Improving access to primary care services for those on low income: voluntary advocacy

2020 ◽  
Vol 25 (4) ◽  
pp. 162-166
Author(s):  
Thomas George ◽  
Helen Aveyard

Nurses in primary care are often the first point of access for those seeking health care, and it is well known that accessing health services can be difficult for some, especially those on a low income. A charity initiative has been developed in a low-income area in England to help such individuals, wherein volunteers help local residents to access local services and support. This study explores the experiences of service users in order to understand their perceptions and feelings about the service, using an instrumental case study method with semi-structured interviews. Qualitative data were collected from six service users and transcribed by the researcher for subsequent thematic analysis. The participants' experiences were characterised by reduced social isolation, reduced emotional distress, improved mobility and transport options, improved confidence and control over life, and effective management of memory issues. Various aspects of advocacy and empowerment were also observed. Further, the coping strategies used by the participants while facing the challenges of social isolation and ageing were highlighted. The findings provide important insight into the support needs of populations on low income, the ways in which they access healthcare and how the volunteer service can best support them.

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Fatema Mamou ◽  
Matthew Davis ◽  
Jim Collins ◽  
Jay Fiedler ◽  
Tiffany Henderson ◽  
...  

Using the Michigan Syndromic Surveillance System changes in emergency department (ED) volume are being monitored as health insurance coverage expands through the Healthy Michigan Plan (HMP), which provides healthcare coverage to low-income adults. Seasonally adjusted monthly ED visits prior to and after the HMP implementation on April 1, 2014 are being compared. Preliminary data show increasing trends in ED utilization among populations with previously low levels of health insurance coverage. Increased health insurance coverage may expand healthcare service options beyond EDs. Alternatively, the demand for primary care services may exceed the level of access leading to increased ED utilization for primary care.


2021 ◽  
Vol 50 (7) ◽  
pp. 505-510
Author(s):  
Bernadette Ward ◽  
Riki Lane ◽  
Brendan Quinn ◽  
Grant Russell

1999 ◽  
Vol 2 (1) ◽  
pp. 24-25
Author(s):  
Rosemary Rodgers ◽  
Linda Mills ◽  
Jean Buckle

Author(s):  
Andreea Elena Neculau ◽  
Liliana Rogozea ◽  
Daniela Popa ◽  
Ioana Atudorei ◽  
Marius Alexandru Moga ◽  
...  

In Romania, users’ perceptions about availability of services in primary care have not been explored since 2009, when a national report was produced, and little is therefore known about the subject. The study aims to identify perceptions of primary healthcare service users regarding the availability of services in primary care. This research is a pen-and-paper self-administered survey applied to an opportunity sample of people, addressing family doctor’s practices, from 17 selected settlements of Brasov county. Overall, the analysis of population’s perceptions on the primary care system in Brasov County shows a high degree of satisfaction among the patients despite a narrow spectrum of services offered by family doctors.


CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S60-S60
Author(s):  
L. Krebs ◽  
S.W. Kirkland ◽  
K. Crick ◽  
C. Villa-Roel ◽  
A. Davidson ◽  
...  

Introduction: Some non-urgent/low-acuity Emergency Department (ED) presentations are considered convenience visits and potentially avoidable with improved access to primary care services. This study surveyed patients who presented to the ED and explored their self-reported reasons and barriers for not being connected to a primary care provider (PCP). Methods: Patients aged 17 years and older were randomly selected from electronic registration records at three urban EDs in Edmonton, Alberta (AB), Canada. Following initial triage, stabilization, and verbal informed consent, patients completed a 47-item questionnaire. Data from the survey were cross-referenced to a minimal patient dataset consisting of ED and demographic information. The questionnaire collected information on patient characteristics, their connection to a PCP, and patients' reasons for not having a PCP. Results: Of the 2144 eligible patients, 1408 (65.7%) surveys were returned and 1402 (65.4%) were completed. The majority of patients (74.4%) presenting to the ED reported having a family physician; however, the ‘closeness’ of the connection to their family physician varied greatly among ED patients with the most recent family physician visit ranging from 1 hour before ED presentation to 45 years prior. Approximately 25% of low acuity ED patients reported no connection with a family physician. Reasons for a lack of PCP connection included: prior physician retired, left, or died (19.8%), they had never tried to find one (19.2%), they had recently moved to Alberta (18.0%), and they were unable to find one (16.5%). Conclusion: A surprisingly high proportion of ED patients (25.6%) have no identified PCP. Patients had a variety of reasons for not having a family physician. These need to be understood and addressed in order for primary care access to successfully contribute to diverting non-urgent, low acuity presentations from the ED.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabelle Gaboury ◽  
Mylaine Breton ◽  
Kathy Perreault ◽  
François Bordeleau ◽  
Sarah Descôteaux ◽  
...  

Abstract Background The Advanced Access (AA) Model has shown considerable success in improving timely access for patients in primary care settings. As a result, a majority of family physicians have implemented AA in their organizations over the last decade. However, despite its widespread use, few professionals other than physicians and nurse practitioners have implemented the model. Among those who have integrated it to their practice, a wide variation in the level of implementation is observed, suggesting a need to support primary care teams in continuous improvement with AA implementation. This quality improvement research project aims to document and measure the processes and effects of practice facilitation, to implement and improve AA within interprofessional teams. Methods Five primary care teams at various levels of organizational AA implementation will take part in a quality improvement process. These teams will be followed independently over PDSA (Plan-Do-Study-Act) cycles for 18 months. Each team is responsible for setting their own objectives for improvement with respect to AA. The evaluation process consists of a mixed-methods plan, including semi-structured interviews with key members of the clinical and management teams, patient experience survey and AA-related metrics monitored from Electronic Medical Records over time. Discussion Most theories on organizational change indicate that practice facilitation should enable involvement of stakeholders in the process of change and enable improved interprofessional collaboration through a team-based approach. Improving access to primary care services is one of the top priorities of the Quebec’s ministry of health and social services. This study will identify key barriers to quality improvement initiatives within primary care and help to develop successful strategies to help teams improve and broaden implementation of AA to other primary care professionals.


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