Community-based primary health care for older adults: a qualitative study of the perceptions of clients, caregivers and health care providers

BMC Geriatrics

Research Article

Selena Santi¹  Paul Stolee²  Kelsey Huson²  Claire Lafortune² 

[1] Institutional Research, University of Waterloo, 200 University Avenue West, N2L 3G1, Waterloo, ON, Canada;School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, N2L 3G1, Waterloo, ON, Canada;

关键词: Primary care;    Community-based care;    Seniors;    Health care providers;    Chronic illness;    Caregivers;   

DOI  :  10.1186/s12877-015-0052-x

 received in 2014-07-07, accepted in 2015-04-20,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundOlder persons are often poorly served by existing models of community-based primary health care (CBPHC). We sought input from clients, informal caregivers, and health care providers on recommendations for system improvements.MethodsFocus group interviews were held with clients, informal caregivers, and health care providers in mid-sized urban and rural communities in Ontario. Data were analyzed using a combination of directed and emergent coding. Results were shared with participants during a series of feedback sessions.ResultsAn extensive list of barriers, facilitators, and recommended health system improvements was generated. Barriers included poor system integration and limited access to services. Identified facilitators were person and family-focused care, self-management resources, and successful collaborative practice. Recommended system improvements included expanding and integrating care teams, supports for system navigation, and development of standardized information systems and care pathways.ConclusionsOlder adults still experience frustrating obstacles when trying to access CBPHC. Identified barriers and facilitators of improved system integration aligned well with current literature and Wagner’s Chronic Care Model. Additional work is needed to implement the recommended improvements and to discern their impact on patient and system outcomes.

【 授权许可】

Unknown   
© Lafortune et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.