Disparities in Unmet Health Service Needs Among People with Disabilities in China

2021 ◽  
Author(s):  
Xintong Zhao ◽  
Hongchuan Wang
Keyword(s):  
Health Care ◽  
Health Service ◽  
Medical Care ◽  
Associated Factors ◽  
People With Disabilities ◽  
Community Level ◽  
Service Needs ◽  
Residential Status ◽  
Access To Health ◽  
Rehabilitation Need

Abstract Background Extensive research has explored disparities in access to health care between people with and without disabilities, but much less is understood about disparities and associated factors within the disabled population. Objective The aim of this study was to examine differences in the prevalence of unmet health care needs by residential status (hukou status) and disability type among people with disabilities. Methods Our data were from the National Survey on Basic Services and Needs of Persons with Disabilities, a large-scale, register-based survey conducted by the China Disabled Persons’ Federation in 2019. The analysis sample included a nationally representative sample of 9,642,112 adults (16+) with disabilities. Associated factors were obtained from both individual-level and community-level. Cross-sectional multivariable logistic regression analyses were conducted to compare people with different residential status and different types of disabilities on unmet medical, care, rehabilitation and accessibility needs. Results The estimated prevalence of unmet medical, care, rehabilitation need and accessibility need are 15.4%, 10.2%, 45.6% and 13.7%, respectively. Rural hukou was associated with an important 13%-40% increase in unmet healthcare needs for people with disabilities in China. These rural-urban disparities in unmet health service needs can be partly explained by community-level factors, including access to facilities, social participation, and health professionals. Disparities across type of disability were smaller, but on average people with multiple disabilities appeared to have the highest rates of unmet care, medical and accessibility needs whereas those with physical disability had the highest unmet rehabilitation need. Conclusions Differences by residential status and impairment type were evident in all types of unmet health service needs. Targeted policy designs that meet the needs for justice and equality of people with disabilities are advisable. Public health and policy efforts are required to improve access to health service and meet the needs of people with disabilities, especially in rural practices and for particular disability groups.

scholarly journals Access to health care for people with disabilities in rural Malawi what are the barriers?

2019 ◽  
Author(s):  
Josephine Harrison ◽  
Rachael Thomson ◽  
Hastings T. Banda ◽  
Grace B. Mbera ◽  
Stefanie Gregorius ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Access To Health Care ◽  
People With Disabilities ◽  
Randomised Control Trial ◽  
Care Access ◽  
Health Care Accessibility ◽  
Access To Health ◽  
Lung Condition ◽  
The Impact

Abstract Introduction People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experienced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside an impairment, on health care accessibility is explored. Method Using data from survey responses obtained through the Research for Equity And Community Health (REACH) Trust’s randomised control trial in Malawi, 12 adult participants, with scores of either 3 or 4 in the Washington Group Questions, were recruited. People with cognitive impairments were excluded. Each of the selected participants underwent an individual in-depth interview and full recordings of these were then transcribed and translated. Findings and discussion Through thematic analysis of the transcripts, three main barriers to timely and adequate health care were identified: 1) Cost of transport, drugs and services, 2) Insufficient health care resources, and 3) Dependence on others. Other barriers identified were distance to a facility, which was most hindering for the participants with a chronic lung condition, and unfavourable health seeking behaviour, whilst ‘time’ was found to be a common underlying factor. Attitudinal factors were not found to influence health care accessibility for this cohort. Conclusions This study finds that health care access for people with disabilities in rural Malawi is hindered by closely interconnected financial, practical and social barriers. There is a clear requirement for policy makers to consider the challenges identified here, and in similar studies, and to address them through improved social security systems and health system infrastructure, including outreach services, in a drive for equitable health care access and provision.

scholarly journals Barriers and Facilitators to Accessing Health Care Services among Married Women in Ethiopia: a Multi-level Analysis of the Ethiopia Demographic and Health Survey

2021 ◽  
Vol 5 (2) ◽  
pp. 183-196
Author(s):  
Betregiorgis Zegeye ◽  
Nicholas Kofi Adjei ◽  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
Eugene Budu ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Married Women ◽  
Community Level ◽  
Factors Associated ◽  
Care Services ◽  
Barriers To Access ◽  
Access To Health ◽  
The Individual

Background and Objective: Access to health care services is a major challenge to women and children in many developing countries such as Ethiopia. In this study, we investigated the individual- and community-level factors associated with barriers to accessing health care services among married women in Ethiopia. Methods: Data from the 2016 Ethiopia demographic and health survey on 9,824 married women of reproductive age (15-49 years) were analyzed. Multilevel logistic regression models were used to assess individual- and community-level factors associated with barriers to access health care services. Regression analysis results revealed adjusted odds ratios at 95% confidence intervals. Results: Over two-thirds (71.8%) of married women in Ethiopia reported barriers to accessing health care services. Some of the individual-level factors that were associated with lower odds of reporting barriers to access health care services include: having secondary education (aOR=0.49, 95% CI: 0.32-0.77), being in the richest quintile (aOR=0.34, 95% CI: 0.22-0.54), and indicating wife-beating as unjustified (aOR=0.66, 95% CI:0.55-0.81). Among the community-level factors, high community-level literacy (aOR=0.56, 95% CI: 0.34-0.92) and moderate community socioeconomic status (aOR=0.62, 95% CI: 0.45-0.85) were significantly associated with lower odds of reporting barriers to access health care services. Conclusion and Implications for Translation: The findings revealed high barriers to access health care services, and both individual- and community-level factors were significant contributing predictors. Therefore, it is important to consider multidimensional strategies and interventions to facilitate access to health care services in Ethiopia.   Copyright © Zegeye et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

scholarly journals Access to health care for people with disabilities in rural Malawi: what are the barriers?

