The Consequences of Universalizing Health Services: Children's Use of Health Services in Catalonia

1998 ◽  
Vol 28 (4) ◽  
pp. 777-791 ◽  
Author(s):  
Luis Rajmil ◽  
Barbara Starfield ◽  
Antoni Plasència ◽  
Andreu Segura
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Multiple Regression ◽  
Universal Access ◽  
Health Needs ◽  
Regression Equations ◽  
Access To Health Services ◽  
Socioeconomic Characteristics ◽  
Number Of Visits ◽  
Use Of Health Services

The purpose of this study was to assess the role of needs and social factors in the use of health services among children under age 15 in Catalonia, Spain, where health care reform was explicitly designed to facilitate universal access to primary care according to health needs. Data from the Catalan Health Interview Survey of 1994, a multistage probability sample (2,433 children under 15 years old), were analyzed. Multiple regression examined the relationship between health needs and number of visits in the last year, controlling for the effect of sociodemographic characteristics. Two logistic regression equations were selected to predict heavy (more than seven visits per year) and light (less than two visits) utilization of services. The multiple regression model explained 14.3 percent of the variance in number of visits, with health status perception, disability, reported chronic condition, restriction of activities, and having had a recent accident by far the most important determinants. No familial socioeconomic characteristics, including social class, education, or family size, influenced the extent of use. In contrast to health systems not designed to achieve either universal access according to need or strong primary care, universal access to health services in Catalonia appears to enhance the use of services among children with health needs, regardless of socioeconomic characteristics.

scholarly journals Socioeconomic determinants of access to health services among older adults: a systematic review

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Ana Paula Santana Coelho Almeida ◽  
Bruno Pereira Nunes ◽  
Suele Manjourany Silva Duro ◽  
Luiz Augusto Facchini
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Health Services ◽  
Developed Countries ◽  
The United States ◽  
Inclusion Criteria ◽  
Access To Health Services ◽  
Socioeconomic Characteristics ◽  
Unequal Access ◽  
Use Of Health Services

ABSTRACT OBJECTIVE The objective of this study was to analyze the association between the socioeconomic characteristics and the access to or use of health services among older adults. METHODS This is a systematic review of the literature. The search has been carried out in the databases PubMed, LILACS and Web of Science, without restriction of dates and languages; however we have included only articles published in Portuguese, English, and Spanish. The inclusion criteria were: observational design, socioeconomic factors as variables of interest in the analysis of the access to or use of health services among older adults, representative sample of the target population, adjustment for confounding factors, and no selection bias. RESULTS We have found 5,096 articles after deleting duplicates and 36 of them have been selected for review after the process of reading and evaluating the inclusion criteria. Higher income and education have been associated with the use and access to medical appointments in developing countries and some developed countries. The same association has been observed in dental appointments in all countries. Most studies have shown no association between socioeconomic characteristics and the use of inpatient and emergency services. We have identified greater use of home visits in lower-income individuals, with the exception of the United States. CONCLUSIONS We have observed an unequal access to or use of health services in most countries, varying according to the type of service used. The expansion of the health care coverage is necessary to reduce this unequal access generated by social inequities.

scholarly journals Use of and access to health services in Brazil, 2013 National Health Survey

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Sheila Rizzato Stopa ◽  
Deborah Carvalho Malta ◽  
Camila Nascimento Monteiro ◽  
Célia Landmann Szwarcwald ◽  
Moisés Goldbaum ◽  
...  
Keyword(s):  
Health Services ◽  
National Health ◽  
Health Survey ◽  
National Health Survey ◽  
Brazilian Population ◽  
Access To Health Services ◽  
Level Of Education ◽  
Head Of Household ◽  
Access To Health ◽  
Use Of Health Services

ABSTRACT OBJECTIVE To analyze the use of health services in the Brazilian population by sociodemographic factors, according to data from the 2013 Brazilian National Health Survey. METHODS The study analyzed data from 205,000 Brazilian citizens in all age groups who participated in the Brazilian National Health Survey, a cross-sectional study carried out in 2013. Prevalence and confidence intervals were estimated for indicators related to access to and use of health services according to age group, level of education of head of household, and Brazilian macroregions. RESULTS Among individuals who sought health services in the two weeks prior to the survey, 95.3% (95%CI 94.9–95.8) received care in their first visit. Percentages were higher in the following groups: 60 years of age and over; head of household with complete tertiary education; living in the South and Southeast regions. In addition, 82.5% (95%CI 81.2–83.7) of individuals who received health care and prescriptions were able to obtain all the necessary medicines, 1/3 of them from SUS. Less than half the Brazilian population (44.4%; 95%CI 43.8–45.1) visited a dentist in the 12 months prior to the survey, with smaller percentages among the following groups: 60 years of age or older; head of household with no education or up to incomplete elementary; living in the North region of Brazil. CONCLUSIONS People living in the South and Southeast regions still have greater access to health services, as do those whose head of household has a higher level of education. The (re)formulation of health policies to reduce disparities should consider differences encountered between regions and social levels.

