Health Care Justice for the Chronically Ill and Disabled

2012 ◽  
pp. 299-312 ◽  
Author(s):  
Anita Silvers
Keyword(s):  
Health Care ◽  
Chronically Ill ◽  
Health Care Justice

scholarly journals National Estimates of Out-of-Pocket Health Care Expenditure Burdens Among Nonelderly Adults With Cancer: 2001 to 2008

2011 ◽  
Vol 29 (20) ◽  
pp. 2821-2826 ◽  
Author(s):  
Didem S.M. Bernard ◽  
Stacy L. Farr ◽  
Zhengyi Fang
Keyword(s):  
Health Care ◽  
Chronic Conditions ◽  
Medical Expenditure Panel Survey ◽  
Health Care Expenditure ◽  
Chronically Ill ◽  
Medical Expenditure ◽  
Never Married ◽  
Patients With Cancer ◽  
Nationally Representative ◽  
Total Burden

Purpose To compare the prevalence of high out-of-pocket burdens among patients with cancer with other chronically ill and well patients, and to examine the sociodemographic characteristics associated with high burdens among patients with cancer. Methods The sample included persons 18 to 64 years of age who received treatment for cancer, taken from a nationally representative sample of the US population from the 2001 to 2008 Medical Expenditure Panel Survey. We examined the proportion of persons living in families with high out-of-pocket burdens associated with medical spending, including insurance premiums, relative to income, defining high health care (total) burden as spending more than 20% of income on health care (and premiums). Results The risk of high burdens is significantly greater for patients with cancer compared with other chronically ill and well patients. We find that 13.4% of patients with cancer had high total burdens, in contrast to 9.7% among those with other chronic conditions and 4.4% among those without chronic conditions. Among nonelderly persons with cancer, the following were associated with higher out-of-pocket burdens: private nongroup insurance, age 55 to 64 years, non-Hispanic black, never married or widowed, one child or no children, unemployed, lower income, lower education level, living in nonmetropolitan statistical areas, and having other chronic conditions. Conclusion High burdens may affect treatment choice and deter patients from getting care. Thus, although a detailed patient-physician discussion of costs of care may not be feasible, we believe that an awareness of out-of-pocket burdens among patients with cancer is useful for clinical oncologists.

scholarly journals The influence of primary health care organizational models on patients’ experience of care in different chronic disease situations

2011 ◽  
Vol 31 (3) ◽  
pp. 109-120 ◽  
Author(s):  
R Pineault ◽  
S Provost ◽  
M Hamel ◽  
A Couture ◽  
JF Levesque
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Primary Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Chronically Ill ◽  
Organizational Models ◽  
Experience Of Care ◽  
Primary Health

Objectives To examine the extent to which experience of care varies across chronic diseases, and to analyze the relationship of primary health care (PHC) organizational models with the experience of care reported by patients in different chronic disease situations. Methods We linked a population survey and a PHC organizational survey conducted in two regions of Quebec. We identified five groups of chronic diseases and contrasted these with a no–chronic-disease group. Results Accessibility of care is low for all chronic conditions and shows little variation across diseases. The contact and the coordination-integrated models are the most accessible, whereas the single-provider model is the least. Process and outcome indices of care experience are much higher than accessibility for all conditions and vary across diseases, with the highest being for cardiovascular-risk-factors and the lowest for respiratory diseases (for people aged 44 and under). However, as we move from risk factors to more severe chronic conditions, the coordination-integrated and community models are more likely to generate better process of care, highlighting the greater potential of these two models to meet the needs of more severely chronically ill individuals within the Canadian health care system.

Three Approaches to Global Health Care Justice: Rejecting the Positive/Negative Rights Distinction

2016 ◽  
Author(s):  
George F. DeMartino ◽  
Jonathan D. Moyer
Keyword(s):  
Health Care ◽  
Global Health ◽  
Global Poverty ◽  
Basic Rights ◽  
Negative Rights ◽  
Global Health Care ◽  
Negative Duties ◽  
Health Care Justice ◽  
Insight Into

This chapter presents three cosmopolitan approaches to global health care justice: Thomas Pogge's negative duties based approach, Gillian Brock's minimal needs view, and Henry Shue's model of basic rights. While these approaches share a common focus on attempting to justify the existence of global duties to aid, held by the wealthy and owed to the global poor, each offers a distinct interpretation of why such duties exist and suggests a range of options for fulfilling them. Importantly, while the chapter argues that Shue's approach to global duties is the most effective of the three, it considers that they all offer important insight into the problem of global poverty and provide a variety of possible practical solutions to this problem.

