have net effects on continuity. The findings suggest two related theoretical implications. First, there are multiple sources of continuity. Second, health service system and individual characteristics affect continuity net of each other. The findings also suggest several practical implications including the importance of full-time outreach staff, verbal instructions to return for care, and more extensive weekly hours at each delivery site, just to name a few.
| Identifer | oai:union.ndltd.org:UMASS/oai:scholarworks.umass.edu:dissertations-7917 |
| Date | 01 January 1990 |
| Creators | Saunders, Sarah Lee |
| Publisher | ScholarWorks@UMass Amherst |
| Source Sets | University of Massachusetts, Amherst |
| Language | English |
| Detected Language | English |
| Type | text |
| Source | Doctoral Dissertations Available from Proquest |
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