scholarly journals Access to Health Care for People with Diabetes: Variation in the Use of Primary Care Services for Diabetes Management According to Country of Birth and Geography among Older Australians

2015 ◽  
Vol 05 (03) ◽  
Author(s):  
Elizabeth Comino
2005 ◽  
Vol 35 (4) ◽  
pp. 797-816 ◽  
Author(s):  
Kamran Nayeri ◽  
Cándido M. López-Pardo

This article explores the effects on access to health care in Cuba of the severe economic crisis that followed the collapse of the Soviet Union and the monetary and market reforms adopted to confront it. Economic crises undermine health and well-being. Widespread scarcities and self-seeking attitudes fostered by monetary and market relations could result in differential access to health services and resources, but the authors found no evidence of such differential access in Cuba. While Cubans generally complain about many shortages, including shortages of health services and resources before the economic recovery began in 1995, no interviewees reported systemic shortages or unequal access to health care services or resources; interviewees were particularly happy with their primary care services. These findings are consistent with official health care statistics, which show that, while secondary and tertiary care suffered in the early years of the crisis because of interruptions in access to medical technologies, primary care services expanded unabated, resulting in improved health outcomes. The combined effects of the well-functioning universal and equitable health care system in place before the crisis, the government's steadfast support for the system, and the network of social solidarity based on grassroots organizations mitigated the corrosive effects of monetary and market relations in the context of severe scarcities and an intensified U.S. embargo against the Cuban people.


Author(s):  
Erin Ziegler ◽  
Ruta Valaitis ◽  
Nancy Carter ◽  
Cathy Risdon ◽  
Jennifer Yost

Abstract Background: Historically transgender adults have experienced barriers in accessing primary care services. In Ontario, Canada, health care for transgender adults is accessed through primary care; however, a limited number of practitioners provide care, and patients are often waiting and/or traveling great distances to receive care. The purpose of this protocol is to understand how primary care is implemented and delivered for transgender adults. The paper presents how the case study method can be applied to explore implementation of health services delivery for the transgender population in primary care. Methods: Case study methodology will be used to explore this phenomenon in different primary care contexts. Normalization Process Theory is used as a guide. Three cases known to provide transgender primary care and represent different Ontario primary care models have been identified. Comparing transgender care implementation and delivery across different models is vital to understanding how care provision to this population can be supported. Qualitative interviews will be conducted. Participants will also complete the NoMAD (NOrmalization MeAsure Development) survey, a tool measuring implementation processes. The tool will be modified to explore the implementation of primary care services for transgender individuals. Documentary evidence will be collected. Cross-case synthesis will be completed to compare the cases. Discussion: Findings will provide an Ontario perspective on the implementation and delivery of primary care for transgender adults in different primary care models. Results may be applicable to other primary care settings in Canada and other nations with similar systems. Barriers and facilitators in delivery and implementation will be identified. Providing an understanding and increasing awareness of the implementation and delivery of primary care may help to reduce the invisibility and disparities transgender individuals experience when accessing primary care services. Understanding delivery of care could allow care providers to implement primary care services for transgender individuals, improving access to health care for this vulnerable population.


2016 ◽  
Vol 10 (1) ◽  
pp. 66-74 ◽  
Author(s):  
Duong Thuy Tran ◽  
Louisa R. Jorm ◽  
Alys Havard ◽  
Mark F. Harris ◽  
Elizabeth Jean Comino

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711005
Author(s):  
Raza Naqvi ◽  
Octavia Gale

BackgroundPreventative medicine has become a central focus in primary care provision, with greater emphasis on education and access to health care screening. The Department of Health reports existing health inequalities and inequalities in access within ethnic minority groups. Studies assessing the value of community engagement in primary care have reported variable outcomes in term of subsequent service utilisation.AimTo consider the benefit of community-based health screening checks to improve access and health outcomes in minority ethnic groups.MethodAn open community health screening event (n = 43), to allow targeted screening within an ethnic minority population. Screening included BP, BMI, BM and cholesterol. Results were interpreted by a healthcare professional and counselling was provided regarding relevant risk factors. Post-event feedback was gathered to collate participant opinion and views.ResultsSeventy-nine per cent of participants were from ethnic minority backgrounds: 64% were overweight or obese and 53% of participants were referred to primary care for urgent review following abnormal findings. All those referred would not have accessed healthcare without the event referral. All (100%) participants believed it improved health education and access to health care.ConclusionThis study clearly demonstrates the value of targeted community-led screening and education events in public health promotion. There was a significant benefit in providing community-based screening. There is a need for a longitudinal analysis to determine the impact on health outcomes and long-term access to healthcare provision.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Buch Mejsner ◽  
S Lavasani Kjær ◽  
L Eklund Karlsson

