scholarly journals Development and Initial Evaluation of a Nurse-Led Healthcare Clinic for Homeless and At-Risk Populations in Tasmania, Australia: A Collaborative Initiative

Author(s):  
Grace Bennett-Daly ◽  
Maria Unwin ◽  
Ha Dinh ◽  
Michele Dowlman ◽  
Leigh Harkness ◽  
...  

People who are homeless experience significantly poorer health than the general population and often face multifaceted challenges engaging with public healthcare services. Mission Health Nurse-led Clinic (MHNC) was established in 2019 to meet the healthcare needs of this marginalised population in Launceston, Tasmania. This study examines barriers to healthcare access amongst individuals who experience homelessness, client and staff perceptions of the MHNC services and explored opportunities for service expansion. Descriptive statistics were drawn from administrative data, and all interviews were thematically analysed. A total of 426 presentations were reported for 174 individuals experiencing homelessness over 26 months. The median client age was 42 years and 60.9% were male; A total of 38.5% were homeless or lived in a supported accommodation. The predominant reasons for clinic visits included prescription requests (25.3%) and immunisations (20.1%). A total of 10 clients and 5 City Mission staff were interviewed with three themes emerging from the findings: personal vulnerability, disconnectedness and acceptability of the MHNC. The MHNC services were reported to be highly appreciated by all clients. Mental health and allied health, extra operating hours and maintaining the flexibility of walk-in appointments were suggested as expansion areas for the service and were highlighted as ways to increase engagement for improved health outcomes. Continued partnerships with interprofessional primary healthcare providers would contribute to addressing unmet healthcare needs in this vulnerable population.

Author(s):  
Ju Young Kim ◽  
Dae In Kim ◽  
Hwa Yeon Park ◽  
Yuliya Pak ◽  
Phap Ngoc Hoang Tran ◽  
...  

The purpose of this study was to examine the current utilization of healthcare services, exploring unmet healthcare needs and the associated factors among people living in rural Vietnam. This cross-sectional study was conducted with 233 participants in a rural area. The methods included face-to-face interviews using a structured questionnaire, and anthropometric and blood pressure measurements. We considered participants to have unmet health needs if they had any kind of health problem during the past 12 months for which they were unable to see a healthcare provider. Multivariate logistic regression analysis was performed to determine the factors associated with unmet healthcare needs. Of the participants, 18% (n = 43) had unmet healthcare needs, for reasons like transportation (30%), a lack of available doctors or medicine (47%), and communication issues with healthcare providers (16%). The multivariate logistic regression showed that living in a rural area, having stage 2 hypertension, and having insurance were associated with unmet healthcare needs. To better meet the healthcare needs in rural or suburban areas of Vietnam, allocation of adequate healthcare resources should be distributed in rural areas and insurance coverage for personalized healthcare needs might be required. Efforts should focus on availability of medicine, improvement of transportation systems, and communication skills of healthcare providers to improve access to healthcare services.


2020 ◽  
Author(s):  
Ju Young Kim ◽  
Ju Young Kim ◽  
Dae In Kim ◽  
Hwa Yeon Park ◽  
Yuliya Pak ◽  
...  

Abstract Background: Although health status in Vietnam has been much improved, people living in rural areas have faced several challenges, including a rapid increase of the aging population, inadequate capacity of health system, and problems of inequities in access to the healthcare system. The purpose of this study was to examine the current utilization of healthcare services, exploring unmet healthcare needs and their associated factors among adults living in rural Vietnam.Methods: This cross sectional study was conducted with 233 participants in a rural area of Binh Phuoc province and a suburban area of Da Lat city in Vietnam from October–December 2017. The methods included face-to-face interviews using a structured questionnaire as well as anthropometric and blood pressure measurements. We considered participants to have unmet health needs if they had any kind of health problem during the past 12 months for which they were unable to see a healthcare provider in the same period. Multivariate logistic regression analysis was performed to determine the factors associated with unmet healthcare needs.Results: Of the participants, 18% (n=43) had unmet healthcare needs. The common causes of unmet healthcare were transportation (30%), a lack of available doctors or medicines (47%), and communication issues with healthcare providers (16%). The multivariate logistic regression showed that having stage 2 high blood pressure and reporting no place to go for medical problems were associated with unmet healthcare needs.Conclusions: Healthcare services are still needed in disadvantaged group living in rural or suburban area of Vietnam. Efforts should focus on availability of medicines, improvement of transportation system as well as communication skills of healthcare providers to improve access to healthcare services.


