scholarly journals Associated factors of access to health care among foreign residents living in Aichi Prefecture, Japan: Secondary data analysis of informal free consultations organized by a non-governmental organization

2020 ◽  
Author(s):  
Michiyo Higuchi ◽  
Maki Endo ◽  
Asako Ito
Keyword(s):  
Health Care ◽  
Insurance Coverage ◽  
Secondary Data ◽  
Medical Facility ◽  
Public Insurance ◽  
Barriers To Health Care ◽  
Governmental Organization ◽  
Factors Associated ◽  
Left Behind ◽  
Barriers To Health

Abstract Background In Japan, foreign residents, and particularly new arrivals in the country, experience barriers to health care and show poorer health outcomes when compared to Japanese nationals. The health-care-related situation for foreign residents in Japan has been characterized by drastic changes over time; thus, there is difficulty identifying individuals who are “left behind” by the system. In this study, we aimed to identify, among foreign residents who attended informal free medical consultations, factors associated with “being advised to visit a medical facility” and “being referred to a medical facility,” which represented hypothetical proxy indicators of barriers to health care. Methods Secondary data analyses were conducted using the activity records of a non-governmental organization that provides free consultations targeting foreign residents in various locations in Aichi Prefecture, Japan. Participant characteristics, including insurance coverage, were determined. Bivariable and multi-variable analyses were performed to identify factors associated with having barriers to health care. Results Among 608 extracted cases, 81.7% were covered by Japanese public insurance, and insurance coverage was associated with sex and region of origin. During the consultations, 164 (27.5%) cases were advised to visit a medical facility, and 72 (11.8%) were referred to a medical facility. Those who were not covered by public insurance showed a 1.56-times (95% confidence interval [CI]: 1.19–2.05) higher prevalence of being advised to visit a medical facility when compared to those who were covered by public insurance. Unemployed people and students were more likely to be referred to a medical facility than were professional workers; the prevalence ratios were 3.28 (95% CI: 1.64–6.57) and 2.77 (95% CI: 1.18–6.46), respectively. Conclusions Information from the non-governmental organization revealed the diversity of foreign residents who require informal health-care-related consultations. Although the majority were insured, almost 30% were advised to visit a medical facility, which implied that they had had limited access to the formal health-care system before availing of the free consultations. The findings highlight specific groups who may be vulnerable, and it is important to provide these groups with the necessary support, based on updated evidence, to ensure that no one is “left behind.”

scholarly journals Factors associated with access to health care among foreign residents living in Aichi Prefecture, Japan: secondary data analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Michiyo Higuchi ◽  
Maki Endo ◽  
Asako Yoshino
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Secondary Data ◽  
Medical Facility ◽  
Unemployed People ◽  
Barriers To Health Care ◽  
Factors Associated ◽  
Left Behind ◽  
Access To Health ◽  
Barriers To Health

Abstract Background In Japan, foreign residents, and particularly new arrivals in the country, experience barriers to health care and show poorer health outcomes when compared to Japanese nationals. The health-care-related situation for foreign residents in Japan has been characterized by drastic changes over time; thus, there is difficulty identifying individuals who are “left behind” by the system. In this study, we aimed to identify, among foreign residents who attended informal free medical consultations, factors associated with “being advised to visit a medical facility” and “being referred to a medical facility,” which represented hypothetical proxy indicators of barriers to health care. Methods Secondary data analyses were conducted using the activity records of a non-governmental organization that provides free consultations targeting foreign residents in various locations in Aichi Prefecture, Japan. Participant characteristics, including insurance coverage, were determined. Bivariate and multi-variate analyses were performed to identify factors associated with having barriers to health care. Results Among 608 extracted cases, 164 (27.5%) cases were advised to visit a medical facility, and 72 (11.8%) were referred to a medical facility during the consultations. Those who were not covered by public insurance showed a 1.56-time (95% confidence interval [CI]: 1.19–2.05) higher prevalence of being advised to visit a medical facility when compared to those who were covered by public insurance. Unemployed people and students were more likely to be referred to a medical facility than were professional workers; the prevalence ratios were 3.28 (95% CI: 1.64–6.57) and 2.77 (95% CI: 1.18–6.46), respectively. Conclusions Although the majority were insured, almost 30% were advised to visit a medical facility, which implied that they had had limited access to the formal health-care system before availing of the free consultations. The findings highlight those uninsured, unemployed people and students, who are considered vulnerable to access to health care. It is vital to provide those who are vulnerable with the necessary support while updatinge evidence, so that no one is “left behind.”

