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BMC Geriatrics
Published in: BMC Geriatrics 1/2018

Open Access 01-12-2018 | Research article

Patient-centred access to health care: a framework analysis of the care interface for frail older adults

Authors: Donata Kurpas, Holly Gwyther, Katarzyna Szwamel, Rachel L. Shaw, Barbara D’Avanzo, Carol A. Holland, Maria Magdalena Bujnowska-Fedak

Published in: BMC Geriatrics | Issue 1/2018

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Abstract

Background

The objective of this study was to explore the issues surrounding access to health and social care services for frail older adults with Polish stakeholders, including healthy and frail/pre-frail older adults, health care providers, social care providers, and caregivers, in order to determine their views and perspectives on the current system and to present suggestions for the future development of a more accessible and person-centred health and social care system.

Methods

Focus groups were used to gather qualitative data from stakeholders. Data were analysed using framework analysis according to five dimensions of accessibility to care: approachability, acceptability, availability and accommodation, affordability and appropriateness.

Results

Generally services were approachable and acceptable, but unavailable. Poor availability related to high staff turnover, staff shortages and a lack of trained personnel. There were problems of long waiting times for specialist care and rehabilitation services, and geographically remote clinics. Critically, there were shortages of long-term inpatient care places, social care workers and caregivers. The cost of treatments created barriers to care and inequities in the system. Participants described a lack of integration between health and social care systems with differing priorities and disconnected budgets. They described an acute medical system that was inappropriate for patients with complex needs, alongside a low functioning social care system, where bureaucratisation caused delays in providing services to the vulnerable. An integrated system with a care coordinator to improve connections between services and patients was suggested.

Conclusions

There is an immediate need to improve access to health and social care systems for pre-frail and frail patients, as well as their caregivers. Health and social care services need to be integrated to reduce bureaucracy and increase the timeliness of treatment and care.
Footnotes
1
Post-production age in Poland is over 65 years for men and over 60 years for women.
 
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Metadata
Title
Patient-centred access to health care: a framework analysis of the care interface for frail older adults
Authors
Donata Kurpas
Holly Gwyther
Katarzyna Szwamel
Rachel L. Shaw
Barbara D’Avanzo
Carol A. Holland
Maria Magdalena Bujnowska-Fedak
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2018
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-018-0960-7

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