scholarly journals An exploration of GP care in outreach settings for people experiencing homelessness: a qualitative study

2021 ◽  
pp. BJGP.2020.0749
Author(s):  
Victoria Hirst ◽  
Fiona Cuthill
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Access To Health Care ◽  
Health Care Services ◽  
Community Outreach ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Care Services ◽  
Outreach Services ◽  
Gp Care

Background: Although people experiencing homelessness (PEH) have the worst health outcomes in society, they have a low uptake of primary care services. GP outreach has developed as a way of increasing access into primary care but little is known about the experience of patients receiving care in this way. Aims: 1) To explore homeless patients’ experiences of GP care in community outreach settings in UK; 2) To seek staff/volunteer views on the strengths and weaknesses of the GP community outreach services. Design and setting: A qualitative study with PEH and staff/volunteers working in 3 different community outreach settings in the UK. Method: Individual semi-structured interviews with 22 PEH and two focus groups with key staff/volunteers. Data was analysed thematically using framework analysis. Findings: GP outreach services better enabled PEH to access medical care and staff/volunteers valued GP support to promote, and facilitate access to, health care services. In particular, findings illuminate the high value that PEH placed on the organisational environment of the GP outreach service. Valued aspects of GP outreach were identified as: 1) comfortable, safe and engendered a sense of belonging; 2) convenient, opportunistic and a one stop shop; and, 3) being heard, having more time and breaking down barriers. Conclusion: Organisational environment is important in enabling PEH to engage with GP services. The physical and organisational environment of the outreach settings were the most important factors: they created a space between the GP and patients where professional barriers were flattened and facilitated a therapeutic relationship.

scholarly journals Personality disorder co-morbidity in primary care ‘Improving Access to Psychological Therapy’ (IAPT) services: a qualitative study exploring patient perspectives on treatment experience

2020 ◽  
pp. 1-15
Author(s):  
Gary Lamph ◽  
John Baker ◽  
Tommy Dickinson ◽  
Karina Lovell
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Personality Disorder ◽  
Qualitative Study ◽  
Patient Group ◽  
Stepped Care ◽  
Research Approach ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Co Morbidity

Abstract Background: High numbers of people present with common mental health disorders and co-morbid personality disorder traits in primary care ‘Improving Access to Psychological Therapies’ (IAPT) services in England and they receive sub-optimal treatments. No previous studies have explored the treatment experiences or needs of this patient population in England. Aims: This qualitative study explored the treatment experiences of patients (n = 22) with common mental health difficulties and co-morbid personality disorder as indicated by a score of 3 or more on the ‘Standardised Assessment of Personality – Abbreviated Scale’ (SAPAS) in receipt of primary care-based IAPT treatment. Method: A qualitative health research approach was used. Qualitative individual face-to-face semi-structured interviews were conducted. All interviews were audio recorded, data were transcribed verbatim and analysed using a framework analysis approach. Results: Findings revealed a need to adapt away from prescriptive cognitive behavioural therapy (CBT) treatment models towards more flexible, personalised and individualised treatment with this patient group. Time to emotionally offload, build a therapeutic relationship and link past experiences to presenting problems were highlighted as important. Conclusions: For the first time, the needs and treatment experiences of this patient group have been explored. This paper provides a unique patient experience insight that should be considered when exploring new approaches to working with and developing effective interventions via a stepped care approach.

scholarly journals Treatment of female and male inpatient crack users: a qualitative study

2013 ◽  
Vol 35 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Rosemeri Siqueira Pedroso ◽  
Félix Kessler ◽  
Flavio Pechansky
Keyword(s):  
Qualitative Study ◽  
Health Care Services ◽  
Spiritual Support ◽  
Structured Interviews ◽  
Criminal Involvement ◽  
Care Services ◽  
Preventive Actions ◽  
The Relationship ◽  
Purposive Sample ◽  
Crack Users

OBJECTIVE: To map treatment trajectories in a sample of male and female crack users through their narratives about the course of treatment seeking and their attempts to access health care services in Brazil. METHODS: Qualitative study of a purposive sample (five female and nine male hospitalized crack users) using semi-structured interviews. The interviews were transcribed and data explored using content analysis. RESULTS: Respondents reported difficulties getting access to hospitalization, relapse after discharge, and abandonment of treatment. There seems to be a peculiar model of behavior for women and men while dealing with craving for crack: while women got involved with prostitution and consequently became infected with HIV, every men of the sample reported criminal involvement. CONCLUSIONS: The relationship between relapse and a social environment conducive to consumption, associated with belief or disbelief in spiritual support, prostitution, and the legal complications arising from the use of crack, are relevant issues and should be taken into consideration in the development of preventive actions aimed at this specific population.

scholarly journals Key components and critical factors for developing a telehealth business framework: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Farnia Velayati ◽  
Haleh Ayatollahi ◽  
Morteza Hemmat ◽  
Reza Dehghan
Keyword(s):  
Qualitative Study ◽  
Health Care Services ◽  
Success Factors ◽  
Digital Health ◽  
Economic Benefits ◽  
Critical Factors ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Equal Distribution ◽  
Business Framework