scholarly journals Barriers to Health Care for Children with Orofacial Clefts: A Systematic Literature Review and Recommendations for Research Priorities

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Nichole Nidey ◽  
George L. Wehby
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Costs ◽  
Insurance Coverage ◽  
Ethnic Disparities ◽  
Research Priorities ◽  
The United States ◽  
Barriers To Health Care ◽  
Barriers To Health ◽  
Care Costs

Background: There is a growing interest in health services research of orofacial clefts (OFC) in the United States. The objective of this study is to summarize the empirical knowledge to date about barriers to health care for children with OFC. Methods: We completed a systematic literature review to identify articles on barriers to health care for children with OFC in the United States. Pubmed, Embase, CINAHL, and Medline were searched from their dates of origin through June 2018 using a combination of key terms related to access and barriers to health care. Case reports and studies of populations outside of the United States were excluded. Results: 4079 publications were identified using our search strategy. After a title and abstract review, 18 were included in our review as they met inclusion criteria. These studies examined health care costs, health insurance coverage, access to team care, geographic barriers, adequacy of training of community-based providers in providing services to children with OFC, and socioeconomic and demographic factors. The key findings indicate much higher health care costs for children with OFC than unaffected children early in childhood, racial/ethnic disparities in certain access measures, and inadequate insurance coverage, distance to teams, and inadequate training of community-based providers in OFC-specific services as potential areas of concern. Except for studies on health care costs, the evidence is largely based on relatively small and primarily descriptive studies. Conclusions: The extant literature documents high health care costs for OFC treatments and suggests inadequate insurance coverage, long distance to cleft teams, and racial/ethnic disparities as critical factors related to access. We discuss multiple future research priorities. Among these, understanding the impacts of variation between states in mandates for private insurance benefits and generosity in Medicaid coverage on access to care as well as effects of differences in provider reimbursements are particularly understudied areas that can be meaningful for policymaking aimed at improving access and health outcomes of children with OFC. Examining access throughout childhood and later in life and employing robust designs and population-representative data are also important research and methodological extensions of the current literature.

scholarly journals Factors associated with the perceived barriers of health care access among reproductive-age women in Ethiopia: a secondary data analysis of 2016 Ethiopian Demographic and Health Survey

2020 ◽  
Author(s):  
Koku Sisay Tamirat ◽  
Zemenu Tadesse Tessema ◽  
Fentahun Bikale Kebede
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Insurance Coverage ◽  
Secondary Data ◽  
Health Insurance Coverage ◽  
Perceived Barriers ◽  
Reproductive Age ◽  
Factors Associated ◽  
Care Access ◽  
Reproductive Age Women