Health Care Financing for the Child With Catastrophic Costs

PEDIATRICS ◽  
1987 ◽  
Vol 80 (5) ◽  
pp. 752-757
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Insurance Coverage ◽  
Chronically Ill ◽  
Medical Needs ◽  
Structural Problems ◽  
Medical Care Costs ◽  
Private And Public ◽  
Care Costs

PURPOSE Historically, health insurance has not treated children fairly. Insured services have been oriented to the medical needs of adults, with children's unique needs given poor coverage or, in the instance or preventive care, rare coverage. These biases inherent in private and public health insurance also manifest themselves in the coverage of catastrophic care for children. The objectives of the following recommendations are to rectify some of the structural problems of health insurance that are faced by children, to ensure access to all needed health care services for all children, and to protect families from overwhelming out-of-pocket medical care costs. PRINCIPLES To address the needs of children through 21 years of age with illnesses that lead to catastrophic costs, all insurance plans must (1) be available to all children (and pregnant women) without regard to race, religion, national origin, economic status, health or functional status, or existing health insurance coverage; (2) include participation of both private and public sectors; (3) support the development of comprehensive, community-based systems of personal health care for the chronically ill child; (4) cover a broad array of child-specific health services; (5) contain costs through managed care and other means; and (6) require some financing from the child's family in proportion to their ability to pay. DEFINITION OF CATASTROPHIC NEED The American Academy of Pediatrics (AAP) defines catastrophic need by relative economic distress. Generally, a child whose family's out-of-pocket medical care costs reach a maximum of 10% of their annual adjusted gross income as reported to the Internal Revenue Services is one who, regardless of health status, income level, or existing insurance coverage, is in need of financial support for further medical expenses.

scholarly journals Utilisation of mobile health by medical doctors in a Zimbabwean health care facility

2017 ◽  
Vol 22 ◽  
Author(s):  
Chester Marufu ◽  
Kefiloe A. Maboe
Keyword(s):  
Health Care ◽  
Data Collection ◽  
Mobile Health ◽  
Delivery Of Health Care ◽  
Care Delivery ◽  
Care Facility ◽  
Health Care Facility ◽  
Chronically Ill ◽  
Medical Doctors ◽  
Patient Identification

Background: Mobile Health is the utilisation of mobile devices like cellphones and tablets for the delivery of health care. It is an up and coming intervention promising to benefit health services. Recent mobile health studies have tended to focus on mHealth for data collection and surveillance rather than on actual patient care. This paper highlights the potential and the challenges of mHealth use in the delivery of health care services.Objectives: This paper focused on determining the use of mHealth and identifying and describing the opportunities and the challenges faced by the medical doctors in using mHealth at a specific health care facility in Zimbabwe.Methods: A quantitative, descriptive, cross-sectional and analytical design was used to determine the rate of utilisation of selected mHealth “patient identification and treatment activities” by medical doctors. A structured questionnaire was used for data collection form 104 respondents. The number of the returned complete and usable questionnaires was 42. No sampling technique was done because the whole population was of interest to the researcher, accessible and available during data collection.Results: Fifty percent (50%) of the respondents indicated, lack of knowledge and unawareness in using mHealth to support chronically ill patients. The majority of the respondents (83.3%) believed that mHealth presented opportunities to improve health care delivery. The majority of the respondents (95%) indicated the potential for its future use.Conclusion: Given the challenges that were encountered mHealth program to be officially launched for mHealth use and the users to be developed on its utilisation.

scholarly journals Our Peers—Empowerment and Navigational Support (OP-ENS): Development of a Peer Health Navigator Intervention to Support Medicaid Beneficiaries With Physical Disabilities

2019 ◽  
Vol 8 ◽  
pp. 117957271984475 ◽  
Author(s):  
Susan Magasi ◽  
Christina Papadimitriou ◽  
Judy Panko Reis ◽  
Kimberly The ◽  
Jennifer Thomas ◽  
...  
Keyword(s):  
Health Care ◽  
Physical Disabilities ◽  
Lessons Learned ◽  
Care Organization ◽  
Disability Rights ◽  
Financial Barriers ◽  
Barriers To Health Care ◽  
Medicaid Beneficiaries ◽  
Health Care Justice ◽  
Barriers To Health