Abstract Background Evidence often shows that migrants in the European region have poor access to quality health care. Having a large number of migrants seeking towards Europe, crossing through i.e. Serbia, it is crucial to improve migrants' access to health care and ensure equality in service provision Aim To investigate what are the barriers and facilitators of access to health care in Serbia, perceived by migrants, policy makers, health care providers, civil servants and experts working with migrants. Methods six migrants in an asylum center and eight civil servants in the field of migration were conducted. A complementary questionnaire to key civil servants working with migrants (N = 19) is being distributed to complement the data. The qualitative and quantitative data will be analysed through Grounded Theory and Logistic Regression respectively. Results According to preliminary findings, migrants reported that they were able to access the health care services quite easily. Migrants were mostly fully aware of their rights to access these health care services. However, the interviewed civil servants experienced that, despite the majority of migrants in camps were treated fairly, some migrants were treated inappropriately by health care professionals (being addressed inappropriately, poor or lacking treatment). The civil servants believed that local Serbs, from their own experiences, were treated poorer than migrants (I.e. paying Informal Patient Payments, poor quality of and access to health care services). The interviewed migrants were trusting towards the health system, because they felt protected by the official system that guaranteed them services. The final results will be presented at the conference. Conclusions There was a difference in quality of and access to health care services of local Serbs and migrants in the region. Migrants may be protected by the official health care system and thus have access to and do not pay additional fees for health care services. Key messages Despite comprehensive evidence on Informal Patient Payments (IPP) in Serbia, further research is needed to highlight how health system governance and prevailing policies affect IPP in migrants. There may be clear differences in quality of and access to health care services between the local population and migrants in Serbia.


2000 ◽  
Vol 4 (2) ◽  
pp. 111-131 ◽  
Author(s):  
Charles Ngwena

The article considers the scope and limits of law as an instrument for facilitating equitable access to health care in South Africa. The focus is on exploring the extent to which the notion of substantive equality in access to health care services that is implicitly guaranteed by the Constitution and supported by current health care reforms, is realisable for patients seeking treatment. The article highlights the gap between the idea of substantive equality in the Constitution and the resources at the disposal of the health care sector and the country as a whole. It is submitted that though formal equality in access to health care services has been realised, substantive equality is currently unattainable, if it is attainable at all, on account of entrenched structural inequality, general poverty and a high burden of disease.


PEDIATRICS ◽  
1994 ◽  
Vol 93 (1) ◽  
pp. 135-136
Author(s):  

The American Academy of Pediatrics recognizes the achievements of the Medicaid program in improving access to health care services for poor children. Despite recent legislative expansions to extend eligibility to more poor and disabled children and to broaden the scope of preventive and treatment services in all states, several additional program improvements are needed to eliminate the following barriers to access: 1. Federal and state fiscal crises are creating major roadblocks to Medicaid program implementation and expansion. 2. Thousands of poor children will not be eligible for Medicaid until October 1, 2001.1 3. Only a portion of those who are potentially eligible for Medicaid apply for coverage, and many eligible children do not utilize services. 4. Fewer Medicaid funds are available for primary and preventive care because of the increasing need for long-term care services. 5. Early and periodic screening, diagnosis and treatment (EPSDT)/preventive health services are being received by too few children and the implementation of expanded service coverage under EPSDT, granted in 1989, is subject to a great deal of inconsistent state interpretation. 6. Inadequate provider reimbursement reduces children's access to health care services. The Academy has developed the "Children First" proposal which calls for the elimination of Medicaid and replaces it with a one-class, private insurance system of universal access to health care for all children through age 21 and for all pregnant women.2 However, until the "Children First" proposal, or a similar health care reform initiative is implemented, the Academy recommends the following policy actions to improve the current Medicaid program.


2018 ◽  
Vol 71 (5) ◽  
pp. 2367-2375 ◽  
Author(s):  
Ana Paula Mhirdaui Sanches ◽  
Karen Sayuri Mekaro ◽  
Rosely Moralez de Figueiredo ◽  
Silvia Carla da Silva André

ABSTRACT Objective: to describe the knowledge of nurses on Health-Care Waste Management (HCW) in Family Health Units (FHU) of São Carlos city, São Paulo State. Method: exploratory, descriptive and quantitative approach. The research was carried out with nurses of 16 FHU of the municipality of São Carlos-SP. Data were collected through an interview using a tool validated and analyzed using descriptive statistics. Results: it is noteworthy that 68.7% (11) of the nurses did not know how to describe how chemical waste was sorted. In addition, regarding the treatment of HCW, 50.0% (8) of the nurses did not know if the general waste were subjected to some type of treatment. Conclusion: the HCW management can be considered a challenge in the nurses' agenda inserted in the Primary Care services, which refers to the need to implement periodic training on the management of this waste.


2020 ◽  
Vol 69 (4) ◽  
pp. 401-418
Author(s):  
Annamária Uzzoli ◽  
Zoltán Egri ◽  
Dániel Szilágyi ◽  
Viktor Pál

The availability of health care services is an important issue, however, improving availability of health care services does not necessarily mean better accessibility for everybody. The main aim of this study is to find out how better availability in the care of acute myocardial infarction vary with accessibility of patients’ geographical location within Hungary. We applied statistical analysis and interview techniques to unfold the role of spatiality in the conditions of access to health care. Results of statistical analysis indicate significant health inequalities in Hungary. Decreasing national mortality rates of acute myocardial infarction, has been coupled by increasing spatial inequalities within the country especially at micro-regional level. According to in-depth interviews with local health care stakeholders we defined factors that support access to health care as well as important barriers. The supporting factors are related to the improvement of availability (i.e. infrastructural developments), while geographical distance, lack of material and human resources, or low level of health literacy proved to be the most relevant barriers. Main conclusion is that barriers to accessibility and availability are not only spatial but are also based on individual stages of acute myocardial infarction care. The development of cardiac catheter centres in Hungary has improved the short-term chances of infarction survival, but long-term survival chances have worsened in recent years due to deficiencies in rehabilitation care as well as low level of health literacy.


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