Abstract Background: Health care access is the timely use of personal health services to achieve the best health outcomes. Problems in accessing health care among reproductive-age may lead to various adverse health outcomes like death and disabilities. Therefore, this study aimed to identify factors associated with the perceived barriers of health care access among reproductive-age women in Ethiopia. Method: This study was based on secondary data sources from the 2016 Ethiopia Demography and Health Survey. From the largest dataset, individual women record (IR) file was used to extract about 15, 683 women for the final analysis. A composite variable of health care access was created from four questions used to rate health care access problems among women of reproductive age. The Generalized Estimating Equation (GEE) model fitted to identify factors associated with perceived barriers of health care access. Crude and adjusted odds ratio (AOR) with a 95% confidence interval (CI) computed to assess the strength of association between independent and outcome variables.Result: This study revealed that the magnitude of perceived barriers of health care access among reproductive-age women found to be 69.9% with 95%CI (69.3 to 70.7) to at least one or more of the four reasons. Rural resident (AOR= 2.13, 95%CI: 1.79 to 2.53), age 35-49 years (AOR= 1.24, 95%CI: 1.09 to 1.40), divorced/separated (AOR= 1.34, 95%CI: 1.17 to 1.54), had no health insurance coverage (AOR=1.19, 95%CI: 1.01 to 1.45), poorer (AOR=2.09,95%CI: 1.86 to 2.35) and middle wealth (AOR=1.57,95%CI:1.38 to 1.79), no education (AOR=2.30, 95%CI:1.95 to 2.72), primary education (AOR= 1.84, 95%CI :1.58 to 2.15) and secondary education (AOR= 1.31, 95%CI: 1.13 to 1.51) were factors associated with the perceived barriers of health care access.Conclusion: A significant proportion of women of reproductive age faced barriers to health care access, of which money and distance were the most frequently perceived barriers. Divorced/separated marital status, old age, rural dwelling, no health insurance coverage, low economic situation, and level of education were factors associated with perceived barriers. These findings suggest further strengthening and improving health care access to those women with low socio-economic status for the realization of universal health coverage.

scholarly journals Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada

PLoS ONE ◽  
2016 ◽  
Vol 11 (5) ◽  
pp. e0155828 ◽  
Author(s):  
M. Eugenia Socías ◽  
Jean Shoveller ◽  
Chili Bean ◽  
Paul Nguyen ◽  
Julio Montaner ◽  
...  
Keyword(s):  
Health Care ◽  
Sex Workers ◽  
Universal Access ◽  
Universal Coverage ◽  
Institutional Barriers ◽  
Barriers To Health Care ◽  
Barriers To Health

Identified Barriers to Health Care and Protocol-Based Treatment of Ectopic Pregnancy

2003 ◽  
Vol 101 (Supplement) ◽  
pp. 52S
Author(s):  
Cindi Lewis-Bliehall ◽  
Rebecca Rogers ◽  
Carla Martinez
Keyword(s):  
Health Care ◽  
Ectopic Pregnancy ◽  
Barriers To Health Care ◽  
Barriers To Health

State-Level Sexism and Women’s Health Care Access in the United States: Differences by Race/Ethnicity, 2014–2019

2021 ◽  
pp. e1-e10
Author(s):  
Kristen Schorpp Rapp ◽  
Vanessa V. Volpe ◽  
Hannah Neukrug
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Hispanic Women ◽  
State Level ◽  
The United States ◽  
Barriers To Health Care ◽  
Care Access ◽  
Race Ethnicity ◽  
The Relationship ◽  
Barriers To Health

Objectives. To quantify racial/ethnic differences in the relationship between state-level sexism and barriers to health care access among non-Hispanic White, non-Hispanic Black, and Hispanic women in the United States. Methods. We merged a multidimensional state-level sexism index compiled from administrative data with the national Consumer Survey of Health Care Access (2014–2019; n = 10 898) to test associations between exposure to state-level sexism and barriers to access, availability, and affordability of health care. Results. Greater exposure to state-level sexism was associated with more barriers to health care access among non-Hispanic Black and Hispanic women, but not non-Hispanic White women. Affordability barriers (cost of medical bills, health insurance, prescriptions, and tests) appeared to drive these associations. More frequent need for care exacerbated the relationship between state-level sexism and barriers to care for Hispanic women. Conclusions. The relationship between state-level sexism and women’s barriers to health care access differs by race/ethnicity and frequency of needing care. Public Health Implications. State-level policies may be used strategically to promote health care equity at the intersection of gender and race/ethnicity. (Am J Public Health. Published online ahead of print September 2, 2021: e1–e10. https://doi.org/10.2105/AJPH.2021.306455 )

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