Socio-economic disparities and accessibility to age-appropriate screening tools.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1529-1529
Author(s):  
Noha Soror ◽  
Amany Keruakous
Keyword(s):  
Cancer Screening ◽  
Medical Care ◽  
Health Care Disparities ◽  
Financial Burden ◽  
Screening Tools ◽  
Medical Services ◽  
Cancer Prevalence ◽  
Economic Disparities ◽  
Age Appropriate ◽  
Prevalence Of Cancer

1529 Background: Pervasive racial and ethnic health disparities continue to be reported throughout the U.S. population. An increasing number of studies have discussed racial disparities in cancer statistics as well as socio-economic differences. The purpose of this study is to investigate sociodemographic health care disparities and the prevalence of cancer diagnosis in the context of challenges in medical services accessibility due to financial burden. Methods: Analysis of pooled cross-sectional data using 2017 Behavioral Risk Factor Surveillance System (BRFSS). Differences between our comparison groups were computed using chi square test for categorical values and t-test for continuous variables. Demographic factors were analyzed through weighted regression for accessibility to cancer treatment and prior cancer screening. Results: We report data from a total of 436,198 respondents to the 2017 BRFSS survey, with cancer prevalence 9.8% and higher prevalence of cancer among females and elderly population (70 years and older). Racial disparities differed significantly between respondents with and without history of cancer, with higher prevalence in Hispanic and multiracial minorities, 19% and 14%, respectively. We also report, differences in annual income are significantly associated with increased cancer prevalence in lower socioeconomic populations. Nineteen percent of participants who had annual income less than 25k were diagnosed with cancer. Additionally, analyzing the association between delayed medical care due to financial burden and its correlation with accessibility to age-appropriate cancer screening tools. We report significant differences in receipt of cancer screening among respondents, with consistently lower probabilities of receiving age-appropriate screening tools among participants who experienced delays in medical care due to cost, that applies to all screening tools. Among respondents who did not receive screening mammograms, 17% reported delays in medical care due to medical cost. Twelve percent of participants who did not receive screening colonoscopy suffered delays in medical care due to cost. Also, among participants who did not receive screening for prostate cancer with PSA testing, 11% reported delays in medical care due to cost. Conclusions: Health care disparities in cancer screening continue to persist including differences in socioeconomic classes and access to medical services. In this study, we report that patients with delayed access to medical services due to cost are not adequately receiving age-appropriate screening for cancer. Given the deleterious effects of delayed diagnosis and treatment of cancer, it is important that public health and clinical professionals utilize tools to improve cancer screening accessibility to minorities with socio-economic disparities.

Racial disparities and medical care accessibility in cancer statistics.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18510-e18510
Author(s):  
Noha Soror ◽  
Amany Keruakous
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Cancer Diagnosis ◽  
Health Care Disparities ◽  
Financial Burden ◽  
P Value ◽  
Annual Income ◽  
History Of ◽  
Prevalence Of Cancer ◽  
History Of Cancer

e18510 Background: Cancer is one of the leading causes of death worldwide. It continues to be the second leading cause of death in the United States despite all national efforts aiming to reduce cancer burden and mortality. Delays in medical care and subsequently age-appropriate screening leads to increased cancer burden which reflect on the overall prognosis. Medical care accessibility has been a challenge that is reported by approximately one third of the USA adult population. We aimed to identify health care disparities and its correlation with prevalence of cancer as well as delays in medical care due to financial challenges among Texas residents. Methods: We analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) 2017. We measured specific health care disparities including patient’s gender, age, race/ethnicity, body mass index (BMI), annual income, alcohol consumption, history of cancer, and delays in medical care due to financial burden, among respondents to the 2017 BRFSS survey from Texas. We computed the difference between our comparison groups using chi-square test for categorical variables and t-test for continuous variables. Results: We analyzed the differences in health care disparities among respondents with and without history of cancer. We report results from 11,165 adult respondents who reside in Texas, among which nine percent were diagnosed with cancer. We noticed a higher proportion of females than males among participants with a history of cancer (64% females p < 0.0001). Age did differ between both groups, with the majority of participants with cancer are aged 50 years and older. Interestingly, BMI did not differ between both groups (p-value = 0.6930). Although annual income did not differ between both groups, twelve percent of participants with cancer diagnosis suffered from delays in medical care due to financial burden. Racial disparities were statistically different between participants with or without cancer (p < .0001). Seventy seven percent of patients with cancer diagnosis were White and non-Hispanic with a cancer prevalence rate of 12% in that racial group. On a stratified analysis to compute the relationship between delayed medical care due to financial burden and cancer diagnosis among all ethnic groups, it was not statistically different (p-value = 0.1063). We showed that prevalence of cancer among multiracial participants and other racial minorities was higher in the group of participants who reported delays in medical care due to financial burden (11% versus 7%). Conclusions: Racial and ethnic disparities could affect accessibility to medical services. Race is a significant variable that is associated with cancer, with higher prevalence of cancer in White and non-Hispanic. Delayed medical care due to financial burden is more pronounced in multiracial population and racial minorities and should be targeted in future quality improvement projects.

