Providing care to people on social assistance: how dentists in Montreal, Canada, respond to organisational, biomedical, and financial challenges

BMC Health Services Research

Paul J Allison⁵  Lucie Richard¹  Anne Landry²  Christine Loignon³  Christophe Bedos⁴ 

[1]Institut de Recherche en Santé Publique de l’Université de Montréal (IRSPUM), Faculté des sciences infirmières, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, Québec H3C 3J7, Canada

[2]Direction de la Santé Publique, Agence de la Santé et des Services Sociaux de Montréal, 1301, rue Sherbrooke Est, Montréal, Québec H2L 1M3, Canada

[3]Faculty of Medicine, University of Sherbrooke, 150 Place Charles Lemoyne Bureau 200, Longueuil, Quebec J4K 0A8, Canada

[4]Institut de Recherche en Santé Publique de l’Université de Montréal (IRSPUM), Montréal, Quebec, Canada

[5]Division of Oral Health and Society, Faculty of Dentistry, McGill University, 2001 McGill college avenue, Montreal, Quebec H3A1G1, Canada

关键词: Discrimination;    Dentist-patient relationship;    Access to dental services;    Qualitative research;    People on social assistance;    Poverty;   

Others  :  1125942
DOI  :  10.1186/1472-6963-14-472

 received in 2014-01-30, accepted in 2014-09-26,  发布年份 2014

【 摘 要 】

Background

Dentists report facing difficulties and experiencing frustrations with people on social assistance, one of the social groups with the most dental needs. Scientists ignore how they deal with these difficulties and whether they are able to overcome them. Our objective was to understand how dentists deal with critical issues encountered with people on social assistance.

Methods

We conducted in-depth, semi-structured interviews with 33 dentists practicing in Montreal, Canada. The interview guides included questions on dentists’ experiences with people on social assistance and potential strategies developed for this group of people. Analyses consisted of interview debriefing, transcript coding, and data interpretation.

Results

Dentists described strategies to resolve three critical issues: missed appointments (organisational issue); difficulty in performing non-covered treatments (biomedical issue); and low government fees (financial issue). With respect to missed appointments, dentists developed strategies to maximise attendance, such as motivating their patients, and to minimise the impact of non-attendance, like booking two people at the same time. With respect to biomedical and financial issues, dentists did not find any satisfactory solutions and considered that it was the government’s duty to resolve them. Overall, dentists seem reluctant to exclude people on social assistance but develop solutions that may discriminate against them.

Conclusions

The efforts and failures experienced by dentists with people on social assistance should encourage us to rethink how dental services are provided and financed.

【 授权许可】

   
2014 Bedos et al.; licensee BioMed Central Ltd.

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