Access to care: a qualitative study exploring the primary care needs and experiences of older people needing assistance with daily living
Marina Kunin A B , Jenny Advocat A , Nilakshi Gunatillaka A and Grant Russell
A
+ Author Affiliations
- Author Affiliations
A School of Primary and Allied Health Care, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia.
B Corresponding author. Email: marina.kunin@monash.edu
Australian Journal of Primary Health 27(3) 228-235 https://doi.org/10.1071/PY20180
Submitted: 30 July 2020 Accepted: 6 April 2021 Published: 22 June 2021
Abstract
Older people who live in the community and need assistance with daily activities are a unique group of patients to treat in the primary care (PC) setting. This study aimed to understand access-related PC needs and experiences of community-living people over 65 years of age receiving home-based assistance through the Home and Community Care (HACC) program in Melbourne, Australia. This descriptive qualitative study used thematic analysis of in-depth interviews with HACC program clients and assessment officers. Access-related needs and experiences were examined using the patient-centred access to care framework. Client (n = 11) and assessment officer (n = 4) interviews showed that community-living older people receiving home-based assistance from social services are able to find a GP according to their preferences; however, some challenges in access to comprehensive care exist. These challenges relate to regularity of PC attendance, out-of-pocket fees for specialist care and maintaining an enduring patient–GP relationship. GPs can play an important role in improving PC access for vulnerable older people. In particular, GPs can contribute to improving PC attendance and facilitating more affordable access to specialist care by improving systems to recall patients more regularly and developing explicit systems for linking vulnerable patients to affordable specialist services.
Keywords: access to care, elderly patients, family physician, GP, patient-centred care, primary health care, vulnerable patients.
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