Access to health care for hispanic women: A primary health care perspective

1995 ◽  
Vol 43 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Teresa C. Juarbe
Author(s):  
Joseph Asumah Braimah ◽  
Yujiro Sano ◽  
Kilian Nasung Atuoye ◽  
Isaac Luginaah

AbstractBackground:Ghana in 1999 adopted the Community-based Health Planning and Service (CHPS) policy to enhance access to primary health care (PHC) service. After two decades of implementation, there remains a considerable proportion of the country’s population, especially women who lack access to basic health care services.Aim:The aim of this paper is to understand the contribution of Ghana’s CHPS policy to women’s access to PHC services in the Upper West Region (UWR) of Ghana.Methods:A logistic regression technique was employed to analyse cross-sectional data collected among women (805) from the UWR.Findings:We found that women who resided in CHPS zones (OR = 1.612;P ≤0.01) were more likely to have access to health care compared with their counterparts who resided in non-CHPS zones. Also, rural-urban residence, distance to health facility, household wealth status and marital status predicted access to health care among women in the region. Our findings underscore the need to expand the CHPS policy to cover many areas in the country, especially rural communities and other deprived localities in urban settings.


2013 ◽  
Vol 119 (6) ◽  
pp. 1432-1436 ◽  
Author(s):  
Arman Jahangiri ◽  
Aaron J. Clark ◽  
Seunggu J. Han ◽  
Sandeep Kunwar ◽  
Lewis S. Blevins ◽  
...  

Object Pituitary apoplexy is associated with worse outcomes than are pituitary adenomas detected without acute clinical deterioration. The association between pituitary apoplexy and socioeconomic factors that may limit access to health care has not been examined in prior studies. Methods This study involved retrospectively evaluating data obtained in all patients who underwent surgery for nonfunctioning pituitary adenoma causing visual symptoms between January 2003 and July 2012 at the University of California, San Francisco. Patients were grouped into those who presented with apoplexy and those who did not (“no apoplexy”). The 2 groups were compared with respect to annual household income, employment status, health insurance status, and whether or not the patient had a primary health care provider. Associations between categorical variables were analyzed by chi-square test and continuous variables by Student t-test. Multivariate logistic regression was also performed. Results One hundred thirty-five patients were identified, 18 of whom presented with apoplexy. There were significantly more unmarried patients and emergency room presentations in the apoplexy group than in the “no apoplexy” group. There was a nonsignificant trend toward lower mean household income in the apoplexy group. Lack of health insurance and lack of a primary health care provider were both highly significantly associated with apoplexy. In a multivariate analysis including marital status, emergency room presentation, income, insurance status, and primary health care provider status as variables, lack of insurance remained associated with apoplexy (OR 11.6; 95% CI 1.9–70.3; p = 0.008). Conclusions The data suggest that patients with limited access to health care may be more likely to present with pituitary apoplexy than those with adequate access.


2017 ◽  
Vol 19 (1) ◽  
pp. 32-36
Author(s):  
Mikhail G Karaylanov ◽  
Iliya T Rusev ◽  
Dmitriy N Borisov ◽  
Oleg Yu Bakanev ◽  
Igor G Prokin

Explore the historical domestic experience of primary health care to the population of major cities, the establishment of this type of medical care as the main and the largest national healthcare system partition stages of the reform of primary health care to date, with a gradual transition to a system of health insurance in order to further increase the availability of and quality of care. Due to the recent modernization of the health system outpatient offices were equipped with modern innovative medical devices for the delivery of primary health care at a high level. In addition, historically proved the effectiveness of medical care at the district territorial principle, which defines and improves access to health care, with subsequent referral to narrow specialists (bibliography: 20 refs).


2020 ◽  
Vol 10 (32) ◽  
pp. 53-61
Author(s):  
Angélica Cristina Silveira Marques ◽  
Adriani Izabel de Souza Moraes ◽  
Sílvia Carla da Silva André Uehara

