Patient-centred access to health care:a framework analysis of the care interface for frail older adults

Kurpas, Donata, Gwyther, Holly, Szwamel, Katarzyna, Shaw, Rachel L, D'Avanzo, Barbara, Holland, Carol A and Bujnowska-Fedak, Maria Magdalena (2018). Patient-centred access to health care:a framework analysis of the care interface for frail older adults. BMC Geriatrics, 18 (1),

Abstract

BACKGROUND: The objective of this study was to explore the issues surrounding access to health and social care services for frail older adults with Polish stakeholders, including healthy and frail/pre-frail older adults, health care providers, social care providers, and caregivers, in order to determine their views and perspectives on the current system and to present suggestions for the future development of a more accessible and person-centred health and social care system. METHODS: Focus groups were used to gather qualitative data from stakeholders. Data were analysed using framework analysis according to five dimensions of accessibility to care: approachability, acceptability, availability and accommodation, affordability and appropriateness. RESULTS: Generally services were approachable and acceptable, but unavailable. Poor availability related to high staff turnover, staff shortages and a lack of trained personnel. There were problems of long waiting times for specialist care and rehabilitation services, and geographically remote clinics. Critically, there were shortages of long-term inpatient care places, social care workers and caregivers. The cost of treatments created barriers to care and inequities in the system. Participants described a lack of integration between health and social care systems with differing priorities and disconnected budgets. They described an acute medical system that was inappropriate for patients with complex needs, alongside a low functioning social care system, where bureaucratisation caused delays in providing services to the vulnerable. An integrated system with a care coordinator to improve connections between services and patients was suggested. CONCLUSIONS: There is an immediate need to improve access to health and social care systems for pre-frail and frail patients, as well as their caregivers. Health and social care services need to be integrated to reduce bureaucracy and increase the timeliness of treatment and care.

Publication DOI: https://doi.org/10.1186/s12877-018-0960-7
Divisions: Life & Health Sciences
Life & Health Sciences > Psychology
Life & Health Sciences > Applied Health Research Group
Life & Health Sciences > Chronic and Communicable Conditions
Additional Information: © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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.
Full Text Link:
Related URLs: https://bmcgeri ... 2877-018-0960-7 (Publisher URL)
Published Date: 2018-11-12
Authors: Kurpas, Donata
Gwyther, Holly ( 0000-0002-2867-4184)
Szwamel, Katarzyna
Shaw, Rachel L ( 0000-0002-0438-7666)
D'Avanzo, Barbara
Holland, Carol A
Bujnowska-Fedak, Maria Magdalena

Download

[img]

Version: Published Version

License: Creative Commons Attribution

| Preview

Export / Share Citation


Statistics

Additional statistics for this record