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Table 2 Recommendations to Improve Access to Health and Social Care Systems in Polanda

From: Patient-centred access to health care: a framework analysis of the care interface for frail older adults

Access Issue Recommendations
Approachability Services should be transparent about what they offer, when and to whom.
Where services are not transparent or easily navigated, a care coordinator (liaison or advocate) should be available to help caregivers and older adults to access health and social care services.
Acceptability Psychological support should be available for caregivers, both during the caregiving activities and after bereavement.
Rehabilitation services are in short supply but may result in changed attitudes towards exercise and ownership of individual’s health where provided.
Availability and accommodation Timeliness is critical when developing interventions for older adults. There needs to be a reduction in waiting times for specific treatments for older or frail adults, in order to prevent the need for potentially more intensive (and consequently expensive) treatments or care plans.
Bureaucracy should be reduced and administrative systems streamlined to prevent communication failures and significant delays in medical treatment or provision of social care for frail older adults
The availability of low or no cost respite care should be investigated.
There should be appropriate training and remuneration for professional caregivers.
Affordability Doctors should recognise the reduced financial situation of some older adults and consider how that situation might affect adherence to (paid for) medical treatment.
There is a willingness among some participants to care for older relatives at home with limited financial support. The cost effectiveness of financially supported home care versus existing alternatives should be explored.
Appropriateness The current health care system provides high functioning emergency provision, which is unsuitable for patients with complex needs. A new model of care should be evaluated which moves away from acute crisis management in older adults and considers a more integrated and holistic health pathway.
The current social care system is low functioning in an emergency situation and bureaucratisation causes serious delays in providing services to the vulnerable. There should be a change in legislation in order to provide effective social care for older adults outside normal office hours.
  1. aBased on Levesque, Harris, & Russell’s [32] theoretical framework of access to health care