Race and gender as factors in access to health insurance and utilization of health care services

2014 ◽  
Author(s):  
Susana J. Ferradas ◽  
G. Nicole Rider ◽  
Johanna D. Williams ◽  
Brittany J. Dancy ◽  
Lauren R. Mcghee
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Race And Gender ◽  
Care Services ◽  
Access To Health ◽  
And Gender

scholarly journals Health Care Access Among Essential Critical Infrastructure Workers, 31 States, 2017-2018

2021 ◽  
pp. 003335492199668
Author(s):  
Winifred L. Boal ◽  
Jia Li ◽  
Sharon R. Silver
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Personal Health ◽  
The Past ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Objectives Essential workers in the United States need access to health care services for preventive care and for diagnosis and treatment of illnesses (coronavirus disease 2019 [COVID-19] or other infectious or chronic diseases) to remain healthy and continue working during a pandemic. This study evaluated access to health care services among selected essential workers. Methods We used the most recent data from the Behavioral Risk Factor Surveillance System, 2017-2018, to estimate the prevalence of 4 measures of health care access (having health insurance, being able to afford to see a doctor when needed, having a personal health care provider, and having a routine checkup in the past year) by broad and detailed occupation group among 189 208 adults aged 18-64. Results Of all occupations studied, workers in farming, fishing, and forestry occupations were most likely to have no health insurance (46.4%). Personal care aides were most likely to have been unable to see a doctor when needed because of cost (29.3%). Construction laborers were most likely to lack a personal health care provider (51.1%) and to have not had a routine physical checkup in the past year (50.6%). Compared with workers in general, workers in 3 broad occupation groups—food preparation and serving; building and grounds cleaning and maintenance; and construction trades—had significantly lower levels of health care access for all 4 measures. Conclusion Lack of health insurance and underinsurance were common among subsets of essential workers. Limited access to health care might decrease essential workers’ access to medical testing and needed care and hinder their ability to address underlying conditions, thereby increasing their risk of severe outcomes from some infectious diseases, such as COVID-19. Improving access to health care for all workers, including essential workers, is critical to ensure workers’ health and workforce stability.

scholarly journals Gender minority stress and access to health care services among transgender women and transfeminine people: results from a cross-sectional study in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yongjie Sha ◽  
Willa Dong ◽  
Weiming Tang ◽  
Lingling Zheng ◽  
Xi Huang ◽  
...  
Keyword(s):  
Health Care ◽  
Minority Stress ◽  
Access To Health Care ◽  
Health Care Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Gender Minority ◽  
Care Services ◽  
Access To Health ◽  
And Gender

Abstract Background Transgender and gender diverse individuals often face structural barriers to health care because of their gender minority status. The aim of this study was to examine the association between gender minority stress and access to specific health care services among transgender women and transfeminine people in China. Methods This multicenter cross-sectional study recruited participants between January 1st and June 30th 2020. Eligible participants were 18 years or older, assigned male at birth, not currently identifying as male, and living in China. Gender minority stress was measured using 45 items adapted from validated subscales. We examined access to health care services and interventions relevant to transgender and gender diverse people, including gender affirming interventions (hormones, surgeries), human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Multivariable regression was used to measure correlations between gender minority stress and access to health care service. Results Three hundred and twenty-four people completed a survey and data from 277 (85.5%) people were analyzed. The mean age was 29 years old (standard deviation [SD] = 8). Participants used hormones (118/277, 42.6%), gender affirming surgery (26/277, 9.4%), HIV testing (220/277, 79.4%), STI testing (132/277, 47.7%), PrEP (24/276, 8.7%), and PEP (29/267, 10.9%). Using gender affirming hormones was associated with higher levels of discrimination (adjusted odds ratio [aOR] 1.41, 95% confidence interval [CI] 1.17–1.70) and internalized transphobia (aOR 1.06, 95%CI 1.00–1.12). STI testing was associated with lower levels of internalized transphobia (aOR 0.91, 95%CI 0.84–0.98). Conclusions Our data suggest that gender minority stress is closely related to using health services. Stigma reduction interventions and gender-affirming medical support are needed to improve transgender health.

