scholarly journals Determinants of perceived health and unmet healthcare needs in universal healthcare systems with high gender equality

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christina P. Tadiri ◽  
Teresa Gisinger ◽  
Alexandra Kautzky-Willer ◽  
Karolina Kublickiene ◽  
Maria Trinidad Herrero ◽  
...  
Keyword(s):  
Marital Status ◽  
Gender Equality ◽  
Social Factors ◽  
Negative Impact ◽  
Perceived Health ◽  
Healthcare Systems ◽  
Care Needs ◽  
Universal Healthcare ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs

Abstract Background Patient attitudes about health and healthcare have emerged as important outcomes to assess in clinical studies. Gender is increasingly recognized as an intersectional social construct that may influence health. Our objective was to determine potential sex differences in self-reported overall health and access to healthcare and whether those differences are influenced by individual social factors in two relatively similar countries. Methods Two public health surveys from countries with high gender equality (measured by UN GII) and universal healthcare systems, Canada (CCHS2014, n = 57,041) and Austria (AT-HIS2014, n = 15,212), were analysed. Perceived health was assessed on a scale of 1 (very bad) to 4 (very good) and perceived unmet healthcare needs was reported as a dichotomous variable (yes/no). Interactions between sex and social determinants (i.e. employment, education level, immigration and marital status) on outcomes were analysed. Results Individuals in both countries reported high perceived health (Scoring > 2, 85.0% in Canada, 79.9% in Austria) and a low percentage reported unmet healthcare needs (4.6% in Canada, 10.7% in Austria). In both countries, sex and several social factors were associated with high perceived health, and a sex-by-marital status interaction was observed, with a greater negative impact of divorce for men. Female sex was positively associated with unmet care needs in both countries, and sex-by-social factors interactions were only detected in Canada. Conclusions The intersection of sex and social factors in influencing patient-relevant outcomes varies even among countries with similar healthcare and high gender equality.

scholarly journals Non-communicable diseases among refugees claimants in Greek refugee camps—are their care needs met?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S S Jervelund ◽  
O Nordheim ◽  
T Stathopoulou ◽  
T A Eikemo
Keyword(s):  
Medical Care ◽  
Communicable Diseases ◽  
Refugee Camps ◽  
Care Needs ◽  
Non Communicable Diseases ◽  
Medical Needs ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Refugee Claimants ◽  
Unmet Medical Needs

Abstract Background Little is known about the prevalence of non-communicable diseases (NCDs) among newly arrived refugees in Europe and whether their medical needs are met. The objective of this study was to investigate patterns of NCDs as refugee claimants migrate, whether refugee claimants experience unmet healthcare needs before, during and after flight when living in Greek refugee camps and to elucidate sociodemographic determinants for unmet medical care needs in the Greek refugee camps. Methods Survey data collected in 2016 among 267 newly arrived adult asylum-seekers staying at six refugee camps in Greece was used. The survey was available in English, Arabic and Farsi. We inspected frequency distributions of NCDs and unmet medical care needs, and using multiple logistic regression analysis, we estimated determinants for unmet medical needs in Greece. Results The majority had a good or fair self-reported health; yet, 17.1% suffered from 1 NCD, while 42.1% suffered from 2 or more NCDs. The most prevalent reported NCDs in Greece were: back or neck pain (26.6%) and severe headache (24.7%). The prevalence of most NCDs in the migration phases followed a U- or J-shaped pattern: decreased during migration and increased after migration to Greece. Unmet medical care needs were reported by 41.3% with one NCD after arrival in Greece. Compared with young adults, adults aged 51+ years were in increased risk of reporting unmet medical needs in Greece [odds ratio = 7.59; p = 0.015]. Conclusions The high number of persons who report NCDs underscore the need for availability of diagnostic tools and agents to ensure that the refugee claimants receive the right healthcare assistance. Tools and guidelines to provide continuity of NCD care when people migrate are likewise important. Many European countries that receive this group of refugees should take the disease patterns, including multi-morbidity, into consideration when planning for health reception and the organization of healthcare. Key messages The prevalence of NCDs among refugee claimants decreased during migration and increased after migration to Greece. Unmet medical care needs were reported by 41.3% with one NCD after arrival in Greece.

scholarly journals How Poverty, Residence Status and Health Insurance Predict Unmet Healthcare Needs among Chinese Elders?

