Developing a Consistent Approach to Determining Priority for HACC Services

2003 ◽  
Vol 9 (1) ◽  
pp. 78 ◽  
Author(s):  
Kirsten J. Black ◽  
Patricia L. Buckley
Keyword(s):  
Local Government ◽  
Local Governments ◽  
Community Services ◽  
Metropolitan Region ◽  
Access To Health Services ◽  
Service Allocation ◽  
Care Services ◽  
Home And Community Care ◽  
Access To Health ◽  
Allocation Decisions

This paper reports on the development of a Priority of Access tool for Home and Community Care services provided by local governments in the Western Metropolitan Region of Victoria. Managing the demand for these services requires an equitable approach to service allocation decisions. The Priority of Access tool was developed with input from Western Metropolitan Region local government HACC representatives and the Department of Human Services. A literature review identified indicators of need that predicted use of community services; however, no substantial contributions were identified relating to prioritising access to health services in the home. The tool developed relies on cross-referencing responses from the Service Coordination tools developed through the Victorian Primary Care Partnership initiative. A pilot was conducted with assessment staff and their feedback led to modification of the tool. Staff found the tool a useful method of increasing objectivity in assessments and providing a framework to consistently determine priority. The importance of training in the use of the tool was reinforced during piloting of the tool. The Priority of Access tool provides a simple and consistent, yet comprehensive, approach for Western Metropolitan Region local government HACC services to equitably determine priority of access for clients.

scholarly journals KAJIAN KEBERLANGSUNGAN RUMAH TUNGGU KELAHIRAN (RTK) DALAM UPAYA MENURUNKAN ANGKA KEMATIAN MATERNAL DI INDONESIA

2018 ◽  
Vol 21 (2) ◽  
pp. 114-124 ◽  
Author(s):  
Noor Edi Widya Sukoco
Keyword(s):  
Local Government ◽  
Pregnant Women ◽  
Health Workers ◽  
Secondary Data ◽  
Access To Health Services ◽  
Policy Makers ◽  
Care Services ◽  
Access To Health ◽  
Asean Countries ◽  
Emergency Detection

Maternal Mortality Rate in Indonesia is still the highest compared to other ASEAN countries and faces a gap in access to health services. It needs a waiting house that is close to health service facility and can be temporarily occupied by pregnant mother before delivery which is Maternal Waiting Homes (MWH). This analysis to know aspects that can maintain the continuity of RTK services. This study uses secondary data by listing the policy and regulatory documents related to RTK policy and by organizing several workshops to gain a view of policy makers. The results show that the MWH fi nancing system is still local and not well coordinated. The number of health workers who provide services in MWH is still limited. Likewise, MWH facilities and facilities are still inadequate, in particular, water and electricity problems, as well as a place for families accompanying maternity mothers. Most MWH s only provide facilities for living without maternal and neonatal care services. Several efforts have been made by the local government in encouraging the utilization of MWH in pregnant women among others by involving customary institutions and the use of communication technology for early emergency detection of pregnant women. MWH sustainability can be built with the full support of local government, socialization and synergies with related sectors. Abstrak Angka Kematian Ibu di Indonesia tertinggi dibandingkan negara-negara ASEAN lain dan menghadapikesenjangan akses pelayanan kesehatan. Rumah tempat menunggu yang dekat dengan fasilitas pelayanankesehatan dan dapat dihuni sementara oleh ibu hamil sebelum persalinan yaitu Rumah Tunggu Kelahiran(RTK) merupakan salah satu alternatif solusi. Analisis dilakukan untuk mengetahui aspek yang dapat menjagakeberlangsungan layanan RTK. Kajian ini menggunakan data sekunder dengan cara menginventarisir dokumenkebijakan dan peraturan perundangan yang terkait dengan kebijakan RTK serta dengan mengadakan beberapaworkhop untuk memperoleh sudut pandang para penentu kebijakan. Hasil menunjukkan sistem pembiayaanRTK masih bersifat lokal dan belum terkoordinasi dengan baik. Jumlah tenaga kesehatan yang memberikanpelayanan di RTK masih terbatas. Demikian juga fasilitas dan sarana RTK masih belum memadai, terutama,masalah air dan listrik, serta tempat untuk keluarga yang mendampingi ibu bersalin. Sebagian besar RTKhanya menyediakan fasilitas untuk tinggal tanpa pelayanan perawatan kesehatan ibu dan bayi. Beberapaupaya telah dilakukan pemerintah lokal dalam mendorong pemanfaatan RTK pada ibu hamil di antaranyadengan melibatkan lembaga adat dan penggunaan teknologi komunikasi untuk deteksi darurat dini bumil risti.Keberlangsungan RTK dapat dibangun dengan dukungan penuh pemerintah daerah, sosialisasi dan bersinergidengan lintas sektor terkait.

