Narratives on Pain and Comfort: Dr. M's Story

1996 ◽  
Vol 24 (4) ◽  
pp. 290-291
Author(s):  
Christine K. Cassel
Keyword(s):  
Access To Health Care ◽  
Musculoskeletal Complaints ◽  
Eastern United States ◽  
Older Woman ◽  
Degenerative Arthritis ◽  
Access To Health ◽  
Social Concerns ◽  
Regional Medical ◽  
Improve Access

Dr. M is a fifty-nine-year-old internist with a successful practice in a major Eastern United States city. He has lived in this city his whole life and is a highly esteemed citizen. Because of his broader social concerns and energetic support of activities to improve access to health care and quality of care for the underserved, Dr. M became involved in a number of local and regional medical organizations and quickly rose to prominence as as a director of a board of a major national organization. In this position, he was an effective, articulate spokesperson, highly respected for his integrity and thoughtfulness.Before one of the meetings of thithis s board, Dr. M personally contacted the organization's other directors, including me, to warn us that we might be hearing some scandalous news about him. He wanted us first to hear it from him personally. This was the scandalous news.Dr. M had assumed the care of a patient of a recently retired colleague. The patient was an older woman with multiple musculoskeletal complaints related to lumbar stenosis and advanced degenerative arthritis of the spine, which left her in immense pain.

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.

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.

Ärztemangel im ländlichen Raum – Neue Anreizstrukturen und innovative Versorgungsmodelle als Ausweg? Zur Bedeutung einer patientenorientierten Steuerung

2014 ◽  
Vol 63 (3) ◽  
Author(s):  
Jürgen Zerth
Keyword(s):  
Risk Sharing ◽  
Access To Health Care ◽  
Division Of Labour ◽  
Point Of View ◽  
Medical Practitioners ◽  
Rural Environments ◽  
Access To Health ◽  
Medical Facilities ◽  
Regional Medical ◽  
Care Models

AbstractIn Germany there is an ongoing debate on the adequate distribution of physicians that are obliged to guarantee the overall access to health care. Especially in rural regions the number of general practioners will decline in the next years. From a health economics point of view it has to be discussed which role physicians have to play within different forms of organizing care and cure. In the paper, a standardized utility function that depicts physicians’ interest helps to figure out the range in which physicians have an interest to choose an engagement in rural environments contingent of aspects of risk sharing between caretaker und cost payers. In consequence, patient driven care models will enforce new organizational and institutional arrangements of division of labour between medical practitioners as well as new needs to reorganize regional medical facilities.

Telemedicine Basics

2021 ◽  
pp. 3-11
Author(s):  
Guenevere Burke ◽  
Jared Lucas
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Access To Health Care ◽  
Electronic Information ◽  
Remote Areas ◽  
Access To Health ◽  
History Of ◽  
Key Terms ◽  
Improve Access

Telemedicine is a rapidly growing field in health care and emergency medicine. Telemedicine, telehealth, and virtual health refer to the use of telecommunications technology and electronic information to support health and provide care over distance. It has been used to improve access to health care in geographically remote areas for decades, but its use and recognized benefits have expanded considerably over the years, accelerated by the COVID-19 pandemic. This chapter provides a brief overview of the history of telemedicine, introduces key terms, and reviews basic definitions that are foundational to telemedicine practice. Finally, it summarizes a wide array of telehealth applications in emergency medicine, which are detailed further in later chapters.

Participation as Inclusion and Exclusion: Policing the Boundaries of “Citizenship” in Roma Health Mediation

2019 ◽  
Vol 24 (3) ◽  
pp. 430-443
Author(s):  
Charlotte Kühlbrandt
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Social Inclusion ◽  
Participant Observation ◽  
Community Members ◽  
Access To Health ◽  
The Social ◽  
Roma Health ◽  
Governing Institutions ◽  
Improve Access

Participatory health interventions have long been advocated as an approach to help marginalised community members exercise their rights as citizens, including access to health care. More than two decades ago, the Roma health mediation programme was established in Romania as a participatory community health intervention. Mediators are employed specifically to act as intermediaries between ‘Roma patients’ and local authorities or health professionals, with the overall aim to increase trust and improve access to health care. Based on data gathered during a year of ethnographic fieldwork with Roma health mediators in Romania, including participant observation and interviews, this article analyses the social processes by which participatory approaches produce both social inclusion and exclusion. It illustrates how mediators exceeded their remit of health and attempted to discipline communities into forms of neoliberal citizenship. Mediators reframed access to health care not as a right that community members already have, but as a benefit that must be individually ‘earned’ through the fulfilment of neoliberal citizenship. The article argues that far from being an ‘empowering tool’, community participation can extend the power of governing institutions and thereby may in fact contribute to the maintenance of a political status quo that perpetuates the precarisation of marginalised communities.

