The intersection of developmental vulnerability and socioeconomic disadvantage on access to health care for preschool aged children: evidence for the inverse-care law

2019 ◽  
Author(s):  
Sue Woolfenden ◽  
Claire Galea ◽  
Hannah Badland ◽  
Hayley Smithers-Sheedy ◽  
Katrina Williams ◽  
...  
Keyword(s):  
Health Services ◽  
Access To Health Care ◽  
Parental Education ◽  
Service Use ◽  
Socioeconomic Disadvantage ◽  
Access To Health Services ◽  
Health Services Use ◽  
Cross Sectional ◽  
Inverse Care Law ◽  
Access To Health

Abstract Aim. Children who are developmentally vulnerable have greater health needs. Socioeconomic disadvantage not only increases this risk of developmental vulnerability but can be associated with less access to health services. Our aim was to compare health services use in children aged 4-5 years in Australia with and without developmentally vulnerability and consider the intersection of socioeconomic disadvantage on this relationship. Method. Cross sectional data were collected from Wave 3 of the Longitudinal Study of Australian Children birth cohort when the children were aged 4-5 years. A composite variable for developmental vulnerability was designed by combining those children who were in the lowest 15% in the physical, socioemotional and/or learning outcome indices. Children were then subgrouped according to developmental vulnerability and disadvantage based on socioeconomic position (SEP) quintile (derived from parental education, occupation, household income). We defined SEP 1 the lowest quintile as ‘disadvantaged’ and SEP quintiles 2-5 as ‘not disadvantaged’. Multivariate regression was used to examine the intersection between health service use and developmental vulnerability and disadvantage using these composite variables. Results The total number of children with information on developmental vulnerability in Wave 3 was 3967 (90% of the sample). A total of 1292 (32.6%) children were classified as developmentally vulnerable. 30.6% of children who were developmentally vulnerable came from families who were disadvantaged. Overall children who were developmentally vulnerable were reported to use more specialist/hospital health services than those who were not developmentally vulnerable (10-25 % vs 5-16%). Children who were developmentally vulnerable and not disadvantaged were 1.4-2.0 times more likely to have reported using a GP, paediatrician, other specialist, and Emergency Department compared with children who were developmentally vulnerable and disadvantaged. Conclusion Preschool children who are developmentally vulnerable have a higher reported use of specialist and hospital services compared with those who are not developmentally vulnerable. There is evidence of an inverse care law; those who were not disadvantaged with and without developmental vulnerability are more likely to use health services compared with their counterparts who were disadvantaged.

scholarly journals Barriers and Facilitators to Accessing Health Services: A Qualitative Study Amongst People with Disabilities in Cameroon and India

2019 ◽  
Vol 16 (7) ◽  
pp. 1126 ◽  
Author(s):  
Maria Zuurmond ◽  
Islay Mactaggart ◽  
Nanda Kannuri ◽  
Gudlavalleti Murthy ◽  
Joseph Oye ◽  
...  
Keyword(s):  
Health Services ◽  
Access To Health Care ◽  
Social Inclusion ◽  
Service Providers ◽  
People With Disabilities ◽  
Personal Factors ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Access To Health

Background: Article 25 of the UNCRPD stipulates the right of people with disabilities to the highest attainable standard of health, and the timely uptake of appropriate health and rehabilitation services. This study seeks to explore the factors which influence access to health care among adults with disabilities in Cameroon and India. Methods: A total of 61 semi-structured interviews were conducted with a purposive sample of adults with vision, hearing or musculoskeletal impairments, using data from an earlier cross-sectional disability survey. In addition, 30 key informants were interviewed to provide contextual information about the local services and context. Results: Key themes included individual-level factors, understanding and beliefs about an impairment, and the nature of the impairment and interaction with environmental factors. At the community and household level, key themes were family dynamics and attitudes, economic factors, social inclusion and community participation. Intersectionality with gender and age were cross-cutting themes. Trust and acceptability of health service providers in India and poor understanding of referral processes in both countries were key service-level themes. Conclusions: The interaction of environmental and personal factors with the impairment and their levels of participation and inclusion in community structures, all contributed to the take up of services. This study illustrated the need for a multi-faceted response to improve access to health services for people with disabilities.

scholarly journals Relationship between Financial Factors and Access to Health Care and Quality of Life for HIV / AIDS Patients

2021 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Laila Salma Iklama ◽  
Nursalam Nursalam ◽  
Ni Ketut Alit Armini
Keyword(s):  
Quality Of Life ◽  
Health Services ◽  
Access To Health Care ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Significance Level ◽  
Financial Factors ◽  
Access To Health ◽  
Hiv Aids