People with disabilities (PWD) are a health disparities population who experience well-documented physical, structural, attitudinal, and financial barriers to health care. The disability rights community is deeply engaged in advocacy to promote health care justice for all PWD. As the community continues to work toward systems change, there is a critical need for community-directed interventions that ensure individuals with disabilities are able to access the health care services they need and are entitled to. Peer health navigator (PHN) programs have been shown to help people from diverse underserved communities break down barriers to health care. The PHN model has not been systematically adapted to meet the needs of PWD. In this article, we describe the collaborative process of developing Our Peers—Empowerment and Navigational Supports (OP-ENS), an evidence-informed PHN intervention for Medicaid beneficiaries with physical disabilities in Chicago, IL, USA. Our Peers—Empowerment and Navigational Supports is a 12-month community-based PHN intervention that pairs Medicaid beneficiaries with physical disabilities (peers) with disability PHNs who use a structured recursive process of barrier identification and asset mapping, goal setting, and action planning to help peers meet their health care needs. Our Peers—Empowerment and Navigational Supports was developed by a collaborative team that included disability rights leaders, representatives from a Medicaid managed care organization, and academic disability health care justice researchers. We highlight both the conceptual and empirical evidence that informed OP-ENS as well as the lessons learned that can assist future developers.

scholarly journals The co-design approach in the MIWOCA project

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Frahsa ◽  
R Farquet ◽  
T Abel
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Healthcare System ◽  
Chronically Ill ◽  
Participatory Planning ◽  
Practical Training ◽  
Extensive Experience ◽  
Swiss Health ◽  
Care System

Abstract MIWOCA study group Background The project MIWOCA researches how chronically ill women of Portuguese, Turkish and German origin and women without a migration background subjectively experience, understand, interpret and use the Swiss health care system. Methods We conducted 48 qualitative semi-structured interviews with chronically ill women between the ages of 23 and 85 in Bern and Geneva (n = 36 with German, Portuguese and Turkish migrant backgrounds) and n = 12 Swiss women. In addition, n = 12 stakeholder interviews were conducted (doctors, nurses, social workers, psychologists, physiotherapists). In focus groups with interviewed women in Bern and Geneva, results are reflected back, identified topics from the interviews prioritized and representatives named for the cooperative planning. In a participatory planning approach, affected women in the canton of Bern, together with stakeholders from the Swiss healthcare system selected by a systematic stakeholder analysis (e.g. Swiss Medical Association, Red Cross Switzerland, Spitex, Federal Office of Public Health), develop recommendations for improving the quality of care and concrete dissemination strategies. Results Interviewees had multiple and chronic diseases and resulting extensive experience with the Swiss healthcare system. Relevant aspects referred to issues such as quality of specific services, complexity of the healthcare system, costs of care, role of family and social support, and multidimensional stigmatization (migration, chronic illness, alleged overuse of the care system). Findings are incorporated in evidence briefs and narrative stories for focus groups and participatory planning. Conclusions MIWOCA contributes to a targeted and differentiated improvement of structures and options for action in health care for specific groups. Results will be relevant for planning in the health system and may be incorporated into academic teaching and practical training in PH, medicine and social sciences.

scholarly journals What matters in health (care) universes: delusions, dilutions, and ways towards universal health justice

2019 ◽  
Vol 15 (S1) ◽  
Author(s):  
Anne-Emanuelle Birn ◽  
Laura Nervi
Keyword(s):  
Health Care ◽  
Three Dimensions ◽  
Health Coverage ◽  
Coup D'etat ◽  
Global Consensus ◽  
Health Justice ◽  
Health Care Justice ◽  
The Universe ◽  
Universal Health ◽  
What Matters

AbstractThe presumed global consensus on achieving Universal Health Coverage (UHC) masks crucial issues regarding the principles and politics of what constitutes “universality” and what matters, past and present, in the struggle for health (care) justice. This article focuses on three dimensions of the problematic: 1) we unpack the rhetoric of UHC in terms of each of its three components: universal, health, and coverage; 2) paying special attention to Latin America, we revisit the neoliberal coup d’état against past and contemporary struggles for health justice, and we consider how the current neoliberal phase of capitalism has sought to arrest these struggles, co-opt their language, and narrow their vision; and 3) we re-imagine the contemporary challenges/dilemmas concerning health justice, transcending the false technocratic consensus around UHC and re-infusing the profoundly political nature of this struggle. In sum, as with the universe writ large, a range of matters matter: socio-political contexts at national and international levels, agenda-setting power, the battle over language, real policy effects, conceptual narratives, and people’s struggles for justice.

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