O processo de adoecimento dos homens vem sendo determinado pelo seu comportamento na sociedade e como expressam suas crenças de masculinidade. O objetivo deste trabalho foi identificar as ações realizadas pelos enfermeiros da Atenção Primária à Saúde (APS) direcionadas à promoção da saúde do homem. Trata-se de uma pesquisa descritiva, exploratória e de abordagem quantitativa. A pesquisa foi realizada com 29 enfermeiros de serviços da APS do município de São Carlos-SP. Os dados foram coletados por meio de uma entrevista, utilizando um instrumento validado. Os dados foram analisados por meio da estatística descritiva. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Os resultados mostram que 65,5% (19) dos enfermeiros referiram não ter recebido capacitação sobre a saúde do homem. Quanto aos fatores facilitadores do acesso dos homens nos serviços de saúde, destacam-se que 19% (11) das respostas incluíram o vínculo estabelecido entre os profissionais e usuários; e, como agentes dificultadores, em 35,1% (19) das respostas foi ressaltada a cultura do homem. Para uma maior efetividade da assistência à saúde do homem, torna-se necessário a sensibilização de profissionais e gestores de saúde na busca de estratégias para facilitar o acesso da população masculina aos serviços de saúde.Descritores: Saúde do Homem, Atenção Primária à Saúde, Enfermagem. Fragilities and strengths of man's health care in primary health careAbstract: The illness process of men has been determined by their behavior in society and how they express their beliefs about masculinity. The objective of this study was to identify the actions performed by nurses of Primary Health Care (PHC) directed to the promotion of men's health. It is descriptive, exploratory, and quantitative approach research. The research was conducted with 29 nurses from the PHC services of the city of São Carlos-SP. Data were collected through an interview using an instrument validated. Data were analyzed using descriptive statistics. Still, data collection began after approval by the Research Ethics Committee. The results show that 65.5% (19) of the nurses reported not having received training on men's health. Regarding factors that facilitate men's access to health services, it is noteworthy that 19% (11) of the answers included the bond established between professionals and users; and, as hindering agents, 35.1% (19) of the answers highlighted men's culture. Thus, for greater effectiveness of men's health care, health professionals and managers need to be sensitized in the search for strategies to facilitate the male population's access to health services.Descriptors: Men's Health, Primary Health Care, Nursing. Fragilidades y fortalezas de la atención médica del hombre en la atención primaria de saludResumen: El proceso de enfermedad de los hombres ha sido determinado por su comportamiento en la sociedad y cómo expresan sus creencias sobre la masculinidad. El objetivo de este estudio fue identificar las acciones realizadas por las enfermeras de Atención Primaria de Salud (APS) dirigidas a la promoción de la salud de los hombres. Es una investigación de enfoque descriptivo, exploratorio y cuantitativo. La investigación se realizó con 29 enfermeras de los servicios de APS de la ciudad de São Carlos-SP. Los datos fueron recolectados a través de una entrevista utilizando un instrumento validado. Los datos se analizaron mediante estadística descriptiva. Aún así, la recopilación de datos comenzó después de la aprobación del Comité de Ética en Investigación. Los resultados muestran que el 65.5% (19) de las enfermeras informaron no haber recibido capacitación sobre la salud de los hombres. En cuanto a los factores que facilitan el acceso de los hombres a los servicios de salud, cabe destacar que el 19% (11) de las respuestas incluyeron el vínculo establecido entre profesionales y usuarios; y, como agentes obstaculizadores, el 35,1% (19) de las respuestas destacaron la cultura de los hombres. Por lo tanto, para una mayor efectividad de la atención médica de los hombres, los profesionales de la salud y los gerentes deben ser sensibilizados en la búsqueda de estrategias para facilitar El acceso de la población masculina a los servicios de salud.Descriptores: Salud del Hombre, Atención Primaria de Salud, Nursing.


Author(s):  
Andreas Älgå ◽  
Thi Dang ◽  
Dell Saulnier ◽  
Gia Nguyen ◽  
Johan von Schreeb

Background: Floods affect over 85 million people every year and are one of the deadliest types of natural disasters. The health effects of floods are partly due to a loss of access to health care. This loss can be limited with proper flood preparedness. Flood preparedness is especially needed at the primary health care (PHC) level. Flood preparedness assessments can be used to identify vulnerable facilities and help target efforts. The existing research on PHC flood preparedness is limited. We aimed to assess the flood preparedness of PHC facilities in a flood-prone province in central Vietnam. Methods: Based on flood experience, the PHC facilities in the province were grouped as “severe” (n = 23) or “non-severe” (n = 129). Assessments were conducted during monsoon season at five facilities from each group, using a pre-tested, semi-structured questionnaire. Data were checked against official records when possible. Results: Nine of the ten facilities had a flood plan and four received regular flood preparedness training. Six facilities reported insufficient preparedness support. Half of the facilities had additional funding available for flood preparedness, or in case of a flood. Flood preparedness training had been received by 21/28 (75%) of the staff at the facilities with severe flood experience, versus 15/25 (52%) of the staff at the non-severe experience facilities. Conclusions: Our results suggest that the assessed PHC facilities were not sufficiently prepared for the expected floods during monsoon season. PHC flood preparedness assessments could be used to identify vulnerable facilities and populations in flood-prone areas. More research is needed to further develop and test the validity and reliability of the questionnaire.


