scholarly journals Transportation barriers to care among frequent health care users during the COVID pandemic

2021 ◽  
Author(s):  
Abigail L. Cochran ◽  
Noreen McDonald ◽  
Lauren Prunkl ◽  
Emma Vinella-Brusher ◽  
Jueyu Wang ◽  
...  

Objective: To investigate transportation barriers to accessing health care services during the COVID-19 pandemic among high-frequency health care users.Data Sources: Between June 21 and July 23, 2021, primary survey data were collected for a sample of patients in North Carolina.Study Design: The study analyzed the prevalence of arriving late to, delaying, or missing medical care and examined how transportation barriers contributed to negative health care outcomes. Data Collection Methods: A web-based survey was administered to North Carolina residents aged 18 and older in the UNC Health system who were enrolled in Medicaid or Medicare and had at least six outpatient medical appointments in the past year. 323 complete responses were analyzed to investigate the prevalence of reporting transportation barriers that resulted in having arrived late to, delayed, or missed care, as well as relationships between demographic and other independent variables and transportation barriers. Qualitative analyses were performed on text response data to explain transportation barriers.Principal Findings: Approximately 1 in 3 respondents experienced transportation barriers to health care between June 2020 and June 2021. Multivariate logistic regressions indicate individuals aged 18–64 were significantly more likely to encounter transportation barriers. Costs of traveling for medical appointments and a lack of driver or car availability emerged as major transportation barriers; however, respondents explained that barriers were often complex, involving circumstantial problems related to one’s ability to access and pay for transportation as well as to personal health.Conclusions: To address transportation barriers, we recommend more coordination between transportation and health professionals and the implementation of programs that expand access to and improve patient awareness of health care mobility services. We also recommend transportation and health entities direct resources to address transportation barriers equitably, as barriers disproportionately burden younger adults under age 65 enrolled in public insurance programs.

2021 ◽  
Vol 10 (8) ◽  
pp. 506
Author(s):  
Jan Ketil Rød ◽  
Arne H. Eide ◽  
Thomas Halvorsen ◽  
Alister Munthali

Central to this article is the issue of choosing sites for where a fieldwork could provide a better understanding of divergences in health care accessibility. Access to health care is critical to good health, but inhabitants may experience barriers to health care limiting their ability to obtain the care they need. Most inhabitants of low-income countries need to walk long distances along meandering paths to get to health care services. Individuals in Malawi responded to a survey with a battery of questions on perceived difficulties in accessing health care services. Using both vertical and horizontal impedance, we modelled walking time between household locations for the individuals in our sample and the health care centres they were using. The digital elevation model and Tobler’s hiking function were used to represent vertical impedance, while OpenStreetMap integrated with land cover map were used to represent horizontal impedance. Combining measures of walking time and perceived accessibility in Malawi, we used spatial statistics and found spatial clusters with substantial discrepancies in health care accessibility, which represented fieldwork locations favourable for providing a better understanding of barriers to health access.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244155
Author(s):  
Suraiya Umar ◽  
Adam Fusheini ◽  
Martin Amogre Ayanore

Background The National Health Insurance Scheme (NHIS) was introduced in Ghana in 2003 to remove financial barriers and to promote equitable access to health care services. Post implementation has been characterized by increases in access and utilization of services among the insured. The uninsured have been less likely to utilize services due to unaffordability of health care costs. In this study, we explored the experiences of the insured members of the NHIS, the uninsured and health professionals in accessing and utilizing health care services under the NHIS in the Hohoe Municipality of Ghana. Methods Qualitative in-depth interviews were held with twenty-five NHIS insured, twenty-five uninsured, and five health care professionals, who were randomly sampled from the Hohoe Municipality to collect data for this study. Data was analyzed using thematic analysis. Results Participants identified both enablers or motivating factors and barriers to health care services of the insured and uninsured. The major factors motivating members to access and use health care services were illness severity and symptom persistence. On the other hand, barriers identified included perceived poor service quality and lack of health insurance among the insured and uninsured respectively. Other barriers participants identified included financial constraints, poor attitudes of service providers, and prolonged waiting time. However, the level of care received were reportedly about the same among the insured and uninsured with access to quality health care much dependent on ability to pay, which favors the rich and thereby creating inequity in accessing the needed quality care services. Conclusion The implication of the financial barriers to health care access identified is that the poor and uninsured still suffer from health care access challenges, which questions the efficiency and core goal of the NHIS in removing financial barrier to health care access. This has the potential of undermining Ghana’s ability to meet the Sustainable Development Goal 3.8 of universal health coverage by the year 2030.


Author(s):  
Walisa Romsaiyud ◽  
Wichian Premchaiswadi

Addressing efforts towards the improvement of maternal and child health management can often prove to be problematic in context to successfully obtaining healthcare and medical treatment information from health care professionals. In this regard, the authors propose an adaptive multi-service system that contains fully integrated health care services, medical treatment services, and maternal and child health management. The system utilized both web-based and mobile technology for implementing the application. A practical framework for generating individual maternal and child health care is also presented from data repositories and fully integrated functional health care services to support an improved quality of life for both mother and children. The application, namely AM-Care, consists of the three main components, i.e., Control Centre Component, Web-based Components, and Mobile Components. Also, AM-Care has the important add-on features such as emergency services and warning services.


