scholarly journals Parental income gradients in adult health: a national cohort study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Miriam Evensen ◽  
Søren Toksvig Klitkou ◽  
Mette C. Tollånes ◽  
Simon Øverland ◽  
Torkild Hovde Lyngstad ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Income Distribution ◽  
Health Inequalities ◽  
Access To Health Care ◽  
Parental Education ◽  
Universal Access ◽  
Health Care Use ◽  
Parental Income ◽  
Primary Health

Abstract Background Disparities in health by adult income are well documented, but we know less about the childhood origins of health inequalities, and it remains unclear how the shape of the gradient varies across health conditions. This study examined the association between parental income in childhood and several measures of morbidity in adulthood. Methods We used administrative data on seven complete Norwegian birth cohorts born in 1967–1973 (N = 429,886) to estimate the association between parental income from birth to age 18, obtained from tax records available from 1967, linked with administrative registries on health. Health measures, observed between ages 39 and 43, were taken from registry data on consultations at primary health care services based on diagnostic codes from the International Classification of Primary Care (ICPC-2) and hospitalizations and outpatient specialist consultations registered in the National Patient Registry (ICD-10). Results Low parental income during childhood was associated with a higher risk of being diagnosed with several chronic and pain-related disorders, as well as hospitalization, but not overall primary health care use. Absolute differences were largest for disorders related to musculoskeletal pain, injuries, and depression (7–9 percentage point difference). There were also differences for chronic disorders such as hypertension (8%, CI 7.9–8.5 versus 4%, CI 4.1–4.7) and diabetes (3.2%, CI 3.0–3.4 versus 1.4%, CI 1.2–1.6). There was no difference in consultations related to respiratory disorders (20.9%, CI 20.4–21.5 versus 19.7%, CI 19.2–20.3). Childhood characteristics (parental education, low birth weight, and parental marital status) and own adult characteristics (education and income) explained a large share of the association. Conclusions Children growing up at the bottom of the parental income distribution, compared to children in the top of the income distribution, had a two- to threefold increase in somatic and psychological disorders measured in adulthood. This shows that health inequalities by socioeconomic family background persist in a Scandinavian welfare-state context with universal access to health care.

Accessibility, Mobility and Spatial Patterns of Primary Health Care use in Ajedabiya: a Household Interview Survey

2010 ◽  
Vol 41 ◽  
pp. 47-62
Author(s):  
Salem F. Salem
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Service Use ◽  
Primary Objective ◽  
Health Care Use ◽  
International Standards ◽  
Consultation Rate ◽  
General Evaluation ◽  
Primary Health ◽  
Time Required

AbstractThe primary objective of this study is to examine the type of Primary Health Care (PHC) facility used by a sample of households in Ajedabiya, taking into account the respondents' living standards and their perception of the quality of the care provided, as well as the mode of travel and travel time required to reach the health care centres. The overall level of service use has been increasing over time, reaching an annual consultation rate of up to four visits per person per year, a high level by international standards. Three major groupings of disease were identified for which the four selected PHC facilities were preferred. Satisfaction with care was analysed by looking at key variables, including staff behaviour, availability of doctors, vector distance to the PHC facility, general evaluation of health services and qualified doctors. Household incomes did not appear to be an important factor except for attending private clinics. Unlike income, distance had a strong effect on utilisation, leading to the conclusion that PHC should continue to be provided within the community, and developed further to achieve equity, effectiveness and affordability.

scholarly journals Hope for the Best, Prepare for the Worst—An Assessment of Flood Preparedness at Primary Health Care Facilities in Central Vietnam

2018 ◽  
Vol 15 (12) ◽  
pp. 2689 ◽  
Author(s):  
Andreas Älgå ◽  
Thi Dang ◽  
Dell Saulnier ◽  
Gia Nguyen ◽  
Johan von Schreeb
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Access To Health Care ◽  
Monsoon Season ◽  
Health Care Facilities ◽  
Validity And Reliability ◽  
Primary Health ◽  
Central Vietnam ◽  
Flood Preparedness ◽  
Flood Experience

