scholarly journals Responsiveness of The Health Care System Towards The Elderly In Tanzania: Does Health Insurance Make a Difference? A cross Sectional Study

2020 ◽  
Author(s):  
Paul Joseph Amani ◽  
Malale Tungu ◽  
Anna-Karin Hurtig ◽  
Angwara Denis Kiwara ◽  
Gasto Frumence ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Waiting Time ◽  
Inpatient Care ◽  
Health Care Services ◽  
The Elderly ◽  
Sectional Study ◽  
Care Services ◽  
Care System

Abstract Background Responsiveness has become an important tool in evaluating the ability of the health care systems to meet the expectations of the patients. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania, in order to contribute with relevant knowledge to improve the performance of health insurance among the elderly in the country. Methods This is across sectional study. We used a pre-tested household survey administered to elderly (60 years +) living in Igunga and Nzega districts. Participants with and without health insurance attending outpatient and inpatient health care services in the past three and twelve months were selected. Responsiveness was based on the WHO-SAGE questionnaire that included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to explore the specific association of the responsiveness index with health insurance and socio-demographic factors. Results A total of 1453 and 744 elderly, of whom 50.1% and 63% had health insurance, used the outpatient and inpatient health services respectively. All the different domains were rated relatively high but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (-1; 95% CI: -1.45, -0.45) and inpatient (-2; 95% CI: -2.69, -1.30) care. Conclusion The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked low. Further research is necessary to reveal the reasons for the lower responsiveness among insured elderly. A continuous monitoring of the health care system responsiveness is recommended.

scholarly journals Responsiveness of health care services towards the elderly in Tanzania: Does health insurance make a difference? A cross-sectional study

2020 ◽  
Author(s):  
Paul Joseph Amani ◽  
Malale Tungu ◽  
Anna-Karin Hurtig ◽  
Angwara Denis Kiwara ◽  
Gasto Frumence ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Waiting Time ◽  
Inpatient Care ◽  
Health Care Services ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services

Abstract BackgroundResponsiveness has become an important health system performance indicator in evaluating the ability of health care systems to meet patients’ expectations. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania and to explore the association of health insurance (HI) with responsiveness in this population. MethodsA community-based cross-sectional study was conducted in 2017 where a pre-tested household survey, administered to the elderly (60 + years) living in Igunga and Nzega districts, was applied. Participants with and without health insurance who attended outpatient and inpatient health care services in the past three and 12 months were selected. Responsiveness was measured based on the short version of the World Health Organization (WHO) multi-country responsiveness survey study, which included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to assess the specific association of the responsiveness index with health insurance adjusted for sociodemographic factors.ResultsA total of 1453 and 744 elderly, of whom 50.1% and 63% had health insurance, used outpatient and inpatient health services, respectively. All domains were rated relatively highly but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (−1; 95% CI: −1.45, −0.45) and inpatient (−2; 95% CI: −2.69, −1.30) care. Conclusion The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked poorly. Further research is necessary to reveal the reasons for the lower responsiveness noted among insured elderly. A continuous monitoring of health care system responsiveness is recommended.

scholarly journals Responsiveness of health care services towards the elderly in Tanzania: Does health insurance make a difference? A cross-sectional study

2020 ◽  
Author(s):  
Paul Joseph Amani ◽  
Malale Tungu ◽  
Anna-Karin Hurtig ◽  
Angwara Denis Kiwara ◽  
Gasto Frumence ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Waiting Time ◽  
Inpatient Care ◽  
Health Care Services ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services

Abstract Introduction Responsiveness has become an important health systems performance indicator in evaluating the ability of the health care systems to meet the expectations of the patients. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania, in order to contribute with relevant knowledge to improve the performance of the health care system among the elderly in the country. Methods A community-based cross-sectional study was conducted in 2017 where a pre-tested household survey administered to elderly (60 +) living in Igunga and Nzega districts was applied. Participants with and without health insurance who attended outpatient and inpatient health care services in the past three and twelve months were selected. Responsiveness was measured based on the WHO-SAGE questionnaire that included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to assess the specific association of the responsiveness index with health insurance and socio-demographic factors.Results A total of 1453 and 744 elderly, of whom 50.1% and 63% had health insurance, used the outpatient and inpatient health services respectively. All the different domains were rated relatively high but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (-1; 95% CI: -1.45, -0.45) and inpatient (-2; 95% CI: -2.69, -1.30) care. Conclusion The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked low. Further research is necessary to reveal the reasons for the lower responsiveness among insured elderly. A continuous monitoring of the health care system responsiveness is recommended.

