TY - JOUR
AU - C. Hudon
AU - M. Bisson
AU - M. C. Chouinard
AU - G. Moullec
AU - L. R. Del Barrio
AU - É Angrignon-Girouard
AU - M. M. Pratte
AU - M. D. Poirier
A1 - 
AB - BACKGROUND: People living in precarious socio-economic conditions are at greater risk of developing mental and physical health disorders, and of having complex needs. This places them at risk of health inequity. Addressing social determinants of health (SDH) can contribute to reducing this inequity. Case management in primary care is an integrated care approach which could be an opportunity to better address SDH. The aim of this study is to better understand how case management in primary care may address the SDH of people with complex needs. METHODS: A case management program (CMP) for people with complex needs was implemented in four urban primary care clinics. A qualitative study was conducted with semi-structured interviews and a focus group with key informants (n = 24). An inductive thematic analysis was carried out to identify emerging themes. RESULTS: Primary care case managers were well-positioned to provide a holistic evaluation of the person's situation, to develop trust with them, and to act as their advocates. These actions helped case managers to better address individuals' unmet social needs (e.g., poor housing, social isolation, difficulty affording transportation, food, medication, etc.). Creating partnerships with the community (e.g., streetworkers) improved the capacity in assisting people with housing relocation, access to transportation, and access to care. Assuming people provide their consent, involving a significant relative or member of their community in an individualized services plan could support people in addressing their social needs. CONCLUSIONS: Case management in primary care may better address SDH and improve health equity by developing a trusting relationship with people with complex needs, improving interdisciplinary and intersectoral collaboration and social support. Future research should explore ways to enhance partnerships between primary care and community organizations.
AD - Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Pavillon Z10, 3001, 12e Avenue Nord, Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada. Catherine.Hudon@USherbrooke.ca.; Faculty of Nursing, Université de Montréal, Pavillon Marguerite-d'Youville, 2375 chemin de la Côte Ste-Catherine, Montreal, QC, H3T 1A8, Canada.; Department of Social and Preventative Medicine, School of Public Health, Université de Montréal, 7101 Avenue du Parc, Montreal, QC, H3N 1X9, Canada.; Department of Social Work, Université de Montréal, Pavillon Lionel-Groulx, 3150 rue Jean-Brillant, Montreal, Quebec, Canada.; Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Pavillon Z10, 3001, 12e Avenue Nord, Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada.; Patient Partner, Canada Research Chair in Implementing Integrated Care for People with Complex Needs, Université de Sherbrooke, Sherbrooke, QC, Canada.
AN - 39506639
BT - BMC Prim Care
C5 - Healthcare Disparities
CP - 1
DA - Nov 6
DO - 10.1186/s12875-024-02643-7
DP - NLM
ET - 20241106
IS - 1
JF - BMC Prim Care
LA - eng
N2 - BACKGROUND: People living in precarious socio-economic conditions are at greater risk of developing mental and physical health disorders, and of having complex needs. This places them at risk of health inequity. Addressing social determinants of health (SDH) can contribute to reducing this inequity. Case management in primary care is an integrated care approach which could be an opportunity to better address SDH. The aim of this study is to better understand how case management in primary care may address the SDH of people with complex needs. METHODS: A case management program (CMP) for people with complex needs was implemented in four urban primary care clinics. A qualitative study was conducted with semi-structured interviews and a focus group with key informants (n = 24). An inductive thematic analysis was carried out to identify emerging themes. RESULTS: Primary care case managers were well-positioned to provide a holistic evaluation of the person's situation, to develop trust with them, and to act as their advocates. These actions helped case managers to better address individuals' unmet social needs (e.g., poor housing, social isolation, difficulty affording transportation, food, medication, etc.). Creating partnerships with the community (e.g., streetworkers) improved the capacity in assisting people with housing relocation, access to transportation, and access to care. Assuming people provide their consent, involving a significant relative or member of their community in an individualized services plan could support people in addressing their social needs. CONCLUSIONS: Case management in primary care may better address SDH and improve health equity by developing a trusting relationship with people with complex needs, improving interdisciplinary and intersectoral collaboration and social support. Future research should explore ways to enhance partnerships between primary care and community organizations.
PY - 2024
SN - 2731-4553
SP - 391
ST - Opportunities of integrated care to improve equity for adults with complex needs: a qualitative study of case management in primary care
T1 - Opportunities of integrated care to improve equity for adults with complex needs: a qualitative study of case management in primary care
T2 - BMC Prim Care
TI - Opportunities of integrated care to improve equity for adults with complex needs: a qualitative study of case management in primary care
U1 - Healthcare Disparities
U3 - 10.1186/s12875-024-02643-7
VL - 25
VO - 2731-4553
Y1 - 2024
ER -