School of Nursing, Queensland University of Technology, Brisbane, QLD 4000, Australia.
Homeless Health Service, St Vincent's Hospital Sydney, Sydney, NSW 2010, Australia.
Int J Environ Res Public Health. 2022 Nov 29;19(23):15928. doi: 10.3390/ijerph192315928.
People experiencing homelessness find it challenging to access the healthcare they so desperately need. To address this, we have developed the Homeless Health Access to Care Tool, which assesses health related vulnerability (burden of injury and/or illness and ability to access healthcare) and can be used to prioritize people for access to healthcare. Here, we report the initial psychometrics of the Homeless Health Access to Care Tool. To assess interrater reliability, clinician participants were invited to instinctually rate the health-related vulnerability of 18-fictional case studies and then apply the Homeless Health Access to Care Tool to these same case studies. To assess convergent validity, the Homeless Health Access to Care Tool and the tool it was adapted from, the Australian Vulnerability Index Service Prioritization Decision Assistance Tool were administered to people experiencing homelessness. Feedback was sought from the participants receiving these two tools and from those administering them. The Homeless Health Access to Care Tool demonstrated a high interrater reliability and internal consistency. Participants using and receiving the Homeless Health Access to Care Tool reported it as straightforward, unintrusive and clear. Median time of administration was 7 min 29 s (SD 118.03 s). Convergent validity was established for the Homeless Health Access to Care Tool with a moderate correlation (r = 0.567) with the total score of the Australian Vulnerability Index Service Prioritization Decision Assistance Tool. Findings suggest that the Homeless Health Access to Care Tool is feasible and reliable. Larger samples are required to report construct validity.
无家可归者在获取他们迫切需要的医疗保健方面存在困难。为了解决这个问题，我们开发了无家可归者医疗保健准入工具，该工具评估了与健康相关的脆弱性（受伤和/或患病负担以及获得医疗保健的能力），并可用于确定人们获得医疗保健的优先级。在这里，我们报告了无家可归者医疗保健准入工具的初始心理测量学结果。为了评估评分者间信度，邀请临床医生参与者凭直觉对 18 个虚构的案例研究的健康相关脆弱性进行评分，然后对这些相同的案例研究应用无家可归者医疗保健准入工具。为了评估收敛效度，对无家可归者医疗保健准入工具和它改编自的工具，即澳大利亚脆弱性指数服务优先决策辅助工具进行了评估。从接受这两种工具的参与者和管理这些工具的参与者那里寻求反馈。无家可归者医疗保健准入工具表现出较高的评分者间信度和内部一致性。使用和接受无家可归者医疗保健准入工具的参与者报告说该工具简单、不干扰且清晰。管理时间中位数为 7 分 29 秒（SD 118.03 秒）。无家可归者医疗保健准入工具与澳大利亚脆弱性指数服务优先决策辅助工具的总分之间建立了中等相关性（r = 0.567），从而确立了收敛效度。研究结果表明，无家可归者医疗保健准入工具是可行和可靠的。需要更大的样本量来报告构念效度。