Introduction:Patients with HIV-AIDS experience various problems, one of which is related to financial factors and access to health services, this will also affect the patient's quality of life. The purpose of this study was to analyze the relationship between financial factors and access to health services.Method:This was a cross-sectional study with a sample size of 101 respondents who were selected using simple random sampling technique. The independent variable in this study is income and access to services, while the dependent variable in this study is quality of life. The instrument used was a demographic questionnaire and Health-Related Quality of Life, the data were analyzed using chi square with a significance level of p <0.05.Results:The results showed that there was a significant relationship between income (p = 0.044) and the availability of infrastructure (p = 0.003) with the quality of life of HIV-AIDS patients.Conclusion:The financial and access to healthcare factors  are related to the quality of life of clients with HIV-AIDS, so that patients with good quality of life will show that the level of fulfillment of needs and access to health services is also good.

Desigualdade social em doentes renais crônicos/ Social inequality in chronic renal patients

1970 ◽  
Vol 1 (1) ◽  
pp. 44-49
Author(s):  
Beatriz Bertolaccini Martínez ◽  
Fernanda Marcelino Da Silva ◽  
Vinícius Tavares Veiga ◽  
Rodrigo Pereira Custódio ◽  
José Vítor Da Silva
Keyword(s):  
Social Inequality ◽  
Access To Health Care ◽  
Young Patients ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Access To Treatment ◽  
Cross Sectional ◽  
Economic Class ◽  
Access To Health ◽  
Clinical Background

Introdução: A pobreza influencia na evolução dos pacientes com doenças crônicas, porque contribui para o seu agravamento e dificulta o acesso à assistência médica. O objetivo deste trabalho foi avaliar os aspectos relacionados à desigualdade social de pacientes em hemodiálise. Métodos: Estudo transversal com 123 pacientes em hemodiálise no Hospital Samuel Libânio – Pouso Alegre, MG, divididos, de acordo com a classe econômica, em 3 grupos: AB (n=23), C (n=60) e DE (n=40),. Foram coletados dados sociodemográficos e econômicos, antecedentes clínicos e informações sobre o acesso a serviços de saúde. Para a análise dos resultados, foi utilizada estatística analítica e descritiva. Adotou-se p £ 0,05. Resultados: O grupo AB apresentou um menor número de pacientes jovens (4,3% em AB vs 40% em C e 25% em DE, p < 0,05), um maior número de indivíduos com mais anos de escolaridade (65,3% em AB vs 18,3% em C e 2,5% em DE; p < 0,05), predomínio de pacientes com menos de um ano em tratamento de hemodiálise (65,2% em AB vs 10% em C e 5% em DE, p < 0,05), menor número de usuários do SUS (40% em C e 25% em DE vs 4,3% em AB; p < 0,05) e maior acesso ao tratamento com nefrologista (73,9% em AB vs 46,7% em C e 52,5 em DE; p < 0,05). Conclusão: Classes economicamente desfavorecidas agregam indivíduos mais jovens, com menor escolaridade, usuários do SUS, com maior tempo em hemodiálise e pior acesso ao tratamento com nefrologista.Introduction: The poverty influence on the evolution of patients with chronic diseases because it contributes to your aggravation and hinders access to health care. Our goal was to evaluate the aspects related to social inequality on hemodialysis patients. Methods: cross-sectional study with 123 patients on hemodialysis in Samuel Libânio Hospital – Pouso Alegre, MG, divided according to the economic class, into 3 groups: AB (n = 23), C (n = 60) and DE (n = 40). Were collected socio-demographic and economic data, clinical background and information about access to health services. For analysis of the results has been used statistical analytical and descriptive. We take p £ 0,05.  Results: The AB group has fewer young patients (4,3% in AB vs 40% in C and 25% in DE, p< 0,05), a greater number of individuals with more years of schooling (65,3% in AB vs 18,3% in C and 2,5% in DE; p< 0,05), predominance of patients with less than a year on haemodialysis treatment (65,2% in AB vs 10% in C and 5% in DE, p< 0,05), smaller number of users of SUS (40% in C and 25% in DE vs 4,3% in AB; p< 0,05), greater access to treatment with nephrologist (73,9% in AB vs 46,7% in C and 52,5% in DE; p< 0,05). Conclusion: Economically disadvantaged classes bring younger patients, with less schooling, users of SUS, patients with greater time on hemodialysis and worse access to treatment with nephrologist. 

Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study

The Lancet ◽  
2012 ◽  
Vol 379 (9818) ◽  
pp. 805-814 ◽  
Author(s):  
Qun Meng ◽  
Ling Xu ◽  
Yaoguang Zhang ◽  
Juncheng Qian ◽  
Min Cai ◽  
...  
Keyword(s):  
Health Services ◽  
Cross Sectional Study ◽  
Financial Protection ◽  
Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health

scholarly journals HUBUNGAN PENDIDIKAN, AKSES PELAYANAN KESEHATAN DAN DUKUNGAN KELUARGA DENGAN PEMANFAATAN PELAYANAN KESEHATAN PENDERITA TB PARU BTA+ DI PUSKESMAS JANTI KOTA MALANG

2019 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Alfreda Dinayu Purbantari ◽  
Roesdiyanto Roesdiyanto ◽  
Nurnaningsih Herya Ulfah
Keyword(s):  
Public Health ◽  
Health Service ◽  
Health Services ◽  
Health Center ◽  
Family Support ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Education Access ◽  
Utilization Of Health Services ◽  
Access To Health

Abstract: Tuberculosis (TB) is a contagious disease that is still the world's attention, Until now, there is not a single country that is free of TB (Kemenkes 2011). Public Health Center (puskesmas) Janti is a puskesmas where the number of TB BTA+ sufferers increases every year while the number of treatment success rate at Puskesmas Janti decreases every year. In 2013 is 96%, in 2014 is 87,50% and in 2015 is 85,37%. Increasing the number of patients and decreasing the number of success rates of treatment indicates that the utilization of health services is less. This study aims to find out the relationship of Education, Health Service Access and Family Support with Health Service Utilization of BTA+ Pulmonary TB Patients at Public Health Center (puskesmas) Janti Malang. The design of this study is quantitative correlation with samples of all patients with TB Paru + BTA who are still doing treatment at Puskesmas Janti in September 2016 until April 2017. The analysis used correlation test and logistic regression test with cross sectional approach. The results of the research analysis found that there is a significant relationship between education, access to health services and family support together with the utilization of health services of patients Tb Paru BTA+. Based on the results of determination coefficient R2 (Nagelkerke) of 0.619, this means that education (X1), access to health services (X2), and family support (X3) has contributed 61.9% to the utilization of health services of patients with TB Paru BTA+ at Puskesmas Janti.Keywords: education, access, family support, health service utilizationAbstrak: Tuberkulosis (TB) adalah penyakit menular yang masih menjadi perhatian dunia, hingga saat ini, belum ada satu negara pun yang bebas TB (Kemenkes 2011). Puskesmas Janti adalah satu puskesmas yang berada di Kota Malang dengan jumlah pasien TB Paru BTA+ yang paling tinggi dan meningkat setiap tahun diantara puskesmas yang lain di Kota Malang, sedangkan jumlah angka keberhasilan pengobatan di Puskesmas Janti mengalami penurunan setiap tahun. Tahun 2013 sebesar 96%, pada tahun 2014 sebesar 87,50% dan pada tahun 2015 sebesar 85,37%. Peningkatan jumlah penderita dan penurunan jumlah angka keberhasilan pengobatan menunjukkan bahwa pemanfaatan pelayanan kesehatan kurang. Penelitian ini bertujuan untuk mengetahui Hubungan Pendidikan, Akses Pelayanan Kesehatan dan Dukungan Keluarga dengan Pemanfaatan Pelayanan Kesehatan Penderita TB Paru BTA+ di Puskesmas Janti Kota Malang. Rancangan penelitian ini adalah kuantitatif korelasional dengan sampel seluruh penderita TB Paru BTA+ yang masih melakukan pengobatan di Puskesmas Janti pada bulan September 2016 sampai dengan April 2017. Analisis menggunakan uji korelasi dan uji regresi logistik dengan pendekatan cross sectional. Hasil analisis penelitian di dapatkan ada hubungan yang dignifikan antara pendidikan, akses pelayanan kesehatan dan dukungan keluarga secara bersama-sama dengan pemanfaatan pelayanan kesehatan penderita Tb Paru BTA+. Berdasarkan hasil koefisien determinasi R2 (Nagelkerke) sebesar 0,619, hal ini berarti bahwa pendidikan (X1), akses pelayanan kesehatan (X2), dan dukungan keluarga (X3) memiliki kontribusi sebesar 61,9% terhadap pemanfaatan pelayanan kesehatan penderita TB Paru BTA+ di Puskesmas Janti.Kata Kunci:    pendidikan, akses pelayanan kesehatan, dukungan keluarga, pemanfaatan pelayanan kesehatan penderita TB Paru BTA+

scholarly journals Factors associated with access to health services and quality of life in knee osteoarthritis patients: a multilevel cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Siriwan Choojaturo ◽  
Siriorn Sindhu ◽  
Ketsarin Utriyaprasit ◽  
Chukiat Viwatwongkasem
Keyword(s):  
Quality Of Life ◽  
Health Service ◽  
Health Services ◽  
Self Management ◽  
Access To Health Services ◽  
Patient Factors ◽  
Cross Sectional ◽  
Knee Oa ◽  
Access To Health

