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Health mediation: an intervention mode for improving emergency department care and support for patients living in precarious conditions
BACKGROUND: Severe overcrowding of emergency departments (EDs) impacts the quality of healthcare. One factor of this overcrowding is precariousness, but it has rarely been considered a key factor in designing interventions to improve ED care. Health mediation (HM) aims to facilitate access to rights...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10186303/ https://www.ncbi.nlm.nih.gov/pubmed/37194100 http://dx.doi.org/10.1186/s12913-023-09522-4 |
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author | Naït Salem, Riwan Rotily, Michel Apostolidis, Themistoklis Odena, Sophie Lamouroux, Aurore Chischportich, Célia Persico, Nicolas Auquier, Pascal |
author_facet | Naït Salem, Riwan Rotily, Michel Apostolidis, Themistoklis Odena, Sophie Lamouroux, Aurore Chischportich, Célia Persico, Nicolas Auquier, Pascal |
author_sort | Naït Salem, Riwan |
collection | PubMed |
description | BACKGROUND: Severe overcrowding of emergency departments (EDs) impacts the quality of healthcare. One factor of this overcrowding is precariousness, but it has rarely been considered a key factor in designing interventions to improve ED care. Health mediation (HM) aims to facilitate access to rights, prevention, and care for the most vulnerable persons and to raise awareness among healthcare providers about obstacles in accessing healthcare. We here present the results of an ancillary qualitative study to explore the prospects regarding a health mediation intervention implemented in EDs for deprived persons who are frequent ED users, from professionals’ and patients’ perspectives. METHODS: Design, data collection, and data analysis were done according to a psychosocial approach, based on thematic content analysis and semi-structured interviews of 16 frequent ED users and deprived patients exposed to HM and of 14 professionals in 4 EDs of South-eastern France. RESULTS: All patients reported multifactorial distress. Most of them expressed experiencing isolation and powerlessness, and lacking personal resources to cope with healthcare. They mentioned the use of ED as a way of quickly meeting a professional to respond to their suffering, and recognized the trustworthy alliance with health mediators (HMrs) as a means to put them back in a healthcare pathway. The presence of HMrs in EDs was appreciated by ED professionals because HMrs responded to requests they were not able to access and were perceived as an efficient support for caring for deprived persons in emergency contexts. CONCLUSIONS: Our results are in favour of health mediation in EDs as a promising solution, requested by patients and ED professionals, to cope with frequent ED users and deprived patients. Our results could also be used to adapt other strategies for the most vulnerable populations to reduce the frequency of ED readmissions. At the interface of the patients’ health experience and the medico-social sector, HM could complete the immediate responses to medical needs given in EDs and contribute in alleviating the social inequalities of health. |
format | Online Article Text |
id | pubmed-10186303 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-101863032023-05-17 Health mediation: an intervention mode for improving emergency department care and support for patients living in precarious conditions Naït Salem, Riwan Rotily, Michel Apostolidis, Themistoklis Odena, Sophie Lamouroux, Aurore Chischportich, Célia Persico, Nicolas Auquier, Pascal BMC Health Serv Res Research BACKGROUND: Severe overcrowding of emergency departments (EDs) impacts the quality of healthcare. One factor of this overcrowding is precariousness, but it has rarely been considered a key factor in designing interventions to improve ED care. Health mediation (HM) aims to facilitate access to rights, prevention, and care for the most vulnerable persons and to raise awareness among healthcare providers about obstacles in accessing healthcare. We here present the results of an ancillary qualitative study to explore the prospects regarding a health mediation intervention implemented in EDs for deprived persons who are frequent ED users, from professionals’ and patients’ perspectives. METHODS: Design, data collection, and data analysis were done according to a psychosocial approach, based on thematic content analysis and semi-structured interviews of 16 frequent ED users and deprived patients exposed to HM and of 14 professionals in 4 EDs of South-eastern France. RESULTS: All patients reported multifactorial distress. Most of them expressed experiencing isolation and powerlessness, and lacking personal resources to cope with healthcare. They mentioned the use of ED as a way of quickly meeting a professional to respond to their suffering, and recognized the trustworthy alliance with health mediators (HMrs) as a means to put them back in a healthcare pathway. The presence of HMrs in EDs was appreciated by ED professionals because HMrs responded to requests they were not able to access and were perceived as an efficient support for caring for deprived persons in emergency contexts. CONCLUSIONS: Our results are in favour of health mediation in EDs as a promising solution, requested by patients and ED professionals, to cope with frequent ED users and deprived patients. Our results could also be used to adapt other strategies for the most vulnerable populations to reduce the frequency of ED readmissions. At the interface of the patients’ health experience and the medico-social sector, HM could complete the immediate responses to medical needs given in EDs and contribute in alleviating the social inequalities of health. BioMed Central 2023-05-16 /pmc/articles/PMC10186303/ /pubmed/37194100 http://dx.doi.org/10.1186/s12913-023-09522-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Naït Salem, Riwan Rotily, Michel Apostolidis, Themistoklis Odena, Sophie Lamouroux, Aurore Chischportich, Célia Persico, Nicolas Auquier, Pascal Health mediation: an intervention mode for improving emergency department care and support for patients living in precarious conditions |
title | Health mediation: an intervention mode for improving emergency department care and support for patients living in precarious conditions |
title_full | Health mediation: an intervention mode for improving emergency department care and support for patients living in precarious conditions |
title_fullStr | Health mediation: an intervention mode for improving emergency department care and support for patients living in precarious conditions |
title_full_unstemmed | Health mediation: an intervention mode for improving emergency department care and support for patients living in precarious conditions |
title_short | Health mediation: an intervention mode for improving emergency department care and support for patients living in precarious conditions |
title_sort | health mediation: an intervention mode for improving emergency department care and support for patients living in precarious conditions |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10186303/ https://www.ncbi.nlm.nih.gov/pubmed/37194100 http://dx.doi.org/10.1186/s12913-023-09522-4 |
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