Diagnóstico comunitario mediante técnicas cualitativas de las expectativas y vivencias en salud de una zona necesitada de transformación social()

OBJECTIVE: To know the views, experiences and expectations of care provided by the Andalusian Public Health System (SSPA) of users of an urban area in need of social transformation (ZNTS). DESIGN: Qualitative methodology (exploratory study). LOCATION: Urban basic health zone (16,000 inhabitants, 40% ZNTS). PARTICIPANTS: Purposive sampling of users of SSPA and community leaders. Homogeneity criteria: age. Heterogeneity criteria: sex, frequency, active/pensioner, level cultural/economic. MAIN INTERVENTIONS: Conversational techniques recorded by videotape and moderated by a sociologist (user dicussion groups and in-depth interviews for community leaders). Analysis: transcription of speeches, coding, categories triangulation and final outcome. RESULTS: Seven groups (43 participants, 58% ZNTS) and 6 leaders. They want continuity of care and choice of professionals, but not the medical change without information and attention's discontinuity primary care/hospital. There's bad physical accesibility by the urban environment in the ZNTS and is criticized admission services and paperwork; the programmed appointment and the electronic prescriptions are improvements but asking more hospital referrals and reviews. There's good appreciation of the professionals (primary care-closer, hospital-greater technical capacity). It needs to improve nursing education and speed of emergency assistance. There's a lack of leadership in the system organization, very fragmented. They know a range of services focusing on the demand for care; other health activities not spread to the users. CONCLUSION: The SSPA should incorporate the views and expectations of communities in social risk to a real improvement in the quality of care.