Improving Health Care for the Future Uninsured in Los Angeles County: A Community Partnered Dialogue

Objectives: To understand the health care access issues faced by Los Angeles (LA) County’s uninsured and residually uninsured after implementation of the Affordable Care Act (ACA) and to identify potential solutions using a community-partnered dialogue.Design: Qualitative study using a community-partnered participatory research framework.Setting: Community forum breakout discussion.Discussants: Representatives from LA County health care agencies, community health care provider organizations, local community advocacy and service organizations including uninsured individuals, and the county school district.Main Outcome Measures: Key structural and overarching value themes identified through community-partnered pile sort, c-coefficients measuring overlap between themes.Results: Five overarching value themes were identified – knowledge, trust, quality, partnership, and solutions. Lack of knowledge and misinformation were identified as barriers to successful enrollment of the eligible uninsured and providing health care to undocumented individuals. Discussants noted dissatisfaction with the quality of traditional sources of health care and a broken cycle of trust and disengagement. They also described inherent trust by the uninsured in “outsider” community-based providers not related to quality.Conclusions: Improving health care for the residually uninsured after ACA implementation will require addressing dissatisfaction in safety-net providers, disseminating knowledge and providing health care through trusted nontraditional sources, and using effective and trusted partnerships between community and health care agencies with mutual respect. Community-academic partnerships can be a trusted conduit to discuss issues related to the health care of vulnerable populations. Ethn Dis. 2015; 25(4)487- 494; doi:10.18865/ed.25.4.487

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Engaging African American Veterans with Health Care Access Challenges in a Community Partnered Care Coordination Initiative: A Qualitative Needs Assessment

Ethnicity & Disease ◽

10.18865/ed.28.s2.475 ◽

2018 ◽

Vol 28 (Supp) ◽

pp. 475-484

Author(s):

Adriana Izquierdo ◽

Michael Ong ◽

Felica Jones ◽

Loretta Jones ◽

David Ganz ◽

...

Keyword(s):

Health Care ◽

African American ◽

Los Angeles ◽

Health Care System ◽

Health Care Access ◽

Veterans Health ◽

Health Administration ◽

Health Care Environment ◽

Care Access ◽

Care System

Background: Little has been written about engaging potentially eligible members of a health care system who are not accessing the care to which they are entitled. Knowing more about the experiences of African American Veterans who regularly experience health care access challenges may be an important step toward equitable, coordinated Veterans Health Administration (VHA) care. This article explores the experiences of African American Veterans who are at risk of experiencing poor care coordination.Design: We partnered with a community organization to recruit and engage Veterans in three exploratory engagement workshops between October 2015 and February 2016.Participants and Setting: Veterans living in South Los Angeles, CaliforniaMain Outcome Measures: Veterans were asked to describe their experiences with community care and the VHA, a division of the US Department of Veterans Affairs (VA). Field notes taken during the workshops were analyzed by community and academic partners using grounded theory methodology to identify emergent themes.Results: 12 Veterans and 3 family members of Veterans participated in one or more engagement workshops. Their trust in the VA was generally low. Positive themes included: Veterans have knowledge to share and want to help other Veterans; and connecting to VA services can result in positive experiences. Negative themes included: functional barriers to accessing VA health care services; insensitive VA health care environment; lack of trust in the VA health care system; and Veteran status as disadvantageous for accessing non-VA community services.Conclusions: Veterans living in underserved areas who have had difficulty accessing VA care have unique perspectives on VA services. Partnering with trusted local community organizations to engage Veterans in their home communities is a promising strategy to inform efforts to improve care access and coordination for vulnerable Veterans.Ethn Dis. 2018;28(Suppl 2):475-484; doi:10.18865/ed.28.S2.475.

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Health Care Access and Health Behavior Quality of Life among Hispanic/Latino-American Cancer Survivors

Applied Research in Quality of Life ◽

10.1007/s11482-018-9677-1 ◽

2018 ◽

Vol 15 (3) ◽

pp. 637-650

Author(s):

Endia J. Santee ◽

Keith A. King ◽

Rebecca A. Vidourek ◽

Ashley L. Merianos

Keyword(s):

Quality Of Life ◽

Health Care ◽

Health Behavior ◽

Cancer Survivors ◽

Health Care Access ◽

Care Access ◽

Latino American

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The Philippine Health Care Delivery System and Health Expenditure

Public Health and Welfare ◽

10.4018/978-1-5225-1674-3.ch022 ◽

2016 ◽

pp. 457-470

Author(s):

Abdulkadir Işık ◽

Abdulhamid Mauyag Gunda ◽

Birol Topçu

Keyword(s):

Health Care ◽

Health Care Access ◽

Human Resources For Health ◽

Care Delivery ◽

Health Care Delivery System ◽

The Philippines ◽

Human Right ◽

Care Access ◽

Out Of Pocket Payments

Health is recognized by the Philippine constitution as a basic human right. The Philippines, compared to most Asian countries, produces more and better human resources for health. However, the Philippines are challenged by attracting and retaining staff in the under-served areas of the country. Philippine allotted 4.2-4.4% of its GDP to health from 2009 to 2011. Furthermore, considerable inequities in health care access and outcomes between Socio-economic groups remain. The Phil Health's limited breadth and depth of coverage has resulted in high levels of out of pocket payments. The implementation of the reforms in financing, service delivery and regulation which are aimed to tackle the inefficiencies and inequalities in the health system has been challenged by the decentralized environment and the presence of private sector, often creating fragmentation and variation in the quality of health services across the country.

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Quality of Life and Health Care Access in Transgender Population: Findings From 21 U.S. States in the Behavioral Risk Factor Surveillance System (BRFSS) Survey

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2017.08.111 ◽

2017 ◽

Vol 24 (7) ◽

pp. S59 ◽

Cited By ~ 3

Author(s):

A. Motwani ◽

S. Fatehchehr

Keyword(s):

Quality Of Life ◽

Health Care ◽

Health Care Access ◽

Surveillance System ◽

Behavioral Risk ◽

Behavioral Risk Factor ◽

Care Access ◽

Behavioral Risk Factor Surveillance ◽

Risk Factor Surveillance

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Telehealth in the COVID-19 Era: A Balancing Act to Avoid Harm (Preprint)

10.2196/preprints.24785 ◽

2020 ◽

Author(s):

J. Jeffery Reeves ◽

John W. Ayers ◽

Christopher A. Longhurst

Keyword(s):

Health Care ◽

Health Care Access ◽

Care Delivery ◽

Healthcare Delivery ◽

Patient Characteristics ◽

Virtual Patient ◽

Unintended Consequences ◽

Disease States ◽

Care Access

UNSTRUCTURED The telehealth revolution has been heralded for its potential to improve health care access and improve the efficiency of health care delivery. However, virtual patient care can bring unintended consequences that eclipse the benefits including potentially limiting the patient-provider relationship, the quality of the examination, the efficiency of healthcare delivery, and the overall quality of care. Facing the most rapidly adopted medical trend in modern history, clinicians are beginning to grasp its possibilities, but we also need to understand its boundaries. As outcomes are studied and federal regulations reconsidered, it is important to be precise in the approach to the virtual patient encounter. We offer some simple guidelines to assist providers in determining the appropriateness of a telehealth visit, considering visit types, chief complaint or disease states, and patient characteristics.

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