Barreras y facilitadores en el acceso y la utilización de los centros de atención primaria para las personas en situación de sinhogarismo

Abstract

ObjectiveTo identify barriers and facilitators for the access and use of primary care centers for people experiencing homelessness. DesignQualitative study, phenomenological theoretical-methodological approach. Between May 19 and July 27, 2023. LocationBesòs Primary Health Care Center and Gregal social dining (Besòs and Maresme neighborhood, Barcelona). ParticipantsPeople experiencing homelessness attending the Gregal social dining and professionals from the Besòs Primary Health Care Center. MethodTheoretical purposive sampling. Individual and group interviews and open non-participant observation. Thematic content analysis, triangulation by independent analysis of three members of the research team and triangulation of methods. Discourse saturation was achieved through variability of discourse and techniques. ResultsEleven individual interviews, three group interviews and two observations. Different barriers and facilitators were identified. These were classified into five categories: (1)concept and identification of people experiencing homelessness; (2)personal factors of people experiencing homelessness; (3)behaviors and attitudes of professionals; (4)structural factors related to health system regulation, anf (5)internal organizational factors of primary health care centers. ConclusionsPeople experiencing homelessness face multiple barriers to access primary health care, although there are also facilitators such as trusting relationships and multidisciplinary and intersectoral work that can be enhanced from primary health care centers to contribute to health equity.