scholarly journals Factors associated with access to health care among foreign residents living in Aichi Prefecture, Japan: secondary data analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Michiyo Higuchi ◽  
Maki Endo ◽  
Asako Yoshino

Abstract Background In Japan, foreign residents, and particularly new arrivals in the country, experience barriers to health care and show poorer health outcomes when compared to Japanese nationals. The health-care-related situation for foreign residents in Japan has been characterized by drastic changes over time; thus, there is difficulty identifying individuals who are “left behind” by the system. In this study, we aimed to identify, among foreign residents who attended informal free medical consultations, factors associated with “being advised to visit a medical facility” and “being referred to a medical facility,” which represented hypothetical proxy indicators of barriers to health care. Methods Secondary data analyses were conducted using the activity records of a non-governmental organization that provides free consultations targeting foreign residents in various locations in Aichi Prefecture, Japan. Participant characteristics, including insurance coverage, were determined. Bivariate and multi-variate analyses were performed to identify factors associated with having barriers to health care. Results Among 608 extracted cases, 164 (27.5%) cases were advised to visit a medical facility, and 72 (11.8%) were referred to a medical facility during the consultations. Those who were not covered by public insurance showed a 1.56-time (95% confidence interval [CI]: 1.19–2.05) higher prevalence of being advised to visit a medical facility when compared to those who were covered by public insurance. Unemployed people and students were more likely to be referred to a medical facility than were professional workers; the prevalence ratios were 3.28 (95% CI: 1.64–6.57) and 2.77 (95% CI: 1.18–6.46), respectively. Conclusions Although the majority were insured, almost 30% were advised to visit a medical facility, which implied that they had had limited access to the formal health-care system before availing of the free consultations. The findings highlight those uninsured, unemployed people and students, who are considered vulnerable to access to health care. It is vital to provide those who are vulnerable with the necessary support while updatinge evidence, so that no one is “left behind.”

2020 ◽  
Author(s):  
Michiyo Higuchi ◽  
Maki Endo ◽  
Asako Ito

Abstract Background In Japan, foreign residents, and particularly new arrivals in the country, experience barriers to health care and show poorer health outcomes when compared to Japanese nationals. The health-care-related situation for foreign residents in Japan has been characterized by drastic changes over time; thus, there is difficulty identifying individuals who are “left behind” by the system. In this study, we aimed to identify, among foreign residents who attended informal free medical consultations, factors associated with “being advised to visit a medical facility” and “being referred to a medical facility,” which represented hypothetical proxy indicators of barriers to health care. Methods Secondary data analyses were conducted using the activity records of a non-governmental organization that provides free consultations targeting foreign residents in various locations in Aichi Prefecture, Japan. Participant characteristics, including insurance coverage, were determined. Bivariable and multi-variable analyses were performed to identify factors associated with having barriers to health care. Results Among 608 extracted cases, 81.7% were covered by Japanese public insurance, and insurance coverage was associated with sex and region of origin. During the consultations, 164 (27.5%) cases were advised to visit a medical facility, and 72 (11.8%) were referred to a medical facility. Those who were not covered by public insurance showed a 1.56-times (95% confidence interval [CI]: 1.19–2.05) higher prevalence of being advised to visit a medical facility when compared to those who were covered by public insurance. Unemployed people and students were more likely to be referred to a medical facility than were professional workers; the prevalence ratios were 3.28 (95% CI: 1.64–6.57) and 2.77 (95% CI: 1.18–6.46), respectively. Conclusions Information from the non-governmental organization revealed the diversity of foreign residents who require informal health-care-related consultations. Although the majority were insured, almost 30% were advised to visit a medical facility, which implied that they had had limited access to the formal health-care system before availing of the free consultations. The findings highlight specific groups who may be vulnerable, and it is important to provide these groups with the necessary support, based on updated evidence, to ensure that no one is “left behind.”


2020 ◽  
Vol 110 (6) ◽  
pp. 857-862
Author(s):  
Stephanie M. Hernandez ◽  
P. Johnelle Sparks

Objectives. To examine the relationship between minoritized identity and barriers to health care in the United States. Methods. Nationally representative data collected from the 2013 to 2017 waves of the National Health Interview Survey were used to conduct descriptive and logistic regression analyses. Men and women were placed in 1 of 4 categories: no minoritized identities, minoritized identities of race/ethnicity (MIoRE), minoritized identities of sexuality (MIoS), or minoritized identities of both race/ethnicity and sexuality (MIoRES). Five barriers to health care were considered. Results. Relative to heterosexual White adults and after controlling for socioeconomic status, adults with MIoRE were less likely to report barriers, adults with MIoS were more likely to report barriers, and adults with MIoRES were more likely to report barriers across 2 of the study measures. Conclusions. Barriers to care varied according to gender, minoritized identity, and the measure of access to health care itself. Public Health Implications. Approaching health disparities research using an intersectional lens moves the discussion from examining individual differences to examining the role of social structures such as the health care system in maintaining and reproducing inequality.