Analysis of Current Practices of Organizing the Export of Medical Services in the United Kingdom, Italy, South Korea and China

2020 ◽  
pp. 30-42
Author(s):  
Arkady Nikolaevich Daykhes ◽  
Vladimir Anatolievich Reshetnikov ◽  
Olga Aleksandrovna Manerova ◽  
Ilya Aleksandrovich Mikhailov
Keyword(s):  
United Kingdom ◽  
South Korea ◽  
Medical Care ◽  
Medical Tourism ◽  
Value Added ◽  
External Factors ◽  
Medical Services ◽  
High Tech ◽  
Medical Organization ◽  
The United Kingdom

Aim of the study. Analysis of medical tourism’s organizational features based on the example of the large medical organizations in the United Kingdom, South Korea, Italy and China. Materials and methods. The data were collected by the authors by interviewing the heads of medical organizations and their deputies in the United Kingdom, South Korea, Italy and China (3–4 respondents per medical organization) using the developed questionnaire to identify the main mechanisms and tools for organizing the export of medical services. SWOT-analysis (Strengths; Weaknesses; Opportunities; Threats) was performed in order to comprehensively evaluate the received information. Results. Along with weaknesses and threats that slow down the development of medical services exports, strengths (internal factors) and opportunities ( external factors) that contribute to the development of medical tourism were also identified: the widespread popularity of the brand of medical organizations abroad which is associated with the provision of premium medical services; versatility and ability to conduct high-tech surgical operations; the presence of a separate premium class building and an international department for working with foreign patients and promoting a medical organization in the world market; well-established business relationships with assistance companies; foreign medical personnel who speak foreign languages and possess necessary skills to treat foreign patients; developed electronic medical care system; developed system of quality control of medical care; the presence of branches in other countries; the presence of a medical visa in the system of legislation; established cooperation with many countries at the embassy level; state licensing and accreditation for the provision of medical services to foreign citzens; the availability of a state website on the provision of medical assistance to foreign citizens; the possibility of the age of value added tax. Conclusion. We identified main patterns in the organization of export of medical services that can be applied to develop this direction in medical organizations of the Russian Federation during the analysis the strengths and weaknesses of four large medical organizations abroad, as well as external factors that affect the work of these medical organizations.

THE ROAD AHEAD TO BETTER MEDICAL CARE FOR CHILDREN

PEDIATRICS ◽  
1950 ◽  
Vol 6 (3) ◽  
pp. 553-556
Keyword(s):  
Child Health ◽  
Medical Care ◽  
Medical Center ◽  
Point Of View ◽  
Medical Services ◽  
High Quality ◽  
The Road ◽  
Provide Child Care ◽  
Ultimate Objective ◽  
The Many

THE road to better child health has been discussed in relation to the doctor and his training, health services and their distribution. We have dealt with the unavoidable question of costs. Particular attention has been given to some of the advantages and dangers of decentralization of pediatric education and services. Each of the various subjects has been discussed from the point of view of its bearing on the ultimate objective of better health for all children and the steps necessary to attain this goal. Now, we may stand back from the many details of the picture, view the whole objectively and note its most outstanding features. First is the fact that the improvement of child health depends primarily upon better training for all doctors who provide child care, general practitioners as well as specialists. This is the foundation without which the rest of the structure cannot stand. The second dominant fact is the need for extending to outlying and isolated areas the high quality medical care of the medical centers, without at the same time diluting the service or training at the center. The road to better medical care, therefore, begins at the medical center and extends outward through a network of integrated community hospitals and health centers, finally reaching the remote and heretofore isolated areas. Inherent in all medical schools is a unique potential for rendering medical services as well as actually training physicians. The very nature of medical education—whereby doctors in training work under the tutelage of able specialists in the clinic, hospital ward, and out-patient department—provides medical services of high quality to people in the neighboring communities.

