Care-seeking experiences of unattached patients in the Canadian health care system: Qualitative study.

Autor:	Mathews M; Professor in the Department of Family Medicine in the Schulich School of Medicine and Dentistry at Western University in London, Ont., Ryan D; Research Assistant in the Department of Family Medicine in the Schulich School of Medicine and Dentistry at Western University., Deslauriers V; Research Coordinator in the Department of Community Health Sciences at the University of Sherbrooke in Longueuil, Que., Moritz LR; Research Associate in the Dalhousie Family Medicine Primary Health Care Research Unit in the Department of Family Medicine at Dalhousie University in Halifax, NS., Xiao J; Clinical Research Coordinator at the Ottawa Hospital Research Institute in Ontario., Breton M; Canada Research Chair in Clinical Governance on Primary Health Care and Professor in the Department of Community Health Sciences at the University of Sherbrooke., Green ME; Professor in the Department of Family Medicine and the Department of Public Health Sciences at Queen's University in Kingston, Ont, and President of the College of Family Physicians of Canada., Isenor JE; Associate Professor in the College of Pharmacy in the Faculty of Health at Dalhousie University., Marshall EG; Professor in the Dalhousie Family Medicine Primary Health Care Research Unit in the Department of Family Medicine at Dalhousie University, and with the Nova Scotia Health Authority., Buote R; Senior Research Associate in the Dalhousie Family Medicine Primary Health Care Research Unit at Dalhousie University., Meredith L; Manager of the Primary Health Care System Program in the Department of Family Medicine in the Schulich School of Medicine and Dentistry at Western University., Smithman MA; Post-doctoral fellow at the Upstream Lab in the MAP Centre for Urban Health Solutions at Unity Health Toronto at the University of Toronto in Ontario., Ashcroft R; Associate Professor in the Factor-Inwentash Faculty of Social Work at the University of Toronto., Bowles S; Associate Professor in the College of Pharmacy in the Faculty of Health at Dalhousie University., Guénette L; Associate Professor in the Faculty of Pharmacy at Laval University and a researcher in the Population Health and Health Best Practices Axis of the Centre Hospitalier Universitaire of the Quebec-Laval University Research Centre in Quebec., Lawrence L; Health Outcomes Scientist with the Nova Scotia Health Authority in Halifax., Martin-Misener R; Professor in and Director of the School of Nursing and Assistant Dean of Research in the Faculty of Health, both at Dalhousie University., McCarthy LM; Associate Professor of Pharmacy and Epidemiology in the Leslie Dan Faculty of Pharmacy at the University of Toronto and Clinician Scientist at Trillium Health Partners' Institute for Better Health in Mississauga, Ont., McDougall B; Doctoral candidate in the Department of Community Health and Epidemiology in the Faculty of Medicine at Dalhousie University., Mooney M; Health Services Manager at Nova Scotia Health in Yarmouth., Morrison B; Associate Professor in the Department of Marketing and Enterprise Systems in the Schwartz School of Business at St Francis Xavier University in Antigonish, NS., Murphy A; Associate Professor in the College of Pharmacy in the Faculty of Health at Dalhousie University., Stringer K; Head of the Department of Family Medicine in the Faculty of Medicine at Dalhousie University.
Jazyk:	angličtina
Zdroj:	Canadian family physician Medecin de famille canadien [Can Fam Physician] 2024 Jun; Vol. 70 (6), pp. 396-403.
DOI:	10.46747/cfp.7006396
Abstrakt:	Objective: To understand how lack of attachment to a regular primary care provider influences patients' outlooks on primary care, ability to address their health care needs, and confidence in the health care system. Design: Qualitative descriptive study using semistructured interviews. Setting: Canadian provinces of Nova Scotia, Ontario, and Quebec. Participants: Patients aged 18 years or older who were unattached or had become attached within 1 year of being interviewed and who resided in the province in which they were interviewed. Methods: Forty-one semistructured interviews were conducted, during which participants were asked to describe how they had become unattached, their searches to find new primary care providers, their perceptions of and experiences with the centralized waiting list in their province, their experiences seeking care while unattached, and the impact of being unattached on their health and on their perceptions of the health care system. Interviews were transcribed and analyzed using a thematic approach. Main Findings: Two main themes were identified in interviews with unattached or recently attached patients: unmet needs of unattached patients and the impact of being unattached. Patients' perceived benefits of attachment included access to care, longitudinal relationships with health care providers, health history familiarity, and follow-up monitoring and care coordination. Being unattached was associated with negative effects on mental health, poor health outcomes, decreased confidence in the health care system, and greater pre-existing health inequities. Conclusion: Having a regular primary care provider is essential to having access to high-quality care and other health care services. Attachment also promotes health equity and confidence in the public health care system and has broader system-level, social, and policy implications. (Copyright © 2024 the College of Family Physicians of Canada.)
Databáze:	MEDLINE
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