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 mediator model as a way to access to care and health information for Syrian refugees in Turkey

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
I Kayi ◽  
Z Şimşek2 ◽  
G Yıldırımkaya
Keyword(s):  
Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Health Care Services ◽  
Legal Status ◽  
Healthcare Access ◽  
Syrian Refugees ◽  
Care Services ◽  
Access To Health ◽  
The City

Abstract The number of Syrian refugees residing in Turkey has increased over 200 times since 2012 reaching to 3,621,330 (April 2019). Turkey has granted temporary protection status, including access healthcare in the city of registration. Ministry of Health provides on-site health service in temporary shelters, however more than 90% of the Syrian refugees choose to stay in community settings, which along with language barriers limits their ability to access health care and information. With UNFPA we have designed a health mediator model to improve access to health care and awareness on priority concerns such as mental health, reproductive health, child health, health system in Turkey and legal status provided to Syrian refugees. This study is a participatory operational research to test the health mediator model. Operationalization took place in 3 phases: (1) selection and training of Syrian health mediators and provincial coordinators; (2) household visits and data collection; (3) evaluation and supervision. So far, we have trained 174 health mediators from 24 different Turkish cities. Training took 5 days with up to 30 participants each. UNFPA collaborated with NGOs that work with Syrian refugees for coordination purposes. Health mediators made household visits to reach out to Syrian families, gave health education and where necessary support for access to health care services, and conducted a needs assessment. Data collected has been the subject to weekly supervision meetings by local NGOs, health mediators and coordinators to set priorities for the upcoming week. Health mediator model was effective in reaching out to hard-to-reach groups among Syrian refugees, increased health system and legal awareness, contribute to improved healthcare access and prevention of negative health outcomes such as teenage marriages and pregnancies. Inclusion of refugees in decision-making and guidance during the implementation of the project was key for project success.

scholarly journals Assessment of factors influencing health care service utilization in rural area of Bangladesh

2019 ◽  
Vol 6 (9) ◽  
pp. 3710
Author(s):  
M. Hasan Howlader ◽  
M. Ashfikur Rahman ◽  
M. Imtiaz Hasan Rahul
Keyword(s):  
Health Care ◽  
Rural Area ◽  
Service Utilization ◽  
Access To Health Care ◽  
Health Care Services ◽  
Care Providers ◽  
Community Group ◽  
Care Services ◽  
Policy Interventions ◽  
Access To Health

Background: Access to health care services is one of the important preconditions for ensuring good health that is influenced by many socio-demographic characteristics of the individual population as well as policy interventions. The main objective of this study was to identify the factors that determine healthcare service utilization in rural area of Bangladesh.Methods: A cross-sectional descriptive study was carried out in the Rangpur union of Dumuria Upazila of Khulna division in Bangladesh. Data were collected from 195 household heads administering a structured questionnaire. The study applies principal component analysis (PCA) for determining the factors that affect health care services utilization.Results: Need factors (chronic diseases, disability, child sickness, and old aged parents) play the pivotal role to utilize the health care services. The second important factor that contributes to access to health care services is enabling factors consisting of income, distance to the nearest health care center, health cards/health insurance, land ownership, types of latrine use, and membership in a community group. The predisposing factors i.e. age, sex, religion, occupation and education have the least significant role in utilizing health care services.Conclusions: Utilization of health care services depends mostly on the perception and attitudes of people towards disease and disability. So, policy interventions should be taken to raise awareness among people along with regular monitoring of the activities of health care providers.

scholarly journals MALFEASANCE, ADMINISTRATIVE JUSTICE AND THE RIGHT OF ACCESS TO HEALTH-CARE SERVICES: AN ASSESSMENT OF MEC for Health v Kirkland Investment (Pty) Ltd 2014 (5) BCLR 547 (CC)

Obiter ◽  
2015 ◽  
Vol 36 (1) ◽  
Author(s):  
Karthy Govender
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Civil Servants ◽  
Economic Rights ◽  
Care Services ◽  
Access To Health ◽  
The Right ◽  
Right Of Access ◽  
Watch List

This case will reflect on some of the decisions made by senior civil servants in the discharge of important statutory powers, and will argue that improper decisions retard our growth as a democracy. The Kirkland case demonstrates that the failure to act in a just administrative manner will also hinder the progressive realization of socio-economic rights, such as the right of access to health care. We appear to be faring poorly on two of the three factors on Mureinik’s watch list and this must give cause for concern.

Health System Reforms in The Netherlands: From Public to Private and its Effects on Equal Access to Health Care

2010 ◽  
Vol 17 (3) ◽  
pp. 223-233 ◽  
Author(s):  
Andre den Exter
Keyword(s):  
Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Health Care Services ◽  
Social Values ◽  
Equal Access ◽  
Care Services ◽  
Access To Health ◽  
Dutch Health ◽  
Restrictive Measures

AbstractDutch health system reforms can be characterized by an ambiguous approach, combining competition and private initiatives on several health care markets with restrictive measures inspired by social values. Respecting equal access to necessary health care services on a competitive market appears to be an extremely difficult and bureaucratic exercise, if not impossible.

scholarly journals Use, access, and equity in health care services in São Paulo, Brazil

2017 ◽  
Vol 33 (4) ◽  
Author(s):  
Camila Nascimento Monteiro ◽  
Mariëlle A. Beenackers ◽  
Moisés Goldbaum ◽  
Marilisa Berti de Azevedo Barros ◽  
Reinaldo José Gianini ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Sao Paulo ◽  
São Paulo ◽  
Socioeconomic Groups ◽  
Care Services ◽  
Lower Socioeconomic ◽  
Access To Health

Abstract: The study analyzed how socioeconomic factors are associated with seeking, access, use, and quality of health care services in São Paulo, Brazil. Data were obtained from two household health surveys in São Paulo. We used logistic regression to analyze associations between socioeconomic factors and seeking, access, use, and quality of health care services. Access to health care services was high among those who sought it (94.91% in 2003 and 94.98% in 2008). The proportion of access to and use of health care services did not change significantly from 2003 to 2008. Use of services in the public sector was more frequent in lower socioeconomic groups. There were some socioeconomic differences in seeking health care and resolution of health problems. The study showed almost universal access to health care services, but the results suggest problems in quality of services and differences in quality experienced by lower socioeconomic groups, who mostly use the Brazilian Unified National Health System (SUS).

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.

Payment Accuracy in Value-Based Care Contracts

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Mackenzie A ◽  
◽  
Wang J ◽  
Teppema S ◽  
Duncan I ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Model Risk ◽  
Care Services ◽  
Value Based Care ◽  
Stochastic Risk

Reimbursement for health care services is transferring more risk away from payers and toward health care providers in the form of Alternative Payment Models (APMs), also known as Value-Based Care (VBC) models. VBC models cover a wide variety of forms but all include guarantees by providers of services to improve quality of care and/or reduce cost. Types of risk include performance risk, contract design risk or stochastic risk (because of the random variation in health care services and costs). A form of contract risk that can be a significant driver of cost is model risk, defined as the probability that the savings calculated at contract reconciliation will deviate from the actual savings generated. To estimate the degree of risk we quantify the potential variance in outcomes in a naïve population prior to intervention and the components that could affect outcomes, using examples of maternity and type 2 diabetes. This analysis has implications for both participants in, and designers of value-based contracts.

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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