scholarly journals The CRCbiome study: a large prospective cohort study examining the role of lifestyle and the gut microbiome in colorectal cancer screening participants

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ane Sørlie Kværner ◽  
Einar Birkeland ◽  
Cecilie Bucher-Johannessen ◽  
Elina Vinberg ◽  
Jan Inge Nordby ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Gut Microbiome ◽  
Precancerous Lesions ◽  
Colorectal Carcinogenesis ◽  
Screening Tools ◽  
Screening Methods ◽  
Crc Screening ◽  
Link Type ◽  
Incidence And Mortality

Abstract Background Colorectal cancer (CRC) screening reduces CRC incidence and mortality. However, current screening methods are either hampered by invasiveness or suboptimal performance, limiting their effectiveness as primary screening methods. To aid in the development of a non-invasive screening test with improved sensitivity and specificity, we have initiated a prospective biomarker study (CRCbiome), nested within a large randomized CRC screening trial in Norway. We aim to develop a microbiome-based classification algorithm to identify advanced colorectal lesions in screening participants testing positive for an immunochemical fecal occult blood test (FIT). We will also examine interactions with host factors, diet, lifestyle and prescription drugs. The prospective nature of the study also enables the analysis of changes in the gut microbiome following the removal of precancerous lesions. Methods The CRCbiome study recruits participants enrolled in the Bowel Cancer Screening in Norway (BCSN) study, a randomized trial initiated in 2012 comparing once-only sigmoidoscopy to repeated biennial FIT, where women and men aged 50–74 years at study entry are invited to participate. Since 2017, participants randomized to FIT screening with a positive test result have been invited to join the CRCbiome study. Self-reported diet, lifestyle and demographic data are collected prior to colonoscopy after the positive FIT-test (baseline). Screening data, including colonoscopy findings are obtained from the BCSN database. Fecal samples for gut microbiome analyses are collected both before and 2 and 12 months after colonoscopy. Samples are analyzed using metagenome sequencing, with taxonomy profiles, and gene and pathway content as primary measures. CRCbiome data will also be linked to national registries to obtain information on prescription histories and cancer relevant outcomes occurring during the 10 year follow-up period. Discussion The CRCbiome study will increase our understanding of how the gut microbiome, in combination with lifestyle and environmental factors, influences the early stages of colorectal carcinogenesis. This knowledge will be crucial to develop microbiome-based screening tools for CRC. By evaluating biomarker performance in a screening setting, using samples from the target population, the generalizability of the findings to future screening cohorts is likely to be high. Trial registration ClinicalTrials.gov Identifier: NCT01538550.

scholarly journals FEATURES OF RESPONSIBILITY OF A MEDICAL ORGANIZATION FOR CAUSING THE PATIENT'S HEALTH

2021 ◽  
Vol 38 (2) ◽  
pp. 73-80
Author(s):  
Yu.N. Slepenok ◽  
◽  
G.V. Stankevich ◽  
L.P. Stepanova ◽  
◽  
...  
Keyword(s):  
Medical Care ◽  
Causal Relationship ◽  
Civil Liability ◽  
Medical Personnel ◽  
Medical Services ◽  
Medical Organization ◽  
Approximate Order ◽  
Average Sample

The article discusses the particular conditions of holding medical organizations accountable for causing harm to the health of patients. The conditions of civil liability, as well as the degree of responsibility of a medical organization in the provision of medical services, are analyzed. The authors are of the opinion that medical care should be organized in accordance with the procedures, conditions and standards for the provision of such care, however, the standards cannot cover all the options that may arise during the provision of medical care, therefore they are aimed at creating an average “sample”, to determine the approximate order of possible actions carried out by medical personnel. Attention is also paid to the consideration of the features of causing harm to the patient’s health, depending on whether the harm was caused in the provision of medical care or medical services. In conclusion, it was concluded that the conditions for bringing medical organizations to justice should include: unlawful action (inaction), harm, a causal relationship between unlawful action and harm, as well as the fault of the injurer.

scholarly journals ETHICAL DIMENSIONS OF WILLINGNESS TO PAY FOR MEDICAL CARE IN BULGARIA

2018 ◽  
Vol 6 (1) ◽  
pp. 516-522
Author(s):  
Kalina Peycheva ◽  
Mariela Deliverska
Keyword(s):  
Higher Education ◽  
Medical Care ◽  
Education Level ◽  
Medical Services ◽  
Medical Professionals ◽  
Chi Square ◽  
New Methods ◽  
Gender And Education ◽  
Anonymous Questionnaire ◽  
Methods Of Treatment

