An observation of Taiwan's health care system of clinical efficiency as a possible model for increased patient access to care and affordability

2013 ◽  
Vol 68 (4) ◽  
pp. AB93
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Health Care System ◽  
Patient Access ◽  
Clinical Efficiency ◽  
Care System

scholarly journals Impacts of Health Care Industry Consolidation in Pittsburgh, Pennsylvania: A Qualitative Study

2020 ◽  
Vol 57 ◽  
pp. 004695802097624
Author(s):  
Claire E. O’Hanlon
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Access To Care ◽  
Health Care System ◽  
Health Care Industry ◽  
Health Care Facilities ◽  
Negative Consequences ◽  
Care Industry ◽  
Industry Consolidation ◽  
Care System

While most studies of health care industry consolidation focus on impacts on prices or quality, these are not its only potential impacts. This exploratory qualitative study describes industry and community stakeholder perceptions of the impacts of cumulative hospital, practice, and insurance mergers, acquisitions, and affiliations in Pittsburgh, Pennsylvania. Since the 1980s, Pittsburgh’s health care landscape has been transformed and is now dominated by competition between 2 integrated payer-provider networks, health care system UPMC (and its insurance arm UPMC Health Plan) and insurer Highmark (and its health care system Allegheny Health Network). Semi-structured interviews with 20 boundary-spanning stakeholders revealed a mix of perceived impacts of consolidation: some positive, some neutral or ambiguous, and some negative. Stakeholders perceived consolidation’s positive impacts on long-term viability of health care facilities and their ability to adopt new care models, enhanced competition in health insurance, creation of foundations, and pioneering medical research and innovation. Stakeholders also believed that consolidation changed geographic access to care, physician referral behaviors, how educated patients were about their health care, the health care advertising environment, and economies of surrounding neighborhoods. Interviewees noted that consolidation raised questions about what the responsibilities of non-profit organizations are to their communities. However, stakeholders also reported their perceptions of negative outcomes, including ways in which consolidation had potentially reduced patient access to care, accountability and transparency, systems’ willingness to collaborate, and physician autonomy. As trends toward consolidation are not slowing, there will be many opportunities to experiment with policy levers to mitigate its potentially negative consequences.

scholarly journals Intersection of Migration and Access to Health Care: Experiences and Perceptions of Female Economic Migrants in Canada

2020 ◽  
Vol 17 (10) ◽  
pp. 3682
Author(s):  
Solina Richter ◽  
Helen Vallianatos ◽  
Jacqueline Green ◽  
Chioma Obuekwe
Keyword(s):  
South Africa ◽  
Health Care ◽  
Access To Care ◽  
Health Care System ◽  
Access To Health Care ◽  
Social Connectedness ◽  
Reproductive Age ◽  
African Countries ◽  
Access To Health ◽  
Care System

More people are migrating than ever before. There are an estimated 1 billion migrants globally—of whom, 258 million are international migrants and 763 million are internal migrants. Almost half of these migrants are women, and most are of reproductive age. Female migration has increased. The socioeconomic contexts of women migrants need investigation to better understand how migration intersects with accessing health care. We employed a focused ethnography design. We recruited 29 women from three African countries: Ghana, Nigeria, and South Africa. We used purposive and convenient sampling techniques and collected data using face-to-face interviews. Interviews were audio-recorded and transcribed verbatim. Data were analyzed with the support of ATLAS.ti 8 Windows (ATLAS.ti Scientific Software Development GmbH), a computer-based qualitative software for data management. We interviewed 10 women from both South Africa and Ghana and nine women from Nigeria. Their ages ranged between 24 and 64 years. The four themes that developed included social connectedness to navigate access to care, the influence of place of origin on access to care, experiences of financial accessibility, and historical and cultural orientation to accessing health care. It was clear that theses factors affected economic migrant women’s access to health care after migration. Canada has a universal health care system but multiple research studies have documented that migrants have significant barriers to accessing health care. Most migrants indeed arrive in Canada from a health care system that is very different than their country of origin. Access to health care is one of the most important social determinants of health.

Obstacles to Developing and Using Technology: The Case of the Artificial Heart

1986 ◽  
Vol 2 (3) ◽  
pp. 411-424 ◽  
Author(s):  
James H. Maxwell ◽  
David Blumenthal ◽  
Harvey M. Sapolsky
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Health Care System ◽  
Opportunity Cost ◽  
Artificial Heart ◽  
Health Benefits ◽  
Improve Access ◽  
Care System

For some observers, the artificial heart represents the latest, and perhaps the most flagrant example of the health system's tendency to favor the rapid introduction of expensive but ineffective technologies over efforts to prevent disease and to improve access to care (5;6;19;44;45). Even if it can be perfected, they argue, its opportunity cost in terms of other foregone health benefits would be exorbitant. The ultimate failing of the health care system, it would seem, is its failure to establish mechanisms to select among alternative uses of resources. If such mechanisms had existed, some critics believe that the quest for an artificial heart never would have begun and certainly its premature clinical uses could have been prevented (6;45).

M1025 Screening for Colorectal Cancer in a Safety-Net Health Care System: Access to Care Is Critical and Has Implications for Screening Policy

2009 ◽  
Vol 136 (5) ◽  
pp. A-334
Author(s):  
Samir Gupta ◽  
Liyue Tong ◽  
James E. Allison ◽  
Elizabeth Carter ◽  
Mark Koch ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Access To Care ◽  
Health Care System ◽  
Safety Net ◽  
Screening Policy ◽  
System Access ◽  
Care System

scholarly journals Equality versus equity: Barriers to health care access for Indigenous populations in Canada

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Tremblay
Keyword(s):  
Health Care ◽  
General Population ◽  
Access To Care ◽  
Health Care System ◽  
Health Professionals ◽  
Social Inequalities ◽  
Indigenous Populations ◽  
Social Inequalities In Health ◽  
Inequalities In Health ◽  
Care System

Abstract Canada's universal and publicly funded health-care system aims to promote universal and equitable access to care based on the needs of individuals, rather than on their capacity to pay for these services. Despite these principles, some groups, such as Indigenous peoples, experience significant and persistent social inequalities in health compared to the general population. This situation results from the continuing impacts of colonialism, which has an undeniable influence on social determinants of health, including access to care. This is surprising for many health professionals because it contradicts the democratic ideals of justice and equality that underlie the health-care system, as well as the rhetoric of their professional practice which asserts that 'everyone is treated the same'. Based on literature and on research findings, this presentation will demonstrate several ways in which a universal and homogeneous approach to health-care can contribute to creating social inequalities in health for Indigenous populations. First, health professionals tend to favor socially and culturally neutral practice, which can hinder the recognition of the influence of historical and socio-cultural factors on patients' health. This kind of practice may encourage a distorted reading of patients' issues and can lead to inappropriate responses. Second, a homogenous approach to care refers by default to health-care models and practices that are rooted in values and perspectives of the dominant culture, which contributes to the provision of culturally unsafe care for Indigenous patients. Finally, this type of approach overlooks the critical and specific needs of vulnerable groups, who often require more than the general population to achieve the same results. We will conclude by outlining some potential solutions, mainly how cultural safety as a transformative approach to care allows health professionals to better consider the needs and cultural identity of Indigenous patients.

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