scholarly journals Quality of life of Zambian breast cancer women receiving care at the cancer diseases hospital Lusaka

2020 ◽  
Vol 10 (9) ◽  
pp. 57
Author(s):  
Masadza Wezzie ◽  
Siankulu Elaine ◽  
Kawalika Micheal ◽  
Victoria Mwiinga-Kalusopa ◽  
Patricia Katowa-Mukwato
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Sexual Functioning ◽  
Access To Health Care ◽  
Symptom Experience ◽  
Symptom Scale ◽  
Financial Status ◽  
Access To Health ◽  
Cancer Diseases

Background: Breast cancer is the most frequently diagnosed malignancy among women in the world with an estimation of 1.67 million new diagnoses worldwide in 2012 estimated at 25% of all cancers. In Zambia, breast cancer is the second most common cancer affecting women and accounts for 9% of all histologically proven cancers among patients admitted at the country’s only Cancer Diseases Hospital Most of the patients receive multiple treatment modalities; Surgery, Chemotherapy, Radiation Therapy and Hormonal Therapy, each with its own long-term side effects with a potential to affect  the women’s functionality, self-image and sexuality consequently the general quality of life of these women.Methods: A descriptive cross-sectional study design was used to investigate the Quality of Life (QoL) and factors influencing QoL among women with breast cancer receiving care at Zambia’s only Cancer Diseases Hospital. A total of 130 breast cancer patients on treatment who were willing to participate in the study were selected using simple random sampling. Data was collected using the European Organization for Research and Treatment in Cancer Quality of Life Questionnaire (EORTCQLQ–C30) and its breast cancer supplementary measure (QLQ-BR23). The tool assessed QoL across the physical, role, cognitive, emotional, and social functioning and sexual function domains.Results: Overall, just about half (52.5%) of the 130 respondents had high Quality of Life. QoL which was measured by the EORTCQLQ–C30 under the five domains (Physical, role, emotional, cognitive and sexual functioning) was high in four out of the five which scored above the global mean score of 68. Only the emotional functioning domain scored (65) below the mean. Conversely, the symptom scale scored high on all the eight sub items of fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation and diarrhea which signified high symptom experience among respondents. Similarly using the breast cancer supplementary measure (QLQ-BR23), two out of the four functional subscales (body image and sexual functioning) score high than average while sexual enjoyment and future perspectives score low. On the symptom scale, three out of the four scales scored higher than averages, signifying high symptom experience. Demographic characteristics which had significant association with QoL were age (p < .023), level of education (p < .023) and financial status (p < .000). Other factors that had significant association with QoL were type of treatment being received (p < .023), the severity of condition (p < .000), access to health care services (p < .000) and social support (p < .000).Conclusions: A diagnosis of breast cancer and its subsequent treatment affects several facets of a woman’s life ranging from physical, emotional, social and financial aspects consequently affecting the entire QoL. However the QoL varies and is influenced by a number of factors including age at diagnosis of cancer, level of education, financial status, type of treatment received, severity of the condition, access to health care facilities and social support. Therefore any intervention aimed at improving the QoL should be multidimensional.

Healthcare infrastructure development in rural India: a critical analysis of its status and future challenges

2019 ◽  
Vol 25 (12) ◽  
pp. 1-9
Author(s):  
Nenavath Sreenu
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Access To Health Care ◽  
Health Care Facilities ◽  
Rural India ◽  
Infrastructure Development ◽  
Poor Access ◽  
Access To Health ◽  
Future Challenges

At present, the development of healthcare infrastructure in India is poor and needs fundamental reforms in order to deal with emerging challenges. This study surveys the growth of the healthcare infrastructure. The development of infrastructure and health care facilities, the position of the workforce, and the quality of service delivery are important challenges that are confronting healthcare centres in rural India. This article critically analyses the future challenges of Indian healthcare infrastructure development in rural areas, discussing the burden of disease, widespread financial deficiency, the vaccination policy and poor access to health care as some of the main issues. Life expectancy, literacy and per capita income are further considerations.

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