scholarly journals Telemedicine: Bridging the Gap between Refugee Health and Health Services Accessibility in Hamilton, Ontario

Refuge ◽  
2016 ◽  
Vol 32 (3) ◽  
pp. 108-118 ◽  
Author(s):  
Anthony Robert Sandre ◽  
K. Bruce Newbold
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Service Providers ◽  
Health Services Accessibility ◽  
Refugee Health ◽  
Cultural Barriers ◽  
Structured Interviews ◽  
Care Services ◽  
Specialist Health Care

Refugees face considerable challenges upon seeking asylum in Canada, and accessing health care services remains a prominent issue. Recurrent themes in the literature outlining barriers to health-services accessibility include geographic, economic, and cultural barriers. Drawing on the experiences of service providers in Hamilton, Ontario, we explored the efficacy of telemedicine services in bridging the gap between refugee health and health services accessibility. Research methodology included structured interviews with clinicians who provide health-care services to refugees, complemented by a scoping literature review. The results of this exploratory study demonstrate the efficacy of telemedicine in encouraging dialogue and policy change in the greater health-care setting, and its potential to increase access to specialist health-care services.

scholarly journals Indigenous access barriers to health care services in London, Ontario

2017 ◽  
Vol 86 (2) ◽  
pp. 6-9 ◽  
Author(s):  
Stephanie McConkey
Keyword(s):  
Health Care ◽  
Health Services ◽  
Indigenous Peoples ◽  
Health Care Services ◽  
Service Providers ◽  
Cultural Safety ◽  
Cultural Barriers ◽  
Access Barriers ◽  
Care Services ◽  
Pain Medications

Introduction: Indigenous peoples in Canada suffer higher rates of health inequalities and encounter a number of health services access barriers when compared to their non-Indigenous counterparts. Indigenous peoples experience social and economic challenges, cultural barriers, and discrimination when accessing mainstream health services. Methods: In London, Ontario, 21 interviews and 2 focus groups (n = 25) with service providers were completed, each session spanning approximately 1 to 1.5 hours. Interviews were voice recorded and transcribed verbatim. Themes were identified using NVIVO 10 software. Findings: Approximately 2 to 5% of clients are Indigenous in hospital-based services. There are a number of social factors that influence whether Indigenous peoples access health services. Indigenous peoples do not have access to adequate pain medications because physicians are reluctant to provide Indigenous patients with pain medications due to common perceptions of addiction. Indigenous peoples also have barriers accessing a family physician because physicians are reluctant to take on new patients with complex health needs. Conclusion: Systemic discrimination is still alive in the health care system; therefore, there is a need for cultural safety training among physicians to increase awareness of access barriersand challenges that many Indigenous patients face when seeking health care.

scholarly journals Assesing Health Services in Colombia: Development of a Conceptual Framework and Measurement tools based on primary data

SAGE Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 215824402110168
Author(s):  
Marcela Arrivillaga
Keyword(s):  
Health Care ◽  
Health Services ◽  
Conceptual Framework ◽  
Health Care Services ◽  
Health Services Accessibility ◽  
Primary Data ◽  
Health Coverage ◽  
Care Services ◽  
Concept Of Health ◽  
Measurement Tools

Colombia has a mixed public-private health care system, and although official data indicate more than 95% of health coverage, research in this field has demonstrated the persistence of barriers to accessing health care services. This study aimed to analyze the conceptual framework of health services accessibility and develop measurement tools for its assessment using primary data and also to propose a method for ascertaining health services accessibility and availability using a territory-based approach. A mixed method study with concurrent design was carried out in four phases between 2014 and 2017. The starting points were a review of the literature and a documentary research that identified five conceptual frameworks for health services accessibility published between 1970 and 2013. It was found that the theoretical concept of health services availability has not been clear; the literature does not define it explicitly and does not differentiate it from the concept of health coverage. As a result, two measurement tools were developed: a Health Care Services Accessibility Household Survey and a Health Care Services Availability Questionnaire. These tools and the proposed method for ascertaining health services accessibility can be useful for government, institutions, and social and scientific organizations to monitor progress in guaranteeing the fundamental human right to health, declared in the Health Organic Law issued in 2015 in Colombia.

scholarly journals Setting Health Care Services Tariffs in Iran: Half a Century Quest for a Window of Opportunity

2020 ◽  
Author(s):  
Leila Doshmangir ◽  
Arash Rashidian ◽  
Farhad Kouhi ◽  
Vladimir S Gordeev
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Price Policy ◽  
Evidence Based ◽  
Analysis Model ◽  
Structured Interviews ◽  
Comprehensive Overview ◽  
Contentious Issue ◽  
Care Services

