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Master Thesis

Renoncements aux soins de premier recours des personnes en situation de précarité à La Réunion, quels leviers ?

Abstract : Introduction : In Reunion island, a third of the inhabitants are renouncing to health care at least once a year. Social health inequalities emphasize this problem among people in precarious situations. The objective of this study was to determine modifiable factors associated with renouncing of primary care among people in precarious situations in Saint-Louis, town with highest poverty indicators. Method : This is a qualitative study with recorded semi-structured interviews at people’s home. Participants were included according to precariousness score (EPICES). Anonymized data were analysed through principle of anchored theorization. Results : Individual and systemic factors were associated with renouncing primary care at anytime of care pathways. Critical points were the stability of health insurance, dental care, prevention and treatment access. A late recourse to medical aid was observed. System knowledge were motley. Migrant population seemed to describe specific causes. Discussion: This is the first study on Réunion island. Further studies on EPICES score and refusal of care are needed. To improve health accessibility, a better understanding of social sciences and humanities, social inequities and transculturality among medical community could help. Interpreters and mediators in primary care would strengthen caring relationship and communication. A simplification of the administrative process is required; a permanent access to health care (PASS) in the city could be a solution.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02885896
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Sylvain Brunet. Renoncements aux soins de premier recours des personnes en situation de précarité à La Réunion, quels leviers ?. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02885896⟩

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