Exploring user experiences in a novel primary care center: a qualitative grounded theory study

Background: Primary care serves as the initial point of healthcare contact; however, the shortage of general practitioners can threaten equitable access to primary care, necessitating innovative models. In a district in the north of Italy, an alternative primary care model, as a primary care center (PCC), has been established to care for citizens unattached to a general practitioner. We aimed to explore the users' experience with the novel alternative primary care model. Methods: We conducted a qualitative study using a grounded theory approach. We interviewed a total of 33 participants, including 25 patients and eight informal caregivers. Results: Findings suggest a core concept of the "Patient experience process at the PCC as a dynamic and interconnected journey" that unfolds in three interconnected themes, starting from "Living the care pathway at the PCC ", progressing to "Evaluating the care pathway at the PCC", and concluding with "Drawing conclusion on the PCC". Patients transitioned through these phases as they interact with healthcare professionals, reflect on the quality of care, and make informed decisions regarding their preferences. Findings indicate that the transition from a general practitioner to the PCC is often marked by uncertainty and frustration, primarily due to the lack of structured handovers and clear service explanations. However, effective communication, proactive follow-up, and home visits by healthcare professionals significantly enhance patient satisfaction and trust in the PCC model. Nurses emerge as central figures in ensuring continuity of care and holistic support, while multidisciplinary collaboration fosters comprehensive and personalized care. Patients critically assess their care experiences, weighing the benefits of PCC services against their previous GP experiences. While many patients appreciate the structured and multidisciplinary nature of PCC care, some still prefer a dedicated GP for continuity and familiarity. Digital health solutions, including telehealth and remote monitoring, are recognized as useful additions but require careful integration to avoid reducing human interaction and address potential barriers for older people needing support from informal caregivers. Conclusion: Our study underscores the importance of effective communication, proactive follow-up, multidisciplinary care, and continuity of care to ensure a positive user experience satisfaction when delivering primary care to patients unattached to a GP through a new alternative primary care model.