[Access to health care: perceptions of patients with multiple chronic conditions]

To explore access to health care for patients presenting with multiple chronic conditions and to identify barriers and factors conducive to access.

Qualitative study with focus groups.

Family practice unit in Chicoutimi (Saguenay), Que.

Twenty-five male and female adult patients with at least four chronic conditions but no cognitive disorders or decompensating conditions.

For this pilot study, only three focus group discussions were held.

The main barriers to accessing follow-up appointments included long waits on the telephone, automated telephone-answering systems, and needing to attend at specific times to obtain appointments. The main barriers to specialized care were long waiting times and the need to get prescriptions and referrals from family physicians. Factors reported conducive to access included systematic callbacks and the personal involvement of family physicians. Good communication between family physicians and specialists was also perceived to be an important factor in access.

Systematic callbacks, family physicians' personal efforts to obtain follow-up visits, and better physician-specialist communication were all suggested as ways to improve access to care for patients with multiple chronic conditions.