[Barriers and facilitators in accessing and using primary health care centers for people experiencing homelessness].

OBJECTIVE

To identify barriers and facilitators for the access and use of primary care centers for people experiencing homelessness.

DESIGN

Qualitative study, phenomenological theoretical-methodological approach. Between May 19 and July 27, 2023.

LOCATION: Besòs Primary Health Care Center and Gregal social dining (Besòs and Maresme neighborhood, Barcelona).

PARTICIPANTS

People experiencing homelessness attending the Gregal social dining and professionals from the Besòs Primary Health Care Center.

METHOD: Theoretical purposive sampling. Individual and group interviews and open non-participant observation. Thematic content analysis, triangulation by independent analysis of three members of the research team and triangulation of methods. Discourse saturation was achieved through variability of discourse and techniques.

RESULTS

Eleven individual interviews, three group interviews and two observations. Different barriers and facilitators were identified. These were classified into five categories: (1)concept and identification of people experiencing homelessness; (2)personal factors of people experiencing homelessness; (3)behaviors and attitudes of professionals; (4)structural factors related to health system regulation, anf (5)internal organizational factors of primary health care centers.

CONCLUSIONS

People experiencing homelessness face multiple barriers to access primary health care, although there are also facilitators such as trusting relationships and multidisciplinary and intersectoral work that can be enhanced from primary health care centers to contribute to health equity.