scholarly journals Improving access to health care in a rural regional hospital in South Africa: Why do patients miss their appointments?

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Lucy Frost ◽  
Louis S. Jenkins ◽  
Benjamin Emmink
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Economic Status ◽  
Missed Appointments ◽  
Access To Health Services ◽  
Targeted Interventions ◽  
Access To Health ◽  
Hospital Systems ◽  
Underlying Causes ◽  
People First

Background: Access to health services is one of the Batho Pele (‘people first’) values and principles of the South African government since 1997. This necessitated some changes around public service systems, procedures, attitudes and behaviour. The challenges of providing health care to rural geographically spread populations include variations in socio-economic status, transport opportunities, access to appointment information and patient perceptions of costs and benefits of seeking health care. George hospital, situated in a rural area, serves 5000 outpatient visits monthly, with non-attendance rates of up to 40%. Objectives: The aim of this research was to gain a greater understanding of the reasons behind non-attendance of outpatient department clinics to allow locally driven, targeted interventions. Methods: This was a descriptive study. We attempted to phone all patients who missed appointments over a 1-month period (n = 574). Only 20% were contactable with one person declining consent. Twenty-nine percent had no telephone number on hospital systems, 7% had incorrect numbers, 2% had died and 42% did not respond to three attempts. Results: The main reasons for non-attendance included unaware of appointment date (16%), out of area (11%), confusion over date (11%), sick or admitted to hospital (10%), family member sick or died (7%), appointment should have been cancelled by clerical staff (6%) and transport (6%). Only 9% chose to miss their appointment. The other 24% had various reasons. Conclusions: Improved patient awareness of appointments, adjustments in referral systems and enabling appointment cancellation if indicated would directly improve over two-thirds of reasons for non-attendance. Understanding the underlying causes will help appointment planning, reduce wasted costs and have a significant impact on patient care.

scholarly journals Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Access To Health Services ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health services can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

How accessible is the Serbian health system? Main barriers and challenges ahead

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Hernandez-Quevedo ◽  
V Bjegovic-Mikanovic ◽  
M Vasic ◽  
D Vukovic ◽  
J Jankovic ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Medical Care ◽  
Access To Health Care ◽  
Unmet Need ◽  
Policy Issue ◽  
Vulnerable Groups ◽  
Free Access ◽  
Access To Health ◽  
Underlying Causes

Abstract Background Access to health care is a key health policy issue faced by countries in the WHO European Region and Serbia is not an exception. There is increasing concern that financial and economic crisis may have delay progress regarding the performance of the Serbian health system. While substantial development has been experienced by the Serbian health system since 2000, we analyse whether barriers to health care access exist in the country and the underlying causes. Methods We combine quantitative and qualitative methods to assess the accessibility of the Serbian health system. We use the latest data available both at national (e.g. National Health Survey) and European (EUSILC) level to understand whether barriers to access exist and the underlying causes. On the qualitative side, we analyse the different policies implemented by the Serbian government to improve the accessibility of the health system in the last decade, identifying the challenges ahead for the country. Results We find that, in 2018, 5.8% of the Serbian population reported unmet need for medical care due to costs, travel distances or waiting lists, well above the EU28 average and much higher than in neighbouring countries. Financial constraints are reported to be the main reason for unmet needs for medical care. Long waiting times also impede the accessibility of health services in Serbia. Conclusions Serbia has a comprehensive universal health system with free access to health care, however, some vulnerable groups, such as those living in poverty or Roma people in settlements, have more barriers in accessing health care. It is expected that Serbia will continue to develop policies focused on reducing barriers to accessing health care and improving the efficiency of the health system, supported by international organisations and in the context of the EU accession negotiations. Key messages Some vulnerable groups have more barriers in accessing adequate care in Serbia. National initiatives are in place to increase access to the health system but there is scope for further work.

scholarly journals Information, communication and equitable access to health care: a conceptual note

2008 ◽  
Vol 24 (5) ◽  
pp. 1168-1173 ◽  
Author(s):  
Michael Thiede ◽  
Di McIntyre
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health Services ◽  
Access To Health Care ◽  
Communicative Action ◽  
Information Communication ◽  
Equitable Access ◽  
Access To Health Services ◽  
Access To Health

This conceptual paper addresses the health policy goal of equitable access to health care from a perspective that highlights the role of choice. It sketches a framework around the three access dimensions availability, affordability, and acceptability. The "degree of fit" with respect to each of these dimensions between the health system and individuals or communities plays a role in determining the level of access to health services by outlining the existing choice set. Yet it is the degree of informedness about the choices that ultimately determines access to health services. Access is therefore defined as the freedom to utilize. The paper focuses on information and its properties, which cut across the dimensions of access. It is argued that equity-oriented health policy should stimulate communicative action in order to empower individuals and communities by expanding their subjective choice sets.

Impact of low economic status, low screening coverage and access to health care on cancer management in a cohort in Mexico.

