Science.gov

Sample records for access health corp

  1. Mental health disorders in a cohort of U.S. Navy and Marine Corps personnel receiving waivers of medical accession standards.

    PubMed

    Krahl, Pamela L; Litow, Francesca K

    2009-03-01

    To assess risk of disability discharge in U.S. Navy and Marine Corps personnel receiving waivers of medical accession standards for mental health, we retrospectively identified a cohort of 22,960 waiver recipients from February 2001 to November 2005. Relative risk of Medical Evaluation Board (MEB) for any diagnosis was the same in the mental health waiver versus other waiver groups, but risk of MEB specifically for a mental health diagnosis was five times higher in the mental health waiver group. Also, risk of MEB for a musculoskeletal condition was significantly decreased in the mental health waiver group. Because of the high per-case compensation cost for mental health disability, this excess risk represents an estimated 32% higher disability compensation cost. We recommend further analysis of the waiver cohort to identify disqualifying conditions without excess disability risk. Targeting these conditions for policy changes could increase manpower without incurring long-term disability costs.

  2. The Chicago Health Corps: strengthening communities through structured volunteer service.

    PubMed

    McElmurry, B J; Wansley, R; Gugenheim, A M; Gombe, S; Dublin, P

    1997-01-01

    The Chicago Health Corps is an AmeriCorps*USA program, established in 1994 by the Corporation for National Service in partnership with the Health Resources and Services Administration (HRSA) of the U.S. Public Health Service. The Chicago Health Corps deploys 20 full-time equivalent corps members in selected community sites that offer primary health care services to Chicago's underserved families. Chicago Health Corps members provide a combination of outreach, home visit, and case management services to address unmet health needs identified by community members, including both laypersons and professionals. Providing meaningful opportunities for participants to assist their communities with health care helps corps members develop an awareness of their fellow community members and an ethic of service.

  3. The revitalization of the Public Health Service Commissioned Corps.

    PubMed

    Koop, C E; Ginzburg, H M

    1989-01-01

    The Public Health Service (PHS) is the second oldest uniformed service of the United States; its tradition commenced with the establishment of the Marine Hospital Service in 1798. Congress, in 1889, established the United States Public Health Service Commissioned Corps under the aegis of the Treasury. The Corps was created as a uniformed nonmilitary service with a distinct uniform, insignia, and with titles, pay, and retirement protocols that corresponded to those of the uniformed military services (the Armed Forces). Initially the health care system of the country, and Commissioned Corps members, were concerned with infectious and vitamin-deficiency diseases; more recently the nation's medical community has focused on cardiovascular diseases, cancer, and AIDS. A comprehensive revitalization of the Commissioned Corps began in April 1987. The intent was to restore the Commissioned Corps to its traditional leadership role as a cadre of mobile, compassionate experts ensuring the nation's health. The revitalization activities have been successful. The Commissioned Corps has approximately 5,500 active duty officers. The Surgeon General directed the development of career tracks for 11 categories of commissioned officers to increase the opportunities for professional development within the PHS and thus increase retention and professional growth. The theme for the 1989 celebration of the centennial of the Commissioned Corps is "a century of service with distinction." A hundred years from now, at the bicentennial of the Commissioned Corps, the current Surgeon General would like it to be said that the Public Health Service has had "two centuries of service with distinction."

  4. Peace Corps Partnered Health Services Implementation Research in Global Health: Opportunity for Impact

    PubMed Central

    Hedrick, Chris; Ndiaye, Youssoupha; Linn, Annē

    2014-01-01

    Background: There is abundant evidence of the affordable, life-saving interventions effective at the local primary health care level in low- and middle-income countries (LMICs). However, the understanding of how to deliver those interventions in diverse settings is limited. Primary healthcare services implementation research is needed to elucidate the contextual factors that can influence the outcomes of interventions, especially at the local level. US universities commonly collaborate with LMIC universities, communities, and health system partners for health services research but common barriers exist. Current challenges include the capacity to establish an ongoing presence in local settings in order to facilitate close collaboration and communication. The Peace Corps is an established development organization currently aligned with local health services in many LMICs and is well-positioned to facilitate research partnerships. This article explores the potential of a community–Peace Corps–academic partnership approach to conduct local primary healthcare services implementation research. Discussion: The Peace Corps is well positioned to offer insights into local contextual factors because volunteers work closely with local leaders, have extensive trust within local communities, and have an ongoing, constant, well-integrated presence. However, the Peace Corps does not routinely conduct primary healthcare services implementation research. Universities, within the United States and locally, could benefit from the established resources and trust of the Peace Corps to conduct health services implementation research to advance access to local health services and further the knowledge of real world application of local health services in a diversity of settings. The proposed partnership would consist of (1) a local community advisory board and local health system leaders, (2) Peace Corps volunteers, and (3) a US-LMIC academic institutional collaboration. Within the

