It 'makes you feel more like a person than a patient': patients' experiences receiving home-based primary care (HBPC) in Ontario, Canada.
The lack of effective systems to appropriately manage the health and social care of frail older adults - especially among those who become homebound - is becoming all the more apparent. Home-based primary care (HBPC) is increasingly being promoted as a promising model that takes into account the accessibility needs of frail older adults, ensuring that they receive more appropriate primary and community care. There remains a paucity of literature exploring patients' experiences with HBPC programmes. The purpose of this study was to explore the experiences of patients accessing HBPC delivered by interprofessional teams, and their perspectives on the facilitators and barriers to this model of care in Ontario, Canada. Using certain grounded theory principles, we conducted an inductive qualitative content analysis of in-depth patient interviews (n = 26) undertaken in the winter of 2013 across seven programme sites exploring the lived experiences and perspectives of participants receiving HBPC. Themes emerged in relation to patients' perceptions regarding the preference for and necessity of HBPC, the promotion of better patient care afforded by the model in comparison to office-based care, and the benefits of and barriers to HBPC service provision. Underlying patterns also surfaced related to patients' feelings and emotions about their quality of life and satisfaction with HBPC services. We argue that HBPC is well positioned to serve frail homebound older adults, ensuring that patients receive appropriate primary and community care - which the office-based alternative provides little guarantee - and that they will be cared for, pointing to a model that may not only lead to greater patient satisfaction but also likely contributes to bettering the quality of life of a highly vulnerable population.
School of Social Work, King's University College at Western University, London, Ontario, Canada.
Tracy
0000-0002-5806-8943
T
Smith-Carrier
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.|Johns Hopkins University School of Medicine, Balitmore, Maryland, USA.|Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Samir K
SK
Sinha
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.|House Calls: Interdisciplinary Healthcare for Homebound Seniors, SPRINT Senior Care, Toronto, Ontario, Canada.
Mark
M
Nowaczynski
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.|Home-Based Care Program, Toronto Western Family Health Team, Toronto, Ontario, Canada.
Sabrina
S
Akhtar
Toronto Central Community Care Access Centre, Toronto, Ontario, Canada.
Gayle
G
Seddon
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.|South East Toronto Family Health Team, Toronto, Ontario, Canada.
Thuy-Nga Tia
TT
Pham
D000368:Aged; D006699:Home Care Services; D018577:Homebound Persons; D006801:Humans; D007407:Interviews as Topic; D009864:Ontario; D017060:Patient Satisfaction; D011320:Primary Health Care; D036301:Qualitative Research; D011788:Quality of Life
Ontario, Canada; home visits; home-based primary care; interprofessional team care; patient experience; patient satisfaction; quality of life