Abstract
ContextThe aim of this study was to ask whether there are shared ideas about what good health care looks like that apply across different populations and conditions. Do priorities among “seldom heard” groups differ from mainstream views and, if so, how might we understand these differences?DesignFocus groups were recruited with the help of our study patient representatives. Participants discussed and prioritized a set of eight “core components” of good care. We recorded and transcribed the data for thematic analysis.Setting and participantsWe recruited people who are seldom heard in health and policy research for separate focus group discussions (one each with illegal drug users, Irish Travellers, migrant workers, young men and learning disabled people). We also ran a reference group of educated, older adults and an online group with people with long‐term conditions.ResultsThere were few differences in what participants thought was important in health care but considerable differences in their expectations that they might personally receive good care. Differences related to participants' previous experiences. The drug users group reported particularly poor experiences and low expectations of good care.DiscussionDifferences in what is regarded as an entitlement or privilege in health care underline the persistence of structural and relational differences in how services are experienced. While we can be reassured that core aspects of care are similarly prioritized across different patient groups, including those who are seldom heard, a more intractable challenge remains: how to provide equitable health care for marginalized groups in an unequal society.
Highlights
Recent attention in the UK has been keenly focused on what goes wrong in health care, and with good reason.[1,2,3] At the most basic level, health and care services should be safe and delivered by trained staff with the appropriate mix of skills and caseload.[4]
We examine the reach of current ideas about what matters to patients, drawing on focus group discussions with people who are seldom heard in health and policy research
Between January and April 2013, we ran six face-to-face and one online focus group to examine whether how and why ideas about “good care” might differ when discussed with participants from social groups who rarely appear in mainstream research
Summary
Recent attention in the UK has been keenly focused on what goes wrong in health care, and with good reason.[1,2,3] At the most basic level, health and care services should be safe and delivered by trained staff with the appropriate mix of skills and caseload.[4]. RYAN et al whether these definitions and standards encompass what matters to “seldom heard” groups, that is sections of the population who are typically left out of research.[5] Are priorities different when care is viewed from less familiar, typically less privileged, perspectives? Given the enduring health inequalities in England (despite a National Health Service free at the point of delivery6), a focus on “seldom heard” groups is important. We examine the reach of current ideas about what matters to patients, drawing on focus group discussions with people (illegal drug users, Irish Travellers, migrant workers, young men and learning disabled people) who are seldom heard in health and policy research
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