Abstract Background Telehealth technology and related products can help to solve the problems associated with providing health care services and equal distribution of resources. However, in order to run a telehealth business successfully, key components and critical factors need to be taken into account. A telehealth business framework can provide a rich understanding of these components and factors. Therefore, the present study aimed to identify the key components and critical factors for developing a telehealth business framework from the experts’ perspectives. Methods The present qualitative study was conducted in 2020. The participants were 22 experts in the fields of medical informatics, health information management, telemedicine, telehealth, health entrepreneurship, health insurance, and digital health start-ups. In depth semi-structured interviews were conducted to collect data, and the data were analyzed using framework analysis. Results Four main themes derived from data analysis. The themes included key components for developing a telehealth business framework, success factors, challenges, and barriers of a telehealth business. Overall, the results indicated that the key components in a telehealth business framework included created value, key resources, key activities, key partners, licenses and permissions, product pricing, revenue, marketing, supporting services, and getting feedback from customers. Although receiving support from different individuals and organizations as well as economic benefits of telehealth services may consider as success factors, there are a number of challenges and barriers which should be taken into account. Otherwise, these factors may hinder the success of a telehealth business. Conclusions The development of a telehealth business framework might be an important step towards developing a more complete business plan, facilitating the commercialization of telehealth products, and providing a solution for product sustainability in a competitive market. In the current study, the key components and critical factors for developing a telehealth business framework were identified; however, further research is needed to explore how these components and factors can be helpful in developing business plans and running a successful telehealth business.

Have the poor been considered in the Health Sector Evolution Plan? A qualitative study of the Iranian health system

2019 ◽  
Vol 13 (1) ◽  
pp. 45-57
Author(s):  
Manal Etemadi ◽  
Kioomars Ashtarian ◽  
Nader Ganji ◽  
Hannaneh Mohammadi Kangarani ◽  
Hasan Abolghasem Gorji
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Services ◽  
Healthcare Sector ◽  
Poor People ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Content Type ◽  
Care Services ◽  
The Poor

Purpose Reducing health inequalities between the poor and the rich is one of the challenges that the Iranian healthcare sector is facing. One of the goals of the Iranian Government in the Healthcare Sector Evolution Plan (HSEP) is claimed to be creating an opportunity for the poor to use inexpensive services. The purpose of this paper is to provide an analysis of the status of the poor in the HSEP. Based on this evaluation, the authors will provide policy recommendations to improve the benefits of the HSEP for the poor people. Design/methodology/approach This paper is based on a qualitative study conducted in 2017. The research sample includes policymakers, experts and scholars at the macro-level of the Iranian healthcare system who were well-aware of the financial support for the poor. Overall, 35 semi-structured interviews were carried out. Data were analyzed based on the thematic analysis method. Findings The effects of the HSEP on the poor were studied in terms of their positive outcomes and challenges. Despite the achievements of the HSEP for all people, the most important challenge was the lack of targeted state subsidies for the poor. These subsidies should have included free insurance coverage, reducing inpatient payment and allocation of a separate budget for the poor. Originality/value Adopting some policies to target public health subsidies toward the poor such as free insurance specific for the poor (based on means testing), as well as user fee exemption and waivers could improve access to health services for them in Iran. In addition, separate funding for such policies, strengthening health prevention and health care services for marginalized populations, and improving their health literacy could help ensure the poor’s benefiting more from the health care services.

scholarly journals Primary Care for Transgender Individuals: A Review of the Literature Reflecting a Canadian Perspective

SAGE Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 215824402096282
Author(s):  
Erin Ziegler ◽  
Ruta Valaitis ◽  
Nancy Carter ◽  
Cathy Risdon ◽  
Jennifer Yost
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Care Needs ◽  
Care Services ◽  
Primary Care Delivery ◽  
Canadian Perspective ◽  
Primary Care Practitioners

Literature related to transgender health in adults has focused on definitions, hormone therapy, and transgender-sensitive care provision. Further understanding is needed on the delivery of primary care for transgender adults. The aim of this review was to understand the primary-care needs and access to health care services for transgender adults in Canada. A state-of-the-art literature review was conducted. Thirteen research studies were included. There is limited literature on the delivery of primary care for transgender adults, particularly in Canada. Health care issues and access to care have been explored. However, there remains minimal Canadian content on primary-care delivery for transgender adults. Additional studies are needed to understand transgender primary-care needs in Canada. Further understanding can reduce the invisibility and disparities experienced by transgender individuals. With better understanding of transgender primary health care issues, primary-care practitioners can advocate for the heath needs of their patients and improve care delivery.

scholarly journals Using Prospective Methods to Identify Fieldwork Locations Favourable to Understanding Divergences in Health Care Accessibility

2021 ◽  
Vol 10 (8) ◽  
pp. 506
Author(s):  
Jan Ketil Rød ◽  
Arne H. Eide ◽  
Thomas Halvorsen ◽  
Alister Munthali
Keyword(s):  
Health Care ◽  
Low Income ◽  
Access To Health Care ◽  
Health Care Services ◽  
Good Health ◽  
Low Income Countries ◽  
Care Services ◽  
Health Care Accessibility ◽  
Barriers To Health ◽  
Walking Time

Central to this article is the issue of choosing sites for where a fieldwork could provide a better understanding of divergences in health care accessibility. Access to health care is critical to good health, but inhabitants may experience barriers to health care limiting their ability to obtain the care they need. Most inhabitants of low-income countries need to walk long distances along meandering paths to get to health care services. Individuals in Malawi responded to a survey with a battery of questions on perceived difficulties in accessing health care services. Using both vertical and horizontal impedance, we modelled walking time between household locations for the individuals in our sample and the health care centres they were using. The digital elevation model and Tobler’s hiking function were used to represent vertical impedance, while OpenStreetMap integrated with land cover map were used to represent horizontal impedance. Combining measures of walking time and perceived accessibility in Malawi, we used spatial statistics and found spatial clusters with substantial discrepancies in health care accessibility, which represented fieldwork locations favourable for providing a better understanding of barriers to health access.

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