scholarly journals Responsiveness of health care services towards the elderly in Tanzania: does health insurance make a difference? A cross-sectional study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul Joseph Amani ◽  
Malale Tungu ◽  
Anna-Karin Hurtig ◽  
Angwara Denis Kiwara ◽  
Gasto Frumence ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Waiting Time ◽  
Inpatient Care ◽  
Health Care Services ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services

Abstract Background Responsiveness has become an important health system performance indicator in evaluating the ability of health care systems to meet patients’ expectations. However, its measurement in sub-Saharan Africa remains scarce. This study aimed to assess the responsiveness of the health care services among the insured and non-insured elderly in Tanzania and to explore the association of health insurance (HI) with responsiveness in this population. Methods A community-based cross-sectional study was conducted in 2017 where a pre-tested household survey, administered to the elderly (60 + years) living in Igunga and Nzega districts, was applied. Participants with and without health insurance who attended outpatient and inpatient health care services in the past three and 12 months were selected. Responsiveness was measured based on the short version of the World Health Organization (WHO) multi-country responsiveness survey study, which included the dimensions of quality of basic amenities, choice, confidentiality, autonomy, communication and prompt attention. Quantile regression was used to assess the specific association of the responsiveness index with health insurance adjusted for sociodemographic factors. Results A total of 1453 and 744 elderly, of whom 50.1 and 63% had health insurance, used outpatient and inpatient health services, respectively. All domains were rated relatively highly but the uninsured elderly reported better responsiveness in all domains of outpatient and inpatient care. Waiting time was the dimension that performed worst. Possession of health insurance was negatively associated with responsiveness in outpatient (− 1; 95% CI: − 1.45, − 0.45) and inpatient (− 2; 95% CI: − 2.69, − 1.30) care. Conclusion The uninsured elderly reported better responsiveness than the insured elderly in both outpatient and inpatient care. Special attention should be paid to those dimensions, like waiting time, which ranked poorly. Further research is necessary to reveal the reasons for the lower responsiveness noted among insured elderly. A continuous monitoring of health care system responsiveness is recommended.

scholarly journals Does health insurance contribute to improved utilization of health care services for the elderly in rural Tanzania? A cross-sectional study

2020 ◽  
Vol 13 (1) ◽  
pp. 1841962
Author(s):  
Malale Tungu ◽  
Paul Joseph Amani ◽  
Anna-Karin Hurtig ◽  
Angwara Dennis Kiwara ◽  
Mughwira Mwangu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Rural Tanzania

scholarly journals Rural Michigan Farmers’ Health Concerns and Experiences: A Focus Group Study

2021 ◽  
Vol 12 ◽  
pp. 215013272110535
Author(s):  
Nathan Wright ◽  
Marylee Scherdt ◽  
Michelle L. Aebersold ◽  
Marjorie C. McCullagh ◽  
Barbara R. Medvec ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Health Care System ◽  
Health Care Services ◽  
Well Being ◽  
The United States ◽  
Full Time ◽  
Rural Residents ◽  
Care Services ◽  
Care System

Objectives: Rural residents comprise approximately 15% of the United States population. They face challenges in accessing and using a health care system that is not structured to meet their unique needs. It is important to understand rural residents’ perceptions of health and experiences interacting with the health care system to identify gaps in care. Methods: Our team conducted focus groups with members of the Michigan Farm Bureau during their 2019 Annual Meeting. Topics explored included resources to manage health, barriers to virtual health care services, and desired changes to localized healthcare delivery. Surveys were used to capture demographic and internet access information. Conclusion: Analysis included data from 2 focus groups (n = 14). Participants represented a wide age range and a variety of Michigan counties. The majority were full-time farm owners with most—93% (n = 13)—reporting they had access to the internet in their homes and 86% (n = 12) reporting that their cellphones had internet capabilities. Participants identified challenges and opportunities in 4 categories: formal health care; health and well-being supports; health insurance experiences; and virtual health care. Conclusion: The findings from this study provide a useful framework for developing interventions to address the specific needs of rural farming residents. Despite the expressed challenges in access and use of health care services and resources, participants remained hopeful that innovative approaches, such as virtual health platforms, can address existing gaps in care. The study findings should inform the design and evaluation of interventions to address rural health disparities.

Post-Fordism's Contradictory Trends: The Case of the Israeli Health Care System

2004 ◽  
Vol 33 (3) ◽  
pp. 417-436 ◽  
Author(s):  
DANI FILC
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Political Struggle ◽  
Care Services ◽  
National Health Insurance Law ◽  
The Right ◽  
Care System

The transition from the Fordist hegemonic model to post-Fordism is a complex process. It is not the unavoidable result of technological changes, but the contingent consequence of a hegemonic, political, struggle taking place at the different spheres of the social. This article studies the transformations that took place in the Israeli health care system during the last two decades in order to exemplify the political and contradictory character of the transition to post-Fordism. The article emphasises the contradiction between the partial commodification of financing and the privatisation of certain health care facilities, and the legislation of the National Health Insurance Law, which guaranteed the right to access to public health care services.