2021 ◽  
Vol 8 (6) ◽  
pp. 10
Author(s):  
Lili Wu ◽  
Chunyin Wang ◽  
Jiayun Kou
Keyword(s):  
Health Insurance ◽  
Social Stratification ◽  
Healthcare Access ◽  
Care Needs ◽  
Financial Barriers ◽  
Multinomial Logistic Model ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Unmet Health Care Needs ◽  
Chinese Elders

This study focuses on the variability in unmet healthcare needs among vulnerable Chinese elders and the degree to which these unmet needs are associated with socioeconomic disadvantages. We use the 2013 wave of China Health and Retirement Longitudinal Study (CHARLS) and a multinomial logistic model to investigate how poverty, residence status and particular health insurance schemes influence unmet healthcare needs independently and in combination. Our results show that poverty and rural residence are strong predictors of unmet healthcare needs due to financial and non-financial constraints, respectively. Although health insurance can reduce financial barriers, its influence varies with different insurance schemes, thus generating unequal healthcare access among heterogeneous vulnerable subgroups of elders and putting poor rural migrants at the highest risk for unmet healthcare needs. Our findings direct attention to the differences in resources available to various subgroups of elders and the importance of social stratification in predicting unmet health care needs.

Hoe universeel en billijk is de Belgische ziekteverzekering?

2021 ◽  
Author(s):  
N. BOUCKAERT ◽  
C. MAERTENS DE NOORDHOUT ◽  
C. VAN DE VOORDE
Keyword(s):  
Low Income ◽  
Third Party ◽  
Vulnerable Groups ◽  
Specialist Care ◽  
Care Needs ◽  
Protection Measures ◽  
Universal Healthcare ◽  
Healthcare Needs ◽  
Out Of Pocket Payments ◽  
Gp Care

How equitable and universal is the Belgian health insurance? Accessibility to and delivery of effective, high-quality and affordable healthcare are fundamental objectives that have shaped health policy and the universal healthcare coverage in Belgium. To what extent are access to and financing of healthcare in Belgium equitable? In general, the use of hospital care is in proportion to healthcare needs, and access can be considered equitable. However, inequity in the use of outpatient specialist care is important and increasing over time. When accounting for healthcare needs, we find that care use among high-income groups and individuals with a high educational attainment is substantially higher compared to financially vulnerable groups (individuals at risk of poverty, people with severe material deprivation, unemployed, singles). Also individuals who are entitled to an increased reimbursement, show a lower use of specialist care than expected based on their care needs. On the other hand, increased reimbursement is effective in improving the accessibility to GP care, while for other financially vulnerable individuals we find a lower use of GP care. The ability of a health system to realize an equitable access to care depends, among other things, on the user charges and the advance payments borne by the patient. In 2018, almost 4% of the households experienced catastrophic out‑of‑pocket payments, strongly concentrated among low-income households. Protection measures, such as the increased reimbursement, the mandatory third‑party payer arrangement and the system of maximum billing, reduce inequities, but there is room to improve and strengthen the financial protection against co-payments and supplements.

scholarly journals The Unmet Healthcare Needs: Evidence from Serbia

2020 ◽  
Author(s):  
Milos MITRASEVIC ◽  
Snezana RADOVANOVIC ◽  
Svetlana RADEVIC ◽  
Milena MARICIC ◽  
Ivana Zivanović MACUZIC ◽  
...  
Keyword(s):  
Health Care ◽  
The Elderly ◽  
Economic Factors ◽  
Health Care Needs ◽  
Care Needs ◽  
Factors Associated ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Unmet Health Care Needs ◽  
Socio Economic Factors

