An innovative model for improving access to care: Patients’ experience of a primary care network caring for underserved communities in France

Abstract

Background

Vulnerable people have complex health needs but face multiple barriers to accessing healthcare. In 2018, Médecins du Monde (MDM), a French non-governmental association which care for underserved people, initiated an ambulatory primary care network in Marseille, France: the “PASS De Ville” (PDV). It supports vulnerable populations in obtaining immediate access to common primary care in the city before their health insurance rights are established. We aimed to assess the experience and care expectations of the patients who used the PDV.

Methods

We conducted a qualitative study based on a grounded theory approach. Patients who met at least one of the general practitioners involved in the PDV were included. We conducted semi-structured interviews amongst 16 service users, between February and May 2021. Two researchers performed an inductive analysis using NVivo.

Results

The patients had both medical and non-medical needs. Alongside health, access to health insurance was a subject often considered a key priority. Although patients seemed to have little understanding of how the PDV works, they nevertheless managed to benefit from it and access medical care more easily. PDV users reported feeling more socially integrated through consideration by healthcare givers. Most of them still identified the general practitioner encountered during the PDV as their referent doctor once their health insurance rights were established.

Conclusion

The PDV seems to support better integration into the French primary care system for patients who encounter barriers seeking medical care. Other studies are needed to identify PDV's efficiency on care pathways and patients’ overall health.