Blurring the boundaries between public and private health care services as an alternative explanation for the emergence of black medicine: the Israeli case

2014 ◽  
Vol 10 (3) ◽  
pp. 293-310 ◽  
Author(s):  
Dani Filc ◽  
Nissim Cohen
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Services ◽  
Qualitative Methodology ◽  
Health Care Systems ◽  
Public Health Care ◽  
Private Health Care ◽  
Public And Private ◽  
Care Services ◽  
Care System

AbstractBlack medicine represents the most problematic configuration of informal payments for health care. According to the accepted economic explanations, we would not expect to find black medicine in a system with a developed private service. Using Israel as a case study, we suggest an alternative yet a complimentary explanation for the emergence of black medicine in public health care systems – even though citizens do have the formal option to use private channels. We claim that when regulation is weak and political culture is based on ‘do it yourself’ strategies, which meant to solve immediate problems, blurring the boundaries between public and private health care services may only reduce public trust and in turn, contribute to the emergence of black medicine. We used a combined quantitative and qualitative methodology to support our claim. Statistical analysis of the results suggested that the only variable significantly associated with the use of black medicine was trust in the health care system. The higher the respondents’ level of trust in the health care system, the lower the rate of the use of black medicine. Qualitatively, interviewee emphasized the relation between the blurred boundaries between public and private health care and the use of black medicine.

An Analysis of the Role of Health Care in Reducing Socioeconomic Inequalities in Health: The Case of the Netherlands

2003 ◽  
Vol 33 (3) ◽  
pp. 523-541 ◽  
Author(s):  
Johan P. MaCkenbach
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Services ◽  
Health Problems ◽  
Socioeconomic Inequalities ◽  
Care Utilization ◽  
Inequalities In Health ◽  
Socioeconomic Groups ◽  
Care Services ◽  
Care System

The aim of this article is to analyze the role of the health care system in reducing socioeconomic inequalities in health in countries with good access to health services, using the Dutch example. In the past, health care has contributed substantially to reducing a number of health problems in the population, particularly health problems leading to mortality. Data on trends in mortality from selected conditions by socioeconomic group show that both higher and lower socioeconomic groups have profited from these mortality reductions, probably because of largely equal access to essential health care services, and that absolute inequalities in mortality from these conditions have declined notably. The current situation is still one of largely equal financial access to health care services, with relatively small differences between socioeconomic groups in health care utilization, after adjustment for differences in prevalence of health problems. There is no evidence that inequalities in health care utilization contribute to a widening of socioeconomic inequalities in health. Financing of the health care system, however, is slightly regressive, and out-of-pocket payments contribute to the poor financial situation of the chronically ill. For the future, three possible contributions of the health care system to reducing socioeconomic inequalities in health are described: preservation of equal access to high-quality health care; development of specific care packages for lower socioeconomic groups; promotion and support of intersectoral activities.

scholarly journals The Health Care System of the Semipalatinsk Region of the Steppe Territory: Stages of Formation (60s of the 19th Century — the Beginning of the 20th Century)

2021 ◽  
pp. 13-18
Author(s):  
A.I. Vlasova
Keyword(s):  
Health Care ◽  
19Th Century ◽  
Health Care System ◽  
Health Care Services ◽  
Care Services ◽  
Mass Migration ◽  
Medical Institutions ◽  
Statistical Surveys ◽  
The 19Th Century ◽  
Care System

On the basis of different sources, mainly annual regional statistical surveys, the stages of the formation of the health care system of the Semipalatinsk region of the Steppe Governor General are revealed. At the first stage, the end of the 60s — 80s of the 19th century, the accession of the Steppe Territory to the Russian Empire was completed. The integrating policy of this ethnoregion into the political-legal and socio-economic space of the empire was initiated. In the social sphere, it led to the creation of a health system. The procesas had a number of specific features due to the absence of zemstvos and zemstvo medicine and the predominance of Kazakh nomads in the ethnosocial structure of the region. Therefore, in contrast to the central regions of Russia, the development of the health care system in the Steppe Territory was dealt with by the provincial and regional administrations. The second stage (the end of the 80s 19th century — 1917) is associated with the beginning of the mass migration of peasant migrants from the European part of Russia to the Steppe Territory. This stage is characterized by the expansion of the network of regional and county medical institutions, the improvement of their material and technical base, the expansion of the specialization of practicing doctors, and the solution of the personnel problem. Also, at that stage, the system of management of medical institutions was improved and government organizations, for example, the Resettlement Department, were involved in solving problems related to health care services for the p opulation. In general, statistics show that by 1917 the quality of health care services and the percentage of population involvement remained at a low level.

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