  5. Culture shock and a peace corps field mental health program.

    PubMed

    Arnold, C B

    1967-03-01

    The Peace Corps has developed a unique mental health guidance program to facilitate the selection and training of volunteers. It is pointed out, however, that there are some limitations in this overall program. The Peace Corps staff physician acts as the activator of preventive and curative psychiatric resources in the field. Culture shock provides the focal point for nearly all overseas adjustment problems. The author devised a field mental health program upon group therapy precepts in order to minimize the effects of adjustment dilemmas. A preliminary evaluation of this type of program with the Bolivian Peace Corps contingent indicates it is effective.

  6. Healthy Volunteer 2020: Comparing Peace Corps Volunteers' health metrics with Healthy People 2020 national objectives.

    PubMed

    Henderson, Susan J; Newman, Jeannette; Ferguson, Rennie W; Jung, Paul

    2016-12-01

    Healthy People 2020 (HP2020) provides a set of quantifiable objectives for improving the health and well-being of Americans. This study examines Peace Corps Volunteers' health metrics in comparison with the Leading Health Indicators (LHIs) in order to set baseline measures for Volunteers' health care and align our measurements with Healthy People 2020 standards. Health data from multiple internal Peace Corps datasets were compared with relevant LHIs and analyzed using descriptive statistics. Seventeen (65%) of the 26 LHIs were relevant to Peace Corps Volunteers. Of these, Volunteers' health measures met or were more favorable than the goals of 13 (76%) of the LHIs. There were no data available for 4 (24%) of the LHIs. The entire Volunteer population has full access to primary care, oral health, and reproductive health services. No suicides or homicides were reported among Volunteers during the analyzed time period. Utilizing the LHIs, we have identified high-priority public health issues relevant for the Peace Corps Volunteer population. We discuss the need for quality data to measure and monitor Volunteers' health progress and outcomes over time, and also to standardize our measurements with Healthy People 2020 benchmarks. This framework may foster greater collaboration to engage in health promotion and disease prevention activities driven by evidence-based information, which may, in turn, encourage healthy behavior among Volunteers.

  7. The revitalization of the Public Health Service Commissioned Corps.

    PubMed Central

    Koop, C E; Ginzburg, H M

    1989-01-01

    The Public Health Service (PHS) is the second oldest uniformed service of the United States; its tradition commenced with the establishment of the Marine Hospital Service in 1798. Congress, in 1889, established the United States Public Health Service Commissioned Corps under the aegis of the Treasury. The Corps was created as a uniformed nonmilitary service with a distinct uniform, insignia, and with titles, pay, and retirement protocols that corresponded to those of the uniformed military services (the Armed Forces). Initially the health care system of the country, and Commissioned Corps members, were concerned with infectious and vitamin-deficiency diseases; more recently the nation's medical community has focused on cardiovascular diseases, cancer, and AIDS. A comprehensive revitalization of the Commissioned Corps began in April 1987. The intent was to restore the Commissioned Corps to its traditional leadership role as a cadre of mobile, compassionate experts ensuring the nation's health. The revitalization activities have been successful. The Commissioned Corps has approximately 5,500 active duty officers. The Surgeon General directed the development of career tracks for 11 categories of commissioned officers to increase the opportunities for professional development within the PHS and thus increase retention and professional growth. The theme for the 1989 celebration of the centennial of the Commissioned Corps is "a century of service with distinction." A hundred years from now, at the bicentennial of the Commissioned Corps, the current Surgeon General would like it to be said that the Public Health Service has had "two centuries of service with distinction." Images p106-a p107-a p107-b p108-a p109-a PMID:2495543

  8. 75 FR 13805 - Aspen Group Resources Corp., Commercial Concepts, Inc., Desert Health Products, Inc., Equalnet...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-23

    ... COMMISSION Aspen Group Resources Corp., Commercial Concepts, Inc., Desert Health Products, Inc., Equalnet Communications Corp., Geneva Steel Holdings Corp., Orderpro Logistics, Inc. (n/k/a Securus Renewable Energy, Inc... Aspen Group Resources Corp. because it has not filed any periodic reports since the period ended...

