Cargando…

Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)

BACKGROUND: In Spain, homeless individuals have lower perceived quality of health than the rest of the population and their life expectancy is 30 years lower than the national average. While the Spanish health system provides universal access and coverage, homeless individuals do not access or use p...

Descripción completa

Detalles Bibliográficos
Autores principales: Cernadas, Andrés, Fernández, Ángela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980324/
https://www.ncbi.nlm.nih.gov/pubmed/33743729
http://dx.doi.org/10.1186/s12939-021-01409-2
_version_ 1783667423009832960
author Cernadas, Andrés
Fernández, Ángela
author_facet Cernadas, Andrés
Fernández, Ángela
author_sort Cernadas, Andrés
collection PubMed
description BACKGROUND: In Spain, homeless individuals have lower perceived quality of health than the rest of the population and their life expectancy is 30 years lower than the national average. While the Spanish health system provides universal access and coverage, homeless individuals do not access or use public care enough to maintain their health. The objective of this study is to determine if homeless individuals can access public health services in conditions of equality with the rest of the population, as established in healthcare legislation, and to better understand the causes of observed inequalities or inequities of access. METHODS: A detailed qualitative study was carried out in the city of Barcelona (Spain) from October 2019 to February 2020. A total of nine open and in-depth interviews were done with homeless individuals along with seven semi-structured interviews with key informants and two focus groups. One group was composed of eight individuals who were living on the street at the time and the other consisted of eight individuals working in healthcare and social assistance. RESULTS: The participants indicated that homeless individuals tend to only access healthcare services when they are seriously ill or have suffered some kind of injury. Once there, they tend to encounter significant barriers that might be 1) administrative; 2) personal, based on belief that that will be poorly attended, discriminated against, or unable to afford treatment; or 3) medical-professional, when health professionals, who understand the lifestyle of this population and their low follow-through with treatments, tend towards minimalist interventions that lack the dedication they would apply to other groups of patients. CONCLUSIONS: The conclusions derived from this study convey the infrequent use of health services by homeless individuals for reasons attributable to the population itself, to healthcare workers and to the entire healthcare system. Accordingly, to reduce inequities of access to these services, recommendations to healthcare service providers include adapting facilities to provide more adequate care for this population; increasing sensitivity/awareness among healthcare workers; developing in situ care systems in places where the homeless population is most concentrated; and establishing healthcare collaboration agreements with entities that work with this population.
format Online
Article
Text
id pubmed-7980324
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-79803242021-03-22 Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain) Cernadas, Andrés Fernández, Ángela Int J Equity Health Research BACKGROUND: In Spain, homeless individuals have lower perceived quality of health than the rest of the population and their life expectancy is 30 years lower than the national average. While the Spanish health system provides universal access and coverage, homeless individuals do not access or use public care enough to maintain their health. The objective of this study is to determine if homeless individuals can access public health services in conditions of equality with the rest of the population, as established in healthcare legislation, and to better understand the causes of observed inequalities or inequities of access. METHODS: A detailed qualitative study was carried out in the city of Barcelona (Spain) from October 2019 to February 2020. A total of nine open and in-depth interviews were done with homeless individuals along with seven semi-structured interviews with key informants and two focus groups. One group was composed of eight individuals who were living on the street at the time and the other consisted of eight individuals working in healthcare and social assistance. RESULTS: The participants indicated that homeless individuals tend to only access healthcare services when they are seriously ill or have suffered some kind of injury. Once there, they tend to encounter significant barriers that might be 1) administrative; 2) personal, based on belief that that will be poorly attended, discriminated against, or unable to afford treatment; or 3) medical-professional, when health professionals, who understand the lifestyle of this population and their low follow-through with treatments, tend towards minimalist interventions that lack the dedication they would apply to other groups of patients. CONCLUSIONS: The conclusions derived from this study convey the infrequent use of health services by homeless individuals for reasons attributable to the population itself, to healthcare workers and to the entire healthcare system. Accordingly, to reduce inequities of access to these services, recommendations to healthcare service providers include adapting facilities to provide more adequate care for this population; increasing sensitivity/awareness among healthcare workers; developing in situ care systems in places where the homeless population is most concentrated; and establishing healthcare collaboration agreements with entities that work with this population. BioMed Central 2021-03-20 /pmc/articles/PMC7980324/ /pubmed/33743729 http://dx.doi.org/10.1186/s12939-021-01409-2 Text en © The Author(s) 2021 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
Cernadas, Andrés
Fernández, Ángela
Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)
title Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)
title_full Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)
title_fullStr Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)
title_full_unstemmed Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)
title_short Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)
title_sort healthcare inequities and barriers to access for homeless individuals: a qualitative study in barcelona (spain)
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980324/
https://www.ncbi.nlm.nih.gov/pubmed/33743729
http://dx.doi.org/10.1186/s12939-021-01409-2
work_keys_str_mv AT cernadasandres healthcareinequitiesandbarrierstoaccessforhomelessindividualsaqualitativestudyinbarcelonaspain
AT fernandezangela healthcareinequitiesandbarrierstoaccessforhomelessindividualsaqualitativestudyinbarcelonaspain