Abstract Background Pricing health services remains to be a contentious issue in Iran. The Universal Health Services Insurance Law of 1994 aimed at introducing structural and legal bases for pricing health services to enhance efficiency and to equate demand and supply, while referring to equity objectives. Until now, the implementation of this law has failed to meet its original objectives. This paper explores the experience of setting health care services tariffs in the Iranian health care system over the last five decades. Methods We analyzed data collected through documentary and literature reviews of the official documents developed at the various levels of the Iranian health using inductive and deductive content analysis. 22 face-to-face semi-structured interviews supplemented the analysis. Policy triangle policy analysis model was used to guide data analysis. Results Our comprehensive overview of changes in the medical pricing system provides valuable lessons for major stakeholders. Most changes were implemented in a sporadic, inadequate, and a non-evidence-based manner. Disparities in prices between public and private sectors make tariffs setting a contentious issue in Iran. Lack of clarity in pricing health care services makes negotiations between various stakeholders difficult and can potentially become a source of a corrupt income. Such clarity can be achieved by using adequate and technically sound pricing. Technical aspects of pricing health services should be separated from the political negotiations over the overall payment to the medical professionals. Transparency regarding a conflict of interest and establishing punitive measures against those violating the rules could help improving trust in the doctor-patient relationship. Conclusion Evidence-based changes in medical pricing policies can help striking the right balance in the health care services provision process. A sensitive application of policy models can offer significant insights into the nature of medical price policy setting and highlight existing constraints and opportunities.

scholarly journals Investigating the Factors Affecting Health Services Utilization in Hepatitis B Patients of Yazd City in 2017

2019 ◽  
Author(s):  
Raziyeh Montazeralfaraj ◽  
Mohsen Pakdaman ◽  
Hossein Fallahzad ◽  
Masoudeh Mojahed ◽  
Mahdi Ghadiri Atabak
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Hepatitis B ◽  
Health Services ◽  
Health Care Services ◽  
Service Providers ◽  
Statistical Tests ◽  
Healthcare Services ◽  
Counseling Services ◽  
Care Services

Background: We can achieve a clear picture of the demands for services and the ways to respond to them by examining the status of health care services in patients with hepatitis B. In this way, we can minimize the gap between the promotion and improvement of the performance of service providers. Therefore, the aim of this study was to evaluate the utilization of healthcare services in patients with hepatitis B. Methods: This cross-sectional study was conducted among 464 patients with hepatitis B who were selected by simple random sampling using a researcher-made questionnaire containing 20 items, according to the study variables. We entered the data into the Excel software and analyzed them by STATA 13 software using descriptive statistical tests and linear regression. Results: There was a significance association between the utilization of education and counseling services, specialist visits, clinical services, and the place of provision of services. In addition, the utilization of education and counseling services had a significant association with the supplemental insurance and the incidence of hepatitis B in the family. A significance relationship was also observed between the number of visits to the specialist and the type of occupation, educational level, and duration of diagnosis. Utilization of inpatient cares had a significant relationship with the place of residence and the basic insurance status. Conclusion: Generally, the rate of visits to access the healthcare services is low among patients with hepatitis B. Considering the fact that this disease is special, we suggest the authorities to provide health care services in three preventive levels free of charge (by providing a health insurance card for the patients). Furthermore, the government needs to implement the national health insurance (NHI) and therefore does not receive the franchise. Patients should refer to specialist according to the general practitioner's opinion. They also should have access to the services during the evening.   Key words: Utilization of health services, Hepatitis B, Specific Patients

scholarly journals Accessibility of Primary, Specialist, and Allied Health Services for Aboriginal People Living in Rural and Remote Communities: Protocol for a Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Rona Macniven ◽  
Kate Hunter ◽  
Michelle Lincoln ◽  
Ciaran O’Brien ◽  
Thomas Lee Jeffries Jr ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Allied Health ◽  
Service Providers ◽  
Aboriginal People ◽  
Mixed Methods Study ◽  
Snowball Sampling ◽  
Rural And Remote ◽  
Care Services

