110 Interim Federal Health Program (IFHP): Survey of Access & Utilization by Pediatric Health Care Providers

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e79-e80
Author(s):  
Caroline Leps ◽  
Jessica Monteiro ◽  
Tony Barozzino ◽  
Ashna Bowry ◽  
Meb Rashid ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Health Program ◽  
Subject Area ◽  
Refugee Children ◽  
Surveillance Program ◽  
Care Providers ◽  
Survey Responses ◽  
Interim Federal Health Program

Abstract Primary Subject area Public Health and Preventive Medicine Background Canada is currently facing an increasing number of refugees and refugee claimants, yet Canadian health professionals are underutilizing the system intended to provide these individuals with healthcare. The Interim Federal Health Program (IFHP) provides temporary healthcare coverage for those who are ineligible for provincial or territorial insurance, including resettled refugees and asylum seekers. Research suggests there are ongoing challenges around the program such as who is covered and what services are covered. Objectives The objective of this study was to assess Canadian pediatricians’ current understanding and utilization of the IFHP, and perceived barriers to its utilization. Design/Methods A one-time survey was administered via the Canadian Paediatric Surveillance Program. The ten question adaptive survey was available in English or French, in either paper or electronic format. Survey responses were collected for 6 weeks in early 2020 with two reminders sent prior to survey closing. In addition to descriptive statistics, multinomial logistic regressions were built to examine pediatrician use of the IFHP, work with IFHP-covered patients, and provider characteristics associated with registration and use. Results Of the 2,753 pediatricians and pediatric subspecialists surveyed, there were 1006 respondents (36.5% response rate). 52.2% of respondents had provided care to the IFHP-eligible patients in the previous 6 months. Of those participants, only 26.4% were registered IFHP providers, and just 10% could identify all services covered by the IFHP (Figure 1). Knowledge of 80% or more of supplemental benefits was associated with registration status (adjusted odds ratio [aOR] 1.92; 95% CI 1.09 - 3.37). Amongst those who knew they were not registered, 70.2% indicated they did not know they had to register. aOR demonstrated that those with fewer years of practice had higher odds of not knowing that they had to register (aOR 1.22; 95% CI 1.01 - 1.49) Conclusion We demonstrate that the IFHP is poorly utilized by pediatric providers, with low registration rates and poor understanding of the IFHP-covered supplemental services, even among those who have recently provided care to the IFHP-eligible patients. Efforts to improve registration and knowledge of the IFHP are essential to improving access to health care for refugee children and youth. Funding: Study funded by the CPSP Resident Research Grant

Interim Federal Health Program: Survey of access and utilization by paediatric health care providers

2021 ◽  
Author(s):  
Caroline Leps ◽  
Jessica Monteiro ◽  
Tony Barozzino ◽  
Ashna Bowry ◽  
Meb Rashid ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Health Program ◽  
Refugee Children ◽  
Surveillance Program ◽  
Care Providers ◽  
Knowing That ◽  
Supplemental Services ◽  
Interim Federal Health Program

Abstract Background The Interim Federal Health Program (IFHP) provides health care coverage to refugees and refugee claimants, yet remains underused by providers. The objective of this study was to assess Canadian paediatricians’ current understanding and utilization of the IFHP, and perceived barriers to utilization. Methods A one-time survey was administered via the Canadian Paediatric Surveillance Program in February 2020. In addition to descriptive statistics, multinomial logistic regressions were built to examine paediatrician use of the IFHP, and characteristics associated with registration and use. Results Of the 2,753 physicians surveyed, there were 1,006 respondents (general paediatricians and subspecialists). 52.2% of respondents had provided care to IFHP-eligible patients in the previous 6 months. Of those participants, only 26.4% were registered IFHP providers, and just 16% could identify 80% or more of IFHP-covered services. Knowledge of 80% or more of IFHP-covered services was associated with registration status (adjusted odds ratio [aOR] 1.92; 95%CI 1.09 to 3.37). Among those who knew they were not registered, 70.2% indicated they did not know they had to register. aOR demonstrated that those with fewer years of practice had higher odds of not knowing that they had to register (aOR 1.22; 95%CI 1.01 to 1.49). Conclusions We demonstrate that IFHP is poorly utilized by paediatric providers, with low registration rates and poor understanding of IFHP-covered supplemental services, even among those who have recently provided care to IFHP-eligible patients. Efforts to improve registration and knowledge of IFHP are essential to improving access to health care for refugee children and youth.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

The legal framework applicable to insecurity and violence affecting the delivery of health care in armed conflicts and other emergencies

2013 ◽  
Vol 95 (889) ◽  
pp. 83-127 ◽  
Author(s):  
Alexander Breitegger
Keyword(s):  
Health Care ◽  
Medical Ethics ◽  
Health Care Providers ◽  
Delivery Of Health Care ◽  
Access To Health Care ◽  
Legal Framework ◽  
Armed Conflicts ◽  
Health Care Personnel ◽  
International Human Rights Law ◽  
Care Providers

