How French general practitioners adapt their care to patients with social difficulties?

ObjectiveSeveral studies have shown the role of the primary care system in access to care and in reducing social inequalities in health. The objective of this study was to describe the practices of general practitioners (GPs) in taking into account the social environment of their patient, and the wa...

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Bibliographic Details
Published in:Family medicine and community health 2019-11, Vol.7 (4), p.e000044
Main Authors: De Oliveira, Annie, Chavannes, Barbara, Steinecker, Magali, Denantes, Mady, Chastang, Julie, Ibanez, Gladys
Format: Article
Language:English
Subjects:
Employment
Family physicians
Focus groups
France
general practice
general practitioners
Health care access
Health care policy
Health disparities
Health education
Health literacy
healthcare disparities
Housing
Indoor air quality
Interviews
Original Research
Patients
Physicians
Primary care
primary health care
Qualitative research
socioeconomic factors
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Summary:ObjectiveSeveral studies have shown the role of the primary care system in access to care and in reducing social inequalities in health. The objective of this study was to describe the practices of general practitioners (GPs) in taking into account the social environment of their patient, and the ways they adapted to social difficulties.DesignQualitative study comprising interviews and focus groups.SettingFrench primary care settings.ParticipantsTwenty semistructured interviews and two focus groups were conducted with 33 GPs. Sessions were audio recorded, transcribed verbatim and analysed using thematic analysis. The reporting of findings was guided by consolidated criteria for reporting qualitative research.ResultThis study identified adaptations at three levels: in the individual management of patients (alert system, full involvement in prevention, better communication, prioritised additional examinations, financial facilities, help in administrative tasks), in the collective management of patients in an office (consultation without appointment, pay-for-performance indicators, medical staffs, multidisciplinary protocols, medical practice in group, medical student), and in the community management (patients description, cooperation with associations, public health sector and politics).ConclusionIn France, GPs can take into account the social determinants of health in practice through simple or more complex actions.
ISSN:2305-6983
2009-8774
DOI:10.1136/fmch-2018-000044