BACKGROUND Primary, specialist, and allied health services can assist in providing equitable access in rural and remote areas, where higher proportions of Aboriginal and Torres Strait Islander people (Aboriginal Australians) reside, to overcome the high rates of chronic diseases experienced by this population group. Little is currently known about the location and frequency of services and the extent to which providers believe delivery is occurring in a sustained and coordinated manner. OBJECTIVE The objective of this study will be to determine the availability, accessibility, and level of coordination of a range of community-based health care services to Aboriginal people and identify potential barriers in accessing health care services from the perspectives of the health service providers. METHODS This mixed-methods study will take place in 3 deidentified communities in New South Wales selected for their high population of Aboriginal people and geographical representation of location type (coastal, rural, and border). The study is designed and will be conducted in collaboration with the communities, Aboriginal Community Controlled Health Services (ACCHSs), and other local health services. Data collection will involve face-to-face and telephone interviews with participants who are health and community professionals and stakeholders. Participants will be recruited through snowball sampling and will answer structured, quantitative questions about the availability and accessibility of primary health care, specialist medical and allied health services and qualitative questions about accessing services. Quantitative data analysis will determine the frequency and accessibility of specific services across each community. Thematic and content analysis will identify issues relating to availability, accessibility, and coordination arising from the qualitative data. We will then combine the quantitative and qualitative data using a health ecosystems approach. RESULTS We identified 28 stakeholder participants across the ACCHSs for recruitment through snowball sampling (coastal, n=4; rural, n=12; and border, n=12) for data collection. The project was funded in 2017, and enrolment was completed in 2017. Data analysis is currently under way, and the first results are expected to be submitted for publication in 2019. CONCLUSIONS The study will give an indication of the scope and level of coordination of primary, specialist, and allied health services in rural communities with high Aboriginal populations from the perspectives of service providers from those communities. Identification of factors affecting the availability, accessibility, and coordination of services can assist ways of developing and implementing culturally sensitive service delivery. These findings could inform recommendations for the provision of health services for Aboriginal people in rural and remote settings. The study will also contribute to the broader literature of rural and remote health service provision. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11471

Needs assessment for gender sensitive reproductive health services for adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

Reaction of New Soviet Immigrants to Primary Health Care Services in Israel

1998 ◽  
Vol 28 (3) ◽  
pp. 555-574 ◽  
Author(s):  
Larissa I. Remennick ◽  
Naomi Ottenstein-Eisen
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
The Elderly ◽  
Medical Services ◽  
Structured Interviews ◽  
Cultural Aspects ◽  
Care Services ◽  
Israeli Population ◽  
Primary Health Care Services ◽  
Diverse Cultures

The post-1989 immigration wave from the former U.S.S.R. has increased the Israeli population by over 12 percent, seriously affecting the host health care system. This study draws on semi-structured interviews with the immigrants visiting outpatient clinics in the Tel-Aviv area in order to explore organizational and cultural aspects of their encounter with the Israeli medical services. While instrumental aspects of care were seen as an improvement over the Soviet standards, communication between providers and clients was seriously flawed, reflecting both a language barrier and diverse cultures of illness and cure. Many interviewees complained of the impersonal, “technical” attitude of Israeli physicians toward patients and the lack of holism in care, which they allegedly enjoyed before emigration. Some immigrant patients feel deprived of the paternalism of the Soviet medical system, complaining that Israeli providers “forego responsibility” for patients' health. A consumerist approach to medical services is also a novelty, and immigrants have to learn to be informed and assertive clients. Most problems are experienced by the elderly patients; overall, women seem to adjust to the new system better than men.

scholarly journals Helsepersonells erfaringer med pasientforløp i kommuner i Vest-Norge

2017 ◽  
Vol 13 (2) ◽  
Author(s):  
Torill Aarskog Skorpen ◽  
Marit Kvangarsnes ◽  
Torstein Hole
Keyword(s):  
Health Services ◽  
Health Personnel ◽  
Health Care Services ◽  
User Participation ◽  
Local Health ◽  
Care Services ◽  
Western Norway ◽  
Patient Pathways ◽  
Specialist Health Care ◽  
Group Interviews

Health services in Norway have been described as fragmented with weak coordination between different care levels with respect to patient pathways. The Coordination Reform’s aim was to improve patient pathways and strengthen user participation. The aim of this study was to investigate health personnel ́s experiences with patient pathways in municipalities in Western Norway. A qualitative design was chosen. Six focus group interviews with health personnel working in municipalities in Western Norway were conducted in 2013 and 2014. The interviews revealed that health personnel experienced that local health services gave cohesive patient pathways and strengthened user participation. Cohesive patient pathways and locally adapted pathways were considered important. Coordination and electronic communication between primary and specialist health care services were seen as inadequate. Trust, teamwork, competence and necessary resources were considered vital. Health personnel ́s experiences indicated that the intended aim of cohesive patient pathways near the patient was met. 

scholarly journals Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

2012 ◽  
Vol 68 (2) ◽  
Author(s):  
N. Mlenzana ◽  
R. Mwansa
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Care Services ◽  
Waiting Times ◽  
Care Providers ◽  
Persons With Disabilities ◽  
Care Services ◽  
Primary Health

To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54%) were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction. Other clients were satisfied with thoroughness ofhealth care providers regarding symptoms, feelings, reception and treatment received at the primary health care centre.Understanding the views of the clients is essential in improving health delivery services and could impact on thecompliance of people attending primary health care services.

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