Remote primary care during the COVID-19 pandemic for people experiencing homelessness: a qualitative study

The British journal of general practice: the journal of the Royal College of General Practitioners

article

Kelly Howells¹  Mat Amp²  Martin Burrows³  Jo Brown²  Rachel Brennan²  Joanne Dickinson⁴  Shaun Jackson⁵  Wan-Ley Yeung⁶  Darren Ashcroft⁷  Stephen Campbell¹  Thomas Blakeman⁸  Caroline Sanders¹ 

[1] NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, and Division of Population Health, Health Services Research and Primary Care, Centre for Primary Care and Health Services Research, University of Manchester;Groundswell;Inclusive Insight ,(previously director of research and campaigns;Bolton NHS Foundation Trust;Urban Village Medical Practice;Salford Primary Care Together;NIHR Greater Manchester Patient Safety Translational Research Centre, Division of Pharmacy and Optometry, University of Manchester;Division of Population Health, Health Services Research and Primary Care, Centre for Primary Care and Health Services Research, University of Manchester

关键词: COVID-19;    healthcare disparities;    homelessness;    primary care;    qualitative research;    remote consultation;   

DOI  :  10.3399/BJGP.2021.0596

学科分类：卫生学

来源: Royal College of General Practitioners

【 摘 要 】

Background The COVID-19 pandemic has caused unprecedented disruption and change to the organisation of primary care, including for people experiencing homelessness who may not have access to a phone. Little is known about whether the recent changes required to deliver services to people experiencing homelessness will help to address or compound inequality in accessing care.Aim To explore the experience and impact of organisational and technology changes in response to COVID-19 on access to health care for people experiencing homelessness.Design and setting An action-led and participatory research methodology was employed in three case study sites made up of primary care services delivering care for people experiencing homelessness.Method Individual semi-structured interviews were conducted with 21 people experiencing homelessness and 22 clinicians and support workers. Interviews were analysed using a framework approach.Results The move to remote telephone consultations highlighted the difficulties experienced by participants in accessing health care. These barriers included problems at the practice level associated with remote triage as participants did not always have access to a phone or the means to pay for a phone call. This fostered increased reliance on support workers and clinicians working in the community to provide or facilitate a primary care appointment.Conclusion The findings have emphasised the importance of addressing practical and technology barriers as well as supporting communication and choice for mode of consultation. The authors argue that consultations should not be remote ‘by default’ and instead take into consideration both the clinical and social factors underpinning health.

【 授权许可】

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