Abstract
We examined factors associated with referral keeping among 118 homeless women screened for health care needs in Seattle. Referral keeping for medical conditions among the homeless was comparable to rates found in general low-income populations (62 percent vs. 65 percent), but their proportion of kept referrals for preventive care was much lower (22 percent vs. 44–51 percent). Referral keeping varied directly with symptom severity. Consistant with this finding was that among interviewed subjects who did not keep the index referral, 37 percent kept other referrals for more severe problems or if the condition worsened. Personal stresses and competing priorities, weighted against perceived medical urgency, were the major factors influencing referral keeping. Screener encouragement and communication of medical urgency were indicated by one-third of the subjects who kept referrals as providing important motivation for treatment.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Brickner PW, Scharer LK, Conanan B, Elvy A, Savarese M (eds.):Health care for homeless people. New York: Springer Publishing, 1985.
Wright JD:The national health care for the homeless program. Boston: Social and Demographic Research Institute, University of Mass., March 1987; Pp. 45–51.
Lipton FR, Sabatini A, Katz SE: Down and out in the city: the homeless mentally ill.Hosp Community Psychiatry 34:817–821, 1983.
Bassuk EL, Rubin L, Lauriet AS: Characteristics of sheltered homeless families.Am J Public Health 76:1097–1101, 1986.
Arce AA, Tadlock M, Vergare MJ, Shapiro SH: A psychiatric profile of street people admitted to an emergency shelter.Hosp Community Psychiatry 34:812–817, 1983.
Chavkin C, Kristal A, Seaborn C, Guigli PE: The reproductive experience of women living in hotels for the homeless in New York City.NY State J Med 87:10–13, 1987.
Jonas S: Appointment breaking in a general medical clinic.Med Care 9:82, 1971.
Haynes RB: A critical review of the “determinants” of patient compliance with theraputic regimens. In: Haynes RB (ed).Compliance in Health Care. Baltimore: Johns Hopkins University Press. 1979. Pp. 26–93.
Hertz P, Stamps PL: Appointment keeping behavior re-evaluated.Am J Public Health 67:1033, 1977.
Alpert JJ: Broken appointments.Pediatrics 34:127, 1964.
Hurtado AV, Greenlick MR, Columbo TJ: Determinants of medical care utilization: failure to keep appointments.Med Care 11:190–191, 1973.
Go HT, Becker A: Reducing broken appointments in a primary care clinic.J Ambulatory Care 2:23, 1979.
Oppenheim GL, Bergman JJ: Failed Appointments: a review.J Fam Pract 8:789, 1979.
Fink R: Delay behavior in breast cancer screening. In: Cullen JW, Fox BH, Isom RN:Cancer: The Behavioral Dimensions. New York: Raven Press, 1976. Pp. 28–29.
Hulka B: Motivation techniques in a cancer detection program.Public Health Rep 81:1014, 1966.
Rosner, B:Fundamentals of Biostatistics. Boston: PWS Publishers, 1982. Pp. 167–8.
Author information
Authors and Affiliations
Additional information
Edythe Schlossstein is M.P.H., Medical Student, University of Washington School of Medicine, Seattle, WA 98195.
Patricia St. Clair is Clinical Assistant Professor of Health Services; Frederick Connell is Professor of Health Services; both are in the School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195.
Rights and permissions
About this article
Cite this article
Schlossstein, E., Clair, P.S. & Connell, F. Referral keeping in homeless women. J Community Health 16, 279–285 (1991). https://doi.org/10.1007/BF01324513
Issue Date:
DOI: https://doi.org/10.1007/BF01324513