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Disconnected relationships between primary care and community-based health and social services and system navigation for older adults: a qualitative descriptive study
BACKGROUND: There are gaps in knowledge and understanding about the relationships between primary care and community-based health and social services in the context of healthy aging at home and system navigation. This study examined provider perspectives on: a) older adults’ health and social needs;...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7181491/ https://www.ncbi.nlm.nih.gov/pubmed/32326880 http://dx.doi.org/10.1186/s12875-020-01143-8 |
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author | Valaitis, Ruta Cleghorn, Laura Ploeg, Jenny Risdon, Cathy Mangin, Derelie Dolovich, Lisa Agarwal, Gina Oliver, Doug Gaber, Jessica Chung, Harjit |
author_facet | Valaitis, Ruta Cleghorn, Laura Ploeg, Jenny Risdon, Cathy Mangin, Derelie Dolovich, Lisa Agarwal, Gina Oliver, Doug Gaber, Jessica Chung, Harjit |
author_sort | Valaitis, Ruta |
collection | PubMed |
description | BACKGROUND: There are gaps in knowledge and understanding about the relationships between primary care and community-based health and social services in the context of healthy aging at home and system navigation. This study examined provider perspectives on: a) older adults’ health and social needs; b) barriers to accessing services; c) the nature of relationships between primary care and health and social services; and d) ways to facilitate primary care and health and social services navigation to optimize older adults’ health. METHODS: Four focus groups were conducted involving providers (n = 21) in: urban primary care clinics and health and social services organizations serving older adults in Hamilton, Ontario, Canada. Purposive sampling was employed to recruit community health and social services managers, directors or supervisors and primary health care providers in a Family Health Team via email. RESULTS: Health and social services needs were exacerbated for community-dwelling older adults with multiple chronic conditions. Strong family/caregiver social support and advocacy was often lacking. Access barriers for older adults included: financial challenges; lack of accessible transportation; wait times and eligibility criteria; and lack of programs to address older adults’ needs. Having multiple providers meant that assessments among providers and older adults resulted in contradictory care pathways. Primary care and health and social services linkages were deficient and complicated by poor communication with patients and health literacy barriers. Primary care had stronger links with other health services than with community-based health and social services; primary care providers were frustrated by the complex nature of health and social services navigation; and care coordination was problematic. Health and social services referred older adults to primary care for medical needs and gathered patient information to gauge program eligibility, but not without challenges. CONCLUSIONS: Results point to strategies to strengthen primary care and health and social services system navigation for older adults including: using a person-focused approach; employing effective primary care and health and social services communication strategies; applying effective system navigation; building trust between primary care and health and social services providers; advocating for improved program access; and adapting services/programs to address access barriers and meet older adults’ needs. |
format | Online Article Text |
id | pubmed-7181491 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-71814912020-04-28 Disconnected relationships between primary care and community-based health and social services and system navigation for older adults: a qualitative descriptive study Valaitis, Ruta Cleghorn, Laura Ploeg, Jenny Risdon, Cathy Mangin, Derelie Dolovich, Lisa Agarwal, Gina Oliver, Doug Gaber, Jessica Chung, Harjit BMC Fam Pract Research Article BACKGROUND: There are gaps in knowledge and understanding about the relationships between primary care and community-based health and social services in the context of healthy aging at home and system navigation. This study examined provider perspectives on: a) older adults’ health and social needs; b) barriers to accessing services; c) the nature of relationships between primary care and health and social services; and d) ways to facilitate primary care and health and social services navigation to optimize older adults’ health. METHODS: Four focus groups were conducted involving providers (n = 21) in: urban primary care clinics and health and social services organizations serving older adults in Hamilton, Ontario, Canada. Purposive sampling was employed to recruit community health and social services managers, directors or supervisors and primary health care providers in a Family Health Team via email. RESULTS: Health and social services needs were exacerbated for community-dwelling older adults with multiple chronic conditions. Strong family/caregiver social support and advocacy was often lacking. Access barriers for older adults included: financial challenges; lack of accessible transportation; wait times and eligibility criteria; and lack of programs to address older adults’ needs. Having multiple providers meant that assessments among providers and older adults resulted in contradictory care pathways. Primary care and health and social services linkages were deficient and complicated by poor communication with patients and health literacy barriers. Primary care had stronger links with other health services than with community-based health and social services; primary care providers were frustrated by the complex nature of health and social services navigation; and care coordination was problematic. Health and social services referred older adults to primary care for medical needs and gathered patient information to gauge program eligibility, but not without challenges. CONCLUSIONS: Results point to strategies to strengthen primary care and health and social services system navigation for older adults including: using a person-focused approach; employing effective primary care and health and social services communication strategies; applying effective system navigation; building trust between primary care and health and social services providers; advocating for improved program access; and adapting services/programs to address access barriers and meet older adults’ needs. BioMed Central 2020-04-23 /pmc/articles/PMC7181491/ /pubmed/32326880 http://dx.doi.org/10.1186/s12875-020-01143-8 Text en © The Author(s) 2020 Open AccessThis 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/. 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 in a credit line to the data. |
spellingShingle | Research Article Valaitis, Ruta Cleghorn, Laura Ploeg, Jenny Risdon, Cathy Mangin, Derelie Dolovich, Lisa Agarwal, Gina Oliver, Doug Gaber, Jessica Chung, Harjit Disconnected relationships between primary care and community-based health and social services and system navigation for older adults: a qualitative descriptive study |
title | Disconnected relationships between primary care and community-based health and social services and system navigation for older adults: a qualitative descriptive study |
title_full | Disconnected relationships between primary care and community-based health and social services and system navigation for older adults: a qualitative descriptive study |
title_fullStr | Disconnected relationships between primary care and community-based health and social services and system navigation for older adults: a qualitative descriptive study |
title_full_unstemmed | Disconnected relationships between primary care and community-based health and social services and system navigation for older adults: a qualitative descriptive study |
title_short | Disconnected relationships between primary care and community-based health and social services and system navigation for older adults: a qualitative descriptive study |
title_sort | disconnected relationships between primary care and community-based health and social services and system navigation for older adults: a qualitative descriptive study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7181491/ https://www.ncbi.nlm.nih.gov/pubmed/32326880 http://dx.doi.org/10.1186/s12875-020-01143-8 |
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