scholarly journals Inequity and benefit incidence analysis in healthcare use among Syrian refugees in Egypt

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hani Fares ◽  
Jaume Puig-Junoy
Keyword(s):  
Health Services ◽  
Decomposition Analysis ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Syrian Refugees ◽  
Horizontal Inequity ◽  
Services Utilization ◽  
Healthcare Needs ◽  
Benefit Incidence Analysis ◽  
Incidence Analysis

Abstract Background The Syrian conflict has created the worst humanitarian refugee crisis of our time, with the largest number of people displaced. Many have sought refuge in Egypt, where they are provided with the same access to healthcare services as Egyptian citizens. Nevertheless, in addition to the existing shortcomings of the Egyptian health system, many obstacles specifically limit refugees’ access to healthcare. This study looks to assess equity across levels of care after observing services utilization among the Syrian refugees, and look at the humanitarian dilemma when facing resource allocation and the protection of the most vulnerable. Methods A cross‐sectional survey was used and collected information related to access and utilization of outpatient and inpatient health services by Syrian refugees living in Egypt. We used concentration index (CI), horizontal inequity (HI) and benefit incidence analysis (BIA) to measure the inequity in the use of healthcare services and distribution of funding. We decomposed inequalities in utilization, using a linear approximation of a probit model to measure the contribution of need, non-need and consumption influential factors. Results We found pro-rich inequality and horizontal inequity in the probability of refugees’ outpatient and inpatient health services utilization. Overall, poorer population groups have greater healthcare needs, while richer groups use the services more extensively. Decomposition analysis showed that the main contributor to inequality is socioeconomic status, with other elements such as large families, the presence of chronic disease and duration of asylum in Egypt further contributing to inequality. Benefit incidence analysis showed that the net benefit distribution of subsidies of UNHCR for outpatient and inpatient care is also pro-rich, after accounting for out-of-pocket expenditures. Conclusion Our results show that without equitable subsidies, poor refugees cannot afford healthcare services. To tackle health inequities, UNHCR and organisations will need to adapt programmes to address the social determinants of health, through interventions within many sectors. Our findings contribute to assessments of different levels of accessibility to healthcare services and uncover related sources of inequities that require further attention and advocacy by policymakers.

scholarly journals Healthcare needs and health service utilization by Syrian refugee women in Toronto

2021 ◽  
Author(s):  
Sepali Guruge ◽  
Souraya Sidani ◽  
Vathsala Illesinghe ◽  
Rania Younes ◽  
Huda Bukhari ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Public Transportation ◽  
Health Service Utilization ◽  
Healthcare Services ◽  
Syrian Refugees ◽  
Enabling Factors ◽  
Long Term Conditions ◽  
Healthcare Needs

Objective Access to healthcare is an important part of the (re)settlement process for Syrian refugees in Canada. There is growing concern about the healthcare needs of the 54,560 Syrian refugees who were admitted to Canada by May 2018, 80% of whom are women and children. We explored the healthcare needs of newcomer Syrian women, their experiences in accessing and using health services, and the factors and conditions that shape whether and how they access and utilize health services in the Greater Toronto Area (GTA). Method This community-based qualitative descriptive interpretive study was informed by Yang & Hwang (2016) health service utilization framework. Focus group discussions were held with 58 Syrian newcomer women in the GTA. These discussions were conducted in Arabic, audio-recorded with participants’ consent, translated into English and transcribed, and analyzed using thematic analysis. Results Participants’ health concerns included chronic, long-term conditions as well as new and emerging issues. Initial health insurance and coverage were enabling factors to access to services, while language and social disconnection were barriers. Other factors, such as beliefs about naturopathic medicine, settlement in suburban areas with limited public transportation, and lack of linguistically, culturally, and gender-appropriate services negatively affected access to and use of healthcare services. Conclusion Responding to the healthcare needs of Syrian newcomer women in a timely and comprehensive manner requires coordinated, multi-sector initiatives that can address the financial, social, and structural barriers to their access and use of services.

scholarly journals Healthcare needs and health service utilization by Syrian refugee women in Toronto

2021 ◽  
Author(s):  
Sepali Guruge ◽  
Souraya Sidani ◽  
Vathsala Illesinghe ◽  
Rania Younes ◽  
Huda Bukhari ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Public Transportation ◽  
Health Service Utilization ◽  
Healthcare Services ◽  
Syrian Refugees ◽  
Enabling Factors ◽  
Long Term Conditions ◽  
Healthcare Needs

