scholarly journals How Socioeconomic Status Affects Patient Perceptions of Health Care: A Qualitative Study

2017 ◽  
Vol 8 (3) ◽  
pp. 169-175 ◽  
Author(s):  
Nicholas C. Arpey ◽  
Anne H. Gaglioti ◽  
Marcy E. Rosenbaum
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Health Care Disparities ◽  
Clinical Decision Making ◽  
Care Delivery ◽  
Clinical Decision ◽  
Clinician Bias ◽  
Low Socioeconomic ◽  
The Individual

Introduction: Clinician perceptions of patients with low socioeconomic status (SES) have been shown to affect clinical decision making and health care delivery in this group. However, it is unknown how and if low SES patients perceive clinician bias might affect their health care. Methods: In-depth interviews with 80 enrollees in a state Medicaid program were analyzed to identify recurrent themes in their perceptions of care. Results: Most subjects perceived that their SES affected their health care. Common themes included treatment provided, access to care, and patient-provider interaction. Discussion: This study highlights complex perceptions patients have around how SES affects their health care. These results offer opportunities to reduce health care disparities through better understanding of their impact on the individual patient-provider relationship. This work may inform interventions that promote health equity via a multifaceted approach, which targets both providers and the health care system as a whole.

scholarly journals Eliminating disparities and implicit bias in health care delivery by utilizing a hub-and-spoke model

2018 ◽  
Vol 4 ◽  
pp. e26370
Author(s):  
Pradeep Joseph
Keyword(s):  
Health Care ◽  
Health Care Disparities ◽  
Clinical Decision Making ◽  
Care Delivery ◽  
Implicit Bias ◽  
Complex Form ◽  
Community Outreach ◽  
The United States ◽  
Great Success ◽  
Nurse Navigator

The state of health disparities in the United States has remained relatively stable over a number of years. Although overall outcomes for all patients have improved, a difference persists in how different racial, ethnic, and gender groups have fared in our health care system. Many programs that have sought to combat this problem have been predicated on the belief that only a small number of providers in the medical community are aware of their own biases. Accordingly, it was believed that bias awareness is the direct conduit for this particular change in the health system. However, the results of such programs have been unsatisfactory. The reason for such ineffectiveness is that many programs have not taken into account the presence of implicit bias within the patient-provider relationship. This complex form of bias operates in specific ways, and must be dealt with appropriately. The use of digital checklists to aid in clinical decision making has proved to be both a way that patients can receive equitable care, and a way to improve overall patient outcomes. Secondly, in order to reach the most at-risk populations, health care must expand beyond the hospital walls, and out into the community. Nurse navigator programs have been shown to accomplish this with great success. Together, checklists and nurse navigators are the necessary next-step in the battle against health care disparities. What’s more, this two-pronged approach is relatively simple to implement. By making use of current electronic medical records, digital checklists can be quickly installed. Likewise, nurse navigator programs, a comparatively inexpensive option, can be rolled out quickly because of their simple design. A focus on the patient-provider relationship and community outreach is critical for progress in eliminating health care disparities.

Defining the paramedic process

2015 ◽  
Vol 21 (1) ◽  
pp. 22 ◽  
Author(s):  
Holly Carter ◽  
James Thompson
Keyword(s):  
Process Model ◽  
Clinical Decision Making ◽  
Care Delivery ◽  
Clinical Decision ◽  
Nursing Process ◽  
Process Of Care ◽  
Ovid Medline ◽  
Hospital Practices ◽  
The Individual

The use of a ‘process of care’ is well established in several health professions, most evidently within the field of nursing. Now ingrained within methods of care delivery, it offers a logical approach to problem solving and ensures an appropriate delivery of interventions that are specifically suited to the individual patient. Paramedicine is a rapidly advancing profession despite a wide acknowledgement of limited research provisions. This frequently results in the borrowing of evidence from other disciplines. While this has often been useful, there are many concerns relating to the acceptable limit of evidence transcription between professions. To date, there is no formally recognised ‘process of care’-defining activity within the pre-hospital arena. With much current focus on the professional classification of paramedic work, it is considered timely to formally define a formula that underpins other professional roles such as nursing. It is hypothesised that defined processes of care, particularly the nursing process, may have features that would readily translate to pre-hospital practice. The literature analysed was obtained through systematic searches of a range of databases, including Ovid MEDLINE, Cumulative Index to Nursing and Allied Health. The results demonstrated that the defined process of care provides nursing with more than just a structure for practice, but also has implications for education, clinical governance and professional standing. The current nursing process does not directly articulate to the complex and often unstructured role of the paramedic; however, it has many principles that offer value to the paramedic in their practice. Expanding the nursing process model to include the stages of Dispatch Considerations, Scene Assessment, First Impressions, Patient History, Physical Examination, Clinical Decision-Making, Interventions, Re-evaluation, Transport Decisions, Handover and Reflection would provide an appropriate model for pre-hospital practices.

scholarly journals The Effectiveness of Health Informatics

2010 ◽  
pp. 13-37
Author(s):  
Francesco Paolucci ◽  
Henry Ergas ◽  
Terry Hannan ◽  
Jos Aarts
Keyword(s):  
Health Care ◽  
Health Information ◽  
Information Management ◽  
Health Informatics ◽  
Clinical Decision Making ◽  
Care Delivery ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Long Run ◽  
Information Management Systems

