scholarly journals Evaluating access to health and care services during lockdown by the COVID-19 survey in five UK national longitudinal studies

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045813
Author(s):  
Constantin-Cristian Topriceanu ◽  
Andrew Wong ◽  
James C Moon ◽  
Alun D Hughes ◽  
David Bann ◽  
...  
Keyword(s):  
Chronic Illness ◽  
Ethnic Minorities ◽  
Health Inequalities ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health ◽  
Meta Regression ◽  
The Uk ◽  
Meta Analyses

ObjectiveAccess to health services and adequate care is influenced by sex, ethnicity, socioeconomic position (SEP) and the burden of comorbidities. Our study aimed to assess whether the COVID-19 pandemic further deepened these already existing health inequalities.DesignCross-sectional study.SettingData were collected from five longitudinal age-homogenous British cohorts (born in 2000-2002, 1989-1990, 1970, 1958 and 1946).ParticipantsA web survey was sent to the cohorts. Anybody who responded to the survey was included, resulting in 14 891 eligible participants.Main outcomes measuredThe survey provided data on cancelled surgical or medical appointments, and the number of care hours received in a week during the first UK COVID-19 national lockdown.InterventionsUsing binary or ordered logistic regression, we evaluated whether these outcomes differed by sex, ethnicity, SEP and having a chronic illness. Adjustment was made for study design, non-response weights, psychological distress, presence of children or adolescents in the household, COVID-19 infection, key worker status, and whether participants had received a shielding letter. Meta-analyses were performed across the cohorts, and meta-regression was used to evaluate the effect of age as a moderator.ResultsWomen (OR 1.40, 95% CI 1.27 to 1.55) and those with a chronic illness (OR 1.84, 95% CI 1.65 to 2.05) experienced significantly more cancellations during lockdown (all p<0.0001). Ethnic minorities and those with a chronic illness required a higher number of care hours during the lockdown (both OR≈2.00, all p<0.002). SEP was not associated with cancellation or care hours. Age was not independently associated with either outcome in the meta-regression.ConclusionThe UK government’s lockdown approach during the COVID-19 pandemic appears to have deepened existing health inequalities, impacting predominantly women, ethnic minorities and those with chronic illnesses. Public health authorities need to implement urgent policies to ensure equitable access to health and care for all in preparation for a fourthwave.

scholarly journals Inequality in access to health and care services during lockdown - Findings from the COVID-19 survey in five UK national longitudinal studies

2020 ◽  
Author(s):  
Constantin-Cristian Topriceanu ◽  
Andrew Wong ◽  
James C Moon ◽  
Alun Hughes ◽  
David Bann ◽  
...  
Keyword(s):  
Chronic Illness ◽  
Ethnic Minorities ◽  
Health Inequalities ◽  
Access To Health Services ◽  
Care Services ◽  
Access To Health ◽  
Public Health Authorities ◽  
Meta Regression ◽  
The Uk ◽  
Meta Analyses

Background: Access to health services and adequate care is influenced by sex, ethnicity, socio-economic position (SEP) and burden of co-morbidities. However, it is unknown whether the COVID-19 pandemic further deepened these already existing health inequalities. Methods: Participants were from five longitudinal age-homogenous British cohorts (born in 2001, 1990, 1970, 1958 and 1946). A web and telephone-based survey provided data on cancelled surgical or medical appointments, and the number of care hours received during the UK COVID-19 national lockdown. Using binary or ordered logistic regression, we evaluated whether these outcomes differed by sex, ethnicity, SEP and having a chronic illness. Adjustment was made for study-design, non-response weights, psychological distress, presence of children or adolescents in the household, keyworker status, and whether participants had received a shielding letter. Meta-analyses were performed across the cohorts and meta-regression evaluated the effect of age as a moderator. Findings: 14891 participants were included. Females (OR 1.40, 95% confidence interval [1.27,1.55]) and those with a chronic illness (OR 1.84 [1.65-2.05]) experienced significantly more cancellations during lockdown (all p<0.0001). Ethnic minorities and those with a chronic illness required a higher number of care hours during the lockdown (both OR approx. 2.00, all p<0.002). Age was not independently associated with either outcome in meta-regression. SEP was not associated with cancellation or care hours. Interpretation: The UK government's lockdown approach during the COVID-19 pandemic appears to have deepened existing health inequalities, impacting predominantly females, ethnic-minorities and those with chronic illnesses. Public health authorities need to implement urgent policies to ensure equitable access to health and care for all in preparation for a second wave.

scholarly journals Usage of purchased self-tests for HIV infections among migrants living in the UK, France and the Netherlands: a cross-sectional study

