Health Survey in a Peruvian health system (ENSSA)

OBJECTIVE: To report the design, methodology and initial results of the National Socioeconomic Survey of Access to Health of the EsSalud Insured. RESULTS: There were interviews in 25,000 homes, surveying 79,874 people, of which 62,659 were affiliated to EsSalud. The insured people are mainly males (50.6%) with a higher technical education level (39.7%). The insured population has mostly independent (95.0%) and own (68.1%) home. Only 34.5% of the insured practice some sport or physical exercise; 14.0% of the population suffers from a chronic disease; 3.5% have diabetes; and 7.1%, arterial hypertension. In the last three months, 35.4% of the members needed medical attention; of these, only 73.1% received health care and the remaining 10.9% were treated in pharmacies or non-formal health care services. RESULTS: The 25,000 homes were interviewed, surveying 79,874 people, of which 62,659 were affiliated to EsSalud. The insured people are mainly males (50.6%) with a higher technical education level (39.7%). The insured population has mostly independent (95.0%) and own (68.1%) home. Only 34.5% of the insured practice some sport or physical exercise; 14.0% of the population suffers from a chronic disease; 3.5% have diabetes; and 7.1%, arterial hypertension. In the last three months, 35.4% of the members needed medical attention; of these, only 73.1% received health care and the remaining 10.9% were treated in pharmacies or non-formal health care services. CONCLUSIONS: This survey is the first performed in the population of EsSalud affiliates, applied at the national level, and has socio-economic and demographic data of the insured, their distribution, risk factors of health, prevalence of health problems and the degree of access to health services.

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Race and gender as factors in access to health insurance and utilization of health care services

PsycEXTRA Dataset ◽

10.1037/e536152014-001 ◽

2014 ◽

Author(s):

Susana J. Ferradas ◽

G. Nicole Rider ◽

Johanna D. Williams ◽

Brittany J. Dancy ◽

Lauren R. Mcghee

Keyword(s):

Health Care ◽

Health Insurance ◽

Health Care Services ◽

Race And Gender ◽

Care Services ◽

Access To Health ◽

And Gender

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Legislative and executive translation of the right to have access to health care services

Law Democracy & Development ◽

10.4314/ldd.v14i1.7 ◽

2011 ◽

Vol 14 (1) ◽

Author(s):

M Pieterse

Keyword(s):

Health Care ◽

Access To Health Care ◽

Health Care Services ◽

Care Services ◽

Access To Health ◽

The Right

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Access to health care and Informal Patient Payments for health care in Serbia

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.774 ◽

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.

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Structure and Distribution of Health Care Costs across Age Groups of Patients with Multimorbidity in Lithuania

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052767 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2767

Author(s):

Laura Nedzinskienė ◽

Elena Jurevičienė ◽

Žydrūnė Visockienė ◽

Agnė Ulytė ◽

Roma Puronaitė ◽

...

Keyword(s):

Health Care ◽

Health Insurance ◽

Chronic Disease ◽

National Health Insurance ◽

Health Care Services ◽

Age Groups ◽

Age Group ◽

Resource Usage ◽

Care Services ◽

Care Costs

Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management.

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Substantive Equality in South African Health Care: The Limits of Law

Medical Law International ◽

10.1177/096853320000400203 ◽

2000 ◽

Vol 4 (2) ◽

pp. 111-131 ◽

Cited By ~ 1

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.

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Medicaid Policy Statement

PEDIATRICS ◽

10.1542/peds.93.1.135 ◽

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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Does better availability mean better accessibility? Spatial inequalities in the care of acute myocardial infarction in Hungary

Hungarian Geographical Bulletin ◽

10.15201/hungeobull.69.4.5 ◽

2020 ◽

Vol 69 (4) ◽

pp. 401-418

Author(s):

Annamária Uzzoli ◽

Zoltán Egri ◽

Dániel Szilágyi ◽

Viktor Pál

Keyword(s):

Myocardial Infarction ◽

Health Care ◽

Acute Myocardial Infarction ◽

Statistical Analysis ◽

Health Literacy ◽

Access To Health Care ◽

Health Care Services ◽

Care Services ◽

Spatial Inequalities ◽

Access To Health

The availability of health care services is an important issue, however, improving availability of health care services does not necessarily mean better accessibility for everybody. The main aim of this study is to find out how better availability in the care of acute myocardial infarction vary with accessibility of patients’ geographical location within Hungary. We applied statistical analysis and interview techniques to unfold the role of spatiality in the conditions of access to health care. Results of statistical analysis indicate significant health inequalities in Hungary. Decreasing national mortality rates of acute myocardial infarction, has been coupled by increasing spatial inequalities within the country especially at micro-regional level. According to in-depth interviews with local health care stakeholders we defined factors that support access to health care as well as important barriers. The supporting factors are related to the improvement of availability (i.e. infrastructural developments), while geographical distance, lack of material and human resources, or low level of health literacy proved to be the most relevant barriers. Main conclusion is that barriers to accessibility and availability are not only spatial but are also based on individual stages of acute myocardial infarction care. The development of cardiac catheter centres in Hungary has improved the short-term chances of infarction survival, but long-term survival chances have worsened in recent years due to deficiencies in rehabilitation care as well as low level of health literacy.

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Community Residents’ Awareness of Family Doctor Contract Services, Signing With Family Doctor, Willingness to Use Community Health Care Centers: A Community-Based Analysis in Shenzhen, China

10.21203/rs.3.rs-118080/v1 ◽

2020 ◽

Author(s):

Qingming Zheng ◽

Lu Shi ◽

Tiantian Pang ◽

Willie Leung

Keyword(s):

Health Care ◽

Chronic Disease ◽

Health Care Services ◽

Family Doctor ◽

Disease Status ◽

Care Services ◽

Community Health Care Centers ◽

Primary Health Care Services ◽

Willingness To Use ◽

The Impact

Abstract Background: Family doctor contracted services (FDCS) began in China in 2016. Shenzhen, one of the most developed cities in China, implemented a family doctor (FD) policy in 2017. The objectives of this study were to identify the impact of the awareness of the FD and signing with a FD on health care seeking behavior, as well as the impact of chronic disease status on the awareness of FDs and signing with a FD. Methods: Cross-sectional secondary data based on residents living in Luohu district was used for analysis. Linear probability models (LPM) were used to determine the relationship between willingness to use community health care centers (CHCs) and awareness of the FDCS, as well as the association between willingness to use CHCs and signing with a FD. LPM was also used to estimate the association between chronic disease status and awareness of the FDCS, as well as the association between chronic disease status and signing with a FD.Results: Among 1205 adults included in analysis, 27% of the participants knew the FDCS, 5% signed with FD, and 20% had chronic disease. Both awareness of the FDCS and signing with a FD significantly increased the probability of using CHCs. The results indicated that participants with chronic disease were more likely to be aware of the FDCS and sign with a FD.Conclusions: Consequently, this study provided evidence that awareness of FDCS and signing with a FD had positive impact on utilization of primary health care services in the at community level. Also, individuals with chronic disease tend to use FDCS. More interventions to improve awareness of FDCS can help to increase the utilization of primary health care services.

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