Temporary shelters to support accessibility to tertiary health care services for rural dispersed populations: patients and companions experiences

Albergues temporales como apoyo a la accesibilidad al tercer nivel de atención para poblaciones rurales dispersas: experiencias de pacientes y acompañantes

Introduction: health services in disperse rural areas have focused on primary care. In order to achieve comprehensive services, access to tertiary health care services needs to be provided. This represents a challenge for health systems in terms of costs and availability of healthcare professionals. In several countries, specialists and equipment are moved to rural areas; while in Colombia it is the patient who travels to the specialized centers. Health insurers administer money from the state to cover the expenses. This requires temporary shelters providing accommodation and food to low-income patients and their families. Methods:  a phenomenological qualitative case study approach to learn about users´ experiences in two lodges serving patients and their companions who come from an area 700 km away from Bogota. Results: shelters´ services are well qualified by users, although facilities need to be improved in some aspects. Services are centered on accommodation, transportation and food leaving a gap in other needs such as free time and leisure activities and emotional and social support. Delay in health care provision is the main cause of dissatisfaction for it affects family everyday life due to displacement and lack of communication.  Conclusions: specialized assistance by transferring patients from dispersed areas to urban centers represents an innovative experience which should be evaluated from the economic and emotional perspective to enable a cost-benefit and sustainability analysis.

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