Development and testing of the Primary Care Homeless Organizational Assessment Tool (PC-HOAT) to evaluate primary care services for the homeless

Abstract

The purpose of this dissertation is to develop and test an organizational assessment tool that can used to evaluate primary care services for the homeless. The research evaluates the importance, feasibility, reliability, and validity of organizational processes and structures of primary care services for the homeless. The final product is the validated Primary Care Homeless Organizational Assessment Tool (PC-HOAT). This tool provides stakeholders with information regarding the organizational structures and processes associated with greater quality of primary care for the homeless. This tool will help managers better understand their organization's strengths and weaknesses, guide discussions regarding operations, and provide information to inform future strategies.

The researcher conducted a mixed-method study of key informants and organizations receiving federal health care for the homeless funding. The study used eight key informants to refine the initial PC-HOAT. The researcher distributed the final instrument through a web-based survey to determine reliability and validity of the PC-HOAT. Data analysis included descriptive statistics, factor analysis, and regression analysis.

The study yielded a 7-factor scale, 34-item tool focused on evaluation and delivery of primary care services, organizational structures relevant to effective delivery of care, and patient and family centeredness. In particular, the scale describing access and quality of care provided a positive statistical association with the proportion of patients with controlled hypertension. The study yielded results that provide a better understanding of the vital organizational characteristics that contribute most appropriately to the design of health care for the homeless organization.

Keywords: homeless, primary care, organizational assessment, reliability, validity, factor analysis