OALib ◽  
2019 ◽  
Vol 06 (10) ◽  
pp. 1-17
Author(s):  
Kabongo Mwamba A. Guillaume ◽  
Bukasa Tshilonda J. Christophe ◽  
Kankologo Biakulamabo Christine ◽  
Mbuyi Kabeya J. Henock ◽  
Mbuyi Mishinda Anaclet ◽  
...  

2021 ◽  
Vol 9 (E) ◽  
pp. 89-94
Author(s):  
Askhat Shaltynov ◽  
Aizhan Raushanova ◽  
Ulzhan Jamedinova ◽  
Aigerim Sepbossynova ◽  
Altay Myssayev ◽  
...  

BACKGROUND: Global health initiatives such as health for all and universal health coverage aim to improve access to health care. These goals require constant comprehensive monitoring to eliminate inequalities in the availability of health care. AIM: The purpose of our study was to assess the physical availability of medical care in Kazakhstan. METHODS: A descriptive study based on a Service Availability and Readiness Assessment (SARA) general availability index calculation that used secondary data as a source of information. RESULTS: The general availability index calculated for the regions of Kazakhstan ranged from 95% to 100%. When considering individual indicators of the index, decrease trends of the volume of inpatient care were identified. Outpatient care had fluctuations with values better than benchmark after 2009. Stable upward trend illustrates positive picture of core health personnel. CONCLUSION: According to the SARA availability index, it can be concluded that health care in Kazakhstan exceeds the threshold values and is available in all regions. Trends for individual indicators of the index should be studied in more detail, taking into account the influence of health policy and other factors.


Author(s):  
Betregiorgis Zegeye ◽  
Nicholas Kofi Adjei ◽  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
Eugene Budu ◽  
...  

Background and Objective: Access to health care services is a major challenge to women and children in many developing countries such as Ethiopia. In this study, we investigated the individual- and community-level factors associated with barriers to accessing health care services among married women in Ethiopia. Methods: Data from the 2016 Ethiopia demographic and health survey on 9,824 married women of reproductive age (15-49 years) were analyzed. Multilevel logistic regression models were used to assess individual- and community-level factors associated with barriers to access health care services. Regression analysis results revealed adjusted odds ratios at 95% confidence intervals. Results: Over two-thirds (71.8%) of married women in Ethiopia reported barriers to accessing health care services. Some of the individual-level factors that were associated with lower odds of reporting barriers to access health care services include: having secondary education (aOR=0.49, 95% CI: 0.32-0.77), being in the richest quintile (aOR=0.34, 95% CI: 0.22-0.54), and indicating wife-beating as unjustified (aOR=0.66, 95% CI:0.55-0.81). Among the community-level factors, high community-level literacy (aOR=0.56, 95% CI: 0.34-0.92) and moderate community socioeconomic status (aOR=0.62, 95% CI: 0.45-0.85) were significantly associated with lower odds of reporting barriers to access health care services. Conclusion and Implications for Translation: The findings revealed high barriers to access health care services, and both individual- and community-level factors were significant contributing predictors. Therefore, it is important to consider multidimensional strategies and interventions to facilitate access to health care services in Ethiopia.   Copyright © Zegeye et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.


2021 ◽  
Vol 49 (1) ◽  
pp. 104-113
Author(s):  
Krishna Chaitanya Vadlamannati ◽  
Arusha Cooray ◽  
Indra de Soysa

Aims: The COVID-19 pandemic has led to a spate of studies showing a close connection between inequitable access to health care, welfare services and adverse outcomes from the pandemic. Others have argued that democratic governments have generally failed relative to more autocratic ones, simply because autocrats can make the hard choices required for stemming the spread of viruses. We address this question by asking whether more ‘egalitarian’ forms of democracy matter, given that they contain more equitable health-care access and societal infrastructure, such as social capital and trust. Methods: We use standard regression techniques, including instrumental variables analysis addressing endogeneity on COVID-19 testing and deaths data as of the end of May and beginning of September. We use novel data from the Varieties of Democracy Project on health-system equity and egalitarian democracy. Results: Our results suggest that more equitable access to health care increases testing rates and lowers the death rate from COVID-19. Broader egalitarian governance, measured as egalitarian democracy, however, shows the opposite effect. Thus, factors associated with health-care capacity to reach and treat matter more than broader societal factors associated with social capital and trust. The results are robust to alternative testing procedures, including instrumental variable technique for addressing potential endogeneity. Conclusions: Despite a great deal of public health focus on how equitable governance helps fight the adverse effects of so-called neoliberal pandemics, we find that broadly egalitarian factors have had the opposite effect on fighting COVID-19, especially when an equitable health system has been taken into account. Fighting disease, thus, might be more about the capacity of health systems rather than societal factors, such as trust in government and social capital.


Author(s):  
Pauline A. Mashima

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.


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