2004 ◽  
Vol 10 (3) ◽  
pp. 144
Author(s):  
Hal Swerissen ◽  
Lucinda Jordan

The Commonwealth Government, currently, does not have a primary health care policy. Instead, policy is heavily focused on general practitioners (GPs) and, in particular, on payment arrangements. Since 2000 bulk-billing rates have declined significantly in Australia, raising concerns about affordability and access to health care. This paper examines the relationship between affordability, health need, the supply of GPs, and capacity to pay. Bulk-billing and per capita consultation rates are likely to be higher and co-payments lower in areas where GP supply is higher, health needs are high and capacity to pay is low. Implications for the Commonwealth Government?s new MedicarePlus package are also discussed in light of the findings.


2013 ◽  
Vol 19 (4) ◽  
pp. 283 ◽  
Author(s):  
Melissa Raven ◽  
Caryn Butler ◽  
Petra Bywood

Many Australians have limited access to health-care services due to a range of barriers, including geographic distance and restricted mobility, which telehealth can potentially address. This paper reviews the current and potential use of video consultation in primary health care in Australia, drawing on international literature. There is substantial evidence of high patient satisfaction, but many studies have methodological limitations. Overall, evidence of effectiveness and cost-effectiveness is weak. There is reasonable evidence for diagnosis, home care and specialist consultations by GPs with patients present. Two telehealth initiatives using video consultation are briefly presented. Both provide evidence that video consultation has a valuable role to play, but does not obviate the need for face-to-face consultations. Video consultation challenges traditional professional roles, particularly those of nurses, and can improve health workers’ skills and job satisfaction. More fundamentally, telehealth challenges the traditional distinction between primary and secondary care. This can be a source of resistance but may ultimately be one of its strengths. Appropriately targeted video consultation has much potential to improve the delivery of primary health care in Australia, particularly in rural and remote regions.


2019 ◽  
Vol 13 (2) ◽  
pp. 1-14
Author(s):  
Katarzyna Wiktorzak

Background The National Health Fund (NHF) is the public payer solely accountable for securing and organizing access to health care services in Poland. The NHF is responsible for implementing a project entitled “Primary Health Care PLUS” which aims to introduce a primary care centered model, based on coordinated, proactive and preventive methods relevant to patients’ needs and furthermore, works to keep patients well-informed and active participants in health care decision-making. The implementation period of the project is July 1, 2018 through Dec. 31, 2021. Aim of the study The purpose of this study is to outline patient demographics and staff structures of providers that took part in the PHC PLUS pilot program, as well as the status of the program throughout the first year of its implementation. Materials and Methods Following an open and transparent recruitment process, 42 urban and rural primary health care providers were selected. The purpose of the providers’ geographic spread was to ensure the model was tested in all representative regions of the country. Results 42 PHC PLUS providers attending to 288,392 patients are participating in the project. Approximately 1,100 medical staff members are involved in the project. PHC PLUS medical teams consist of specialists including physicians, coordinators, nurses, dietitians, psychologists, physiotherapists and health educators. Out of 41,022 health risk assessments declared to be conducted during the project, 18,058 (43.1%) were performed from July 1, 2018 to April 30, 2019, including 4,537 basic and 13,521 extended assessments. Furthermore, 15,020 patients in total, participated in the disease management programs, which are also paid from the project. Conclusions A Polish health care pilot project that centers primary care can help shift the focus toward preventive interventions, rather than the current system, which often focuses on providing medical care to patients who have already been diagnosed with diseases, often in their more advanced stages.


2004 ◽  
Vol 10 (3) ◽  
pp. 83 ◽  
Author(s):  
Peter Harvey

Many health professionals and rural health academics are motivated by the challenge of achieving equitable access to health care in rural communities with the implicit vision that fairer access to services might ultimately lead to more equitable health outcomes for people living in rural and remote settings. The purpose of this paper is to put the issue of rural and urban health outcome parity into perspective and assess recent progress towards achieving the ultimate goal of improving rural health status. I will also explore ways in which rural communities might increase their access to and use of primary health care revenue in the future to improve community health outcomes. While some improvements have been achieved across the rural health system in recent times, the fundamental problem of maintaining infrastructure to service community needs in rural areas remains as daunting as ever. Extensive evidence has now been assembled to show that rural people generally enjoy a much lower standard of health care, health outcomes and life expectancy than their urban cousins. The question underlying all of this evidence, however, is... must this always be so? Is it possible to redress the current inequities between rural and urban populations and could new primary health care initiatives, such as the Enhanced Primary Care (EPC) program, be vehicles for achieving more equitable health care arrangements and health outcomes for people living in rural communities?


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