2021 ◽  
Author(s):  
Bafreen Sherif ◽  
Ahmed Awaisu ◽  
Nadir Kheir

Abstract Background The annual New Zealand refugee quota was increased to 1500 places from 2020 onwards as a response to the global refugee crisis. The specific healthcare needs of refugees are not clearly understood globally and communication between healthcare providers and refugees remains poor. Methods A phenomenological qualitative methodology was employed to conduct semi-structured interviews among purposively selected stakeholders who work in refugee organisations and relevant bodies in New Zealand. Results The participants indicated the need for a national framework of inclusion, mandating cultural competency training for frontline healthcare and non-healthcare personnel, creation of a national interpretation phone line, and establishing health navigators. Barriers to accessing health services identified included some social determinants of health such as housing and community environment; health-seeking behaviour and health literacy; and social support networks. Future healthcare delivery should focus on capacity building of existing services, including co-design processes, increased funding for refugee-specific health services, and whole government approach. Conclusion Policymakers and refugee organisations and their frontline personnel should seek to address the deficiencies identified in order to provide equitable, timely and cost-effective healthcare services for refugees in New Zealand.


2020 ◽  
Author(s):  
Pratik Adhikary ◽  
Nirmal Aryal ◽  
Raja Ram Dhungana ◽  
Radheyshyam Krishna KC ◽  
Pramod Raj Regmi ◽  
...  

Abstract Background: Migration to India is a common livelihood strategy for poor people in remote Western Nepal. To date, little research has explored the degree and nature of healthcare access among Nepali migrant workers in India. This study explores the experiences of returnee Nepali migrants with regard to accessing healthcare and the perspectives of stakeholders in the government, support organizations, and health providers working with migrant workers in India. Methods: Six focus group discussions (FGDs) and 12 in-depth interviews with returnee migrants were conducted by trained moderators in six districts in Western Nepal in late 2017. A further nother 12 key persons working in the health and education sector were also interviewed. With the consent of the participants, FGDs and interviews were audio-recorded. They were then transcribed and translated into English and the data w ere as analysed thematically. Results: The interviewed returnee migrants worked in 15 of India’s 29 states, most as daily wage labourers. Most were from among the lowest castes so called-Dalits. Most migrants had had difficulty accessing healthcare services in India. The major barriers to access were the lack of insurance, low wages, not having an Indian identification card tied to individual biometrics so called: Aadhaar card. Other barriers were unsupportive employers, discrimination at healthcare facilities and limited information about the locations of healthcare services. Conclusions: Nepali migrants experience difficulties in accessing healthcare in India. Partnerships between the Nepali and Indian governments, migrant support organizations and relevant stakeholders such as healthcare providers, government agencies and employers should be strengthened so that this vulnerable population can access the healthcare they are entitled to. Keywords: Migrants, Returnees, Healthcare access, Qualitative research, Nepal, South Asia


2020 ◽  
Vol 18 (2) ◽  
pp. 1809
Author(s):  
Ali A. Al Jumaili ◽  
Kawther K. Ahmed ◽  
Dave Koch

Objective: To identify barriers to healthcare access, to assess the health literacy levels of the foreign-born Arabic speaking population in Iowa, USA and to measure their prevalence of seeking preventive healthcare services. Methods: A cross-sectional study of native Arabic speaking adults involved a focus group and an anonymous paper-based survey. The focus group and the Andersen Model were used to develop the survey questionnaire. The survey participants were customers at Arabic grocery stores, worshippers at the city mosque and patients at free University Clinic. Chi-square test was used to measure the relationship between the characteristics of survey participants and preventive healthcare services. Thematic analysis was used to analyze the focus group transcript. Results: We received 196 completed surveys. Only half of the participants were considered to have good health literacy. More than one-third of the participants had no health insurance and less than half of them visit clinics regularly for preventive measures. Two participant enabling factors (health insurance and residency years) and one need factor (having chronic disease(s)) were found to significantly influence preventive physician visits. Conclusions: This theory-based study provides a tool that can be used in different Western countries where Arabic minority lives. Both the survey and the focus group agreed that lacking health insurance is the main barrier facing their access to healthcare services. The availability of an interpreter in the hospital is essential to help those with inadequate health literacy, particularly new arriving individuals. More free healthcare settings are needed in the county to take care of the increasing number of uninsured Arabic speaking patients.


2019 ◽  
Vol 255 ◽  
pp. 04005
Author(s):  
Paul K.Y. Siu ◽  
K.L. Choy ◽  
H.Y. Lam

Due to the advancement of living standard and medical technologies, the life expectancy of people is further extended which brings tremendous impact to the society in the near future. The ageing population not only increases the pressure to public healthcare services, but also brings urgent needs in long term healthcare resources allocation planning in the society. This paper presents an Elderly Behaviour Analytics Model (EBAM) to identify the hospital healthcare service preferences of elderly for the future planning of healthcare industry. By conducting an elderly-targeted survey, the collected data is analysed to understand the factors affecting the decision of elderly to acquire healthcare services in hospitals. The model applies the genetic algorithm-guided clustering-based association rule mining approach for the segmentation of hospital service preferences of the elderly, and, the identification of relationship between personal characteristics within each cluster. This research study contributes to the understanding the actual healthcare needs of elderly which allows the government and healthcare service providers to adjust or modify the elderly policies and service content.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Raja Aishah binti Raja Adnan ◽  
Mahazan Abdul Mutalib ◽  
Muhammad Ridhwan Ab Aziz

