scholarly journals Exploring the implementation and delivery of primary care services for transgender individuals in Ontario: case study protocol

2020 ◽  
Vol 21 ◽  
Author(s):  
Erin Ziegler ◽  
Ruta Valaitis ◽  
Nancy Carter ◽  
Cathy Risdon ◽  
Jennifer Yost
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Access To Health Care ◽  
Care Providers ◽  
Case Study Methodology ◽  
Care Services ◽  
Services Delivery ◽  
Primary Care Services ◽  
Care Models

Abstract Background: Historically transgender adults have experienced barriers in accessing primary care services. In Ontario, Canada, health care for transgender adults is accessed through primary care; however, a limited number of practitioners provide care, and patients are often waiting and/or traveling great distances to receive care. The purpose of this protocol is to understand how primary care is implemented and delivered for transgender adults. The paper presents how the case study method can be applied to explore implementation of health services delivery for the transgender population in primary care. Methods: Case study methodology will be used to explore this phenomenon in different primary care contexts. Normalization Process Theory is used as a guide. Three cases known to provide transgender primary care and represent different Ontario primary care models have been identified. Comparing transgender care implementation and delivery across different models is vital to understanding how care provision to this population can be supported. Qualitative interviews will be conducted. Participants will also complete the NoMAD (NOrmalization MeAsure Development) survey, a tool measuring implementation processes. The tool will be modified to explore the implementation of primary care services for transgender individuals. Documentary evidence will be collected. Cross-case synthesis will be completed to compare the cases. Discussion: Findings will provide an Ontario perspective on the implementation and delivery of primary care for transgender adults in different primary care models. Results may be applicable to other primary care settings in Canada and other nations with similar systems. Barriers and facilitators in delivery and implementation will be identified. Providing an understanding and increasing awareness of the implementation and delivery of primary care may help to reduce the invisibility and disparities transgender individuals experience when accessing primary care services. Understanding delivery of care could allow care providers to implement primary care services for transgender individuals, improving access to health care for this vulnerable population.

Economic Crisis and Access to Care: Cuba's Health Care System since the Collapse of the Soviet Union

2005 ◽  
Vol 35 (4) ◽  
pp. 797-816 ◽  
Author(s):  
Kamran Nayeri ◽  
Cándido M. López-Pardo
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Soviet Union ◽  
Economic Crisis ◽  
Access To Health Care ◽  
Care Services ◽  
The Soviet Union ◽  
Primary Care Services ◽  
Access To Health ◽  
Market Relations

This article explores the effects on access to health care in Cuba of the severe economic crisis that followed the collapse of the Soviet Union and the monetary and market reforms adopted to confront it. Economic crises undermine health and well-being. Widespread scarcities and self-seeking attitudes fostered by monetary and market relations could result in differential access to health services and resources, but the authors found no evidence of such differential access in Cuba. While Cubans generally complain about many shortages, including shortages of health services and resources before the economic recovery began in 1995, no interviewees reported systemic shortages or unequal access to health care services or resources; interviewees were particularly happy with their primary care services. These findings are consistent with official health care statistics, which show that, while secondary and tertiary care suffered in the early years of the crisis because of interruptions in access to medical technologies, primary care services expanded unabated, resulting in improved health outcomes. The combined effects of the well-functioning universal and equitable health care system in place before the crisis, the government's steadfast support for the system, and the network of social solidarity based on grassroots organizations mitigated the corrosive effects of monetary and market relations in the context of severe scarcities and an intensified U.S. embargo against the Cuban people.

Access to health care and Informal Patient Payments for health care in Serbia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Buch Mejsner ◽  
S Lavasani Kjær ◽  
L Eklund Karlsson
Keyword(s):  
Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Health Care Services ◽  
Local Population ◽  
Civil Servants ◽  
Care Providers ◽  
Care Services ◽  
Access To Health

Abstract Background Evidence often shows that migrants in the European region have poor access to quality health care. Having a large number of migrants seeking towards Europe, crossing through i.e. Serbia, it is crucial to improve migrants' access to health care and ensure equality in service provision Aim To investigate what are the barriers and facilitators of access to health care in Serbia, perceived by migrants, policy makers, health care providers, civil servants and experts working with migrants. Methods six migrants in an asylum center and eight civil servants in the field of migration were conducted. A complementary questionnaire to key civil servants working with migrants (N = 19) is being distributed to complement the data. The qualitative and quantitative data will be analysed through Grounded Theory and Logistic Regression respectively. Results According to preliminary findings, migrants reported that they were able to access the health care services quite easily. Migrants were mostly fully aware of their rights to access these health care services. However, the interviewed civil servants experienced that, despite the majority of migrants in camps were treated fairly, some migrants were treated inappropriately by health care professionals (being addressed inappropriately, poor or lacking treatment). The civil servants believed that local Serbs, from their own experiences, were treated poorer than migrants (I.e. paying Informal Patient Payments, poor quality of and access to health care services). The interviewed migrants were trusting towards the health system, because they felt protected by the official system that guaranteed them services. The final results will be presented at the conference. Conclusions There was a difference in quality of and access to health care services of local Serbs and migrants in the region. Migrants may be protected by the official health care system and thus have access to and do not pay additional fees for health care services. Key messages Despite comprehensive evidence on Informal Patient Payments (IPP) in Serbia, further research is needed to highlight how health system governance and prevailing policies affect IPP in migrants. There may be clear differences in quality of and access to health care services between the local population and migrants in Serbia.

