Promoting health equity in the health-care system: How can we identify potentially vulnerable patients?

2021 ◽  
pp. 140349482110597
Author(s):  
Anna Thit Johnsen ◽  
Christine Enevoldsen Flink ◽  
Katrina Pitt Winther ◽  
Anne-Lene Rye Markussen ◽  
Line Lund ◽  
...  
Keyword(s):  
Health Care ◽  
Health Equity ◽  
Health Care System ◽  
Palliative Medicine ◽  
Health Care Personnel ◽  
Vulnerable Patients ◽  
Literature Reviews ◽  
The Individual ◽  
Additional Support ◽  
Care System

Background: There is documented social inequality in cancer. The health-care system may contribute to health equity by targeting interventions to potentially vulnerable patients who may be at risk of not receiving optimal treatment and care. Aim: This study aimed to develop and pilot test a tool to identify patients who may need additional support. Method: The study took place in a department of palliative medicine and in a team for head and neck cancer within an oncology department. The tool to identify potentially vulnerable patients was developed based on literature reviews and interviews with patients and health-care personnel. It was pilot tested in a six-month period, with subsequent interviews with health-care personnel. Results: In total, 212 consecutive patients referred to the departments were systematically screened with the tool by health-care personnel. Of these, 74 (35%) patients were considered potentially vulnerable. The most frequently reported sign of vulnerability was ‘few supportive relations’ (47% of the vulnerable patients). Most health-care personnel found it relevant to focus systematically on these patients. However, some were concerned that using the tool could prove to be stigmatising and were critical of attributing the vulnerability to the individual. Conclusions: Most patients were considered in need of additional support because they lacked a social network or had difficulties communicating with health-care personnel. Applying a tool to identify potentially vulnerable patients was feasible and increased attention to this group of patients. However, the screening procedure was also questioned.

Navigating the health care system: perceptions of patients with chronic pain

2009 ◽  
Vol 29 (4) ◽  
pp. 162-168
Author(s):  
AL Dewar ◽  
K Gregg ◽  
MI White ◽  
J Lander
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Health Care System ◽  
Health Care Professionals ◽  
Primary Care Physicians ◽  
Treatment Compliance ◽  
Care Utilization ◽  
Semistructured Interviews ◽  
The Individual ◽  
Care System

A new framework is needed for patients with chronic pain and their primary care physicians that acknowledges the individual’s experiences and provides evidence-informed education and better linkages to community-based resources. This study describes the experience of 19 chronic-pain sufferers who seek relief via the health care system. Their experiences were recorded through in-depth semistructured interviews and analyzed through qualitative methods. The participants reported early optimism, then disillusionment, and finally acceptance of living with chronic pain. Both individuals with chronic pain and their health care professionals need evidence-informed resources and information on best practices to assist them to manage pain. Empathetic communication between health care professionals and individuals with chronic pain is crucial because insensitive communication negatively affects the individual, reduces treatment compliance and increases health care utilization.

“We’re Going Through a Lot of Struggles That People Don’t Even Know About”

2012 ◽  
Vol 6 (5) ◽  
pp. 354-364 ◽  
Author(s):  
Michael A. Lindsey ◽  
Arik V. Marcell
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Social Network ◽  
Health Care System ◽  
Black Males ◽  
Help Seeking ◽  
Relationship Closeness ◽  
Mental Health Interventions ◽  
The Individual ◽  
Care System

Young adult Black males face challenges related to addressing their mental health needs, yet there is much more to know about their help-seeking experiences. Twenty-seven Black males, recruited from four community-based organizations, participated in four focus groups to explore perceptions of help-seeking for mental health. Identified themes, which function at individual, social network, community, and health care system levels, may facilitate or hinder Black males’ mental health help-seeking. Themes included (a) “taking care of it oneself” as opposed to seeking help from someone; (b) issues engaging sources of help, including the ability to trust providers or the relationship closeness with social network members; and (c) “tipping points” that activate help-seeking to avert crises. Study findings provide initial evidence about the importance of addressing mental health interventions for Black males on multiple levels beyond the individual including engaging men’s social supports, community, and the health care system.