2018 ◽  
Vol 95 (8) ◽  
pp. 629-632 ◽  
Author(s):  
Janneke P Bil ◽  
Maria Prins ◽  
Ibidun Fakoya ◽  
Alain Volny-Anne ◽  
Fiona Burns ◽  
...  
Keyword(s):  
The Netherlands ◽  
Hiv Infections ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Web Based ◽  
Access To Health ◽  
Male Sexual Partners ◽  
Sex With Men ◽  
The Uk

ObjectivesSelf-tests are performed and interpreted autonomously by a person without involving a healthcare professional or a certified laboratory. To gain insight into the usage of purchased HIV self-tests (HIVST) among migrants living in high-income countries, we studied the prevalence and determinants of HIVST usage among migrants living in the UK, France and the Netherlands.MethodsWe used web-based questionnaire data collected between April 2014 and July 2015 among migrants living in the UK, France and the Netherlands who participated in the cross-sectional community survey of the aMASE (advancing Migrant Access to health Services in Europe) study. HIVST usage in the preceding 12 months and the corresponding 95% CIs were calculated. Using univariate logistic regression analyses, determinants of HIVST usage were evaluated.ResultsAmong 477 migrants living in the UK (n=235), France (n=98) and the Netherlands (n=144), HIVST usage in the preceding 12 months was 1.89% (9/477, 95% CI 0.66% to 3.11%). As all nine HIVST users were men who have sex with men (MSM), we restricted our univariate analyses to MSM (n=240). HIVST usage was borderline significantly lower among MSM living in France and the Netherlands compared with those living in the UK (UK: reference; France: OR 0.20, 95% CI 0.03 to 1.14; the Netherlands: OR 0.06, 95% CI 0.00 to 1.05). Age, region of birth, educational level, registration at a general practitioner, recent number of male sexual partners and hard drug use were not associated with HIVST usage among MSM.ConclusionsHIVST usage among migrants from the UK, France and the Netherlands was relatively low between 2014 and 2015 but higher among migrant MSM. To increase HIV testing rates among migrants, programmes need to be developed to promote HIVST among this group. Also, as more countries approve usage of HIVST, systems need to be established to ensure linkage to confirmatory testing and care following a positive test.

scholarly journals Vaccine Willingness and Impact of the COVID-19 Pandemic on Women’s Perinatal Experiences and Practices—A Multinational, Cross-Sectional Study Covering the First Wave of the Pandemic

2021 ◽  
Vol 18 (7) ◽  
pp. 3367
Author(s):  
Michael Ceulemans ◽  
Veerle Foulon ◽  
Alice Panchaud ◽  
Ursula Winterfeld ◽  
Léo Pomar ◽  
...  
Keyword(s):  
Access To Health Care ◽  
Cross Sectional Study ◽  
Vaccine Hesitancy ◽  
Access To Health Services ◽  
Breastfeeding Support ◽  
Cross Sectional ◽  
Care And Support ◽  
Access To Health ◽  
The Uk ◽  
The Impact

The COVID-19 pandemic may be of particular concern for pregnant and breastfeeding women. We aimed to explore their beliefs about the coronavirus and COVID-19 vaccine willingness and to assess the impact of the pandemic on perinatal experiences and practices. A multinational, cross-sectional, web-based study was performed in six European countries between April and July 2020. The anonymous survey was promoted via social media. In total, 16,063 women participated (including 6661 pregnant and 9402 breastfeeding women). Most responses were collected from Belgium (44%), Norway (18%) and the Netherlands (16%), followed by Switzerland (11%), Ireland (10%) and the UK (3%). Despite differences between countries, COVID-19 vaccine hesitancy was identified among 40–50% of the respondents at the end of the first wave of the pandemic and was higher among pregnant women. Education level and employment status were associated with vaccine hesitancy. The first wave had an adverse impact on pregnancy experiences and disrupted access to health services and breastfeeding support for many women. In the future, access to health care and support should be maintained at all times. Evidence-based and tailored information on COVID-19 vaccines should also be provided to pregnant and breastfeeding women to avoid unfounded concerns about the vaccines and to support shared decision making in this population.

Desigualdade social em doentes renais crônicos/ Social inequality in chronic renal patients

1970 ◽  
Vol 1 (1) ◽  
pp. 44-49
Author(s):  
Beatriz Bertolaccini Martínez ◽  
Fernanda Marcelino Da Silva ◽  
Vinícius Tavares Veiga ◽  
Rodrigo Pereira Custódio ◽  
José Vítor Da Silva
Keyword(s):  
Social Inequality ◽  
Access To Health Care ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Access To Treatment ◽  
Cross Sectional ◽  
Economic Class ◽  
Access To Health ◽  
Clinical Background