Background: We aimed to determine the socio-economic factors associated with unmet healthcare needs of the population aged 20 and over in Serbia. Methods: We used data from the 2013 National Health Survey (NHS) of the population of Serbia. We focused only on the data concerning the population aged 20 and over. The final sample thus included 13,765 participants. The logistic regression was used to examine the socio-economic factors associated with unmet health care needs. Results: According to the data obtained in this study, 26.2% of the population aged 20 and over reported unmet health care needs during the previous 12 months. The multivariate analysis shows that significant indicators of unmet healthcare needs include: gender, age, marital status, level of education, financial and employment status. Conclusion: Females, the elderly and those with the lowest levels of education and household income, as well as those who are divorced and unemployed are at highest risk of unmet healthcare needs. Different policies and approaches should be taken into consideration when it comes to vulnerable population groups in order to reduce the currently existing gaps to a minimum and provide more equal opportunities for health care to all citizens.  

scholarly journals Bioethics and the use of social media for medical crowdfunding

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Brenda Zanele Kubheka
Keyword(s):  
Social Media ◽  
Human Rights ◽  
Care Needs ◽  
Undue Influence ◽  
Ethics Framework ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Use Of Social Media ◽  
Policy Failures ◽  
Socio Economic Factors

Abstract Background Social media has globalised compassion enabling requests for donations to spread beyond geographical boundaries. The use of social media for medical crowdfunding links people with unmet healthcare needs to charitable donors. There is no doubt that fundraising campaigns using such platforms facilitates access to financial resources to the benefit of patients and their caregivers. Main text This paper reports on a critical review of the published literature and information from other online resources discussing medical crowdfunding and the related ethical questions. The review highlighted the benefits of crowdfunding as well as the under-exploration of the risk of having patients’ desires and human rights undermined during online fundraising campaigns. Majority of these campaigns get initiated on behalf of the patients, especially the very sick and dependant. The ethical questions raised relate to the voluntariness of informed consent and the possibility of patients being used as a means to an end. Vulnerability of patients may expose them to coercion, undue influence, manipulation, and violation of their human rights. The success of these campaigns is influenced by the digital skills, pre-existing social networks and, the emotional potency. Healthcare is a public good, and online market forces should not determine access to essential health services. The benefits of crowdfunding cannot be subverted, but it can perpetuate unintended injustices, especially those arising from socio-economic factors. Conclusions Policymakers ought to monitor the utilisation of crowdfunding sites to identify policy failures and unmet essential health care needs responsible for driving individuals to use these platforms. The upholding of human rights and the fundamental respect of the individual’s wishes is a moral imperative. The need for an ethics framework to guide different stakeholders during medical crowdfunding needs further examination.

Impact of Multiple Sclerosis on Family and Employment: A Retrospective Study in the Aegean District of Turkey

2000 ◽  
Vol 2 (3) ◽  
pp. 48-57 ◽  
Author(s):  
Muhtesem Gedizlioglu ◽  
Hatice Mavioglu ◽  
Fatma Uzunel ◽  
Pinar Ce ◽  
Meral Oguz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Marital Status ◽  
Employment Status ◽  
Negative Impact ◽  
Strongly Correlated ◽  
Care Needs ◽  
Patients Âgés ◽  
Outpatient Departments ◽  
Survey Results ◽  
One Year

Abstract We investigated many of the effects of multiple sclerosis (MS) on patients in the Aegean District of Turkey who have had the disease for longer than one year to establish their social and occupational needs. Questions covered income, marital status, employment status of patient and spouse, housing, employment status of children, special care needs, and what changes had occurred in any of the preceding areas due to the illness. Our survey questionnaire yielded responses from 246 MS patients (ages 16–65; 87 men, 159 women) from the outpatient departments of six centers in Izmir, Turkey. The survey was conducted from March 2, 1998, to March 5, 1999. Survey results were tabulated and analyzed statistically for correlations between factors and were similar to other reports from western countries. Men reported reduced income and higher unemployment than women, many of whom were housewives. First-degree relatives carried the burden of caregiving. Disease duration and higher Expanded Disability Status Scale (EDSS) scores were strongly correlated with changes in employment, marital status, and housing. Higher EDSS scores had a negative impact on the spouse's work and the patient's need for care. Among disease types, secondary progressive MS (SPMS) also negatively affected the family structure. The disease had little effect on children's employment status.

