Political, Policy and Social Barriers to Health System Interoperability: Emerging Opportunities of Web 2.0 and 3.0

ObjectiveThe aim of this study was to describe health services utilisation and responsiveness in East Azerbaijan province, Iran.DesignA cross-sectional household study as part of a larger research on primary healthcare system.SettingWe carried out the study in East Azerbaijan Province, northwest Iran from July to September 2015.ParticipantsA total of 1318 households were included.ResultsMost of the participating households had social security health insurance. Heart failure or hypertension care, general outpatient care and arthritis care were the most used services. High services cost and inadequate medicine and medical equipment were introduced to be the main barriers to health services utilisation in Tabriz and province representative sample (PRS), respectively. Health system responsiveness mean score (the maximum is 100) was 33.71±16.15 (95% CI 32.45 to 34.97) in Tabriz and 32.02±14.3 (95% CI 30.9 to 33.13) in PRS, which showed significant difference (p≤0.02).ConclusionsDifferences in the utilisation and responsiveness of health services and distribution of health resources were observed between Tabriz and PRS. Evidently, health system responsiveness in both Tabriz and PRS was at low level. The results demonstrate the need for changing resource distribution policies and employing reactive health policies to response the public health.

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Enabling Technologies and Challenges for the Future of Ubiquitous Health The Interoperability Framework

Ubiquitous Health and Medical Informatics ◽

10.4018/978-1-61520-777-0.ch028 ◽

2010 ◽

pp. 596-622 ◽

Cited By ~ 1

Author(s):

Donald W. M. Juzwishin

Keyword(s):

Health Care ◽

Web 2.0 ◽

Health Care System ◽

Care Delivery ◽

Future Research ◽

Health Care Reforms ◽

High Performing ◽

Web 3.0 ◽

System Interoperability ◽

Care System

Web 2.0 and Web 3.0 emerge at a time when health care reforms are stymied. Current barriers to an effectively functioning health care system are linked to the historical, political and social institutions and processes that are preventing health system interoperability causing issues with access (to service and information), continuity of care, safety and the assessment of program delivery. An interoperability framework, identifying citizens, providers, policy makers and researchers is developed and related to the improvement of understanding, access, trust, discourse, and practice for the purpose of moving toward a high performing health care system. Web 2.0 and Web 3.0 offer great promise as an eHealth platform to synergistically catalyze significant improvements to health care delivery, however, caution is advised about uncritical adoption. Barriers to progress and opportunities for advancement are identified and questions for future research are posited.

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The relationship between having a regular general practitioner (GP) and the experience of healthcare barriers: a cross-sectional study among young people in NSW, Australia, with oversampling from marginalised groups

BMC Family Practice ◽

10.1186/s12875-020-01294-8 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Melissa Kang ◽

Fiona Robards ◽

Georgina Luscombe ◽

Lena Sanci ◽

Tim Usherwood

Keyword(s):

Health Care ◽

General Practice ◽

Young People ◽

Health System ◽

Free Text ◽

Cross Sectional ◽

Healthcare Barriers ◽

Positive Attitudes ◽

Marginalised Groups ◽

Barriers To Health

Abstract Background Young people (12–24 years) visit general practice but may not have a ‘regular’ general practitioner (GP). Whether continuity of GP care influences experiences with, and barriers to, health care among young people is unknown. This paper explores the association between having a regular GP and experience of healthcare barriers and attitudes to health system navigation among young people in New South Wales (NSW), Australia. Methods This study was a cross-sectional survey administered either online or face-to-face in community settings. Young people living in NSW were recruited, with oversampling of those from five socio-culturally marginalised groups (those who were Aboriginal and Torres Strait Islander, homeless, of refugee background, in rural or remote locations, sexuality and/or gender diverse). In this analysis of a larger dataset, we examined associations between having a regular GP, demographic and health status variables, barriers to health care and attitudes to health system navigation, using chi-square tests and odds ratios. Content and thematic analyses were applied to free-text responses to explore young people’s views about having a regular GP. Results One thousand four hundred and sixteen young people completed the survey between 2016 and 2017. Of these, 81.1% had seen a GP in the previous 6 months and 57.8% had a regular GP. Cost was the most frequently cited barrier (45.8%) to accessing health care generally. Those with a regular GP were less likely to cite cost and other structural barriers, feeling judged, and not knowing which service to go to. Having a regular GP was associated with having more positive attitudes to health system navigation. Free-text responses provided qualitative insights, including the importance of building a relationship with one GP. Conclusions General practice is the appropriate setting for preventive health care and care coordination. Having a regular GP is associated with fewer barriers and more positive attitudes to health system navigation and may provide better engagement with and coordination of care. Strategies are needed to increase the proportion of young people who have a regular GP.

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It’s like a black woman’s Charlie Brown moment: An autoethnography of being diagnosed with lupus

Journal of Health Psychology ◽

10.1177/1359105316664128 ◽

2016 ◽

Vol 23 (12) ◽

pp. 1566-1578 ◽

Cited By ~ 1

Author(s):

Renata Ferdinand

Keyword(s):

Health Care ◽

Women’S Health ◽

Women's Health ◽

Healthcare System ◽

Critical Race ◽

Barriers To Health Care ◽

Social Barriers ◽

The Social ◽

Personal Experiences ◽

Barriers To Health

This essay uses autoethnography to relate the experience of being diagnosed with lupus. By using my personal experiences and a discussion of illness and Black women’s health, I critically examine larger critical race issues of race, gender, and the social barriers to health care. Specifically, the essay focuses on the ways in which race impacts my experiences with the healthcare system, from my own insecurities of being stereotyped to the ways that doctors interact with me. The essay is framed by popular quotes from Charlie Brown because they help mediate the very personal experiences I am recounting.

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