Interventions with Battered Women in Health Care Settings

1990 ◽  
Vol 5 (4) ◽  
pp. 243-256 ◽  
Author(s):  
Demie Kurz
Keyword(s):  
Health Care ◽  
Battered Women ◽  
Health Care System ◽  
Health Care Personnel ◽  
Observation Data ◽  
Hospital Emergency ◽  
Health Care Settings ◽  
The Past ◽  
Hospital Emergency Departments ◽  
Care System

Over the past decade advocates for battered women in the health care system, citing the large number of battered women who come to health care settings, have proposed interventions and trainings for health care personnel on behalf of battered women. However, little is currently known about the effectiveness of intervention efforts. This paper presents observation data on characteristics of battered women in four hospital Emergency Departments (EDs) and on staff responses to battered women in these EDs. The data show definite patterns in the women’s characteristics and in staff responses to battered women. These data raise issues which should be considered in the researching and designing of interventions for battered women in the health care system.

scholarly journals Family Members’ Perspectives of Health Care System Interactions With Suicidal Patients and Responses to Suicides: Protocol for a Qualitative Research Study (Preprint)

2019 ◽  
Author(s):  
Erin Bryksa ◽  
Reham Shalaby ◽  
Laura Friesen ◽  
Kirsten Klingle ◽  
Graham Gaine ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Family Members ◽  
Qualitative Research Study ◽  
System P ◽  
Study Results ◽  
The Individual ◽  
Suicidal Patients ◽  
Suicidal Thoughts And Behaviors ◽  
Care System

BACKGROUND Suicide is a major cause of preventable death globally and a leading cause of death by injury in Canada. To support people who experience suicidal thoughts and behaviors and ultimately prevent people from dying by suicide, it is important to understand the individual and familial experiences with the health care system. OBJECTIVE This study aims to explore how suicide victims, and their family members, interacted with the health care system. METHODS We will invite family members of 6 to 8 suicide victims to participate in the study by sharing their perspectives on both their relative’s as well as their own interactions with the health care system. Interviews will take place in-person and will be audio recorded, transcribed, and analyzed thematically. RESULTS The results of the study are expected to be available in 12 months. We expect the results to shed light on the experiences of suicide victims and their family members with the health care system. CONCLUSIONS Our study results may inform practice, policy, and further research. They may shape how members of the health care system respond to people who are at risk of suicide and their families. INTERNATIONAL REGISTERED REPOR PRR1-10.2196/13797

scholarly journals Public opinion about the health care system in Armenia: findings from a cross-sectional telephone survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tsovinar Harutyunyan ◽  
Varduhi Hayrumyan
Keyword(s):  
Health Care ◽  
Public Opinion ◽  
Health Care System ◽  
Telephone Survey ◽  
Equal Access ◽  
Cross Sectional ◽  
Political Environments ◽  
The Government ◽  
The Individual ◽  
Care System

Abstract Background Few studies have examined public opinion about the health care system in the former Soviet region. The objective of our study was to evaluate the population’s satisfaction with the health care system and identify factors associated with it in Armenia. Methods We conducted a cross-sectional telephone survey among 576 adult residents of the capital Yerevan using Random Digit Dialing technique. Simple and multivariate logistic regression explored associations between potential determinants and satisfaction. Results A substantial proportion of respondents (45.5%) were dissatisfied or very dissatisfied with the health system. About 49% of respondents negatively evaluated the ability of the system to provide equal access to care. About 69% of respondents thought that the responsibility for an individual’s health should be equally shared between the individual and the government or that the government’s share should be larger. The adjusted odds of satisfaction were higher among individuals with better health status, those who positively rated equal access and respect to patients in the system, those thinking that the responsibility for health should be equally shared between the individual and the government, and those who tended to trust the government. Conclusions This study enriched our understanding of factors that shape the population’s satisfaction with the health care system in different cultural and political environments. We recommend further exploration of public opinion about those system attributes that are not directly linked to patient experiences with care, but might be equally important for explaining the phenomenon of satisfaction.

