Are technical aids useful for elderly people? The perception of primary health care-based informants about this Explicit Health Guarantee in Santiago, Chile

Authors

  • Macarena Hirmas Universidad del Desarrollo, Facultad de Medicina, Clínica Alemana, Centro de Epidemiología y Políticas de Salud
  • Lucy Poffald Universidad del Desarrollo, Facultad de Medicina, Clínica Alemana, Centro de Epidemiología y Políticas de Salud
  • Andrea Olea Universidad del Desarrollo, Facultad de Medicina, Clínica Alemana, Centro de Epidemiología y Políticas de Salud
  • Ximena Aguilera Universidad del Desarrollo, Facultad de Medicina, Clínica Alemana, Centro de Epidemiología y Políticas de Salud
  • Isabel Matute Universidad del Desarrollo, Facultad de Medicina, Clínica Alemana, Centro de Epidemiología y Políticas de Salud
  • Claudia González Universidad del Desarrollo, Facultad de Medicina, Clínica Alemana, Centro de Epidemiología y Políticas de Salud
  • Iris Delgado Universidad del Desarrollo, Facultad de Medicina, Clínica Alemana, Centro de Epidemiología y Políticas de Salud
  • Manuel Nájera Universidad del Desarrollo, Facultad de Medicina, Clínica Alemana, Centro de Epidemiología y Políticas de Salud
  • María Inés Gómez Hospital de Padre Hurtado
  • Ligia Gallardo Hospital de Padre Hurtado
  • Hernán Bustamante Hospital de Padre Hurtado
  • María Cristina Di Silvestre Universidad del Desarrollo, Facultad de Medicina, Clínica Alemana

Abstract

Objective: To assess the perception of key informants working in Primary Health Care in Chile, regarding the administration and impact of the national Explicit Health Guarantees (GES) program which provides technical aids to vulnerable elderly adults. Materials and methods: A qualitative study, based on multiple case analysis of semi--structured interviews with 8 key informants of the healthcare network, was conducted in 2015 in three municipalities of Santiago, Chile. The collected information was analyzed by means of content analysis, and máximum variation sampling was carried out until the data saturation point was reached. Rigorous scientific criteria were safeguarded, and the study protocol was approved by an Ethics Committee. Results: Patients deemed the program’s coverage and detection of needs to be adequate, although informants conveyed that the general population is largely unaware of the program. While any health professional can detect a patient’s need for technical aids, only physicians can prescribe the devices, which generates access barriers. Technical aid delivery is timely; however, it is not monitored or considered to form part of a comprehensive care system. Assistive devices are perceived to be high quality, and the delivery network coordination is seen as adequate, although there is no feedback to Primary Health Care. The program’s impact is considered positive among patients and family members, as it improves the performance of daily activities and generates greater autonomy and mobility. Conclusions: This GES program is positively perceived and viewed to improve patients’ quality of life. However, the delivery of technical aids is disconnected from an integral care approach, and thus the program only prioritizes the guarantee of opportunity.

Keywords:

Aging, Elderly adults, Primary health care, Technical devices