AbstractEnsuring respect for, and protection of, the wounded and sick and delivery of health care to them were at the origin of the Red Cross and Red Crescent Movement, as well as the development of international humanitarian law (IHL). In today's armed conflicts and other emergencies, the problem is not the lack of existing international rules but the implementation of relevant IHL and international human rights law (IHRL) which form a complementary framework governing this issue. Against the backdrop of the different manifestations of violence observed by the ICRC in the field and expert consultations held in the framework of the Health Care in Danger Project, this article identifies commonalities between the two legal regimes, including with respect to obligations to provide and facilitate impartial health care; prohibitions of attacks against wounded and sick and health-care providers; prohibitions to arbitrarily obstruct access to health care; prohibitions to harass health-care personnel, in violation of medical ethics; or positive obligations to ensure essential medical supplies and health-care infrastructure and protect health-care providers against violent interferences by others. The article concludes by indicating certain areas where implementation of existing IHL and IHRL is needed, including in domestic normative frameworks, military doctrine and practice, as well as training of health-care personnel on these international legal frameworks and medical ethics.

scholarly journals A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Providers ◽  
Low Income ◽  
Access To Health Care ◽  
Social Determinant ◽  
Evidence Based ◽  
Patient Portal ◽  
Care Providers ◽  
Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

Insurance Type and Access to Health Care Providers and Appointments Under the Affordable Care Act

Medical Care ◽  
2018 ◽  
Vol 56 (2) ◽  
pp. 186-192 ◽  
Author(s):  
Héctor E. Alcalá ◽  
Dylan H. Roby ◽  
David T. Grande ◽  
Ryan M. McKenna ◽  
Alexander N. Ortega
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Affordable Care Act ◽  
Access To Health Care ◽  
Care Providers ◽  
Insurance Type ◽  
Access To Health ◽  
The Affordable Care Act

scholarly journals The status of the Primary Health Care Plus pilot project in Poland

2019 ◽  
Vol 13 (2) ◽  
pp. 1-14
Author(s):  
Katarzyna Wiktorzak
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Current System ◽  
Pilot Project ◽  
Care Providers ◽  
Primary Health ◽  
The Status

Background The National Health Fund (NHF) is the public payer solely accountable for securing and organizing access to health care services in Poland. The NHF is responsible for implementing a project entitled “Primary Health Care PLUS” which aims to introduce a primary care centered model, based on coordinated, proactive and preventive methods relevant to patients’ needs and furthermore, works to keep patients well-informed and active participants in health care decision-making. The implementation period of the project is July 1, 2018 through Dec. 31, 2021. Aim of the study The purpose of this study is to outline patient demographics and staff structures of providers that took part in the PHC PLUS pilot program, as well as the status of the program throughout the first year of its implementation. Materials and Methods Following an open and transparent recruitment process, 42 urban and rural primary health care providers were selected. The purpose of the providers’ geographic spread was to ensure the model was tested in all representative regions of the country. Results 42 PHC PLUS providers attending to 288,392 patients are participating in the project. Approximately 1,100 medical staff members are involved in the project. PHC PLUS medical teams consist of specialists including physicians, coordinators, nurses, dietitians, psychologists, physiotherapists and health educators. Out of 41,022 health risk assessments declared to be conducted during the project, 18,058 (43.1%) were performed from July 1, 2018 to April 30, 2019, including 4,537 basic and 13,521 extended assessments. Furthermore, 15,020 patients in total, participated in the disease management programs, which are also paid from the project. Conclusions A Polish health care pilot project that centers primary care can help shift the focus toward preventive interventions, rather than the current system, which often focuses on providing medical care to patients who have already been diagnosed with diseases, often in their more advanced stages.

scholarly journals “I was trying to speak to their human side” coping responses of Belgium’s undocumented migrants to barriers in health-care access

2020 ◽  
Vol 16 (3) ◽  
pp. 253-267
Author(s):  
Dirk Lafaut ◽  
Gily Coene
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Access ◽  
Access To Health Care ◽  
Undocumented Migrants ◽  
Care Providers ◽  
Content Type ◽  
Coping Responses ◽  
Care Access ◽  
Access To Health

Purpose Undocumented migrants experience major legal constraints in their health-care access. Little is known on how undocumented migrants cope with these limitations in health-care access as individuals. The purpose of this study is to explore the coping responses of undocumented migrants when they experience limited health-care access in face-to-face encounters with health-care providers. Design/methodology/approach The authors conducted multi-site ethnographic observations and 25 semi-structured in-depth interviews with undocumented migrants in Belgium. They combined the “candidacy model” of health-care access with models from coping literature on racism as a framework. The candidacy model allowed them to understand access to health care as a dynamic and interactive negotiation process between health-care workers and undocumented migrants. Findings Responses to impaired health-care access can be divided into four main strategies: (1) individuals can react with a self-protective response withdrawing from seeking further care; (2) they can get around the obstacle; (3) they can influence the health-care worker involved by deploying discursive or performative skills; or (4) they can seek to confront the source of the obstacle. Research limitations/implications These findings point to the importance of care relations and social networks, as well as discursive and performative skills of undocumented migrants when negotiating barriers in access to health care. Originality/value This study refines the candidacy model by highlighting how individuals respond on a micro-level to shifts towards exclusionary health policies and, by doing so dynamically, change provision of health-care services.

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