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

TL;DR

This study explores how general practitioners organize medical services for residents in sheltered housing, identifying three main models and their implications.

Contribution

The paper identifies three distinct models for organizing GP services in sheltered housing and highlights their potential impacts on workload and care quality.

Findings

Three models were identified: multiple GP, single GP, and hybrid.

Models with fewer GPs may offer better care for residents with complex needs.

Current GP schemes may not fully meet the needs of sheltered housing residents.

Abstract

Explore care providers’ experiences with the organisation of the medical services for residents in round-the-clock staffed sheltered housing.

Qualitative study and thematic analysis of individual interviews after strategic sampling of participants.

Round-the-clock staffed sheltered housing in seven municipalities, inhabited by various user groups, and GPs in various locations in Norway.

In-depth interviews with 18 participants: 11 managers or employees in sheltered housing and seven GPs.

Main themes and subthemes reporting participants’ experiences of medical provision to sheltered housing residents.

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.

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.

Residents in round-the-clock staffed sheltered housing are considered ‘home residents’ and consist of various user groups with extensive and often complex medical care needs.

The GP scheme is the most important medical service for home residents.

There is an emerging mismatch between the need for help of residents in sheltered housing and the GP scheme, and municipalities seek to remedy this by developing their own ad hoc solutions.

There is a need for a more systematic approach to deal with the medical needs of residents in round-the-clock staffed care homes.