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. 2019 Nov 3;7(4):e000044.
doi: 10.1136/fmch-2018-000044. eCollection 2019.

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

Annie De Oliveira  1 , Barbara Chavannes  1 , Magali Steinecker  1 , Mady Denantes  1 , Julie Chastang  1 , Gladys Ibanez  1   2
Affiliations

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

Annie De Oliveira et al. Fam Med Community Health. .

Abstract

Objective: Several 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.

Design: Qualitative study comprising interviews and focus groups.

Setting: French primary care settings.

Participants: Twenty 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.

Result: This 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).

Conclusion: In France, GPs can take into account the social determinants of health in practice through simple or more complex actions.

Keywords: France; general practice; general practitioners; healthcare disparities; primary health care; qualitative research; socioeconomic factors.

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Conflict of interest statement

Competing interests: None declared.

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