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Josephine A. K. Harrison ◽  
Rachael Thomson ◽  
Hastings T. Banda ◽  
Grace B. Mbera ◽  
Stefanie Gregorius ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
People With Disabilities ◽  
Access To Health

Managing Calls to Mauri Ora: Medical Reception in Action

2021 ◽  
Author(s):  
◽  
Fiona Grattan
Keyword(s):  
Health Care ◽  
Health Service ◽  
Access To Health Care ◽  
Medical Information ◽  
Medical Training ◽  
Future Research ◽  
Practical Applications ◽  
Related Information ◽  
Access To Health ◽  
Health Related

<p>Often a patient’s first contact with their health service is through a medical receptionist. Literature has framed medical receptionists as gate-keepers, and few studies have examined what they actually do when they answer incoming calls by studying recordings of them. The current thesis asks how receptionists managed calls to Mauri Ora, a student health service, to deliver what the callers were asking for. The findings present evidence that receptionists are skilled and supportive in their interactions with patients.  Following discursive psychology and conversation analysis as theoretical and methodological frameworks this thesis examined naturally occurring social interactions to discover how joint understanding and coordinated action was accomplished. Eighteen (N=18) calls between receptionists and patients were recorded, transcribed and examined in detail for what happened in each call and how receptionists worked to deliver what the callers were asking for.  Callers ring with a broad range of different problems. The analysis documents how receptionists showed that they understood what callers wanted, and the ways they worked to progress solutions. The examination of requests for doctors’ appointments were of particular interest because of their very limited availability and the triage process for getting one. By establishing with the caller the conditions under which they could see a doctor, including if it was an urgent problem, receptionists opened the door to the health care being sought. A difficult matter for receptionists is asking for and responding to health-related information because they have no medical training. An additional aspect of the analysis demonstrated that receptionists only asked for medical information as a record for triage referral, and when it had not previously been disclosed.  Far from casting medical receptionists as gate-keepers withholding help, the current thesis demonstrates their orientation towards granting the requests of callers and doing what they can to facilitate access to health care. Practical applications for the training and practice of medical receptionists are considered as well as future research, and the ethical constraints of this kind of work.</p>

scholarly journals Comparing Health Care Financial Burden With an Alternative Measure of Unaffordability

2017 ◽  
Vol 54 ◽  
pp. 004695801773296
Author(s):  
Edward S. Kielb ◽  
Corwin N. Rhyan ◽  
James A. Lee
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Plan ◽  
Low Income ◽  
Access To Health Care ◽  
Financial Burden ◽  
Access To Health ◽  
Care Costs

Health insurance plans with high deductibles increase exposure to health care costs, raising concerns about how the growth in these plans may be impacting both the financial burden of health care expenditures on families and their access to health care. We find that foregoing medical care is common among low-income, privately insured families, occurring at a greater rate than those with higher incomes or Medicare coverage. To better understand the relationship between out-of-pocket (OOP) spending and access, we used the 2011-2014 Medical Expenditure Panel Survey (MEPS) data and a logistic model to analyze the likelihood of avoiding or delaying needed medical care based on health insurance design and other individual and family characteristics. We find that avoiding or delaying medical care is strongly correlated with coverage under a high-deductible health plan, and with depression, poor perceived health, or poverty. However, it is relatively independent of the percent of income spent on OOP costs, making the percent of income spent on OOP costs by itself a poor measure of health care unaffordability. Individuals who spend a small percentage of their income on health care costs may still be extremely burdened by their health plan when financial concerns prevent access to health care. This work emphasizes the importance of insurance design as a predictor of access and the need to expand the definition of financial barriers to care beyond expenditures, particularly for the low-income, privately insured population.

How accessible is the Serbian health system? Main barriers and challenges ahead

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Hernandez-Quevedo ◽  
V Bjegovic-Mikanovic ◽  
M Vasic ◽  
D Vukovic ◽  
J Jankovic ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Medical Care ◽  
Access To Health Care ◽  
Unmet Need ◽  
Policy Issue ◽  
Vulnerable Groups ◽  
Free Access ◽  
Access To Health ◽  
Underlying Causes

Abstract Background Access to health care is a key health policy issue faced by countries in the WHO European Region and Serbia is not an exception. There is increasing concern that financial and economic crisis may have delay progress regarding the performance of the Serbian health system. While substantial development has been experienced by the Serbian health system since 2000, we analyse whether barriers to health care access exist in the country and the underlying causes. Methods We combine quantitative and qualitative methods to assess the accessibility of the Serbian health system. We use the latest data available both at national (e.g. National Health Survey) and European (EUSILC) level to understand whether barriers to access exist and the underlying causes. On the qualitative side, we analyse the different policies implemented by the Serbian government to improve the accessibility of the health system in the last decade, identifying the challenges ahead for the country. Results We find that, in 2018, 5.8% of the Serbian population reported unmet need for medical care due to costs, travel distances or waiting lists, well above the EU28 average and much higher than in neighbouring countries. Financial constraints are reported to be the main reason for unmet needs for medical care. Long waiting times also impede the accessibility of health services in Serbia. Conclusions Serbia has a comprehensive universal health system with free access to health care, however, some vulnerable groups, such as those living in poverty or Roma people in settlements, have more barriers in accessing health care. It is expected that Serbia will continue to develop policies focused on reducing barriers to accessing health care and improving the efficiency of the health system, supported by international organisations and in the context of the EU accession negotiations. Key messages Some vulnerable groups have more barriers in accessing adequate care in Serbia. National initiatives are in place to increase access to the health system but there is scope for further work.

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