The quality of preventive medical care for homeless veterans with mental illness.

The 2003 National Healthcare Disparities Report underscored the need for performance measurement of evidence-based preventive services for at-risk populations. This study compares receipt of primary care prevention services among homeless and nonhomeless veteran patients who received Veterans Affairs (VA) medical care services. The study used chart review data on a national sample of 94,932 veterans with chronic medical conditions whose care was reviewed through the VA External Peer Review Program during 1998 and 1999. Receipt of eight preventive services was examined: two measures of immunization, four of cancer screening, and two of tobacco use and counseling. In risk-adjusted models, recently homeless veterans received 9% fewer prevention services for which they were eligible. Modest differences in receiving prevention services between domiciled and recently homeless veterans suggest that targeted efforts are needed to facilitate access to needed medical services in this population.