Objective Access to healthcare is an important part of the (re)settlement process for Syrian refugees in Canada. There is growing concern about the healthcare needs of the 54,560 Syrian refugees who were admitted to Canada by May 2018, 80% of whom are women and children. We explored the healthcare needs of newcomer Syrian women, their experiences in accessing and using health services, and the factors and conditions that shape whether and how they access and utilize health services in the Greater Toronto Area (GTA). Method This community-based qualitative descriptive interpretive study was informed by Yang & Hwang (2016) health service utilization framework. Focus group discussions were held with 58 Syrian newcomer women in the GTA. These discussions were conducted in Arabic, audio-recorded with participants’ consent, translated into English and transcribed, and analyzed using thematic analysis. Results Participants’ health concerns included chronic, long-term conditions as well as new and emerging issues. Initial health insurance and coverage were enabling factors to access to services, while language and social disconnection were barriers. Other factors, such as beliefs about naturopathic medicine, settlement in suburban areas with limited public transportation, and lack of linguistically, culturally, and gender-appropriate services negatively affected access to and use of healthcare services. Conclusion Responding to the healthcare needs of Syrian newcomer women in a timely and comprehensive manner requires coordinated, multi-sector initiatives that can address the financial, social, and structural barriers to their access and use of services.

scholarly journals Global Perspective on Telemedicine for Parkinson’s Disease

2021 ◽  
pp. 1-8
Author(s):  
Ali Shalash ◽  
Meredith Spindler ◽  
Esther Cubo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Multidisciplinary Care ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Global Perspective ◽  
Sensitive Information ◽  
Personal Connection ◽  
Healthcare Needs ◽  
Neurological Exam

Telemedicine programs are particularly suited to evaluating patients with Parkinson’s disease (PD) and other movement disorders, primarily because much of the physical exam findings are visual. Telemedicine uses information and communication technologist to overcome geographical barriers and increase access to healthcare services, and it is particularly beneficial for rural and underserved communities, groups that traditionally suffer from lack of access to healthcare. There is a growing evidence of the feasibility of telemedicine, cost and time savings, patients’ and physicians’ satisfaction, and its outcome and impact on patients’ morbidity and quality of life. In addition, given the unusual current situation with the COVID-19 pandemic, telemedicine has offered the opportunity to address the ongoing healthcare needs of patients with PD, to reduce in-person clinic visits, and human exposures (among healthcare workers and patients) to a range of infectious diseases including COVID-19. However, there are still several challenges to widespread implementation of telemedicine including the limited performance of parts of the neurological exam, limited technological savvy, fear of loss of a personal connection, or uneasiness about communicating sensitive information. On the other hand, while we are facing the new wave of COVID-19 pandemic, patients and clinicians are gaining increasing experience with telemedicine, facilitating equity of access to specialized multidisciplinary care for PD. This article summarizes and reviews the current state and future directions of telemedicine from a global perspective.

scholarly journals Examining Stakeholder’s Views On Refugee Healthcare Needs, Current Barriers in Accessing Healthcare Services and Future Healthcare Direction in New Zealand: A Qualitative Phenomenological Approach

2021 ◽  
Author(s):  
Bafreen Sherif ◽  
Ahmed Awaisu ◽  
Nadir Kheir
Keyword(s):  
New Zealand ◽  
Health Services ◽  
Qualitative Methodology ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Healthcare Personnel ◽  
Structured Interviews ◽  
Health Seeking ◽  
Healthcare Needs

Abstract Background The annual New Zealand refugee quota was increased to 1500 places from 2020 onwards as a response to the global refugee crisis. The specific healthcare needs of refugees are not clearly understood globally and communication between healthcare providers and refugees remains poor. Methods A phenomenological qualitative methodology was employed to conduct semi-structured interviews among purposively selected stakeholders who work in refugee organisations and relevant bodies in New Zealand. Results The participants indicated the need for a national framework of inclusion, mandating cultural competency training for frontline healthcare and non-healthcare personnel, creation of a national interpretation phone line, and establishing health navigators. Barriers to accessing health services identified included some social determinants of health such as housing and community environment; health-seeking behaviour and health literacy; and social support networks. Future healthcare delivery should focus on capacity building of existing services, including co-design processes, increased funding for refugee-specific health services, and whole government approach. Conclusion Policymakers and refugee organisations and their frontline personnel should seek to address the deficiencies identified in order to provide equitable, timely and cost-effective healthcare services for refugees in New Zealand.