Health care is complex and there are few sectors that can compare to it in complexity and in the need for almost instantaneous information management and access to knowledge resources during clinical decision-making. There is substantial evidence available of the actual, and potential, benefits of e-health tools that use computerized clinical decision support systems (CDSS) as a means for improving health care delivery. CDSS and associated technologies will not only lead to an improvement in health care but will also change the nature of what we call electronic health records (EHR) The technologies that “define” the EHR will change the nature of how we deliver care in the future. Significant challenges relating to the evaluation of these health information management systems relate to demonstrating their ongoing cost-benefit, cost-effectiveness, and effects on the quality of care and patient outcomes. However, health information technology is still mainly about the effectiveness of processes and process outcomes, and the technology is still not mature, which may lead to unintended consequences, but it remains promising and unavoidable in the long run.

scholarly journals Sociolinguistic Diversity Can Boost Cognitive Functions

2021 ◽  
Author(s):  
Yin Jue Chang
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Cognitive Functions ◽  
Flanker Task ◽  
Set Shifting ◽  
Low Socioeconomic ◽  
Societal Level ◽  
The Individual ◽  
Mixing Costs ◽  
Set Shifting Task

This study investigates the link between sociolinguistic diversity and executive functions. 127 healthy adults from Malaysia were recruited to complete three cognitive tasks and the Contextual Linguistic Profile Questionnaire (CLiP-Q). A sociolinguistic diversity score was derived for each participant, with a higher score reflecting a greater exposure and use of diverse languages both at the individual and the societal level. The results demonstrated a sociolinguistic diversity advantage in cognitive functions. Higher sociolinguistic diversity scores were associated with lesser interference in the Flanker task and better accuracy in the 2-back task. Additionally, a significant interaction between sociolinguistic diversity and socioeconomic status was found for the set-shifting task, showing that sociolinguistic diversity could reduce mixing costs and improve set-shifting task accuracy for low socioeconomic status participants who are usually disadvantaged in cognitive control. Thus, it is important for research in the multilingualism field to take sociolinguistic diversity context into account.

scholarly journals Access to midwifery care for people of low socio-economic status: a qualitative descriptive study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Elizabeth K. Darling ◽  
Lindsay Grenier ◽  
Lisa Nussey ◽  
Beth Murray-Davis ◽  
Eileen K. Hutton ◽  
...  
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Health Care System ◽  
Low Socioeconomic Status ◽  
Post Partum ◽  
Descriptive Study ◽  
Midwifery Care ◽  
Low Socioeconomic ◽  
Qualitative Descriptive ◽  
Care System

Abstract Background Despite public funding of midwifery care, people of low-socioeconomic status are less likely to access midwifery care in Ontario, Canada, but little is known about barriers that they experience in accessing midwifery care. The purpose of this study was to examine the barriers and facilitators to accessing midwifery care experienced by people of low-socioeconomic status. Methods A qualitative descriptive study design was used. Semi-structured interviews were conducted with 30 pregnant and post-partum people of low-socioeconomic status in Hamilton, Ontario from January to May 2018. Transcribed interviews were coded using open coding techniques and thematically analyzed. Results We interviewed 13 midwifery care recipients and 17 participants who had never received care from midwives. Four themes arose from the interviews: “I had no idea…”, “Babies are born in hospitals”, “Physicians as gateways into prenatal care”, and “Why change a good thing?”. Participants who had not experienced midwifery care had minimal knowledge of midwifery and often had misconceptions about midwives’ scope of practice and education. Prevailing beliefs about pregnancy and birth, particularly concerns about safety, drove participants to seek care from a physician. Physicians are the entry point into the health care system for many, yet few participants received information about midwifery care from physicians. Participants who had experienced midwifery care found it to be an appropriate match for the needs of people of low socioeconomic status. Word of mouth was a primary source of information about midwifery and the most common reason for people unfamiliar with midwifery to seek midwifery care. Conclusions Access to midwifery care is constrained for people of low-socioeconomic status because lack of awareness about midwifery limits the approachability of these services, and because information about midwifery care is often not provided by physicians when pregnant people first contact the health care system. For people of low-socioeconomic status, inequitable access to midwifery care may be exacerbated by lack of knowledge about midwifery within social networks and a tendency to move passively through the health care system which traditionally favours physician care. Targeted efforts to address this issue are necessary to reduce disparities in access to midwifery care.

scholarly journals Complementary and alternative medicines usage in elderly patients in tertiary care teaching hospital of North India

2020 ◽  
Vol 9 (9) ◽  
pp. 1434
Author(s):  
Akanksha Mehra ◽  
Vijay Khajuria
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Elderly Patients ◽  
Dietary Supplements ◽  
Low Socioeconomic Status ◽  
Tertiary Care ◽  
North India ◽  
Endocrine Disorders ◽  
Low Socioeconomic ◽  
Complementary And Alternative

Background: Complementary and alternative medicine (CAM) is defined as a group of diverse medical health care systems, practices and products that are not presently considered to be part of conventional medicine. Its use is highly prevalent in elderly population because of presence of chronic diseases. So, present study was planned to assess CAM usage in elderly patients.Methods: This observational, questionnaire-based study was conducted at department of pharmacology, in association with department of medicine and included all adult patients of more than 60 years of age who have taken any CAM therapy. Demographic data, name of CAM preparation, its characteristics and behavioral pattern for its usage were recorded.Results: Out of 200 patients of more than 60 years attending medicine outpatient department, 115 were found to be CAM users. CAM usage was more in females (59.1%); age group of 60-69 years (49.57%); rural residents (66.08%); low socioeconomic status (81.73%). Most common CAM preparations used were dietary supplements (61.7%) and vitamins and minerals (56.52%) for indications such as chronic pain and endocrine disorders because it was thought to be safe. 76.52 % of CAM users did not discuss CAM with their health care provider.Conclusions: CAM use is highly prevalent in elderly patients and more so in females of low socioeconomic status. Most common CAM therapy used was dietary supplements. Continuous educational efforts are needed to enhance the awareness of patients and healthcare providers regarding the CAM therapy.

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