scholarly journals The rural tax: comprehensive out-of-pocket costs associated with patient travel in British Columbia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jude Kornelsen ◽  
Asif Raza Khowaja ◽  
Gal Av-Gay ◽  
Eva Sullivan ◽  
Anshu Parajulee ◽  
...  
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Household Income ◽  
Access To Health Care ◽  
Rural Patient ◽  
Urban Patient ◽  
Access To Health ◽  
Patient Stress ◽  
Rural Patients ◽  
Out Of Pocket Costs

Abstract Background A significant concern for rural patients is the cost of travel outside of their community for specialist and diagnostic care. Often, these costs are transferred to patients and their families, who also experience stress associated with traveling for care. We sought to examine the rural patient experience by (1) estimating and categorizing the various out of pocket costs associated with traveling for healthcare and (2) describing and measuring patient stress and other experiences associated with traveling to seek care, specifically in relation to household income. Methods We have designed and administered an online, retrospective, cross-sectional survey seeking to estimate the out-of-pocket (OOP) costs and personal experiences of rural patients associated with traveling to access health care in British Columbia. Respondents were surveyed across five categories: Distance Traveled and Transportation Costs, Accommodation Costs, Co-Traveler Costs, Lost Wages, and Patient Stress. Bivariate relationships between respondent household income and other numerical findings were investigated using one-way ANOVA. Results On average, costs for respondents were $856 and $674 for transport and accommodation, respectively. Strong relationships were found to exist between the distance traveled and total transport costs, as well as between a patient’s stress and their household income. Patient perspectives obtained from this survey expressed several related issues, including the physical and psychosocial impacts of travel as well as delayed or diminished care seeking. Conclusions These key findings highlight the existing inequities between rural and urban patient access to health care and how these inequities are exacerbated by a patient’s overall travel-distance and financial status. This study can directly inform policy related efforts towards mitigating the rural-urban gap in access to health care.

scholarly journals The Rural Tax: Out-of-Pocket Costs for Patient Travel in British Columbia

2020 ◽  
Author(s):  
Jude Kornelsen ◽  
Asif Khowaja ◽  
Gal Av-gay ◽  
Eva Sullivan ◽  
Anshu Parajulee ◽  
...  
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Access To Health Care ◽  
Care Seeking ◽  
Urban Patient ◽  
Rural And Urban ◽  
Access To Health ◽  
Patient Stress ◽  
The Cost ◽  
Rural Patients

Abstract Background: A significant concern for rural patients is the cost of travel outside of their community for specialist and diagnostic care. Often, these costs are downloaded to patients and their families. Methods: Online retrospective provincial survey seeking to estimate the out-of-pocket (OOP) costs and associated experiences of rural patients traveling to access health care in British Columbia. Respondents were surveyed across five categories: Distance Traveled and Transportation Costs, Accommodation Costs, Co-Traveler Costs, Lost Wages, and Patient Stress. Results: On average, costs for respondents were $777 and $674 for transport and accommodation, respectively. Patient perspectives obtained from this survey expressed a number of related issues, including the physical and psychosocial impacts of travel as well as delayed or diminished care seeking. Conclusions: These key findings highlight the existing inequities between rural and urban patient access to health care. This study can directly inform policy related efforts towards mitigating the rural-urban gap in access to health care.

scholarly journals The Cedar Project - Mobile Phone Use and Acceptability of Mobile Health Among Young Indigenous People Who Have Used Drugs in British Columbia, Canada: Mixed Methods Exploratory Study

10.2196/16783 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e16783
Author(s):  
Kate Jongbloed ◽  
Margo E Pearce ◽  
Vicky Thomas ◽  
Richa Sharma ◽  
Sherri Pooyak ◽  
...  
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Mobile Phone ◽  
Indigenous People ◽  
Mobile Phones ◽  
Exploratory Study ◽  
Access To Health Care ◽  
Mobile Phone Use ◽  
Access To Health ◽  
Prevention And Treatment

