Assessing Health Care Access and Use among Indigenous Peoples in Alberta: a Systematic Review

The Deaf and hard of hearing (DHH) population suffers disproportionately from barriers to health care access. Progress has been made toward improving access to medical care in the human health field; however, the veterinary field has not yet implemented similar standards. More research is needed to improve access to veterinary care for disabled individuals. This systematic review aimed to evaluate all primary research articles pertaining to medical and veterinary health care access for DHH adults in the United States. Its purpose was to assess gaps in knowledge regarding DHH persons’ access to veterinary care. The review includes 39 articles related to DHH access to medical care and 6 articles related to general access to veterinary care. The authors found no articles related specifically to DHH access to veterinary care nor any articles on disability accessibility to veterinary care that met the inclusion criteria. Results outline significant barriers to DHH persons’ access to health care, unique needs specific for this population of patients, and recommendations to improve access to medical care for individuals who identify as DHH. The results also suggest that further research is needed to investigate barriers to veterinary care experienced by DHH pet owners, the unique needs of this population of pet owners, and how the field of veterinary medicine can better accommodate those needs.

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Care of acute conditions and chronic diseases in Canada and the United States: Rapid systematic review and meta-analysis

Journal of Public Health Research ◽

10.4081/jphr.2019.1479 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Keren M. Escobar ◽

Dorian Murariu ◽

Sharon Munro ◽

Kevin M. Gorey

Keyword(s):

Systematic Review ◽

Health Care ◽

Chronic Diseases ◽

Low Income ◽

Health Care Access ◽

Meta Analysis ◽

The United States ◽

Care Access ◽

Acute Conditions ◽

The Usa

This study tested the hypothesis that socioeconomically vulnerable Canadians with diverse acute conditions or chronic diseases have health care access and survival advantages over their counterparts in the USA. A rapid systematic review retrieved 25 studies (34 independent cohorts) published between 2003 and 2018. They were synthesized with a streamlined meta-analysis. Very low-income Canadian patients were consistently and highly advantaged in terms of health care access and survival compared with their counterparts in the USA who lived in poverty and/or were uninsured or underinsured. In aggregate and controlling for specific conditions or diseases and typically 4 to 9 comorbid factors or biomarkers, Canadians’ chances of receiving better health care were estimated to be 36% greater than their American counterparts (RR=1.36, 95% CI 1.35-1.37). This estimate was significantly larger than that based on general patient or non-vulnerable population comparisons (RR=1.09, 95% CI 1.08-1.10). Contrary to prevalent political rhetoric, three studies observed that Americans experience more than twice the risk of long waits for breast or colon cancer care or of dying while they wait for an organ transplant (RR=2.36, 95% CI 2.09-2.66). These findings were replicated across externally valid national studies and more internally valid, metropolitan or provincial/state comparisons. Socioeconomically vulnerable Canadians are consistently and highly advantaged on health care access and outcomes compared to their American counterparts. Less vulnerable comparisons found more modest Canadian advantages. The Affordable Care Act ought to be fully supported including the expansion of Medicaid across all states. Canada’s single payer system ought to be maintained and strengthened, but not through privatization.

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Race, Socioeconomic Status, and Health-Care Access Disparities in Ovarian Cancer Treatment and Mortality: Systematic Review and Meta-Analysis

JNCI Cancer Spectrum ◽

10.1093/jncics/pkz084 ◽

2019 ◽

Vol 3 (4) ◽

Cited By ~ 2

Author(s):

Shama Karanth ◽

Mackenzie E Fowler ◽

XiHua Mao ◽

Lauren E Wilson ◽

Bin Huang ◽

...

Keyword(s):

Systematic Review ◽

Ovarian Cancer ◽

Health Care ◽

Socioeconomic Status ◽

Cancer Treatment ◽

Health Care Access ◽

Meta Analysis ◽

The United States ◽

Care Access

Abstract Background Ovarian cancer remains a leading cause of death from gynecological malignancies. Race, socioeconomic status (SES), and access to health care are important predictors of quality treatment and survival. We provide a systematic review and meta-analysis on the role of these predictors on disparities in ovarian cancer treatment and mortality. Methods Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched PubMed, EMBASE, and Scopus for relevant articles published between January 2000 and March 2017. We selected studies published in the United States that evaluated the role of race, SES, or health-care access on disparities in ovarian cancer treatment or survival. Pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated for each outcome using a random-effects model. Results A total of 41 studies met the inclusion criteria for systematic review. In meta-analysis, there was a 25% decrease (RR = 0.75, 95% CI = 0.66 to 0.84) in receipt of adherent ovarian cancer treatment and 18% increased risk (RR = 1.18, 95% CI = 1.11 to 1.26) of mortality for blacks compared to whites. Receipt of adherent ovarian cancer treatment was 15% lower (RR = 0.85, 95% CI = 0.77 to 0.94) in the lowest vs highest SES group and 30% lower (RR = 0.70, 95% CI = 0.58 to 0.85) among patients at lower vs higher hospital volumes. Conclusion We found consistent and strong evidence for continued lack of quality ovarian cancer treatment and higher mortality among ovarian cancer patients who are black, are of low SES, and/or have poor access to care. Interventions focused on these groups targeting specific barriers to care are needed to reduce disparities in ovarian cancer treatment and mortality.

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