2020 ◽  
Vol 46 (2) ◽  
pp. e154
Author(s):  
Alethia Alvarez-Cano ◽  
Dorian Yarih Garcia-Ortega ◽  
Hector Hugo Romero-Garza ◽  
Edson Rene Marcos-Ramirez ◽  
Edelmiro Perez-Rodriguez ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Economic Status ◽  
Cancer Management ◽  
Access To Health ◽  
Screening Coverage

scholarly journals Spatiotemporal modelling and mapping of cervical cancer incidence among HIV positive women in South Africa: A nationwide study

2020 ◽  
Author(s):  
Dhokotera Tafadzwa ◽  
Riou Julien ◽  
Bartels Lina ◽  
Rohner Eliane ◽  
Chammartin Frederique ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Cervical Cancer ◽  
Access To Health Care ◽  
Hiv Positive ◽  
Equitable Access ◽  
Access To Health Services ◽  
Hiv Positive Women ◽  
Access To Health ◽  
Physical Barriers

AbstractDisparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the associated factors among HIV positive women in South Africa. We included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004-2014. We used the Thembisa model to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers, such as transportation to health centres and strengthening of screening programmes.Novelty and ImpactThis is the first nationwide study in South Africa to evaluate spatial and spatiotemporal distribution of cervical cancer in women diagnosed with HIV. The results show an increased incidence of cervical cancer in affluent municipalities and in those with better access to health care. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers.

scholarly journals Health determinants among refugees in Austria and Germany: A propensity-matched comparative study for Syrian, Afghan, and Iraqi refugees

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250821
Author(s):  
Daniela Georges ◽  
Isabella Buber-Ennser ◽  
Bernhard Rengs ◽  
Judith Kohlenberger ◽  
Gabriele Doblhammer
Keyword(s):  
Health Care ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Access To Health Care ◽  
Good Health ◽  
Determinants Of Health ◽  
Health Determinants ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health

In recent years, Germany and Austria have been among the leading European receiving countries for asylum seekers and refugees (AS&R). The two countries have cultural and economic similarities, but differ, for example, in their health care systems, with AS&R having unrestricted access to health services upon arrival in Austria, but not in Germany. This study investigates the determinants of health among refugees in Austria and Germany, and how these determinants differ between the two countries. We analyze comparable and harmonized survey data from both countries for Syrian, Afghan, and Iraqi nationals aged 18 to 59 years who had immigrated between 2013 and 2016 (Germany: n = 2,854; Austria: n = 374). The study adopts a cross-sectional design, and uses propensity score matching to examine comparable AS&R in the two receiving countries. The results reveal that the AS&R in Germany (72%) were significantly less likely to report being in (very) good health than their peers in Austria (89%). Age and education had large impacts on health, whereas the effects of length of stay and length of asylum process were smaller. Compositional differences in terms of age, sex, nationality, education, and partnership situation explained the country differences only in part. After applying propensity score matching to adjust for structural differences and to assess non-confounded country effects, the probability of reporting (very) good health was still 12 percentage points lower in Germany than in Austria. We conclude that many of the determinants of health among AS&R correspond to those in the non-migrant population, and thus call for the implementation of similar health policies. The health disadvantage found among the AS&R in Germany suggests that removing their initially restricted access to health care may improve their health.

scholarly journals Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Access To Health Services ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health services can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

scholarly journals Pathways to healthcare for migrants and vulnerable people inclusion: the experience of Genti di Pace

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Mancinelli ◽  
E Buonomo ◽  
F Mosaico ◽  
G Biondi ◽  
A Zampa ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Access To Health Care ◽  
Health Care Services ◽  
Access To Health Services ◽  
Public And Private ◽  
Care Services ◽  
Access To Health ◽  
Vulnerable People ◽  
Improve Health

Abstract Issue Chronic and acute diseases affects migrants and vulnerable people who often face barriers in accessing health care services. Here is the description of an innovative health center (HC) developed for identifying barriers and facilitating access to health care services of hard-to-reach (HTR) people in Rome. Description of the Problem The Community of Sant'Egidio together with the “Migrant Health Unit” of ASL Roma 1 has established an innovative HC program aimed to improve health outcomes in HTR urban population. One of the main Public Health challenge is to reduce inequalities among migrants and vulnerable people through improving access to health services. Data here analysed were collected during 2019. Results 897 migrants and vulnerable people received heath care assistance. 52.4% were females, mean age 40.7±21.4 ds, 16.3% aged under 18 years and 69.6% were between 18-64 years. Countries of provenance: 56.8% Eastern Europe (Bosnia and Romania), 16.8% South America and 15.2% North Africa. 3.2% were refugees. Among 1986 health interventions 56.3% were general medical visits, 35.4% prescriptions and free drugs distribution, 4.1% children growth controls and baby milk supplies, 3.6% specialist visits and only 0.3% were sending to the Emergency Room. Lessons Improving the access to health care services of migrants is both a public health and an economic goal. The increase in chronic-degenerative diseases underlines the need to facilitate access to health services, also through collaboration networks between public and private social. This allows continuity in treatment, which has great meaning of secondary prevention, as well as rationalization of resources, reducing an improper use of the Emergency Room, which provides occasional intervention, but does not integrate into an efficient/effective therapeutic path. Key messages Promoting health care services like this can reduce barriers, improve health outcomes in migrants and increase sustainability of the NHS. Improving access to public and private social health services is important especially in presence of chronic-diseases which require continuous therapies and examinations.

Sign in / Sign up

Export Citation Format

Share Document