Three ways of organising general practitioner’s medical services in sheltered housing. A qualitative study

Abstract

Objective Explore care providers’ experiences with the organisation of the medical services for residents in round-the-clock staffed sheltered housing. Design Qualitative study and thematic analysis of individual interviews after strategic sampling of participants. Setting Round-the-clock staffed sheltered housing in seven municipalities, inhabited by various user groups, and GPs in various locations in Norway. Subjects In-depth interviews with 18 participants: 11 managers or employees in sheltered housing and seven GPs. Main outcome measures Main themes and subthemes reporting participants’ experiences of medical provision to sheltered housing residents. Results Three main models of organizing medical services for round-the-clock staffed sheltered housing were identified: (i) the ‘multiple GP’ model, where each resident has their own individual GP; (ii) the ‘single GP’ model, where all residents in the sheltered housing have one common GP; (iii) the ‘hybrid’ model, where a few dedicated GPs follow up the residents. Conclusion Residents in round-the-clock staffed sheltered housing constitute a varied group that generally has substantial medical assistance needs. Given that many residents lack autonomy to manage their own care needs and make decisions, models with fewer GPs like models ii and iii seem to provide a better medical professional offer. Moving towards such an organising of the medical services for sheltered housing residents could have implications for GPs’ workload and competence needs. Future studies are needed to test models and assess implications.