scholarly journals Unmet health and social care needs and associated factors among elderly people aged ≥ 80 years in Balçova, Izmir, Turkey

2021 ◽  
Author(s):  
Hatice Simsek ◽  
Erdem Erkoyun ◽  
Ali Akoz ◽  
Alp Ergor ◽  
Reyhan Ucku
Keyword(s):  
Risk Factor ◽  
Low Income ◽  
Associated Factors ◽  
Social Care ◽  
Community Dwelling ◽  
Care Needs ◽  
Income Status ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
Health And Social Care

Background: The health and social care needs of people aged ≥ 80 years are a neglected topic. Aims: To determine the prevalence of unmet health and social care needs and associated factors in community-dwelling individuals aged ≥ 80 years in Izmir District of Balçova, Turkey. Methods: There were 1075 participants aged ≥ 80 years. The dependent variables were unmet health and social care needs. Independent variables were sociodemographic, socioeconomic and lifestyle characteristics. The data were collected in face-to-face interviews conducted at the homes and analysed by multiple logistic regression model. Ethical approval was obtained from the Non-Invasive Research Ethics Board of Dokuz Eylul University Medical Faculty (2017/26-24). Results: The mean age was 84.1 (3.7) years and 61.0% were female. Healthcare needs were expressed by 88.2% of the participants and 78.9% claimed that they had social care needs. Prevalence of unmet health and social care needs was 32.5% and 46.6%, respectively. Approximately 90.0% of their needs were covered by families. Perceived low-income status was a risk factor for unmet healthcare needs, and lack of social support was a risk factor for unmet social care needs. Additionally, not receiving formal education was a protective factor in unmet social care needs. Conclusion: Public health policy should be developed to enable better access to care, especially for the oldest people, considering that nearly one third of the participants in this study had unmet healthcare needs and almost half had unmet social care needs.

Mapping of Household Surveys to Measure Barriers to Access to Maternal and Child Health Services in India

2021 ◽  
Vol 23 (1) ◽  
pp. 10-19
Author(s):  
Shivam Gupta ◽  
Priyanka Das ◽  
Siddhartha Kumar ◽  
Arindam Das ◽  
P. R. Sodani
Keyword(s):  
Child Health ◽  
Health Services ◽  
Health Survey ◽  
Maternal And Child Health ◽  
Household Surveys ◽  
Access Barriers ◽  
Health Service Provision ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
And Child Health

Objective: To map the range of access barrier indicators for which data can be derived from the three most common health related household surveys in India. Methods: A mapping review study was conducted to identify access dimensions and indicators of access barriers for maternal and child health (MCH) services included in three household surveys in India: National Family Health Survey (NFHS), District Level Household and Facility Survey (DLHS) and Annual Health Survey (AHS). Results: The Tanahashi framework for effective coverage of health services was used in this study, and 12 types of access barriers were identified, from which 23 indicators could be generated. These indicators measure self-reported access barriers for unmet healthcare needs through delayed care, as well as forgone care, and unsatisfactory experiences during health service provision. Multiple barriers could be identified, although there was marked heterogeneity in variables included and how barriers were measured. Conclusions: This study identified tracer indicators that could be used in India to monitor the population that experiences healthcare needs but fails to seek and obtain appropriate healthcare, and determine what the main barriers are. The surveys identified are well validated and allow the disaggregation of these indicators by equity stratifiers. Given the variability of the frequency and methodologies used in these surveys, comparability could be limited.

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