2018 ◽  
Vol 18 (1) ◽  
pp. 1-13
Author(s):  
LX Santos ◽  
DRS Almeida ◽  
JS Silva ◽  
ACMF Rizental ◽  
PAS Goes5 ◽  
...  

2017 ◽  
Vol 50 (1) ◽  
pp. 53-63 ◽  
Author(s):  
William C. Cockerham ◽  
Bryant W. Hamby ◽  
Olena Hankivsky ◽  
Elizabeth H. Baker ◽  
Setareh Rouhani

The ongoing health crisis in the Ukraine has persisted for 48 years with a clear division of gender-based outcomes as seen in the decline of male life expectancy and stagnation of female longevity. The purpose of this paper is to investigate differences in self-rated health and system barriers to health care applicable to gender and its intersections because of the differing negative health outcomes for men and women. Intersectionality theory provides an analytic framework for interpreting our results. Utilizing a nationwide sample of the Ukrainian population (N ¼ 1908), we found that low socioeconomic status (SES) women rate their health worse than men generally and any other socioeconomic group. Yet women also face the greatest barriers to health care until older ages when the ailments of men cause them to likewise face the obstacles. In reviewing the barrier to health care scale, one barrier—that of health care services being too expensive—dominated the responses with some 52.5 percent of the sample reporting it. Consequently, the greatest problem in Ukraine with respect to health reform reported by the population is the out-of-pocket costs for care in a system that is officially free. These costs, constituting some 40 percent of all national health expenditures, affect women and the aged the most.


2020 ◽  
Author(s):  
Abdullah Alsharif

BACKGROUND The increased frequency of epidemics such as Middle East respiratory syndrome, severe acute respiratory syndrome, Ebola virus, and Zika virus has created stress on health care management and operations as well as on relevant stakeholders. In addition, the recent COVID-19 outbreak has been creating challenges for various countries and their respective health care organizations in managing and controlling the pandemic. One of the most important observations during the recent outbreak is the lack of effective eHealth frameworks for managing and controlling pandemics. OBJECTIVE The aims of this study are to review the current National eHealth Strategy of Saudi Arabia and to propose an integrated eHealth framework that can be effective for managing health care operations and services during pandemics. METHODS A questionnaire-based survey was administered to 316 health care professionals to review the current national eHealth framework of Saudi Arabia and identify the objectives, factors, and components that are key for managing and controlling pandemics. Purposive sampling was used to collect responses from diverse experts, including physicians, technical experts, nurses, administrative experts, and pharmacists. The survey was administered at five hospitals in Saudi Arabia by forwarding the survey link using a web-based portal. A sample population of 350 was achieved, which was filtered to exclude incomplete and ineligible samples, giving a sample of 316 participants. RESULTS Of the 316 participants, 187 (59.2%) found the current eHealth framework to be ineffective, and more than 50% of the total participants stated that the framework lacked some essential components and objectives. Additional components and objectives focusing on using eHealth for managing information, creating awareness, increasing accessibility and reachability, promoting self-management and self-collaboration, promoting electronic services, and extensive stakeholder engagement were considered to be the most important factors by more than 80% of the total participants. CONCLUSIONS Managing pandemics requires an effective and efficient eHealth framework that can be used to manage various health care services by integrating different eHealth components and collaborating with all stakeholders.


10.2196/19524 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e19524
Author(s):  
Abdullah Alsharif

Background The increased frequency of epidemics such as Middle East respiratory syndrome, severe acute respiratory syndrome, Ebola virus, and Zika virus has created stress on health care management and operations as well as on relevant stakeholders. In addition, the recent COVID-19 outbreak has been creating challenges for various countries and their respective health care organizations in managing and controlling the pandemic. One of the most important observations during the recent outbreak is the lack of effective eHealth frameworks for managing and controlling pandemics. Objective The aims of this study are to review the current National eHealth Strategy of Saudi Arabia and to propose an integrated eHealth framework that can be effective for managing health care operations and services during pandemics. Methods A questionnaire-based survey was administered to 316 health care professionals to review the current national eHealth framework of Saudi Arabia and identify the objectives, factors, and components that are key for managing and controlling pandemics. Purposive sampling was used to collect responses from diverse experts, including physicians, technical experts, nurses, administrative experts, and pharmacists. The survey was administered at five hospitals in Saudi Arabia by forwarding the survey link using a web-based portal. A sample population of 350 was achieved, which was filtered to exclude incomplete and ineligible samples, giving a sample of 316 participants. Results Of the 316 participants, 187 (59.2%) found the current eHealth framework to be ineffective, and more than 50% of the total participants stated that the framework lacked some essential components and objectives. Additional components and objectives focusing on using eHealth for managing information, creating awareness, increasing accessibility and reachability, promoting self-management and self-collaboration, promoting electronic services, and extensive stakeholder engagement were considered to be the most important factors by more than 80% of the total participants. Conclusions Managing pandemics requires an effective and efficient eHealth framework that can be used to manage various health care services by integrating different eHealth components and collaborating with all stakeholders.


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