Universal Access to Health Services Through the Digital Terrestrial Television

2013 ◽  
Vol 6 (1) ◽  
pp. 51-87 ◽  
Author(s):  
Aldo Franco Dragoni
Keyword(s):  
Health Services ◽  
Web Application ◽  
Universal Access ◽  
Western World ◽  
Digital Television ◽  
Local Health ◽  
Access To Health Services ◽  
Set Top Box ◽  
Digital Terrestrial Television ◽  
The Masses

The Western World has almost completed the transition toward the Digital Television (DTV), and in particular toward the Digital Terrestrial Television (DTT). In every home there is at least one decoder for the DTT. Some of them have a modem, to connect to a telephonic return line, and a Smart Card reader, both required by the “Pay TV” channels. Since those readers are compatible with the Governmental Smart Cards, a new access for the masses to secure and confidential digital services is nowadays available in our Information Society. “T-Government” defines the set of services provided by Governments or private entities via DTT. “Multimedia Home Platform” is the standard for DTT applications. A Local Health will be no more justified for offering services only through the Web disregarding both the broadcast and the return channels of the DTT since by doing so it would contribute to deepen the “digital divide” between skilled (young) people and unskilled (elder) people. The author defines a scenario for providing such T-Health Services both for patients (T-monitoring health parameters) and healthy citizens. These latter will have a bunch of services over DTT, not only informative or interactive applications on the Set top Box, but also transactional services through the secure return channel. However, much effort has to be spent to guarantee the usability of that new interface which is quite different from that of a Web application. The author designed, tested and redesigned a suite of DTT applications as a “proof of concept” to show the potential of this new platform for health information services. DTT may represent a real contribution to bring social healthcare and wellness.

Gypsy/Traveller, migrant, and refugee children

2019 ◽  
Author(s):  
Louise Condon ◽  
Julie Mytton
Keyword(s):  
Health Promotion ◽  
Health Services ◽  
Health Needs ◽  
Refugee Children ◽  
Physical And Mental Health ◽  
Access To Health Services ◽  
Refugee Status ◽  
Access To Health ◽  
Special Circumstances ◽  
Health Programmes

Children living in special circumstances due to migration or refugee status, or being of Gypsy, Roma, or Traveller ethnicity, have extra health needs and difficulty in accessing universal and specialist health services. Migrant, refugee, and Traveller children belong to diverse ethnic and social groups, but share characteristics which increase their need for targeted health promotion. All groups are subsections of the population with poor self-reported health and access to health services, and higher numbers of dependent children. It is well recognized that they experience discrimination and social exclusion which adversely impacts health. There is overlap between groups, for example, refugees are migrants who have left their country of origin to avoid persecution, and Roma are migrants who are of Gypsy ethnicity. This chapter identifies the reasons why children from these groups require focused health promotion; it summarizes their health needs, describes interventions to improve their physical and mental health through the child health programmes, and discusses factors that influence their ability to access preventive services.

scholarly journals Influence of Public Oral Health Services and Socioeconomic Indicators on the Frequency of Hospitalization and Deaths due to Oral Cancer in Brazil, between 2002–2017

2020 ◽  
Vol 18 (1) ◽  
pp. 238
Author(s):  
Aldelany R. Freire ◽  
Deborah E. W. G. Freire ◽  
Elza C. F. de Araújo ◽  
Edson H. G. de Lucena ◽  
Yuri W. Cavalcanti
Keyword(s):  
Primary Care ◽  
Oral Health ◽  
Oral Cancer ◽  
Health Services ◽  
Population Size ◽  
Cox Regression ◽  
Health Coverage ◽  
Socioeconomic Indicators ◽  
Access To Health Services ◽  
Oral Health Services

Background: Oral cancer is a frequent neoplasm worldwide, and socioeconomic factors and access to health services may be associated with its risk. Aim: To analyze effect of socioeconomic variables and the influence of public oral health services availability on the frequency of new hospitalized cases and mortality of oral cancer in Brazil. Materials and Methods: This observational study analyzed all Brazilian cities with at least one hospitalized case of oral cancer in the National Cancer Institute database (2002–2017). For each city were collected: population size, Municipal Human Development Index (MHDI), Gini Coefficient, oral health coverage in primary care, number of Dental Specialized Centers (DSC) and absolute frequency of deaths after one year of the first treatment. The risk ratio was determined by COX regression, and the effect of the predictor variables on the incidence of cases was verified by the Hazard Ratio measure. Poisson regression was used to determine factors associated with higher mortality frequency. Results: Cities above 50,000 inhabitants, with high or very high MHDI, more unequal (Gini > 0.4), with less oral health coverage in primary care (<50%) and without DSC had a greater accumulated risk of having 1 or more cases (p < 0.001). Higher frequency of deaths was also associated with higher population size, higher MHDI, higher Gini and lower oral health coverage in primary care (p < 0.001). Conclusions: The number hospitalization and deaths due to oral cancer in Brazil was influenced by the cities’ population size, the population’s socioeconomic status and the availability of public dental services.

