The Effect of COVID-19 on Referral Time and Cost of Outpatient'S Services Amongst Insured of Iran Health Insurance, Fars, 2020

Background This study aimed to investigate the effect of COVID-19 epidemic on the rate of referral and costs of outpatient services covered by Iran Health Insurance, Fars, Iran. Methods In this cross-sectional study, we used data registry system of Iran health insurance to compare cost of outpatient services and referral time after occurring COVID-19 epidemic with the same time before it. Extracted items included; outpatients’ and complementary services. Statistical analyses were performed with Graph Pad Prism software version 8.0, Wilcoxon and Mann-Whitney test. Results Costs paid for all outpatient and imaging services significantly decreased in 2020 compared to 2019. Also, the number of prescriptions in all outpatient services has significantly decreased, while the number of imaging diagnostic tests significantly increased. Conclusion Further studies are recommended to evaluate whether the reduction in cost of services and referral times are due to underutilization of services or not.

Access and use of health services by quilombolas (inhabitants of black communities) with arterial hypertension

The present study aimed to describe the access and use of health services by hypertensive individuals living in quilombola communities in Bahia. This is a population-based descriptive investigation, with data obtained through the application of a validated questionnaire for the quilombola population,> 18 years old, of both sexes. Hypertension was determined by self-referral medical diagnosis. And, questions regarding access and use of the system and health were obtained. Blood pressure was measured by 72.7% of participants in the last six months. Hypertension was prevalent in 28.0% of the population, higher in the elderly and in women. The diagnoses occurred at 55.3+14.7 years on average. Among the sick, 55.5% cited consultations to monitor their clinical status, while 49.7% purchased all medicines from public health services. There is a discontinuity of assistance or use of health services, so it seems a misconception the indication of underutilization of services by quilombolas, the problem is the absence and / or barriers to access and accessibility for appropriate use to demand.

Returning Veterans’ Experiences of a Holistic Therapeutic Program

Since 2001, over 2.7 million U.S. military service members have been deployed (Wenger et al., 2018). Many of these soldiers have encountered serious challenges readjusting upon their return home and many may not access the services needed to achieve successful reintegration. Current literature calls for holistic approaches to service provision, involving collaboration of support services to address the underutilization of services. To better understand the gap in treatment utilization, a qualitative approach was used to examine returning veterans’ experiences of an intensive and holistic service delivery program implemented in coordination with local veterans’ organizations. Within the study, a generic qualitative approach was used to analyze interviews with 6 military veterans who had previously been deployed and were participating in the holistic therapeutic program. Results of the analysis revealed the following themes pertaining to participants’ experiences of the treatment process: (a) the importance of trusting relationships in the therapeutic setting; (b) importance of gaining adaptive coping strategies; (c) maintaining a sense of strength and independence; (d) difficulty with adjusting to civilian life and access of support services; and (e) difficulty with self-expression in civilian contexts. Limitations and recommendations are also provided.