PurposeThis research paper aims to determine the factors needed to propose a platform where waqf (Islamic endowment) organizations can collaborate with government public hospitals to develop corporate waqf hospitals. Consequently, the elements of governance and sustainability are included in the management of corporate waqf hospitals thereby leading to the corporatization of public hospitals.Design/methodology/approachThis study adopts the qualitative research methodology and undertakes content analysis of data collected from journal articles, magazines and official websites. Data analysis involves open coding with NVivo 12.FindingsGeneral findings from the literature review have shown that architectural and engineering fundamentals were essential factors in the success of past waqf hospitals of the era between 8th and 14th centuries. In that era, the decentralized waqf-based hospitals employed the mutawalli (the trustee/manager of the waqf assets) to govern the administration of the hospitals. Present corporate waqf hospitals can exploit the elements identified from past waqf-based hospitals and additionally adopt the private-public partnership model in the form of a muḍārabah (profit-sharing contract) agreement to design a sustainable waqf governance model for Malaysian public healthcare services.Research limitations/implicationsThe proposed platform is designed for a corporate waqf model developed in collaboration between Malaysian waqf institutions and public healthcare services. It abides by both the Malaysian fatwa (Islamic rulings) on waqf and the laws of the Malaysian Government.Practical implicationsThere is potential for developing the Malaysian corporate waqf-governance healthcare model which will enable the hospital to provide better quality healthcare to more patients through upgrading the quality of equipment used in hospitals and/or better facilities at equal or lower costs. Consequently, this will not only improve waqf management and distribution but also result in reduction of government expenditure.Social implicationsThis research promotes the concept of a corporate waqf hospital which will provide innumerable beneficial healthcare services in terms of improved healthcare quality at affordable costs to the general public and at no cost to the poor and the underprivileged.Originality/valueAlthough waqf has played an important role as a vehicle for Islamic financing in the society for centuries, a model of collaboration or partnership of waqf with public healthcare services has yet to be explored and developed. With proper corporate governance and well-managed sustainability in a corporate waqf model, this newly developed partnership between waqf institutions and public healthcare providers can be a first step in many more interesting collaborative arrangements that can be established between waqf institutions and public services in the future.


2021 ◽  
Vol 8 (6) ◽  
pp. 10
Author(s):  
Lili Wu ◽  
Chunyin Wang ◽  
Jiayun Kou

This study focuses on the variability in unmet healthcare needs among vulnerable Chinese elders and the degree to which these unmet needs are associated with socioeconomic disadvantages. We use the 2013 wave of China Health and Retirement Longitudinal Study (CHARLS) and a multinomial logistic model to investigate how poverty, residence status and particular health insurance schemes influence unmet healthcare needs independently and in combination. Our results show that poverty and rural residence are strong predictors of unmet healthcare needs due to financial and non-financial constraints, respectively. Although health insurance can reduce financial barriers, its influence varies with different insurance schemes, thus generating unequal healthcare access among heterogeneous vulnerable subgroups of elders and putting poor rural migrants at the highest risk for unmet healthcare needs. Our findings direct attention to the differences in resources available to various subgroups of elders and the importance of social stratification in predicting unmet health care needs.


2020 ◽  
Author(s):  
Nina Tjukanov ◽  
Paula Tiittala ◽  
Heli Salmi

Abstract AimThe increase in immigration to Europe has led to an increasing demand for information about healthcare needs and costs of vulnerable migrant populations, but few data based on actual demand for healthcare services and related costs exist.MethodsIn this single-centre retrospective register study, we examined the reasons for encounter and diagnoses, service use and costs of healthcare among patients at a voluntary clinic for migrants in an irregular situation in Helsinki, Finland in 2016. ICPC-2 classification and unit costs for primary healthcare in Finland were used as a basis for the cost estimation.Results546 patient visits accounted for 620 ICPC-2 coded reasons for encounter, diagnoses and process codes. The most common health problems were teeth/gum disease (10%), acute upper respiratory infection (5%) and oesophageal disease (3%). Visits seldom led to complementary investigations (2%), follow-up visit to the clinic (5%) or referral to public healthcare (11%). The total cost of treatment, excluding dental health costs, was 39 547 euros, or 71 euros per visit. ConclusionsMigrants in an irregular situation present with a variety of health concerns, the majority of which can be treated in a basic primary healthcare facility. The cost of healthcare was relatively low, as most of the complaints could be treated with simple means. More research is needed to understand the health and cost benefits of extending public healthcare services for migrants in an irregular situation beyond emergency care.


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