Verity Aaminah, Tzortziou Brown Victoria
Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Wolfson Institute of Population Health, Queen Mary University of London, London, UK
BJGP Open. 2023 Jun 27;7(2). doi: 10.3399/BJGPO.2023.0023. Print 2023 Jun.
The COVID-19 pandemic has led to rapid and widespread adoption of remote consultations and triage-first pathways in general practice. However, there is a lack of evidence on how these changes have been perceived by patients from inclusion health groups.
To explore the perspectives of individuals from inclusion health groups on the provision and accessibility of remote general practice services.
DESIGN & SETTING: A qualitative study with individuals from Gypsy, Roma and Traveller communities, sex workers, vulnerable migrants, and those experiencing homelessness, recruited by Healthwatch in east London.
The study materials were co-produced with people with lived experience of social exclusion. Semi-structured interviews with 21 participants were audiorecorded, transcribed, and analysed using the framework method.
Analysis identified barriers to access owing to lack of translation availability, digital exclusion, and a complex healthcare system, which is difficult to navigate. The role of triage and general practice in emergencies often seemed unclear to participants. Other themes identified included the importance of trust, face-to-face consultation options for ensuring safety, and the benefits of remote access, particularly in terms of convenience and saving time. Themes on reducing barriers included improving staff capacity and communication, offering tailored options and continuity of care, and simplifying care processes.
The study highlighted the importance of a tailored approach for addressing the multiple barriers to care for inclusion health groups and the need for clearer and inclusive communication on the available triage and care pathways.
新冠疫情导致远程会诊和分诊优先路径在全科医疗中迅速且广泛地被采用。然而，对于包容性健康群体的患者如何看待这些变化，目前缺乏相关证据。
探讨包容性健康群体的个体对远程全科医疗服务的提供情况及可及性的看法。
一项定性研究，研究对象为吉普赛、罗姆和旅行者社区的个体、性工作者、弱势移民以及无家可归者，由伦敦东部的健康观察组织招募。
研究材料是与有社会排斥生活经历的人共同制作的。对21名参与者进行的半结构化访谈进行了录音、转录，并使用框架法进行分析。
分析发现，由于缺乏翻译服务、数字排斥以及复杂的医疗系统（难以理解），存在获取医疗服务的障碍。参与者往往不清楚分诊和全科医疗在紧急情况下的作用。确定的其他主题包括信任的重要性、确保安全的面对面咨询选项以及远程问诊的好处，特别是在便利性和节省时间方面。关于减少障碍的主题包括提高工作人员能力和沟通水平、提供量身定制的选项和持续护理，以及简化护理流程。
该研究强调了采用量身定制方法来解决包容性健康群体获得医疗服务的多重障碍的重要性，以及就可用的分诊和护理路径进行更清晰、更具包容性沟通的必要性。
