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Exploring Primary Care Non-Attendance: A Study of Low-Income Patients
INTRODUCTION: While evidence has been established on the impact of medical appointment non-attendance on the healthcare system and patient health, previous research has not focused on how poverty and rurality may influence patient experiences with non-attendance. This paper explores patient percepti...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918768/ https://www.ncbi.nlm.nih.gov/pubmed/35259972 http://dx.doi.org/10.1177/21501319221082352 |
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author | Chapman, Kyle A. Machado, Stephanie S. van der Merwe, Katie Bryson, Ashley Smith, Dwight |
author_facet | Chapman, Kyle A. Machado, Stephanie S. van der Merwe, Katie Bryson, Ashley Smith, Dwight |
author_sort | Chapman, Kyle A. |
collection | PubMed |
description | INTRODUCTION: While evidence has been established on the impact of medical appointment non-attendance on the healthcare system and patient health, previous research has not focused on how poverty and rurality may influence patient experiences with non-attendance. This paper explores patient perceptions of non-attendance among those experiencing poverty in a rural U.S county to better inform providers to the context in which their patients make attendance-related decisions. METHODS: Using a grounded theory approach, we conducted semi-structured interviews with 32 U.S. low-income adults in the rural Western U.S. who recurrently missed primary care appointments. We also used a questionnaire to assess individual characteristics related to health, resiliency, personal mastery, medical mistrust, life chaos, and adverse childhood experiences. RESULTS: Participants identified 3 barriers to attending appointments: appointment disinterest, competing demands, and insufficient systems. Appointment disinterest stemmed from physical and mental health issues, misalignment between needs and treatment, and comfort with the provider. Competing demands included family responsibilities, employment, and relationships. Finally, participants reported that current scheduling and transportation systems were helpful but insufficient. To provide further context, participants also reported low overall health, moderate levels of medical mistrust, life chaos, and mastery, moderate to low resilience, and very a high number of adverse childhood experiences. CONCLUSIONS: Results point to the need for modified structures that allow low-income patients more control over their personal health and highlight opportunities for clinics to address patients’ lack of interest and fear in the medical encounter. |
format | Online Article Text |
id | pubmed-8918768 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-89187682022-03-15 Exploring Primary Care Non-Attendance: A Study of Low-Income Patients Chapman, Kyle A. Machado, Stephanie S. van der Merwe, Katie Bryson, Ashley Smith, Dwight J Prim Care Community Health Original Research INTRODUCTION: While evidence has been established on the impact of medical appointment non-attendance on the healthcare system and patient health, previous research has not focused on how poverty and rurality may influence patient experiences with non-attendance. This paper explores patient perceptions of non-attendance among those experiencing poverty in a rural U.S county to better inform providers to the context in which their patients make attendance-related decisions. METHODS: Using a grounded theory approach, we conducted semi-structured interviews with 32 U.S. low-income adults in the rural Western U.S. who recurrently missed primary care appointments. We also used a questionnaire to assess individual characteristics related to health, resiliency, personal mastery, medical mistrust, life chaos, and adverse childhood experiences. RESULTS: Participants identified 3 barriers to attending appointments: appointment disinterest, competing demands, and insufficient systems. Appointment disinterest stemmed from physical and mental health issues, misalignment between needs and treatment, and comfort with the provider. Competing demands included family responsibilities, employment, and relationships. Finally, participants reported that current scheduling and transportation systems were helpful but insufficient. To provide further context, participants also reported low overall health, moderate levels of medical mistrust, life chaos, and mastery, moderate to low resilience, and very a high number of adverse childhood experiences. CONCLUSIONS: Results point to the need for modified structures that allow low-income patients more control over their personal health and highlight opportunities for clinics to address patients’ lack of interest and fear in the medical encounter. SAGE Publications 2022-03-08 /pmc/articles/PMC8918768/ /pubmed/35259972 http://dx.doi.org/10.1177/21501319221082352 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Chapman, Kyle A. Machado, Stephanie S. van der Merwe, Katie Bryson, Ashley Smith, Dwight Exploring Primary Care Non-Attendance: A Study of Low-Income Patients |
title | Exploring Primary Care Non-Attendance: A Study of Low-Income Patients |
title_full | Exploring Primary Care Non-Attendance: A Study of Low-Income Patients |
title_fullStr | Exploring Primary Care Non-Attendance: A Study of Low-Income Patients |
title_full_unstemmed | Exploring Primary Care Non-Attendance: A Study of Low-Income Patients |
title_short | Exploring Primary Care Non-Attendance: A Study of Low-Income Patients |
title_sort | exploring primary care non-attendance: a study of low-income patients |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918768/ https://www.ncbi.nlm.nih.gov/pubmed/35259972 http://dx.doi.org/10.1177/21501319221082352 |
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