Social inequality in navigating the healthcare maze
Care trajectories from hospital to home via intermediate care for older people in Norway
Bibliographic Data
| ID | 4601934 |
|---|---|
| Authors | Linda Aimée Hartford Kvæl (0000-0002-3551-2271, corresponding author), Heidi Gautun (0000-0001-7258-1543) |
| Year | 2023 |
| Volume | 333 |
| Pages | 116142 |
| Publication date | 2023-09-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2023.116142 |
| PMID | 37598619 |
| OpenAlex | W4385579654 |
| Language | EN |
| Citations received | 3 |
| References cited | 35 |
Although health inequality is a growing concern, striking differences in health and life expectancy still exist across and within OECD countries. In Oslo, the largest city in Norway, life expectancy differs by up to 7 years between districts. Equal access to healthcare can help reduce social differences in health. However, research indicates that older people at the lower level of the social gradient have more difficulty accessing health services. Older people experience early hospital discharge and several transitions between and across care levels. In this study, using Bourdieu's theory of practice as a theoretical lens, we explore social inequality in access to universal healthcare within care trajectories for older people in Oslo. Through observation of family meetings in intermediate care (N = 14) and semi-structured interviews with older patients (N = 15), informal caregivers (N = 12) and healthcare professionals (N = 18), the study identifies 15 unique care trajectories from hospital to home via intermediate care. Informed by a critical realist perspective and moving from west to east via the urban areas, there is a prominent finding of climbing down the social gradient and, subsequently, reduced access to healthcare. An overarching theme, 'Navigating the healthcare maze', was identified along with two subthemes: 'Individuality meets system' and 'Having a feel for the game'. Navigating the healthcare maze depends on where you live, your level of education and health literacy and the ability to mobilize social networks. Furthermore, it is an advantage to fit into the professional habitus of the 'active patient' discourse. The findings will be relevant for politicians, managers, healthcare professionals and other stakeholders working in the field and in the development of services adapted to the needs of various socioeconomic groups
Economic growth · Health care · Inequality · Life expectancy · Population · Social inequality · Sociology · Demography · Global Health Care Issues · Health disparities and outcomes · Intergenerational Family Dynamics and Caregiving · Medicine · Nursing · Psychology · Gerontology
Qualitative interviewing
Caregiving as a Risk Factor for Mortality
Informal Caregiving and Its Impact on Health
The World report on ageing and health
Understanding and Responding to Health Literacy as a Social Determinant of Health
Health Disparities and Health Equity
Outline of a Theory of Practice
Inequalities in health
Health‐care professionals’ experiences of patient participation among older patients in intermediate care—At the intersection between profession, market and bureaucracy
Definitions, key themes and aspects of ‘ageing in place’
A glossary for health inequalities
Cultural capital
Applying critical realism in qualitative research
Inequities in health care utilization by people aged 50
Using thematic analysis in psychology
Exploring patient involvement in healthcare decision making across different education and functional health literacy groups
Sample Size in Qualitative Interview Studies
Case Study Observational Research
Social inequalities in health within countries
Choice, Voice, and Coproduction in Intermediate Care
Thematic Analysis
| Unique citing works | 3 |
|---|---|
| Citations per year | 1 |
| Citation span | 2023 - 2026 (4) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 3 |