Provision and accessibility of primary healthcare services for people who are homeless: a qualitative study of patient perspectives in the UK.
Adult
Aged
Delivery of Health Care
/ statistics & numerical data
England
/ epidemiology
Female
General Practice
/ organization & administration
Health Services Accessibility
/ organization & administration
Health Services Needs and Demand
Healthcare Disparities
/ statistics & numerical data
Ill-Housed Persons
/ psychology
Humans
Male
Middle Aged
Qualitative Research
health services accessibility
homeless persons
primary care
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
10
10
2018
accepted:
14
12
2018
pubmed:
17
7
2019
medline:
7
2
2020
entrez:
17
7
2019
Statut:
ppublish
Résumé
Anecdotal reports of people who are homeless being denied access and facing negative experiences of primary health care have often emerged. However, there is a dearth of research exploring this population's views and experiences of such services. To explore the perspectives of individuals who are homeless on the provision and accessibility of primary healthcare services. A qualitative study with individuals who are homeless recruited from three homeless shelters and a specialist primary healthcare centre for the homeless in the West Midlands, England. Semi-structured interviews were audiorecorded, transcribed verbatim, and analysed using a thematic framework approach. The Theoretical Domains Framework (TDF) was used to map the identified barriers in framework analysis. A total of 22 people who were homeless were recruited. Although some participants described facing no barriers, accounts of being denied registration at general practices and being discharged from hospital onto the streets with no access or referral to primary care providers were described. Services offering support to those with substance misuse issues and mental health problems were deemed to be excluding those with the greatest need. A participant described committing crimes with the intention of going to prison to access health care. High satisfaction was expressed by participants about their experiences at the specialist primary healthcare centre for people who are homeless (SPHCPH). Participants perceived inequality in access, and mostly faced negative experiences, in their use of mainstream services. Changes are imperative to facilitate access to primary health care, improve patient experiences of mainstream services, and to share best practices identified by participants at the SPHCPH.
Sections du résumé
BACKGROUND
BACKGROUND
Anecdotal reports of people who are homeless being denied access and facing negative experiences of primary health care have often emerged. However, there is a dearth of research exploring this population's views and experiences of such services.
AIM
OBJECTIVE
To explore the perspectives of individuals who are homeless on the provision and accessibility of primary healthcare services.
DESIGN AND SETTING
METHODS
A qualitative study with individuals who are homeless recruited from three homeless shelters and a specialist primary healthcare centre for the homeless in the West Midlands, England.
METHOD
METHODS
Semi-structured interviews were audiorecorded, transcribed verbatim, and analysed using a thematic framework approach. The Theoretical Domains Framework (TDF) was used to map the identified barriers in framework analysis.
RESULTS
RESULTS
A total of 22 people who were homeless were recruited. Although some participants described facing no barriers, accounts of being denied registration at general practices and being discharged from hospital onto the streets with no access or referral to primary care providers were described. Services offering support to those with substance misuse issues and mental health problems were deemed to be excluding those with the greatest need. A participant described committing crimes with the intention of going to prison to access health care. High satisfaction was expressed by participants about their experiences at the specialist primary healthcare centre for people who are homeless (SPHCPH).
CONCLUSION
CONCLUSIONS
Participants perceived inequality in access, and mostly faced negative experiences, in their use of mainstream services. Changes are imperative to facilitate access to primary health care, improve patient experiences of mainstream services, and to share best practices identified by participants at the SPHCPH.
Identifiants
pubmed: 31307999
pii: bjgp19X704633
doi: 10.3399/bjgp19X704633
pmc: PMC6650120
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e526-e536Informations de copyright
© British Journal of General Practice 2019.
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