Évaluation d'un protocole d'orientation vers le droit commun parmi des patients ayant été suivis en permanence d'accès aux soins de santé suite à une hospitalisation

Khouani, J.; Jaillard, M.; Launay, E.; Duca, S. Del; Guarinos, G.; Borlot, J.; Auquier, P.; Tabélé, C.

doi:10.1016/j.respe.2023.102125

Cited by 2 publications

(6 citation statements)

References 12 publications

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“…Patients who met the inclusion criteria for the PASS-MULTI received information on the study in their own language, and their consent to participate was sought by a professional outside the care team. A professional telephone interpretation service was used as needed to provide information to the participants in their native language, and they were offered the option to be accompanied by someone they trusted, particularly for those who could not read [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

“…As a result, in this paper, we use the term “vulnerable migrants” to refer to migrants without social health insurance who have visited PASS. Once they have acquired health insurance, vulnerable migrants visiting PASS are referred to common primary care, where they identify a GP and access a stable coordinated care pathway [ 20 ]. In the French healthcare system, ambulatory GPs have the tasks of the “médecin traitant” (treating physician), introduced by the health law of 2005; they are the gatekeepers of the healthcare system and provide global and coordinated care for patients.…”

Section: Introductionmentioning

confidence: 99%

“…The PASS-MULTI study is a multicenter, randomized, open-label, comparative study conducted in Marseille (France) to assess the impact of a multidisciplinary PASS system, including a pharmaceutical interface in addition to social, medical, and healthcare teams on the 12-month re-hospitalization rate of patients in precarious situations. An ancillary study of the PASS-MULTI focused on evaluating a referral protocol from hospitals to common ambulatory general practice for patients following hospitalization [ 20 ]. The hospital-to-community protocol consisted of the following steps: a medical consultation in which the patients were given their medical records and prescriptions if needed.…”

Section: Introductionmentioning

confidence: 99%

“…Depending on the patients’ needs, patients could search for and make an appointment with a GP by themselves, receive a list of GP contacts, have an appointment with a GP scheduled by a PASS professional, or receive individual support with health mediation for their first appointment with a GP [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Only 25% of the patients had declared a treating physician when they could. While 63.4% of the patients needed care, 42.3% had not consulted the GP they identified as a referent doctor [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Care-seeking strategies of migrants during the transition from a specific primary healthcare facility for uncovered individuals to common ambulatory general practice: A French qualitative study

Maeva,

Anne,

Marie

et al. 2024

BMC Public Health

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Background Migrants have complex health needs but face multiple barriers to accessing health care. In France, permanent healthcare access offices (PASSs), as specific primary health care facilities (SPHCs), provide care to people without health insurance coverage. Once these patients obtain health insurance, they are referred to common ambulatory general practice. The aim of this study was to explore migrants’ experiences and strategies for seeking common primary care after having been treated by an SPHC. Methods We conducted a qualitative study based on grounded theory between January and April 2022. We held semi-structured interviews with migrants who had consulted a PASS. Two researchers performed an inductive analysis. Results We interviewed 12 migrants aged 22 to 65 to confirm data saturation. The interviewees relied on “referents”: professional referents (to be properly treated for specific health problems), guides (to find their way through the healthcare system), or practical referents (to address practical issues such as translation, travel needs, or medical matters). Those who considered the PASS to be a referent expressed disappointment and incomprehension at the time of discharge. Referral procedures and the first encounter with common ambulatory general practice were decisive in whether the interviewees accessed and stayed in a coordinated primary care pathway. The perceived quality of care depended on a feeling of being considered and listened to. For interviewees who received first-time services from an ambulatory general practice, the way in which they were referred to and their first experience with an ambulatory GP could influence their adherence to care. Conclusions The conditions of transition from SPHCs to common ambulatory general practice can impact migrants’ adherence to a coordinated primary care pathway. Referral can improve these patients’ care pathways and ease the transition from a PASS to ambulatory care. Healthcare professionals at SPHCs should pay special attention to vulnerable migrants without previous experience in ambulatory general practice and who depend on referents in their care pathways. For these patients, adapted referral protocols with further individual support and empowerment should be considered.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%