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Remote primary care during the COVID-19 pandemic for people experiencing homelessness: a qualitative study

BACKGROUND: The COVID-19 pandemic has caused unprecedented disruption and change to the organisation of primary care, including for people experiencing homelessness who may not have access to a phone. Little is known about whether the recent changes required to deliver services to people experiencin...

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Autores principales: Howells, Kelly, Amp, Mat, Burrows, Martin, Brown, Jo, Brennan, Rachel, Dickinson, Joanne, Jackson, Shaun, Yeung, Wan-Ley, Ashcroft, Darren, Campbell, Stephen, Blakeman, Thomas, Sanders, Caroline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Royal College of General Practitioners 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999705/
https://www.ncbi.nlm.nih.gov/pubmed/35379604
http://dx.doi.org/10.3399/BJGP.2021.0596
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author Howells, Kelly
Amp, Mat
Burrows, Martin
Brown, Jo
Brennan, Rachel
Dickinson, Joanne
Jackson, Shaun
Yeung, Wan-Ley
Ashcroft, Darren
Campbell, Stephen
Blakeman, Thomas
Sanders, Caroline
author_facet Howells, Kelly
Amp, Mat
Burrows, Martin
Brown, Jo
Brennan, Rachel
Dickinson, Joanne
Jackson, Shaun
Yeung, Wan-Ley
Ashcroft, Darren
Campbell, Stephen
Blakeman, Thomas
Sanders, Caroline
author_sort Howells, Kelly
collection PubMed
description BACKGROUND: The COVID-19 pandemic has caused unprecedented disruption and change to the organisation of primary care, including for people experiencing homelessness who may not have access to a phone. Little is known about whether the recent changes required to deliver services to people experiencing homelessness will help to address or compound inequality in accessing care. AIM: To explore the experience and impact of organisational and technology changes in response to COVID-19 on access to health care for people experiencing homelessness. DESIGN AND SETTING: An action-led and participatory research methodology was employed in three case study sites made up of primary care services delivering care for people experiencing homelessness. METHOD: Individual semi-structured interviews were conducted with 21 people experiencing homelessness and 22 clinicians and support workers. Interviews were analysed using a framework approach. RESULTS: The move to remote telephone consultations highlighted the difficulties experienced by participants in accessing health care. These barriers included problems at the practice level associated with remote triage as participants did not always have access to a phone or the means to pay for a phone call. This fostered increased reliance on support workers and clinicians working in the community to provide or facilitate a primary care appointment. CONCLUSION: The findings have emphasised the importance of addressing practical and technology barriers as well as supporting communication and choice for mode of consultation. The authors argue that consultations should not be remote ‘by default’ and instead take into consideration both the clinical and social factors underpinning health.
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spelling pubmed-89997052022-04-15 Remote primary care during the COVID-19 pandemic for people experiencing homelessness: a qualitative study Howells, Kelly Amp, Mat Burrows, Martin Brown, Jo Brennan, Rachel Dickinson, Joanne Jackson, Shaun Yeung, Wan-Ley Ashcroft, Darren Campbell, Stephen Blakeman, Thomas Sanders, Caroline Br J Gen Pract Research BACKGROUND: The COVID-19 pandemic has caused unprecedented disruption and change to the organisation of primary care, including for people experiencing homelessness who may not have access to a phone. Little is known about whether the recent changes required to deliver services to people experiencing homelessness will help to address or compound inequality in accessing care. AIM: To explore the experience and impact of organisational and technology changes in response to COVID-19 on access to health care for people experiencing homelessness. DESIGN AND SETTING: An action-led and participatory research methodology was employed in three case study sites made up of primary care services delivering care for people experiencing homelessness. METHOD: Individual semi-structured interviews were conducted with 21 people experiencing homelessness and 22 clinicians and support workers. Interviews were analysed using a framework approach. RESULTS: The move to remote telephone consultations highlighted the difficulties experienced by participants in accessing health care. These barriers included problems at the practice level associated with remote triage as participants did not always have access to a phone or the means to pay for a phone call. This fostered increased reliance on support workers and clinicians working in the community to provide or facilitate a primary care appointment. CONCLUSION: The findings have emphasised the importance of addressing practical and technology barriers as well as supporting communication and choice for mode of consultation. The authors argue that consultations should not be remote ‘by default’ and instead take into consideration both the clinical and social factors underpinning health. Royal College of General Practitioners 2022-04-05 /pmc/articles/PMC8999705/ /pubmed/35379604 http://dx.doi.org/10.3399/BJGP.2021.0596 Text en © The Authors https://creativecommons.org/licenses/by/4.0/This article is Open Access: CC BY 4.0 licence (http://creativecommons.org/licences/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Research
Howells, Kelly
Amp, Mat
Burrows, Martin
Brown, Jo
Brennan, Rachel
Dickinson, Joanne
Jackson, Shaun
Yeung, Wan-Ley
Ashcroft, Darren
Campbell, Stephen
Blakeman, Thomas
Sanders, Caroline
Remote primary care during the COVID-19 pandemic for people experiencing homelessness: a qualitative study
title Remote primary care during the COVID-19 pandemic for people experiencing homelessness: a qualitative study
title_full Remote primary care during the COVID-19 pandemic for people experiencing homelessness: a qualitative study
title_fullStr Remote primary care during the COVID-19 pandemic for people experiencing homelessness: a qualitative study
title_full_unstemmed Remote primary care during the COVID-19 pandemic for people experiencing homelessness: a qualitative study
title_short Remote primary care during the COVID-19 pandemic for people experiencing homelessness: a qualitative study
title_sort remote primary care during the covid-19 pandemic for people experiencing homelessness: a qualitative study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999705/
https://www.ncbi.nlm.nih.gov/pubmed/35379604
http://dx.doi.org/10.3399/BJGP.2021.0596
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