scholarly journals Equitable access to health services for children aged 5 to 9 in a medium city of northeasth of Brazil: a result of Family Health Strategy

2014 ◽  
Vol 17 (suppl 2) ◽  
pp. 39-52 ◽  
Author(s):  
Adriana Xavier de Santiago ◽  
Ivana Cristina de Holanda Cunha Barreto ◽  
Ana Cecília Silveira Lins Sucupira ◽  
José Wellington de Oliveira Lima ◽  
Luiz Odorico Monteiro de Andrade
Keyword(s):  
Health Services ◽  
Health System ◽  
Family Health ◽  
Northeastern Brazil ◽  
Local Health ◽  
Access To Health Services ◽  
Care Services ◽  
Health Strategy ◽  
Access To Health ◽  
Family Health Strategy

INTRODUCTION: The Brazilian National Health System may reduce inequalities in access to health services through strategies that can reach those most in need with no access to care services. OBJECTIVE: To identify factors associated with the use of health service by children aged 5 to 9 years in the city of Sobral, Ceará, northeastern Brazil. RESULTS: Only 558 (17.0%) children used health care services in the 30 days preceding this survey. Children with any health condition (OR = 3.90) who were frequent attenders of primary care strategy of organization (the Family Health Strategy, FHS) (OR = 1.81) and living in the city's urban area (OR = 1.51) were more likely to use health services. Almost 80% of children used FHS as their referral care service. Children from poorer families and with easier access to services were more likely to be FHS users. CONCLUSION: The study showed that access to health services has been relatively equitable through the FHS, a point of entry to the local health system.

scholarly journals Local Government Expenditures on Care Services vs. Demographic Changes in Poland

2020 ◽  
Vol 1 (346) ◽  
pp. 27-42
Author(s):  
Agnieszka Monika Bobrowska
Keyword(s):  
Local Government ◽  
Local Governments ◽  
Financial Burden ◽  
The Elderly ◽  
Specialist Care ◽  
High Increase ◽  
Demographic Situation ◽  
Care Services ◽  
Local Government Expenditures ◽  
The Republic

Local governments as the smallest units of territorial self‑government in Poland are responsible for providing care services. The growing number of the elderly can influence the expenditures level connected with ensuring proper care for them, and it may constitute a growing problem for local government, especially for districts with a lower level of socio‑economic development. In recent years, a quite high increase in benefits amount due to care services and specialist care services has been observed. Therefore, a question arises whether a significant dependence can be observed between the share of the elderly in the population and the degree of local governments’ financial burden due to providing care services. The aim of this paper is to indicate voivodeships where local governments bear the biggest burden of providing care services and to verify whether it is connected with their demographic situation. The data which were subject to the static analysis conducted came from public sources: the report of the Ministry of Family, Labour and Social Policy of the Republic of Poland and elaborations of the Central Statistic Office. The situation of particular voivodeships has been defined in the scope of society ageing and burdening local government with care services. Only in the case of half of voivodeships it has been proven that the level (low, medium or high) of burden of the said services corresponds to the same level of the number of the elderly in their population, which can confirm that the amount of care services is connected with a demographic situation of a given voivodeship.

scholarly journals Socioeconomic inequalities in the access to and quality of health care services

2014 ◽  
Vol 48 (6) ◽  
pp. 968-976 ◽  
Author(s):  
Bruno Pereira Nunes ◽  
Elaine Thumé ◽  
Elaine Tomasi ◽  
Suele Manjourany Silva Duro ◽  
Luiz Augusto Facchini
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Health Care Services ◽  
Access To Health Services ◽  
Socioeconomic Groups ◽  
Care Services ◽  
Access To Health ◽  
To Receive ◽  
Use Of Health Care

OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in hours) in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services.

scholarly journals Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Access To Health Services ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health services can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

scholarly journals Utilization of Maternity Waiting Home (MWH) to Improve Access to Health Services: Systematic Literature Review

2020 ◽  
Vol 7 (3) ◽  
pp. 368-375
Author(s):  
Nuraina Nuraina
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Access To Health Services ◽  
Care Services ◽  
Access To Health ◽  
Maternity Waiting Home ◽  
Improve Access

Maternity waiting home (MWH) is a home built in the compound or near to health facilities that provides standard medical and emergency obstetric care services. MWH is considered to be a key strategy to "bridge the geographical gap" in obstetric care between rural areas with poor access to equipped facilities, and urban areas where the services are available. This study aimed to systematically review the utilization of MWH to improve access to health service. The method of finding articles in this study was in the period 2014 to 2018, free full text, human species, and scholarly journals which were then identified using an electronic database from Pubmed, Proquest and Onesearch. Three articles were carried out with thematic analysis to identify the main points. Factors associated with the utilization of MWH included (1) Distance; (2) Complication during pregnancy; and (3) Income. Barrier in the utilization of MWH were (1) Inadequate number of room and postpartum bed; (2) Lack of water and sanitation facilities; and (3) Unavailable electricity. Partnership between health workers in rural facilities, stronger role of stakeholders, and a broader health system, were expected to increase the utilization of MWH.

scholarly journals Piloting a trachomatous trichiasis patient case-searching approach in two localities of Sudan

2020 ◽  
Vol 114 (8) ◽  
pp. 561-565
Author(s):  
Angelia M Sanders ◽  
Maha Adam ◽  
Nabil Aziz ◽  
E Kelly Callahan ◽  
Belgesa E Elshafie
Keyword(s):  
Control Program ◽  
Case Finding ◽  
Access To Health Services ◽  
Patient Case ◽  
Medical Assistants ◽  
Remote Areas ◽  
Care Services ◽  
Access To Health ◽  
Advanced Stages ◽  
Trachomatous Trichiasis

Abstract Background Approximately 1.9 million people have become blind or visually impaired from trachoma, the leading cause of infectious blindness. Trachoma prevalence surveys conducted in Sudan have shown that thousands of Sudanese suffer from the advanced stages of the disease, trachomatous trichiasis (TT), and warrant sight-saving surgery. Sudan’s National Trachoma Control Program (NTCP) provides free TT surgery; however, given that many TT patients live in remote areas with limited access to health services, identifying patients and providing eye care services has proved challenging. For this reason, the Sudan NTCP piloted a systematic TT case-finding approach to identify patients. Methods In Gedarif state, 11 villages in Baladyat el Gedarif locality and 21 villages in West Galabat locality were included in a TT case-searching activity from September to November 2018. TT case finders were selected from the villages where the activity took place and were trained by ophthalmic medical assistants to identify possible patients. Results Of 66 626 villagers examined, 491 were identified as having TT by TT case finders. Of those, 369 were confirmed as true cases by the TT surgeons, a 75.2% (369/491) success rate. Conclusions The TT case-finding approach provides an example of an effective method for identifying TT patients and should be expanded to other parts of the country known to be endemic for trachoma.

scholarly journals Reshaping the Regional Order of Health Care Resources in China: The Institutional Participants in an Inter-City Integrated Delivery System

2021 ◽  
Vol 18 (17) ◽  
pp. 9176
Author(s):  
Xuanyi (Maxwell) Nie ◽  
Haobin (Bruce) Fan
Keyword(s):  
Health Care ◽  
Local Government ◽  
Local Governments ◽  
Health Care Services ◽  
Health Care Resources ◽  
Care Services ◽  
Integrated Delivery System ◽  
Regional Health Care ◽  
Integrated Delivery ◽  
Local Government Level