Background Indigenous leaders continue to be concerned about high rates of HIV and barriers to HIV treatment among young Indigenous people involved in substance use. Growing evidence suggests that using mobile phones for health (mHealth) may be a powerful way to support connection with health services, including HIV prevention and treatment. Objective This study examined the patterns of mobile phone ownership and use among young Indigenous people who have used drugs living with or vulnerable to HIV and explored the acceptability of mHealth to support access to health care in this population. Methods The Cedar Project is a cohort study involving young Indigenous people who have used drugs in Vancouver and Prince George, British Columbia. This mixed methods exploratory study involved 131 Cedar Project participants enrolled in our WelTel mHealth program. At enrollment, participants completed a questionnaire related to mobile phone use and interest in mHealth. Data were linked to Cedar Project questionnaires and serodata. We present comparative statistics (quantitative) and results of a rapid thematic analysis (qualitative) related to mobile phone patterns and interest in receiving mHealth. Results Less than half of the participants (59/130; 45.4%) reported owning a phone. Among those with a phone, the majority owned a smartphone (46/59; 78%). Most participants with a phone reported having an unlimited texting plan (39/55; 71%), using the internet on their phone (44/59; 75%), and texting daily (44/55; 80%). A majority reported that using a mobile phone for health would be invaluable (120/130; 92.3%). There were no differences in mHealth acceptance between participants who owned a phone and those who did not (P>.99). All but one participant living with HIV felt using a mobile phone would be helpful for their health, while a small proportion of HIV-negative participants remained unsure (1.9% vs 11.7%; P=.047). In response to open-ended questions asking why using a mobile phone may be helpful for health, participants identified a diverse set of anticipated benefits: (1) connection for emotional, mental, and spiritual support, (2) connection to family, (3) staying in touch and/or being reachable, (4) overcoming current barriers to phone use, (5) convenience, privacy, and safety, and (6) access to health care and emergency services. Conclusions We observed high acceptance and interest in using mobile phone technology for health despite low rates of personal mobile phone connectivity among young Indigenous people who have used drugs living with and vulnerable to HIV in British Columbia, Canada. Mobile phones were viewed as a way to support connections and relationships that are seen as critical to health and well-being among young Indigenous people in this study. Findings may be useful for health care providers preparing to scale up mHealth programs to support HIV prevention and treatment in this population.

scholarly journals Health and Socio-economic Implications of Poverty in Bangladesh

2018 ◽  
Vol 14 (29) ◽  
pp. 301
Author(s):  
Sacchidanand Majumder ◽  
Soma Chowdhury Biswas
Keyword(s):  
Health Care ◽  
Chronic Diseases ◽  
Household Income ◽  
Access To Health Care ◽  
Construction Materials ◽  
Poverty Level ◽  
Economic Implications ◽  
Access To Health ◽  
Chronic Fever ◽  
Socio Economic Factors

The objective of this study was to explore the influences of the health and socio-economic factors associated with the poverty level of households in Bangladesh, through an analysis of data from the Household Income and Expenditure Survey (HIES) 2010 conducted by Bangladesh Bureau of Statistics (BBS). A total of all 12,240 households was considered in this study. CBN method was applied for estimating poverty of the household. A logistic regression analysis was used to identify the main factors that influence the household’s poverty. The results showed that the probability of the household being poor was higher when the household’s head suffered from various chronic diseases like chronic fever, injuries/disability, eczema, leprosy, and asthma/breathing trouble as compared to the household whose head didn’t suffer from any chronic diseases. From the analysis, it was also found that when a large number within household suffered from any chronic disease, the probability of the household being poor was increased. The household that had no access to health care was poorer than the household that had access to health care. The results also showed that with increased investment in health, the probability of the household being poor was decreased. The results showed that rural households were poorer than urban households. Monthly income, land ownership, construction materials of walls and roofs, types of the latrine, source of drinking water, household size; age, sex, and employment status of the household’s head all had a significant impact on the poverty level of the household.

Socioeconomic factors associated with pituitary apoplexy

2013 ◽  
Vol 119 (6) ◽  
pp. 1432-1436 ◽  
Author(s):  
Arman Jahangiri ◽  
Aaron J. Clark ◽  
Seunggu J. Han ◽  
Sandeep Kunwar ◽  
Lewis S. Blevins ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
Household Income ◽  
Access To Health Care ◽  
Pituitary Apoplexy ◽  
Primary Health Care Provider ◽  
Primary Health ◽  
Access To Health

