{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:45:05Z","timestamp":1777859105343,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2017,4,1]],"date-time":"2017-04-01T00:00:00Z","timestamp":1491004800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:p>\n                    <jats:bold>Objectives:<\/jats:bold>\n                    Homeless adults have low primary care engagement and high emergency department (ED) utilization. Homeless-tailored, patient-centered medical homes (PCMH) decrease this population\u2019s acute care use. We studied the feasibility (focused on patient recruitment) and acceptability (conceptualized as clinicians\u2019 attitudes\/beliefs) of a pilot initiative to colocate a homeless-tailored PCMH with an ED. After ED triage, low-acuity patients appropriate for outpatient care were screened for homelessness; homeless patients chose between a colocated PCMH or ED visit.\n                    <jats:bold>Methods:<\/jats:bold>\n                    To study feasibility, we captured (from May to September 2012) the number of patients screened for homelessness, positive screens, unique patients seen, and primary care visits. We focused on acceptability to ED clinicians (physicians, nurses, social workers); we sent a 32-item survey to ED clinicians (n = 57) who worked during clinic hours. Questions derived from an instrument measuring clinician attitudes toward homeless persons; acceptability of homelessness screening and the clinic itself were also explored.\n                    <jats:bold>Results:<\/jats:bold>\n                    Over the 5 months of interest, 281 patients were screened; 172 (61.2%) screened positive for homelessness; 112 (65.1%) of these positive screens were seen over 215 visits. Acceptability data were obtained from 56% (n = 32) of surveyed clinicians. Attitudes toward homeless patients were similar to prior studies of primary care physicians. Most (54.6%) clinicians agreed with the homelessness screening procedures. Nearly all (90.3%) clinicians supported expansion of the homeless-tailored clinic; a minority (42.0%) agreed that ED colocation worked well.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Our data suggest the feasibility of recruiting patients to a homeless-tailored primary care clinic colocated with the ED; however, the clinic\u2019s acceptability was mixed. Future quality improvement work should focus on tailoring the clinic to increase its acceptability among ED clinicians, while assessing its impact on health, housing, and costs.\n                  <\/jats:p>","DOI":"10.1177\/2150131917699751","type":"journal-article","created":{"date-parts":[[2017,4,1]],"date-time":"2017-04-01T05:07:34Z","timestamp":1491023254000},"page":"338-344","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Feasibility and Acceptability of a Colocated Homeless-Tailored Primary Care Clinic and Emergency Department"],"prefix":"10.1177","volume":"8","author":[{"given":"Sonya","family":"Gabrielian","sequence":"first","affiliation":[{"name":"VA Greater Los Angeles, Los Angeles, CA, USA"},{"name":"UCLA David Geffen School of Medicine, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer C.","family":"Chen","sequence":"additional","affiliation":[{"name":"UCLA David Geffen School of Medicine, Los Angeles, CA, USA"},{"name":"Harbor-UCLA Medical Center, Torrance, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beena P.","family":"Minhaj","sequence":"additional","affiliation":[{"name":"MedAmerica, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rishi","family":"Manchanda","sequence":"additional","affiliation":[{"name":"HealthBegins, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Altman","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles, Los Angeles, CA, USA"},{"name":"UCLA David Geffen School of Medicine, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ella","family":"Koosis","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lillian","family":"Gelberg","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles, Los Angeles, CA, USA"},{"name":"UCLA David Geffen School of Medicine, Los Angeles, CA, USA"},{"name":"UCLA Fielding School of Public Health, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,4]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.5888\/pcd13.150567."},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-011-1818-2."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1945-1474.2005.tb00586.x"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/003335491012500308."},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.2.200"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199408043310506."},{"key":"e_1_3_4_8_2","first-page":"1273","article-title":"The behavioral model for vulnerable populations: application to medical care use and outcomes for homeless people","volume":"34","author":"Gelberg L","year":"2000","unstructured":"Gelberg L, Andersen RM, Leake BD. 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Primary Care Foundation; 2010.","journal-title":"Primary Care Foundation"},{"key":"e_1_3_4_15_2","unstructured":"Co-located primary and urgent care helps reduce ED use. CPCPracticeSpotlight66. March 2016:1-1. http:\/\/innovation.cms.gov\/initiatives\/Comprehensive-Primary-Care-Initiative\/. Accessed March 3 2017."},{"key":"e_1_3_4_16_2","first-page":"1","article-title":"critical review of the literature regarding homelessness among veterans","author":"Balshem H","year":"2011","unstructured":"Balshem H, Christensen V, Tuepker A, Kansagara D. A critical review of the literature regarding homelessness among veterans. VA-ESP Project #05-225. April 2011:1-64.","journal-title":"VA-ESP Project #05-225"},{"key":"e_1_3_4_17_2","first-page":"311","article-title":"Innovative efforts to address homelessness among veterans","volume":"76","author":"O\u2019Toole TP","year":"2015","unstructured":"O\u2019Toole TP, Pape L. Innovative efforts to address homelessness among veterans. 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Fed Practitioner. 2014;31(10):10-19.","journal-title":"Fed Practitioner"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.17226\/1092."},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0183-7."},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7599.2008.00371.x."},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1446.2008.00726.x."},{"key":"e_1_3_4_25_2","unstructured":"Cortes A Henry M la Cruz de RJ Brown S. The 2012 Point-in-Time Estimates of Homelessness: Volume I of the 2012 Annual Homeless Assessment Report. November 2012:1-24."},{"key":"e_1_3_4_26_2","volume-title":"Emergency Severity Index (ESI)","author":"Gilboy N","year":"2011","unstructured":"Gilboy N, Tanabe P, Travers D, Rosenau A. Emergency Severity Index (ESI). 4th ed. 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