COMPETING PRIORITIES AS A BARRIER TO MEDICAL-CARE AMONG HOMELESS ADULTS IN LOS-ANGELES

Objectives. The role of competing priorities as a barrier to the utili zation of physical health services was assessed in a subset (n = 363) of a probability sample of homeless adults in Los Angeles. Methods. Un adjusted odds of four measures of health services utilization were cal culated for those with frequent difficulty in meeting their subsistenc e needs. These odds were then adjusted for a range of characteristics assumed to affect the utilization of health services among the homeles s. Results. Before and after adjustment, those with frequent subsisten ce difficulty were less likely to have a regular source of care (odds ratio [OR] = 0.30, 95% confidence interval [CI] = 0.16, 0.53) and more likely to have gone without needed medical care (OR = 1.77, 95% CI = 1.04, 3.00). Subsistence difficulty had no impact on the likelihood of having an outpatient visit or having been hospitalized. Conclusions r emained the same after adjustment. Conclusions. Frequent subsistence d ifficulty appears to be an important nonfinancial barrier to the utili zation of health services perceived as discretionary among homeless ad ults.