Object Pituitary apoplexy is associated with worse outcomes than are pituitary adenomas detected without acute clinical deterioration. The association between pituitary apoplexy and socioeconomic factors that may limit access to health care has not been examined in prior studies. Methods This study involved retrospectively evaluating data obtained in all patients who underwent surgery for nonfunctioning pituitary adenoma causing visual symptoms between January 2003 and July 2012 at the University of California, San Francisco. Patients were grouped into those who presented with apoplexy and those who did not (“no apoplexy”). The 2 groups were compared with respect to annual household income, employment status, health insurance status, and whether or not the patient had a primary health care provider. Associations between categorical variables were analyzed by chi-square test and continuous variables by Student t-test. Multivariate logistic regression was also performed. Results One hundred thirty-five patients were identified, 18 of whom presented with apoplexy. There were significantly more unmarried patients and emergency room presentations in the apoplexy group than in the “no apoplexy” group. There was a nonsignificant trend toward lower mean household income in the apoplexy group. Lack of health insurance and lack of a primary health care provider were both highly significantly associated with apoplexy. In a multivariate analysis including marital status, emergency room presentation, income, insurance status, and primary health care provider status as variables, lack of insurance remained associated with apoplexy (OR 11.6; 95% CI 1.9–70.3; p = 0.008). Conclusions The data suggest that patients with limited access to health care may be more likely to present with pituitary apoplexy than those with adequate access.

scholarly journals The Cedar Project - Mobile Phone Use and Acceptability of Mobile Health Among Young Indigenous People Who Have Used Drugs in British Columbia, Canada: Mixed Methods Exploratory Study (Preprint)

2019 ◽  
Author(s):  
Kate Jongbloed ◽  
Margo E Pearce ◽  
Vicky Thomas ◽  
Richa Sharma ◽  
Sherri Pooyak ◽  
...  
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Mobile Phone ◽  
Indigenous People ◽  
Mobile Phones ◽  
Exploratory Study ◽  
Access To Health Care ◽  
Mobile Phone Use ◽  
Access To Health ◽  
Prevention And Treatment

BACKGROUND Indigenous leaders continue to be concerned about high rates of HIV and barriers to HIV treatment among young Indigenous people involved in substance use. Growing evidence suggests that using mobile phones for health (mHealth) may be a powerful way to support connection with health services, including HIV prevention and treatment. OBJECTIVE This study examined the patterns of mobile phone ownership and use among young Indigenous people who have used drugs living with or vulnerable to HIV and explored the acceptability of mHealth to support access to health care in this population. METHODS The Cedar Project is a cohort study involving young Indigenous people who have used drugs in Vancouver and Prince George, British Columbia. This mixed methods exploratory study involved 131 Cedar Project participants enrolled in our WelTel mHealth program. At enrollment, participants completed a questionnaire related to mobile phone use and interest in mHealth. Data were linked to Cedar Project questionnaires and serodata. We present comparative statistics (quantitative) and results of a rapid thematic analysis (qualitative) related to mobile phone patterns and interest in receiving mHealth. RESULTS Less than half of the participants (59/130; 45.4%) reported owning a phone. Among those with a phone, the majority owned a smartphone (46/59; 78%). Most participants with a phone reported having an unlimited texting plan (39/55; 71%), using the internet on their phone (44/59; 75%), and texting daily (44/55; 80%). A majority reported that using a mobile phone for health would be invaluable (120/130; 92.3%). There were no differences in mHealth acceptance between participants who owned a phone and those who did not (<i>P</i>&gt;.99). All but one participant living with HIV felt using a mobile phone would be helpful for their health, while a small proportion of HIV-negative participants remained unsure (1.9% vs 11.7%; <i>P</i>=.047). In response to open-ended questions asking why using a mobile phone may be helpful for health, participants identified a diverse set of anticipated benefits: (1) connection for emotional, mental, and spiritual support, (2) connection to family, (3) staying in touch and/or being reachable, (4) overcoming current barriers to phone use, (5) convenience, privacy, and safety, and (6) access to health care and emergency services. CONCLUSIONS We observed high acceptance and interest in using mobile phone technology for health despite low rates of personal mobile phone connectivity among young Indigenous people who have used drugs living with and vulnerable to HIV in British Columbia, Canada. Mobile phones were viewed as a way to support connections and relationships that are seen as critical to health and well-being among young Indigenous people in this study. Findings may be useful for health care providers preparing to scale up mHealth programs to support HIV prevention and treatment in this population.

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