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Tytuł:
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Health Care Provider Barriers to Patient Referral to Palliative Care.
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Autorzy:
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Enguidanos S; Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA.
Cardenas V; Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA.
Wenceslao M; Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA.
Hoe D; Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA.
Mejia K; Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA.; Los Angeles County Department of Public Health, Los Angeles, CA, USA.
Lomeli S; Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA.
Rahman A; Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA.
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Źródło:
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The American journal of hospice & palliative care [Am J Hosp Palliat Care] 2021 Sep; Vol. 38 (9), pp. 1112-1119. Date of Electronic Publication: 2020 Nov 23.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Thousand Oaks, Calif. : Sage Publications
Original Publication: Weston, MA : Prime National Pub. Corp., c1990-
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MeSH Terms:
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Palliative Care*
Referral and Consultation*
Attitude of Health Personnel ; Health Personnel ; Humans ; Los Angeles ; Qualitative Research
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Contributed Indexing:
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Keywords: Medicaid patients; barriers to care; home-based palliative care; palliative care; primary care; referral
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Entry Date(s):
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Date Created: 20201123 Date Completed: 20210728 Latest Revision: 20220425
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Update Code:
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20240105
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DOI:
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10.1177/1049909120973200
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PMID:
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33222487
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Objective: The purpose of this study was to explore healthcare provider-perceived challenges to HBPC patient referral and elicited providers' feedback for overcoming these challenges.
Methods: We conducted a qualitative study using semi-structured interview s with 25 Medicaid managed care providers (primary care physicians, nurse practitioners, and care managers) working in the greater Los Angeles area. Our interview protocol elicited providers' knowledge and awareness of palliative care; perceived barriers to HBPC referral; and suggestions for overcoming these barriers. We analyzed verbatim transcripts using a grounded theory approach.
Results: Themes related to referral barriers included providers' lack of palliative care knowledge and clarity regarding referral processes, provider reluctance to refer to HBPC, and provider culture. Providers also identified patient-level barriers, including financial barriers, reluctance to have home visits, health literacy, cultural barriers, and challenges related to living situations. Themes related to methods for overcoming challenges included increased HBPC education and outreach to providers, specifically by HBPC agency staff.
Conclusions: Findings from this study underscore the need for additional palliative care education for Medicaid healthcare providers. They point to the need for novel strategies and approaches to address the myriad barriers to patient identification and referral to HBPC.
