‘Why do GPs want to come here?’: residents’ intentions to register with new-coming GPs in a disadvantaged neighbourhood in Copenhagen with a GP shortage: a qualitative study

Abstract

Objective and intervention To explore contextual factors influencing residents’ intentions to register with one of the new-coming GPs established as a result of a municipally driven GP coverage intervention in a disadvantaged neighbourhood in Copenhagen with a GP shortage.Design A qualitative study design informed by realist methodology was used to conduct the study. Data were obtained through a survey with residents (n = 67), two focus group interviews with residents (n = 21), semi-structured interviews with the project- and local community stakeholders (n = 8) and participant observations in the neighbourhood. The analysis was carried out through systematic text condensation and interpreted and structured by Pawson’s layers of contextual influence (infrastructural and institutional). The concept of collective explanations by Macintyre et al. and Wacquant’s framework of territorial stigmatisation were applied to analyse and discuss the empirical findings.Subject and setting Residents from five local community organisations in a disadvantaged neighbourhood in Copenhagen.Main outcome measures Infrastructural and institutional contextual factors influencing residents’ intentions to register with one of the new-coming GPs.Results Infrastructural contextual factors included the national shortage of GPs, the administration fee for registering with a new GP, and the neighbourhood’s reputation as being feared and unattractive for GPs to establish themselves. Institutional contextual factors included mistrust towards municipal authorities and the new-coming GPs shared by many residents, the duration without a local GP, GPs’ reputation and a perceived lack of information about the GP coverage intervention, and an experience of not being involved.Conclusion and implication Infrastructural and institutional contextual factors influenced residents’ intentions to register with one of the new-coming GPs. The findings will be helpful in adjusting, implementing, and disseminating the intervention and developing and implementing future complex interventions in disadvantaged neighbourhoods.

Keywords

• Primary health care
• access to primary care
• general practice
• health inequities
• intervention
• qualitative research