Abstract Background The main purpose of health service systems is to improve patients’ quality of life (QoL) and to ensure equitable access to health services. However, in reality, nearly half of knee osteoarthritis (OA) patients present to the health system do not have access to health services, and their QoL remains poor. These circumstances raise important questions about what (if any) factors can improve health care accessibility and QoL for knee OA patients. Methods A multicenter, cross-sectional survey was performed with 618 knee OA patients who received care at 16 hospitals in Thailand. Structural equation modeling (SEM) was conducted to investigate the association of health service factors and patient factors with access to health services and QoL. Results The QoL of knee OA patients was very poor (mean score = 33.8). Only 2.1% of the knee OA patients found it easy to obtain medical care when needed. Approximately 39.4% of them were able to access appropriate interventions before being referred for knee replacement. More than 85% of orthopedic health services had implemented chronic disease management (CDM) policy into practice. However, the implementation was basic, with an average score of 5.9. SEM showed that QoL was determined by both health system factors (β = .10, p = .01) and patient factors (β = .29, p = .00 for self-management and β = −.49, p = .00 for disease factors). Access to health services was determined by self-management (β = .10, p = .01), but it was not significantly associated with QoL (β = .00, p = 1.0). Conclusions This study provides compelling information about self-management, access to health services and QoL from the individual and health service system perspectives. Furthermore, it identifies a need to develop health services that are better attuned to the patient’s background, such as socioeconomic status, disease severity, and self-management skills.

scholarly journals Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Access To Health Services ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health services can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

scholarly journals An Empirical Analysis of the Socioeconomic and Demographic characteristics influencing Birth Certification in Nigeria

2020 ◽  
Author(s):  
Uchechi Shirley Anaduaka
Keyword(s):  
Health Services ◽  
Parental Education ◽  
Household Wealth ◽  
Ordinary Least Squares ◽  
Conditional Cash Transfer ◽  
Access To Health Services ◽  
Children Under Five ◽  
Under Five ◽  
Access To Health ◽  
Socioeconomic And Demographic Factors

Abstract Background: Promoting birth certification is instrumental to achieving target 16.9 of the Sustainable Development Goals: legal identity for all by 2030. Currently, the birth certification rates are very low: on average, only 16.6% of children under-five years have their births certified. Methods: Using the nationally representative Nigerian Demographic and Health Survey, this paper analyzes the socioeconomic and demographic factors associated with the birth certification of children under-five years. The relationship with these factors and birth certification were analyzed using robust econometric techniques – ordinary least squares and multilevel regression approaches.Results: The study finds that access to health services, parental education and household ‌‌wealth strongly influence birth certification. Conversely, distance to registration center, higher birth orders, longer birth intervals and father’s working status are significant obstacles to birth certification. Finally, child age, maternal age at birth and father age have non-linear effects on birth certification among children under-five years in Nigeria. I find no significant effects of gender on birth certification. Conclusions: Improving access to health services and anchoring birth certification on child-targeted conditional cash transfer programs could be significant policy instruments for increasing birth certification in Nigeria.

scholarly journals Satisfaction with Access to Health Services: The Perspective of Estonian Patients with Rheumatoid Arthritis

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Kaja Põlluste ◽  
Riina Kallikorm ◽  
Kersti Meiesaar ◽  
Margus Lember
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Services ◽  
Negative Impact ◽  
Waiting Times ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health ◽  
Degree Of Satisfaction ◽  
Determinants Of Satisfaction

In this cross-sectional study we explained the possible determinants of satisfaction with access to health services in patients with rheumatoid arthritis (RA). Of the 2000 randomly selected Estonian adult patients with RA, a total 1259 completed the survey. Regression analysis was used to analyse the predictors of patients' satisfaction with access to health services. Half of the respondents were satisfied with their access to health services. Factors that had a negative impact on satisfaction included pain intensity, longer waiting times to see the doctors, as well as low satisfaction with the doctors. Transportation costs to visit a rheumatologist and higher rehabilitation expenses also affected the degree of satisfaction. Patients who could choose the date and time at which they could visit the rheumatologist or who could visit their “own” doctor were more likely to be satisfied than patients whose appointment times were appointed by a healthcare provider.

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