Regardless of what both patients and medical professionals might think, nowadays there is no free medicine. The need of changing the pattern is emphasized and people should become more responsible for their own health. The aim is to find a connection between the trust in GPs, prophylactic check-ups, new methods of treatment and the willingness of patients to pay for the received medical services. Material and Method: A questionnaire was prepared for the purposes of the study. The methods utilized were a direct individual anonymous questionnaire, statistical – descriptive, analytical (Chi-square). The answers were examined and statistically processed according to age, gender and education level of the participants. Results: 1. The results regarding the trust in GP is very unconvincing – only 14,5 % believe in their GP. 2. The percentage of believers in prophylactic check-ups is high - 57,9%.  3.The percentage of those who believe in the new methods and means for treatment is high, over 80%, while no difference is found with respect to the patients’ education level. 4. The patients often (86%) pay for the treatment of a specialist. 5. People with higher education more readily pay for medical care. Conclusions: 1. The lack of trust in GP combined with the strong belief in prophylactic check - ups and the new methods for diagnostic and treatment of diseases lead to higher expectations of patients towards the medical services and their readiness to pay for these services. 2. The patients indicate readiness to pay for medical services which is a part of the patients’ readiness to take care for their own health.

Promises and pitfalls of integrating home-based health services into Shanghai's elder-care system

2018 ◽  
Vol 40 (3) ◽  
pp. 480-500
Author(s):  
Yan-Yan Chen ◽  
Honglin Chen ◽  
Priscilla Song
Keyword(s):  
Medical Care ◽  
Elder Care ◽  
Municipal Government ◽  
Oldest Old ◽  
Medical Services ◽  
Ageing In Place ◽  
Pilot Programme ◽  
Care Giving ◽  
Home Based ◽  
Care System

AbstractFaced with the dramatic pace of population ageing, the Shanghai municipal government launched a pilot programme in 2013 designed to address this and to strengthen ageing-in-place arrangements by providing basic in-home medical services for residents above the age of 80. Yet after a two-year trial run, the ‘Home-Based Medical Care Scheme for the Oldest-Old’ (HBMCSOO) policy remained significantly under-utilised despite the increasing demand for medical services. Our multi-disciplinary research team of social workers and anthropologists identified two key factors impeding the implementation of home-based medical care services: (a) the distortion of policy implementation and (b) the inadequate professionalisation of community-based elder-care workers. Based on our evaluation of the pilot programme, the Shanghai municipal government made several practical adjustments to improve the subsequent city-wide policy implemented in 2016. While these changes mostly focused on minor adjustments to improve in-home medical services for the oldest-old, they represent an encouraging first step towards our call for a holistic integrated care system whose design and delivery takes into account local political and social contexts, including existing institutional infrastructure and cultural expectations about care-giving responsibilities. The challenges of implementing Shanghai's HBMCSOO policy ultimately provide instructive lessons on best practices for integrating medical and social services in order to improve ageing-in-place measures in diverse local settings around the world.

Comparative analysis of patient satisfaction with COVID-19 medical care provided in telemedicine center

2021 ◽  
pp. 73-77
Author(s):  
A. V. Starshinin ◽  
A. A. Tyazhelnikov ◽  
A. V. Pogonin ◽  
E. V. Kostenko
Keyword(s):  
Patient Satisfaction ◽  
Comparative Analysis ◽  
Statistical Analysis ◽  
Medical Care ◽  
Dynamic Assessment ◽  
Medical Services ◽  
Level Of Satisfaction ◽  
Time Periods ◽  
High Level

The article presents the results of a dynamic analysis of the satisfaction of patients diagnosed with CAVID‑19 with the quality of medical services provided remotely at the telemedicine centre in Moscow in 2020.Purpose of research. Conduct a dynamic assessment of patient satisfaction with the quality of remote medical services provided in different time periods.Material and methods. The results of an anonymous survey of 424 patients on the quality of remote medical services were dynamically evaluated. The first group (138) received medical care from 01.04 to 30.04, the second one (286) – from 01.06 to 30.06 of 2020 after the implementation of measures to improve them. Statistical analysis was performed using IBM SPSS Statistics 20.0.Results. When analysing the results, a high level of patient satisfaction was revealed, but there was a significant (p < 0.05) difference in the level of satisfaction between the groups. The factors of connection between telemedicine services and patient satisfaction were identified, which served as the basis for organizational measures.Conclusion. Providing medical services using telemedicine technologies can be considered as one of the most effective ways to provide medical care.

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