Campbell David J T, O'Neill Braden G, Gibson Katherine, Thurston Wilfreda E
Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Room G236 Health Sciences Centre, 3330 Hospital Dr NW, Calgary, AB, T2N 1 N4, Canada.
Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
BMC Fam Pract. 2015 Oct 13;16:139. doi: 10.1186/s12875-015-0361-3.
Despite Canada's universal healthcare system, significant barriers impede individuals experiencing homelessness from accessing health services. Furthermore, there is a paucity in the qualitative literature describing how Canadians experiencing homelessness access health care services. Our objective was to qualitatively explore perceived healthcare needs and barriers among individuals experiencing homelessness in one large Canadian city - Calgary, Alberta.
We conducted a qualitative descriptive study that included open-ended interviews and focus groups with a variety of stakeholders who are involved in healthcare among Calgary's homeless populations. These included individuals experiencing homelessness (n = 11) as well as employees from several healthcare service providers for those experiencing homelessness (n = 11). Transcripts from these interviews were thematically analyzed by two analysts.
Stakeholder interviews yielded several pervasive themes surrounding the health care needs of the homeless and barriers to accessing care. Some of the primary health care needs which were identified included mental health, addictions, and allied health as well as care that addresses the social determinants of health. Notably, it was difficult for many stakeholders to pinpoint specific health care priorities, as they identified that the health care needs among Calgary's homeless populations are diverse and complex, often even describing the needs as overwhelming. Types of barriers to primary care that were identified by stakeholders included: emotional, educational, geographical, financial and structural barriers, as well as discrimination.
Our findings highlight the diverse primary health care needs of Calgary's homeless populations. Despite the fact that Canada has a universal publicly funded health care system, individuals experiencing homelessness face significant barriers in accessing primary care.
尽管加拿大实行全民医疗保健系统，但仍存在重大障碍，阻碍无家可归者获得医疗服务。此外，关于加拿大无家可归者如何获得医疗保健服务的定性文献很少。我们的目标是定性探索加拿大一个大城市——艾伯塔省卡尔加里的无家可归者的医疗需求和障碍。
我们进行了一项定性描述性研究，包括对卡尔加里无家可归人群中参与医疗保健的各种利益相关者进行开放式访谈和焦点小组讨论。这些利益相关者包括无家可归者（n = 11）以及几家为无家可归者提供医疗服务的机构的员工（n = 11）。两名分析师对这些访谈的记录进行了主题分析。
利益相关者访谈产生了几个围绕无家可归者医疗需求和获得医疗服务障碍的普遍主题。确定的一些主要医疗需求包括心理健康、成瘾、辅助医疗以及解决健康社会决定因素的医疗服务。值得注意的是，许多利益相关者难以确定具体的医疗保健优先事项，因为他们指出卡尔加里无家可归人群的医疗需求多样且复杂，甚至常常将这些需求描述为压倒性的。利益相关者确定的初级保健障碍类型包括：情感障碍、教育障碍、地理障碍、经济障碍和结构障碍以及歧视。
我们的研究结果突出了卡尔加里无家可归人群多样的初级医疗保健需求。尽管加拿大有一个由公共资金资助的全民医疗保健系统，但无家可归者在获得初级保健方面面临重大障碍。
