Systematic Review of the Lower Perceived Access to Care Among Populations Experiencing Homelessness

Background: Exposure to homelessness often results in real, systemic and institutional barriers to healthcare access, like lack of insurance. However, current articles lack insight on whether those diagnosed are able to properly access treatment. A systematic literature review was conducted to gain more insight on the homeless populationï¾’s perceived access to care, contextualized by the progression of cardiovascular disease. Methods: Data from articles retrieved from the PubMed database were utilized in a systematic review process to examine the correlation between homelessness and measures of access to healthcare. The mediators of interest were the barriers that could prevent one from getting access to the appropriate care or needed treatment. Systematic exclusion & abstraction of eligible articles was performed by two individuals reviewing sources, with adjudication of discrepancies by a third. Results: The broad search yielded 435 initial articles, then was systematically excluded for reasons such as age of sample group (40), year of publication (49), and commentaries (8), narrowing down the number of applicable articles to 12. However, the lack of access to proper healthcare was more consistently reported in persons experiencing homelessness compared to their housed counterparts. Discussion: A majority of the included articles concluded that homeless individuals have a lower perceived access to care, which likely results in both acute and chronic health conditions going untreated. Further, ongoing searches will characterize how access to care contributes to the overall progression of chronic diseases within a context of the complex exposures associated with homelessness.