Adjudications and tinkering with care for socially vulnerable patients with type 2 diabetes in general practice
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Adjudications and tinkering with care for socially vulnerable patients with type 2 diabetes in general practice. / Guassora, Ann Dorrit; Tvistholm, Nina; Kofod, Frida Greek; a Rogvi, Sofie; Wind, Gitte; Christensen, Ulla.
I: Scandinavian Journal of Primary Health Care, Bind 42, Nr. 2, 2024, s. 295-303.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Adjudications and tinkering with care for socially vulnerable patients with type 2 diabetes in general practice
AU - Guassora, Ann Dorrit
AU - Tvistholm, Nina
AU - Kofod, Frida Greek
AU - a Rogvi, Sofie
AU - Wind, Gitte
AU - Christensen, Ulla
N1 - Publisher Copyright: © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2024
Y1 - 2024
N2 - Objective: To analyse the mechanisms at play in the adjudications made by professionals and socially vulnerable patients with type 2 diabetes about their eligibility for care. Design, setting and subjects: The study included 14 patients and 10 health professionals in seven general practice surgeries in deprived areas in Greater Copenhagen. The study data consist of 17 semi-structured interviews with patients and 22 with health professionals immediately after observation of 23 consultations. Our analytical approach was inspired by Systematic Text Condensation and the concept of ‘candidacy’ for access to health care. Results: Adjudications of patients not being candidates for services were common, but we also found that both patients and health professionals worked to align the services to the needs of the patients. This could include using services differently than was intended by the providers or by changing routines to make it easier for patients to use the services. We discuss these processes as ‘tinkering’. This usually implies that the best individual solution for the patient is aimed for, and in this study, the best solution sometimes meant not focusing on diabetes. Conclusion: The study adds to existing knowledge about access to services for socially vulnerable patients by demonstrating that both patients and professionals in general practice engage in tinkering processes to make services work.
AB - Objective: To analyse the mechanisms at play in the adjudications made by professionals and socially vulnerable patients with type 2 diabetes about their eligibility for care. Design, setting and subjects: The study included 14 patients and 10 health professionals in seven general practice surgeries in deprived areas in Greater Copenhagen. The study data consist of 17 semi-structured interviews with patients and 22 with health professionals immediately after observation of 23 consultations. Our analytical approach was inspired by Systematic Text Condensation and the concept of ‘candidacy’ for access to health care. Results: Adjudications of patients not being candidates for services were common, but we also found that both patients and health professionals worked to align the services to the needs of the patients. This could include using services differently than was intended by the providers or by changing routines to make it easier for patients to use the services. We discuss these processes as ‘tinkering’. This usually implies that the best individual solution for the patient is aimed for, and in this study, the best solution sometimes meant not focusing on diabetes. Conclusion: The study adds to existing knowledge about access to services for socially vulnerable patients by demonstrating that both patients and professionals in general practice engage in tinkering processes to make services work.
KW - candidacy
KW - family practice
KW - general practice
KW - Health inequities
KW - health services accessibility
KW - socioeconomic factors
KW - tinkering
U2 - 10.1080/02813432.2024.2317825
DO - 10.1080/02813432.2024.2317825
M3 - Journal article
C2 - 38437026
AN - SCOPUS:85186889826
VL - 42
SP - 295
EP - 303
JO - Scandinavian Journal of Primary Health Care
JF - Scandinavian Journal of Primary Health Care
SN - 0281-3432
IS - 2
ER -
ID: 386717622