E-Healthcare Disparities Across Cultures

2017 ◽  
pp. 1365-1381
Author(s):  
Seema Biswas ◽  
Keren Mazuz ◽  
Rui Amaral Mendes
Keyword(s):  
Information Technology ◽  
Health Services ◽  
Healthcare Service ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
The World ◽  
Effective Delivery ◽  
Improve Access ◽  
Actual Health

As e-healthcare becomes a reality for healthcare service provision across the world, challenges in acceptance, implementation, usage and effectiveness have begun to emerge. The infrastructure, readiness and literacy levels required for the effective delivery of e-healthcare services may be prohibitive in providing access to those most in need. As research brings to light the real effectiveness of e-healthcare programmes across the globe, this paper explores how e-healthcare has been implemented worldwide and how populations have been served by an innovation in Information Technology and healthcare that has sought to bring health services to remote areas, improve access to healthcare and narrow the divide between healthcare providers and patients. While notable achievements have seen real time clinical data captured and medical records digitalised, the very determinants responsible for actual health and social disparities are equally responsible for disparities is access to e-healthcare.

scholarly journals Inequality in healthcare use among older people in Colombia

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Jorge Garcia-Ramirez ◽  
Zlatko Nikoloski ◽  
Elias Mossialos
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Healthcare Utilization ◽  
Insurance Coverage ◽  
Wealth Quintile ◽  
The Elderly ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Healthcare Use

Abstract Background Since the early 1990s, Colombia has made great strides in extending healthcare coverage to its population. In order to measure the impact of these efforts, it is important to assess whether the introduction of universal health coverage has translated into equitable access to healthcare in the country, particularly for the elderly. Thus, in this study we assessed the inequality in utilization of health services among elderly patients in Colombia. In addition, we identified the determinants of healthcare utilization. Methods We analyzed the 2015 Colombian health, well-being and aging study (SABE). To classify determinants of healthcare use into predisposing, enabling and need factors, we employed the Anderson framework of healthcare utilization. Use of outpatient, inpatient and preventive health services constituted the dependent variables. We performed multivariate logistic regressions, estimated concentration indexes (CI) and performed decomposition analyses of the CIs to determine the contribution of various determinants to inequality of healthcare utilization. Results The study sample included 23,694 adults over 60-years-old. Wealth quintile, urban dwelling, health insurance type and multimorbidity predicted the utilization of all types of healthcare services except for hospitalization. Aside from inpatient care, pro-rich inequality in utilization of healthcare services was present. Wealth quintile and type of health insurance were the largest contributors to pro-rich inequality in use of preventive services. Conclusions While there has been progress in health insurance coverage for the elderly in Colombia, there are still equality challenges in the delivery of healthcare, especially for preventive and outpatient care. These inequalities are driven by individual characteristics such as wealth, urban residence, type of health insurance carried, and presence of multimorbidity. To address this issue, the Colombian health system should extend health insurance coverage to uninsured populations, as well as reduce barriers of access to healthcare services among poorest and the rural population receiving subsidized insurance.

scholarly journals Healthcare services utilization among international students in Ankara, Turkey: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abednego Nzyuko Masai ◽  
Bahar Güçiz-Doğan ◽  
Polet Njeri Ouma ◽  
Israel Nyaburi Nyadera ◽  
Victor Kipkoech Ruto
Keyword(s):  
International Students ◽  
Health Services ◽  
Healthcare Access ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Health Providers ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Exact Test ◽  
Services Utilization

Abstract Background While international students form an increasing population of higher education students in Turkey, there is limited empirical evidence about their health services utilization. The study aim was to investigate healthcare access among a group of international students studying in Ankara city and identify potential barriers that affect full healthcare utilization. Method A total of 535 international students from 83 countries completed an online-based questionnaire. The survey was conducted from September until October 2020. Variables between groups within the study sample were compared using ANOVA and Chi-square tests (with Fisher’s exact test). Logistic regression analysis was used to evaluate the relationships between variables related to access to health services. Results Of the study population, 80.6% accessed the general practitioner (GP), 40% accessed the student health centres, and 11.4% were admitted to the hospital at least once. About 80% of international students reported changing their views to access healthcare more because of the COVID-19 pandemic. Conclusion Lack of awareness of healthcare support systems, perceived stigma associated with mental health services, and language barriers were the main barriers affecting healthcare access by international students. Implications Study findings indicate the need for education of international students on available healthcare, targeted health promotion, and training of health providers on effective communication.

scholarly journals Migrants’ and refugees’ health status and healthcare in Europe: A scoping literature review

2020 ◽  
Author(s):  
Adele Lebano ◽  
Sarah Hamed ◽  
Hannah Bradby ◽  
Alejandro Gil-Salmerón ◽  
Estella Durá-Ferrandis ◽  
...  
Keyword(s):  
Health Status ◽  
Emergency Services ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
European Countries ◽  
Term Care ◽  
Healthcare Needs ◽  
Unmet Healthcare Needs ◽  
The Eu