scholarly journals O acesso universal aos serviços de saúde como construção psicossocial dos usuários/ Universal access to health services as psychosocial construction of users

2019 ◽  
Vol 18 (2) ◽  
Author(s):  
Denize Cristina De Oliveira ◽  
Antonio Marcos Tosoli Gomes ◽  
Thelma Spindola ◽  
Hellen Pollyanna Mantelo Cecilio ◽  
Eduardo Pereira Paschoal ◽  
...  
Keyword(s):  
Health Services ◽  
Rio De Janeiro ◽  
Universal Access ◽  
Access To Health Services ◽  
Access To Health

Objetivo: Analisar o acesso universal à saúde a partir das representações sociais dos usuários acerca do Sistema Único de Saúde, no município do Rio de Janeiro, Brasil. Método: Estudo com abordagem quanti-qualitativa, pautado na Teoria das Representações Sociais, em sua abordagem processual. A coleta de dados foi realizada em 2010, por meio de entrevista semiestruturada. Os dados foram analisados com auxílio do software Alceste 4.7. Resultados: Participaram 104 usuários do sistema de saúde, sendo a maioria mulheres, renda de até um salário mínimo e residentes no município do Rio de Janeiro. Foram evidenciados na análise lexical, dois conjuntos textuais: “O processo de avaliação do sistema de saúde: a experiência dos usuários” e “O sistema de Saúde: estrutura e finalidade”. Conclusão:Os usuários dos serviços de saúde vêm acumulando a experiência de um sistema em permanente construção que carece, em algumas situações, de insumos e ações essenciais, rotineiras e básicas, mas que efetiva a universalidade perpassando classes sociais e distintos níveis de complexidades de assistência.

scholarly journals O acesso do homem ao serviço de saúde na atenção primária Man’s access to health services in primary care

2017 ◽  
Vol 9 (2) ◽  
pp. 302 ◽  
Author(s):  
Lorrainy Da Cruz Solano ◽  
Marco Antônio De Castro Bezerra ◽  
Renata De Sousa Medeiros ◽  
Eumendes Fernandes Carlos ◽  
Francisca Patrícia Barreto De Carvalho ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Access To Health Services ◽  
Access To Health

Objetivo: Investigar os aspectos que influenciam no acesso do homem ao serviço de saúde da atenção primária. Método: Trata-se de um estudo exploratório descritivo, com abordagem qualitativa, realizado com oito homens através de grupo focal em outubro de 2010. Os dados foram analisados com base na técnica do Discurso de Sujeito Coletivo. Resultados: Os usuários expressaram pouco investimento na organização do serviço numa perspectiva de gênero reforçando o senso-comum de que os homens não são usuários da atenção primária, tendo ainda uma ideologia subsidiado pelo patriarcado. Conclusão: É preciso pensar nos determinantes sócio-históricos-culturais dos modos de viver, adoecer e morrer do homem na atualidade e instaurar um novo paradigma acerca da saúde do homem na vida moderna.

Globalization and the Burden of Disease

2021 ◽  
pp. 143-154
Author(s):  
Charles Weiss
Keyword(s):  
Health Services ◽  
Low Income ◽  
Universal Access ◽  
World Health ◽  
Low Income Countries ◽  
Access To Health Services ◽  
Global Epidemic ◽  
Downward Spiral ◽  
Health Organization ◽  
Epidemic Response

More equitable and need-oriented funding of health services and research would safeguard everyone’s health. Worldwide health expenditures on health disproportionately address problems of the well-off, while research on diseases like malaria affecting hundreds of millions of mostly low-income people are underfunded. Nor are sufficient resources devoted to mental illness, traffic injuries, and natural disasters. As people in low-income countries live longer, chronic, non-communicable, and lifestyle diseases add to long-standing burdens of infectious and parasitic disease, and maternal and child health. This epidemiological transition calls for universal access to health services, which will also improve these countries’ ability to detect and respond to infectious diseases like the COVID-19 pandemic. The World Health Organization, coordinator of global epidemic response, needs to be freed from its downward spiral of decreased effectiveness, frozen funding, and increased politicization. Statistics on global causes of death and disability elevate the importance of social determinants of health.

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