Background: Floods affect over 85 million people every year and are one of the deadliest types of natural disasters. The health effects of floods are partly due to a loss of access to health care. This loss can be limited with proper flood preparedness. Flood preparedness is especially needed at the primary health care (PHC) level. Flood preparedness assessments can be used to identify vulnerable facilities and help target efforts. The existing research on PHC flood preparedness is limited. We aimed to assess the flood preparedness of PHC facilities in a flood-prone province in central Vietnam. Methods: Based on flood experience, the PHC facilities in the province were grouped as “severe” (n = 23) or “non-severe” (n = 129). Assessments were conducted during monsoon season at five facilities from each group, using a pre-tested, semi-structured questionnaire. Data were checked against official records when possible. Results: Nine of the ten facilities had a flood plan and four received regular flood preparedness training. Six facilities reported insufficient preparedness support. Half of the facilities had additional funding available for flood preparedness, or in case of a flood. Flood preparedness training had been received by 21/28 (75%) of the staff at the facilities with severe flood experience, versus 15/25 (52%) of the staff at the non-severe experience facilities. Conclusions: Our results suggest that the assessed PHC facilities were not sufficiently prepared for the expected floods during monsoon season. PHC flood preparedness assessments could be used to identify vulnerable facilities and populations in flood-prone areas. More research is needed to further develop and test the validity and reliability of the questionnaire.

scholarly journals Video-based telehealth in Australian primary health care: current use and future potential

2013 ◽  
Vol 19 (4) ◽  
pp. 283 ◽  
Author(s):  
Melissa Raven ◽  
Caryn Butler ◽  
Petra Bywood
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Health Workers ◽  
Geographic Distance ◽  
Care Services ◽  
Primary Health ◽  
Video Consultation ◽  
Restricted Mobility

Many Australians have limited access to health-care services due to a range of barriers, including geographic distance and restricted mobility, which telehealth can potentially address. This paper reviews the current and potential use of video consultation in primary health care in Australia, drawing on international literature. There is substantial evidence of high patient satisfaction, but many studies have methodological limitations. Overall, evidence of effectiveness and cost-effectiveness is weak. There is reasonable evidence for diagnosis, home care and specialist consultations by GPs with patients present. Two telehealth initiatives using video consultation are briefly presented. Both provide evidence that video consultation has a valuable role to play, but does not obviate the need for face-to-face consultations. Video consultation challenges traditional professional roles, particularly those of nurses, and can improve health workers’ skills and job satisfaction. More fundamentally, telehealth challenges the traditional distinction between primary and secondary care. This can be a source of resistance but may ultimately be one of its strengths. Appropriately targeted video consultation has much potential to improve the delivery of primary health care in Australia, particularly in rural and remote regions.

scholarly journals The status of the Primary Health Care Plus pilot project in Poland

2019 ◽  
Vol 13 (2) ◽  
pp. 1-14
Author(s):  
Katarzyna Wiktorzak
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Current System ◽  
Pilot Project ◽  
Care Providers ◽  
Primary Health ◽  
The Status

Background The National Health Fund (NHF) is the public payer solely accountable for securing and organizing access to health care services in Poland. The NHF is responsible for implementing a project entitled “Primary Health Care PLUS” which aims to introduce a primary care centered model, based on coordinated, proactive and preventive methods relevant to patients’ needs and furthermore, works to keep patients well-informed and active participants in health care decision-making. The implementation period of the project is July 1, 2018 through Dec. 31, 2021. Aim of the study The purpose of this study is to outline patient demographics and staff structures of providers that took part in the PHC PLUS pilot program, as well as the status of the program throughout the first year of its implementation. Materials and Methods Following an open and transparent recruitment process, 42 urban and rural primary health care providers were selected. The purpose of the providers’ geographic spread was to ensure the model was tested in all representative regions of the country. Results 42 PHC PLUS providers attending to 288,392 patients are participating in the project. Approximately 1,100 medical staff members are involved in the project. PHC PLUS medical teams consist of specialists including physicians, coordinators, nurses, dietitians, psychologists, physiotherapists and health educators. Out of 41,022 health risk assessments declared to be conducted during the project, 18,058 (43.1%) were performed from July 1, 2018 to April 30, 2019, including 4,537 basic and 13,521 extended assessments. Furthermore, 15,020 patients in total, participated in the disease management programs, which are also paid from the project. Conclusions A Polish health care pilot project that centers primary care can help shift the focus toward preventive interventions, rather than the current system, which often focuses on providing medical care to patients who have already been diagnosed with diseases, often in their more advanced stages.

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