Supporting access to primary care for people experiencing homelessness in Australia: a rapid review of the literature

Homelessness affects >122,000 Australians, and is linked to significantly reduced life expectancy and a heightened risk of preventable acute and chronic health conditions. Optimum management by primary care services enables those experiencing homelessness to avoid exacerbations and unnecessary presentations to hospital emergency departments. The aim of this review was to search the available literature to identify strategies that are effective in supporting people who are experiencing homelessness to engage with primary care services in Australia. A rapid scoping review of the literature was conducted in accordance with the PRISMA guidelines. Ovid MEDLINE was searched. Studies published from 2014 to 2024, and qualitative, quantitative and mixed-methods studies were included. A thematic analysis was conducted to inform a narrative review of included studies. Of 97 papers, 28 met the eligibility criteria. Six key themes were identified: (1) trust and rapport; (2) collaboration; (3) cost and funding; (4) flexibility of services and tailored, person-centred care; and (5) accessible locations and outreach. Access to primary care for people experiencing homelessness in Australia is influenced by a complex web of barriers and enablers. A holistic, person-centred and trauma-informed approach, combined with the development of collaborative networks and sustainable resources, is crucial to reducing healthcare access barriers for people experiencing homelessness in Australia.