Over the past decades, pro-growth policies in China led to rapid economic development but overlooked the provision of health care services. Recently, increasing attention is paid to the emergence of integrated delivery systems (IDS) in China, which is envisioned to consolidate regional health care resources more effectively by facilitating patient referral among hospitals. IDS at an inter-city scale is particularly interesting because it involves both the local governments and the hospitals. Incentives among them will affect the development of an inter-city IDS. This paper thereby builds an economic model to examine both the inter-local government and inter-hospital incentives when participating in an inter-city IDS in China. The findings suggest that while inter-hospital incentives matter, inter-local government incentives should also be considered because the missing incentives at the local government level may oppose the development of inter-city IDSs.

scholarly journals Inequality in access to health and care services during lockdown - Findings from the COVID-19 survey in five UK national longitudinal studies

2020 ◽  
Author(s):  
Constantin-Cristian Topriceanu ◽  
Andrew Wong ◽  
James C Moon ◽  
Alun Hughes ◽  
David Bann ◽  
...  
Keyword(s):  
Chronic Illness ◽  
Ethnic Minorities ◽  
Health Inequalities ◽  
Access To Health Services ◽  
Care Services ◽  
Access To Health ◽  
Public Health Authorities ◽  
Meta Regression ◽  
The Uk ◽  
Meta Analyses

Background: Access to health services and adequate care is influenced by sex, ethnicity, socio-economic position (SEP) and burden of co-morbidities. However, it is unknown whether the COVID-19 pandemic further deepened these already existing health inequalities. Methods: Participants were from five longitudinal age-homogenous British cohorts (born in 2001, 1990, 1970, 1958 and 1946). A web and telephone-based survey provided data on cancelled surgical or medical appointments, and the number of care hours received during the UK COVID-19 national lockdown. Using binary or ordered logistic regression, we evaluated whether these outcomes differed by sex, ethnicity, SEP and having a chronic illness. Adjustment was made for study-design, non-response weights, psychological distress, presence of children or adolescents in the household, keyworker status, and whether participants had received a shielding letter. Meta-analyses were performed across the cohorts and meta-regression evaluated the effect of age as a moderator. Findings: 14891 participants were included. Females (OR 1.40, 95% confidence interval [1.27,1.55]) and those with a chronic illness (OR 1.84 [1.65-2.05]) experienced significantly more cancellations during lockdown (all p<0.0001). Ethnic minorities and those with a chronic illness required a higher number of care hours during the lockdown (both OR approx. 2.00, all p<0.002). Age was not independently associated with either outcome in meta-regression. SEP was not associated with cancellation or care hours. Interpretation: The UK government's lockdown approach during the COVID-19 pandemic appears to have deepened existing health inequalities, impacting predominantly females, ethnic-minorities and those with chronic illnesses. Public health authorities need to implement urgent policies to ensure equitable access to health and care for all in preparation for a second wave.

scholarly journals Healthcare challenges of incarcerated women in Australia: An integrative review

2020 ◽  
Vol 7 (1) ◽  
pp. 10
Author(s):  
Christine Stewart ◽  
Sharon L Bourke ◽  
Janet A Green ◽  
Elianna Johnson ◽  
Ligi Anish ◽  
...  
Keyword(s):  
Health Services ◽  
Health Outcomes ◽  
Health Care Services ◽  
Prison Population ◽  
Incarcerated Women ◽  
Health Needs ◽  
Integrative Review ◽  
Access To Health Services ◽  
Care Services ◽  
Access To Health

Background: Despite the rise in numbers of incarceration women, disparities between health care services and access exist. The health needs of incarcerated women is complex and influenced by multiple social determinants of health.Purpose: Explore the healthcare issues of incarcerated women within Australian Prisons.Methods: Integrative review of the literature.Results: Incarcerated women represent a small proportion of the prison population within Australia, however, health outcomes are significantly impacted. Socioeconomic status, abuse (physical, emotional, sexual), previous incarceration, generational factors are some of the factors impeding the health of incarcerated women. Mental health, chronic disease conditions, maternal and child factors are significant health concerns of this vulnerable population. There is a disparity in health access and programs to improve their health outcomes. This paper explores the challenges impacting the health of incarcerated women.Conclusions: Significant disparities exist in the access of health services available to incarcerated women. There needs to be more focus upon improving access to health services and health support programs to meet the complex health needs of incarcerated in Australia. Furthermore, there is a need for more primary health nurses to prevent and address the healthcare issues of this population.

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