Mental health care in Berlin

2005 ◽  
Vol 20 (S2) ◽  
pp. s270-s273 ◽  
Author(s):  
M. Schouler-Ocak ◽  
A. Heinz ◽  
T. Kienast
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care System ◽  
Health Care Services ◽  
Treatment Options ◽  
Individual Treatment ◽  
Insurance Company ◽  
The Individual ◽  
Care System

AbstractAimTo provide information on the mental health care system in Berlin, Germany.MethodUsing available data we report on the spectrum of mental health care services provided in Berlin, the number of professionalsworking in these sectors, funding arrangements, pathways into care, and user/carer involvement.ResultsThe health care system in Berlin consists of a network of inpatient, outpatient, ancillary, and rehabilitative facilities, all of which are meant to work in a synergistic fashion. However, although the individual treatment options are generally well-planned, there is still a lack of co-ordination between them. Currently, the entire network is threatened by cuts in state funding for ancillary and rehabilitative services, by further reductions in the number of hospital beds, and by insurance company cuts in prescription drug budgets, such as those used for atypical antipsychotics in outpatient care.DiscussionDespite many similarities with the situation in other European capitals, the system of mental health care in Berlin suffersfrom a variety of problems related to co-ordination and costs that are unique to the German capital.

scholarly journals Preparing Laboratories for Interconnected Health Care

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1487
Author(s):  
Andreas Bietenbeck ◽  
Thomas Streichert
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Laboratory Medicine ◽  
Organizational Level ◽  
Full Potential ◽  
Snomed Ct ◽  
Technical Content ◽  
The Individual ◽  
Machine Readable ◽  
Care System

In an increasingly interconnected health care system, laboratory medicine can facilitate diagnosis and treatment of patients effectively. This article describes necessary changes and points to potential challenges on a technical, content, and organizational level. As a technical precondition, electronic laboratory reports have to become machine-readable and interpretable. Terminologies such as Logical Observation Identifiers Names and Codes (LOINC), Nomenclature for Properties and Units (NPU), Unified Code for Units of Measure (UCUM), and SNOMED-CT can lead to the necessary semantic interoperability. Even if only single “atomized” results of the whole report are extracted, the necessary information for correct interpretation must be available. Therefore, interpretive comments, e.g., concerns about an increased measurement uncertainty must be electronically attached to every affected measurement result. Standardization of laboratory analyses with traceable standards and reference materials will enable knowledge transfer and safe interpretation of laboratory analyses from multiple laboratories. In an interconnected health care system, laboratories should strive to transform themselves into a data hub that not only receives samples but also extensive information about the patient. On that basis, they can return measurement results enriched with high-quality interpretive comments tailored to the individual patient and unlock the full potential of laboratory medicine.

Agency in Health Care System Modeling and Analysis

2010 ◽  
pp. 45-68
Author(s):  
Raman Paranjape ◽  
Simerjit Gill
Keyword(s):  
Health Care ◽  
Health Care System ◽  
System Modeling ◽  
System Model ◽  
Modeling And Analysis ◽  
Agent Based ◽  
Agent Simulation ◽  
Care Systems ◽  
The Individual ◽  
Care System

This chapter examines the paradigm that a health care system’s behavior may be examined using an agent simulation in order to illuminate its macroscopic characteristics and the effects of policy on its over all operation. Further, if the individual components are well articulated, the component behavior may be also studied. Health care systems in North America are generally regulated by various processes and mechanisms in order to provide orderly access to, and control of, the health care system. While all processes are designed to be fair and equitable, in many ways the system can not be examined or optimized because the risk, that making changes to the system might result in degraded services, is too great to permit making even simple changes. In this context we propose the development of a health care system model in which agents mimic the behavior of the key components of the system. These components interact and engage each other in a manor analogous to the operation of the health care system. The formulation of such a system is, by its very nature, an extremely complex process, and necessitates development in components or units. In this chapter we present the first components of such a system. Each component has unique and complex behaviors. These components will, with additional development, form the basic structure of a health care system model. Specifically we present results from the development of a diabetic patient agent model, the development of an agent-based neurosurgery ward bed allocation system, and the development of an agent-based scheduling system that may be used to allocate resources within the health care system.

Sign in / Sign up

Export Citation Format

Share Document