Improving access to healthcare services for people experiencing homelessness: evidence from a scoping review of interventions

Purpose People experiencing homelessness display substantial health inequalities when compared to the housedpopulation. Existing studies on access tend to focus on isolated initiatives within specific geographic contexts, oftenlacking in comparative analyses. The research aims to address this gap, answering to the question “which types ofinterventions support access to care for people experiencing homelessness?” and thus providing evidence on the types ofinterventions that foster access to healthcare services for people experiencing homelessness.Design We performed a scoping review of scientific literature published between 2000 and 2023. Included studiesfocused on interventions improving access to care services for people experiencing homelessness. Qualitative andquantitative data were extracted, and findings were synthesised and assessed against the Levesque framework ofaccess to care.Findings Forty-eight studies were included. Healthcare services varied from primary care to outpatient, mentalhealth, prevention, emergency and hospital-based care. Four main types of interventions were determined,answering various access needs. Outreach and community-based interventions were found to ensure available andacceptable responses for people experiencing homelessness; case management and peer support were consideredrelevant for navigation across and towards services; service integration and coordination efforts were deemed asessential in offering complete responses for multifaceted and complex needs; and digital healthcare interventionsproved to make health information more reachable.Originality This paper sheds light on the inner complexity of this target population and informs about valuablestrategies and approaches that can be pursued when designing and implementing interventions to improve peopleexperiencing homelessness access to care.