scholarly journals Health-Care Waste: Knowledge of Primary Care nurses

2018 ◽  
Vol 71 (5) ◽  
pp. 2367-2375 ◽  
Author(s):  
Ana Paula Mhirdaui Sanches ◽  
Karen Sayuri Mekaro ◽  
Rosely Moralez de Figueiredo ◽  
Silvia Carla da Silva André
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Family Health ◽  
Chemical Waste ◽  
Know How ◽  
Paulo State ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Care Nurses ◽  
Health Care Waste

ABSTRACT Objective: to describe the knowledge of nurses on Health-Care Waste Management (HCW) in Family Health Units (FHU) of São Carlos city, São Paulo State. Method: exploratory, descriptive and quantitative approach. The research was carried out with nurses of 16 FHU of the municipality of São Carlos-SP. Data were collected through an interview using a tool validated and analyzed using descriptive statistics. Results: it is noteworthy that 68.7% (11) of the nurses did not know how to describe how chemical waste was sorted. In addition, regarding the treatment of HCW, 50.0% (8) of the nurses did not know if the general waste were subjected to some type of treatment. Conclusion: the HCW management can be considered a challenge in the nurses' agenda inserted in the Primary Care services, which refers to the need to implement periodic training on the management of this waste.

Information as Change Agent or Barrier in Health Care Reform?

2013 ◽  
pp. 1-17
Author(s):  
Alan C. Gillies ◽  
John Howard
Keyword(s):  
Health Care ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Process Models ◽  
Value Systems ◽  
Care Services ◽  
Primary Care Services ◽  
Complex Adaptive ◽  
Care Systems

Health care systems across the world are in a state of flux. If the experience of the early 1990s can be used as a model, the recent global economic downturn will lead to very significant pressures to reduce spending and achieve better value. Systems have provided a range of approaches to modeling and evaluating these more complex organizations, from simple process models to complex adaptive systems. This paper considers the pros and cons of such approaches and proposes a new modeling approach that combines the best elements of other techniques. This paper also describes a case study, where the approach has been deployed by the authors. The case study comes from health care services in Ontario, Canada, who are shifting from the traditionally hospital-based system to one that recognizes a greater role for community and primary care services.

scholarly journals Assessing the quality of maternal health care in Indigenous primary care services

2010 ◽  
Vol 192 (10) ◽  
pp. 597-598 ◽  
Author(s):  
Alice R Rumbold ◽  
Ross S Bailie ◽  
Damin Si ◽  
Michelle C Dowden ◽  
Catherine M Kennedy ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Maternal Health ◽  
Maternal Health Care ◽  
Care Services ◽  
Primary Care Services

It’s Complicated: Improving Undergraduate Nursing Students’ Understanding Family and Care of LGBTQ Older Adults

2019 ◽  
Vol 25 (4) ◽  
pp. 506-532 ◽  
Author(s):  
Nadine Henriquez ◽  
Kathryn Hyndman ◽  
Kathryn Chachula
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Nursing Students ◽  
Health Care Providers ◽  
Social Issues ◽  
Care Providers ◽  
Undergraduate Nursing Students ◽  
Case Study Methodology ◽  
Undergraduate Nursing

Research has identified the need for improved cultural competence of health care providers regarding the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community’s needs. This article articulates the teaching approach and methodology of an unfolding LGBTQ family case study for undergraduate nursing students. This method provided a forum for exploration of personal biases and gender-affirming techniques, and addressed the challenges of aging for a transgender woman and family within the context of societal stigma and discrimination. Students gained knowledge concerning shifts in family structures and understanding of the nurses’ role encouraging inclusiveness and equitable access in health care settings, advocating for vulnerable populations, and addressing specific health concerns for transgender older adults. Student responses demonstrated increased knowledge of family diversity, and critical thought regarding the intersectionality of discrimination and aging. The findings revealed the case study methodology facilitated student understanding of the unique health and social issues for LGBTQ older adults within a family context.

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