Introdução: A pobreza influencia na evolução dos pacientes com doenças crônicas, porque contribui para o seu agravamento e dificulta o acesso à assistência médica. O objetivo deste trabalho foi avaliar os aspectos relacionados à desigualdade social de pacientes em hemodiálise. Métodos: Estudo transversal com 123 pacientes em hemodiálise no Hospital Samuel Libânio – Pouso Alegre, MG, divididos, de acordo com a classe econômica, em 3 grupos: AB (n=23), C (n=60) e DE (n=40),. Foram coletados dados sociodemográficos e econômicos, antecedentes clínicos e informações sobre o acesso a serviços de saúde. Para a análise dos resultados, foi utilizada estatística analítica e descritiva. Adotou-se p £ 0,05. Resultados: O grupo AB apresentou um menor número de pacientes jovens (4,3% em AB vs 40% em C e 25% em DE, p < 0,05), um maior número de indivíduos com mais anos de escolaridade (65,3% em AB vs 18,3% em C e 2,5% em DE; p < 0,05), predomínio de pacientes com menos de um ano em tratamento de hemodiálise (65,2% em AB vs 10% em C e 5% em DE, p < 0,05), menor número de usuários do SUS (40% em C e 25% em DE vs 4,3% em AB; p < 0,05) e maior acesso ao tratamento com nefrologista (73,9% em AB vs 46,7% em C e 52,5 em DE; p < 0,05). Conclusão: Classes economicamente desfavorecidas agregam indivíduos mais jovens, com menor escolaridade, usuários do SUS, com maior tempo em hemodiálise e pior acesso ao tratamento com nefrologista.Introduction: The poverty influence on the evolution of patients with chronic diseases because it contributes to your aggravation and hinders access to health care. Our goal was to evaluate the aspects related to social inequality on hemodialysis patients. Methods: cross-sectional study with 123 patients on hemodialysis in Samuel Libânio Hospital – Pouso Alegre, MG, divided according to the economic class, into 3 groups: AB (n = 23), C (n = 60) and DE (n = 40). Were collected socio-demographic and economic data, clinical background and information about access to health services. For analysis of the results has been used statistical analytical and descriptive. We take p £ 0,05.  Results: The AB group has fewer young patients (4,3% in AB vs 40% in C and 25% in DE, p< 0,05), a greater number of individuals with more years of schooling (65,3% in AB vs 18,3% in C and 2,5% in DE; p< 0,05), predominance of patients with less than a year on haemodialysis treatment (65,2% in AB vs 10% in C and 5% in DE, p< 0,05), smaller number of users of SUS (40% in C and 25% in DE vs 4,3% in AB; p< 0,05), greater access to treatment with nephrologist (73,9% in AB vs 46,7% in C and 52,5% in DE; p< 0,05). Conclusion: Economically disadvantaged classes bring younger patients, with less schooling, users of SUS, patients with greater time on hemodialysis and worse access to treatment with nephrologist. 

scholarly journals Undernutrition and associated factors in orphan children aged 6–59 months in Gambella Southwest, Ethiopia: A community-based cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045892
Author(s):  
Solomon Feleke ◽  
Gudina Egata ◽  
Firehiwot Mesfin ◽  
Gizachew Yilak ◽  
Abebaw Molla
Keyword(s):  
Associated Factors ◽  
Wealth Index ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Orphaned Children ◽  
Access To Health ◽  
Study Participants ◽  
Children Under 5

ObjectiveThe study aimed to assess the prevalence of stunting, wasting, underweight and associated factors in orphaned children under 5 years old.DesignA cross-sectional study.SettingGambella City, Ethiopia.ParticipantsA sample of 419 under 5 orphaned children included in the study. Eligible households with orphans had selected using a systematic random sampling method. The lottery method was used when more than one eligible study participants live in the household. An OR with 95% CI was performed to measure the strength of association between each dependent variable and independent variables. Variables with p<0.05 were declared statistically significant.Primary outcomeThe main outcome of this study was the prevalence of undernutrition among orphaned under 5 and its associated factors.ResultsPrevalence of stunting, wasting and underweight in orphan children under 5 were 12.2%, 37.8% and 21.7%, respectively. The prevalnce of wasting peaks among age group of 36–47 months (42.5%), whereas underweight peaks in 48–59 months (27.7%). Food insecurity, wealth index, family size, vitamin A supplementation, diarrhoea, fever 2 weeks before the survey, children under 5 and parents’ death were associated with undernutrition.ConclusionThe prevalence of stunting, wasting and underweight among orphan children under 5 was significantly high. Multisectoral collaborative efforts towards access to health services, improving income-generating activities, micronutrient supplementation and social support and protection targeting orphan and vulnerable populations have to be built up.

Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study

The Lancet ◽  
2012 ◽  
Vol 379 (9818) ◽  
pp. 805-814 ◽  
Author(s):  
Qun Meng ◽  
Ling Xu ◽  
Yaoguang Zhang ◽  
Juncheng Qian ◽  
Min Cai ◽  
...  
Keyword(s):  
Health Services ◽  
Cross Sectional Study ◽  
Financial Protection ◽  
Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health

scholarly journals Satisfaction with Access to Health Services: The Perspective of Estonian Patients with Rheumatoid Arthritis

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Kaja Põlluste ◽  
Riina Kallikorm ◽  
Kersti Meiesaar ◽  
Margus Lember
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Services ◽  
Negative Impact ◽  
Waiting Times ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health ◽  
Degree Of Satisfaction ◽  
Determinants Of Satisfaction

In this cross-sectional study we explained the possible determinants of satisfaction with access to health services in patients with rheumatoid arthritis (RA). Of the 2000 randomly selected Estonian adult patients with RA, a total 1259 completed the survey. Regression analysis was used to analyse the predictors of patients' satisfaction with access to health services. Half of the respondents were satisfied with their access to health services. Factors that had a negative impact on satisfaction included pain intensity, longer waiting times to see the doctors, as well as low satisfaction with the doctors. Transportation costs to visit a rheumatologist and higher rehabilitation expenses also affected the degree of satisfaction. Patients who could choose the date and time at which they could visit the rheumatologist or who could visit their “own” doctor were more likely to be satisfied than patients whose appointment times were appointed by a healthcare provider.

scholarly journals Polish Nurses’ Opinions on the Expansion of Their Competences—Cross-Sectional Study

2021 ◽  
Vol 11 (2) ◽  
pp. 301-310
Author(s):  
Kinga Harpula ◽  
Anna Bartosiewicz ◽  
Jerzy Krukowski
Keyword(s):  
Health Services ◽  
Medical Science ◽  
Cross Sectional Study ◽  
Advanced Practice ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Significance Level ◽  
Access To Health ◽  
Survey Technique

The development of medical science creates new challenges for nurses to acquire new skills. Thanks to legal changes in Poland, nurses have gained the opportunity to independently provide health services in many areas, including consultations for patients. The aim of the survey is to analyze nurses’ opinions on the expansion of competences in their profession. This is a cross-sectional, descriptive study conducted among 798 nurses using the survey technique. The majority (65.48%) of the respondents believed that they were adequately prepared to take up new competences. Most of the respondents believed that the new competence would improve the efficiency of the healthcare system in Poland (71.06%) and facilitate patients’ access to health services (65.29%). According to the nurses, the scope of nursing advice will mainly concern the promotion of health education, wound treatment and prescribing medications. Age, seniority and education level significantly influenced the nurses’ opinions on the scope of nursing advice. The Mann–Whitney test and the Kruskal–Wallis test were used. A correlation between two quantitative variables was assessed with the Spearman’s rho coefficient. The significance level of p < 0.05 was assumed. The extension of the professional competences of nurses will increase the prestige of the profession and is another step toward introducing the role of Advanced Practice Nurse in Poland.

scholarly journals Epidemiological profile of home deaths due to stroke during the COVID-19 pandemic

2021 ◽  
Author(s):  
Gyovanna Rodrigues Cardoso ◽  
Gabriel David Camargo ◽  
Nikolas Lisboa Coda Dias ◽  
Priscila Anice Fernandes ◽  
Stefan Vilges de Oliveira
Keyword(s):  
Age Groups ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Medical Support ◽  
Cross Sectional ◽  
Access To Health ◽  
Excessive Alcohol ◽  
Epidemiological Profile

Background: Stroke is one of the main causes of death, disability and hospitalization. Although more prevalent in adults and the elderly, it has increased in young people for stress, poor diet, excessive alcohol and sedentary lifestyle. This study is justified because the restrictions in the pandemic, such as social isolation, reduced access to health services, have changed people’s behavior in relation to health care. This can cause the delay in medical care, leading to negative outcomes. Objectives: Analysis of home deaths for stroke, in Brazil, in the pandemic by age intervals. Design and Setting: Cross-sectional study in Federal University of Uberlândia. Methods: Study of home deaths from stroke, based on the Portal de Transparência do Registro Civil (ARPEN). Analyzing a previous context and during the pandemic, the percentage variations by age group between 2019 and 2020 were compared. Results: In 2020, 15,777 home deaths were recorded, while 2019 there were 12,349, representing an increase of 27.76%. In 2020, all age groups analyzed, there were increases in relation to 2019, the most expressive were: 0-9 years (76%), 10-19 (32.14%), 60-69 (28.12%), 70-79 (36.35%) and 80-89 (29.97%). Conclusions: Medical support in the first hours of symptoms is essential. The delay in care can delay the diagnosis, make the use of medications unfeasible, due to the door-to-needle times, as well as increasing home deaths. Thus, it is important to guide the population in the identification of signs and symptoms, to knowledge about the need for immediate hospital care, even in the pandemic.

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