Abstract Background There is increasing attention paid to the arrival of migrants from outwith the EU region to the European countries. Healthcare that is universally and equably accessible needs to be provided for these migrants throughout the range of national contexts and in response to complex and evolving individual needs. It is important to look at the evidence available on provision and access to healthcare for migrants to identify barriers to accessing healthcare and better plan necessary changes. Methods This review scoped seventy seven papers from nine European countries (Austria, Cyprus, France, Germany, Greece, Italy, Malta, Spain, and Sweden) in English and in country-specific languages in order to provide an overview of migrants’ access to healthcare. The review aims at identifying what is known about access to healthcare and healthcare use of migrants and refugees in the EU member states. The evidence included documents from 2011 onward. Results The literature reviewed confirms that despite the aspiration to ensure equality of access to healthcare, there is persistent inequalities between migrants and non-migrants in access to healthcare services. The evidence shows unmet healthcare needs, especially when it comes to mental and dental health as well as the existence of legal barriers in accessing healthcare. Language and communication barriers, overuse of emergency services and underuse of primary healthcare services as well as discrimination are described. Conclusions The European situation concerning migrants’ and refugees’ health status and access to healthcare is heterogenous and it is difficult to compare and draw any firm conclusions due to the scant evidence. Different diseases are prioritised by different countries, although these priorities do not always correspond to the expressed needs or priorities of the migrants. Mental healthcare, preventive care (immunization) and long term care in the presence of a growing migrant older population are identified as priorities that deserve greater attention. There is a need to improve the existing data on migrants’ health status, needs and access to healthcare to be able to tailor care to the needs of migrants. To conduct research that highlights migrants’ own views on their health and barriers to access to healthcare is key.

scholarly journals Health Problems, Financial Capacity, and Access to Healthcare of Older Persons in Metro Dumaguete, Negros Oriental, Philippines

2021 ◽  
Vol 4 (4) ◽  
pp. 62-70
Author(s):  
Theorose June Q. Bustillo ◽  
Enrique G. Oracion ◽  
Chereisle G. Pyponco
Keyword(s):  
Older Persons ◽  
Healthcare Services ◽  
Health Problems ◽  
Access To Healthcare ◽  
Economic Conditions ◽  
Financial Capacity ◽  
Face To Face ◽  
Healthcare Needs ◽  
Health Quality

This descriptive qualitative study explored the experiences of older persons how they availed of and assessed the quality of available healthcare services to address their needs given their capacity to pay. The focus revolved around the concept of financial capacity for healthcare needs to address health problems during old age. Experiences were documented through face-to-face interviews of purposively identified eight older persons using semi-structured guide questions. Thematic analysis was applied, which revealed that financial capacity matters in health quality relative to the particular health problems the older persons have endured. The findings further revealed differentiated access to healthcare services given the variable economic conditions of older persons. This paper reiterates their recommendations that providing them the needed healthcare assistance and information about the management and prevention of common ailments affecting them may avert their health problems from becoming worse and more expensive to cure beyond their financial capacity.

scholarly journals How to do (or not to do) … a benefit incidence analysis

2010 ◽  
Vol 26 (2) ◽  
pp. 174-182 ◽  
Author(s):  
Di McIntyre ◽  
John E Ataguba
Keyword(s):  
Health Service ◽  
Health Services ◽  
Health System ◽  
Economic Status ◽  
Methodological Approach ◽  
Household Survey ◽  
Middle Income ◽  
Unit Costs ◽  
Benefit Incidence Analysis ◽  
Incidence Analysis

Abstract Benefit incidence analysis (BIA) considers who (in terms of socio-economic groups) receive what benefit from using health services. While traditionally BIA has focused on only publicly funded health services, to assess whether or not public subsidies are ‘pro-poor’, the same methodological approach can be used to assess how well the overall health system is performing in terms of the distribution of service benefits. This is becoming increasingly important in the context of the growing emphasis on promoting universal health systems. To conduct a BIA, a household survey dataset that incorporates both information on health service utilization and some measure of socio-economic status is required. The other core data requirement is unit costs of different types of health service. When utilization rates are combined with unit costs for different health services, the distribution of benefits from using services, expressed in monetary terms, can be estimated and compared with the distribution of the need for health care. This paper aims to provide an introduction to the methods used in the ‘traditional’ public sector BIA, and how the same methods can be applied to undertake an assessment of the whole health system. We consider what data are required, potential sources of data, deficiencies in data frequently available in low- and middle-income countries, and how these data should be analysed.

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