Changing Origins of Inequalities in Access to Health Care Services in Turkey: From Occupational Status to Income

2013 ◽  
Vol 48 ◽  
pp. 55-77 ◽  
Author(s):  
Volkan Yilmaz
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Access To Health Care ◽  
Health Care Services ◽  
Occupational Status ◽  
Public Health Insurance ◽  
Care Services ◽  
Access To Health

AbstractHealth care reforms have always been critical political arenas within which the parameters of citizens' access to health care services and thus the new terms of social bargain that backs social policies are negotiated. Despite the relative success of Turkey in establishing public health insurance schemes and developing a public capacity for health care service delivery since the late 1940s, Turkey's health care system has largely failed to institute equality of access to health care services. With the promise of abolishing the inequalities, the ruling Justice and Development Party (AKP) launched Turkey's Health Transformation Program in 2003. Since then, Turkey's health care system has been undergoing a significant transformation. On the one hand, with the unification of all public health insurance schemes under a compulsory universal health insurance scheme and the equalization of benefit packages for all publicly insured, the program has succeeded in abolishing the occupational status-based inequalities in access to health care services. On the other, this article suggests that the program has changed the main origin of inequalities in service access from occupational status to income. As the country suffers from an uneven distribution of income, it is argued that these incomebased inequalities in access pose a significant threat to the realization of the social citizenship ideal in Turkey.

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 Structure and Distribution of Health Care Costs across Age Groups of Patients with Multimorbidity in Lithuania

2021 ◽  
Vol 18 (5) ◽  
pp. 2767
Author(s):  
Laura Nedzinskienė ◽  
Elena Jurevičienė ◽  
Žydrūnė Visockienė ◽  
Agnė Ulytė ◽  
Roma Puronaitė ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Chronic Disease ◽  
National Health Insurance ◽  
Health Care Services ◽  
Age Groups ◽  
Age Group ◽  
Resource Usage ◽  
Care Services ◽  
Care Costs

Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management.

Substantive Equality in South African Health Care: The Limits of Law

2000 ◽  
Vol 4 (2) ◽  
pp. 111-131 ◽  
Author(s):  
Charles Ngwena
Keyword(s):  
Health Care ◽  
South African ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Care Reforms ◽  
Structural Inequality ◽  
Care Services ◽  
Substantive Equality ◽  
African Health ◽  
Access To Health

The article considers the scope and limits of law as an instrument for facilitating equitable access to health care in South Africa. The focus is on exploring the extent to which the notion of substantive equality in access to health care services that is implicitly guaranteed by the Constitution and supported by current health care reforms, is realisable for patients seeking treatment. The article highlights the gap between the idea of substantive equality in the Constitution and the resources at the disposal of the health care sector and the country as a whole. It is submitted that though formal equality in access to health care services has been realised, substantive equality is currently unattainable, if it is attainable at all, on account of entrenched structural inequality, general poverty and a high burden of disease.

Medicaid Policy Statement

PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. 135-136
Author(s):  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Policy Statement ◽  
Medicaid Program ◽  
Term Care ◽  
Care Services ◽  
Access To Health ◽  
Children First ◽  
Poor Children

The American Academy of Pediatrics recognizes the achievements of the Medicaid program in improving access to health care services for poor children. Despite recent legislative expansions to extend eligibility to more poor and disabled children and to broaden the scope of preventive and treatment services in all states, several additional program improvements are needed to eliminate the following barriers to access: 1. Federal and state fiscal crises are creating major roadblocks to Medicaid program implementation and expansion. 2. Thousands of poor children will not be eligible for Medicaid until October 1, 2001.1 3. Only a portion of those who are potentially eligible for Medicaid apply for coverage, and many eligible children do not utilize services. 4. Fewer Medicaid funds are available for primary and preventive care because of the increasing need for long-term care services. 5. Early and periodic screening, diagnosis and treatment (EPSDT)/preventive health services are being received by too few children and the implementation of expanded service coverage under EPSDT, granted in 1989, is subject to a great deal of inconsistent state interpretation. 6. Inadequate provider reimbursement reduces children's access to health care services. The Academy has developed the "Children First" proposal which calls for the elimination of Medicaid and replaces it with a one-class, private insurance system of universal access to health care for all children through age 21 and for all pregnant women.2 However, until the "Children First" proposal, or a similar health care reform initiative is implemented, the Academy recommends the following policy actions to improve the current Medicaid program.

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