family medicine;
general practice;
inequalities;
health inequities;
Ireland;
INVERSE CARE LAW;
HEALTH-CARE;
MULTIMORBIDITY;
PERSISTENCE;
QUALITY;
D O I:
10.3399/BJGPO.2023.0195
中图分类号:
R1 [预防医学、卫生学];
学科分类号:
1004 ;
120402 ;
摘要:
Background: The inverse care law states that availability of good medical care varies inversely with the need for it in the population served. In 2019, the main medical union and the Department of Health in the Republic of Ireland (RoI), agreed on funding a social deprivation practice grant for general practices in urban deprived areas. Aim: To examine the implementation and impact of the social deprivation practice grant in participating general practices. Design & setting: A mixed- methods study with sequential design based in Irish general practice. Method: Data were collected using a questionnaire and online semi- structured interviews with GPs and practice staff. Data were analysed separately, and the findings compared to examine the extent to which they converged or diverged. Results: There were 25 survey responses and nine interviews. All practices reported the grant was beneficial and most practices utilised the grant to fund additional doctor hours (17/25). Both surveys and interviews indicated that a small amount of additional funding allowed additional clinical need in areas of deprivation to be addressed, but there were some barriers identified in accessing the grant and implementing planned expenditure. Conclusion: Delivery of health care in areas of socioeconomic deprivation presents significant challenges. While there were some problems with implementation, the introduction of a small, targeted grant for general practices in areas of social deprivation allowed those practices to enhance their services, with tailored initiatives seeking to meet the needs of their patient populations.
机构:
Univ Med Ctr Gottingen, Dept Gen Practice, Humboldtallee 38, D-37073 Gottingen, GermanyUniv Med Ctr Gottingen, Dept Gen Practice, Humboldtallee 38, D-37073 Gottingen, Germany
Demmer, Iris
Schneider, Anke
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机构:
IMPP, Mainz, GermanyUniv Med Ctr Gottingen, Dept Gen Practice, Humboldtallee 38, D-37073 Gottingen, Germany
Schneider, Anke
Selgert, Lena
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机构:
IMPP, Mainz, GermanyUniv Med Ctr Gottingen, Dept Gen Practice, Humboldtallee 38, D-37073 Gottingen, Germany
Selgert, Lena
Bruenahl, Christian
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机构:
IMPP, Mainz, GermanyUniv Med Ctr Gottingen, Dept Gen Practice, Humboldtallee 38, D-37073 Gottingen, Germany
Bruenahl, Christian
Baum, Erika
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机构:
Philipps Univ Marburg, Abt Allgemein Med Prvent & Rehabil Med, Marburg, GermanyUniv Med Ctr Gottingen, Dept Gen Practice, Humboldtallee 38, D-37073 Gottingen, Germany
Baum, Erika
Bergmann, Antje
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机构:
TU Dresden Fac Med Carl Gustav Carus, Bereich Allgemeinmed MK3, Dresden, GermanyUniv Med Ctr Gottingen, Dept Gen Practice, Humboldtallee 38, D-37073 Gottingen, Germany