  9. A nutrition/health training program for Peace Corps volunteers.

    PubMed

    Bahl, S M; Orban, D A; Montoya, I D

    1989-01-01

    Nutrition and health education is a crucial component of the overall mission of the Peace Corps program. Individuals selected to work as Peace Corps volunteers need to be well prepared to perform this complex and challenging job in recipient countries. This article presents a model for a training program for Peace Corps trainees that was conducted over a 5-week period. The program was planned in accordance with some specific training guidelines that were provided by the Peace Corps. The trainees included nine women ranging in age from 22 to 61 years with diverse backgrounds; however, all had a BA/BS in a health-related discipline. Training curriculum included fundamental nutrition and health-related areas: basic nutrition, foods, clinical nutrition, maternal and child health, communicable diseases and sanitation, health strategies, and community development. Fifty percent of the curriculum was devoted to "hands-on" practical and clinical activities. Maternal and child health was emphasized in the training curriculum as this is an area of concern in all developing countries. The trainees were evaluated by weekly quizzes as well as completion of a special project involving applications of all their newly acquired skills. Implications of the training program are discussed.

  10. 42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Corps Personnel § 23.13 What nondiscrimination requirements apply to National Health Service Corps sites? National Health Service Corps sites are advised that in addition to complying with the terms and conditions... 42 Public Health 1 2010-10-01 2010-10-01 false What nondiscrimination requirements apply...

  11. 42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Corps Personnel § 23.13 What nondiscrimination requirements apply to National Health Service Corps sites? National Health Service Corps sites are advised that in addition to complying with the terms and conditions... 42 Public Health 1 2011-10-01 2011-10-01 false What nondiscrimination requirements apply...

  12. Lessons Learned from a Data-Driven College Access Program: The National College Advising Corps

    ERIC Educational Resources Information Center

    Horng, Eileen L.; Evans, Brent J.; antonio, anthony l.; Foster, Jesse D.; Kalamkarian, Hoori S.; Hurd, Nicole F.; Bettinger, Eric P.

    2013-01-01

    This chapter discusses the collaboration between a national college access program, the National College Advising Corps (NCAC), and its research and evaluation team at Stanford University. NCAC is currently active in almost four hundred high schools and through the placement of a recent college graduate to serve as a college adviser provides…

  13. 32 CFR 22.520 - Campus access for military recruiting and Reserve Officer Training Corps (ROTC).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... higher education during the period of performance of this agreement, the Government will cease all... of higher education that have policies or practices, as described in paragraph (c) of this section... Officer Training Corps Program Access to Institutions of Higher Education.” Part 216...

  14. 32 CFR 22.520 - Campus access for military recruiting and Reserve Officer Training Corps (ROTC).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... higher education during the period of performance of this agreement, the Government will cease all... of higher education that have policies or practices, as described in paragraph (c) of this section... Officer Training Corps Program Access to Institutions of Higher Education.” Part 216...

  15. 77 FR 11557 - National Advisory Council on the National Health Service Corps; Request for Nominations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-27

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Request for Nominations AGENCY: Health Resources and Services Administration, Department of Health and Human Services. ACTION: Notice. SUMMARY: The Health Resources and Services...

  16. Fairness, health, and access.

    PubMed

    Gusmano, Michael

    2013-01-01

    During the past two years, much of my work at The Hastings Center has explored the implementation of health reform in the United States and its implications for poor and vulnerable groups. These projects include a study of access to care for undocumented patients and one that examines state-level decisions about health reform, including Medicaid expansion and the creation of health insurance "marketplaces." Both raise issues central to bioethics, including fairness, justice, and the stewardship of society's resources. Our nation spent about 2.7 trillion dollars on health care in 2012, and its major public health insurance programs represent over 20 percent of the federal budget. Despite these investments, there are troubling differences in life expectancy, infant mortality, and premature death depending on factors like income, race, ethnicity, gender, and where people live. © 2013 by The Hastings Center.

  17. 75 FR 36427 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-25

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Notice of Meeting In accordance with section 10(a)(2) of the Federal Advisory... Council on the National Health Service Corps (NHSC). Date and Time: August 4, 2010, 9 a.m.-4 p.m. Place...

  18. Evaluating the Effectiveness of Navy Medical Corps Accession Programs

    DTIC Science & Technology

    2012-03-01

    GAO General Accounting Office GME Graduate Medical Education GMO General Medical Officer GPA Grade Point Average xiv HPLRP Health...supersede, or automatically promote, to O-3. At this juncture, a student will begin internship training, followed by a General Medical Officer ( GMO ) or...medical students will not complete a GMO or FS tour, and they will instead continue on through residency and fellowship training. This is commonly

  19. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Health Service Corps scholarship program? 62.1 Section 62.1 Public Health PUBLIC HEALTH SERVICE... SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.1 What is the scope and purpose of the National Health Service Corps scholarship program? These regulations apply to...

  20. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Health Service Corps scholarship program? 62.1 Section 62.1 Public Health PUBLIC HEALTH SERVICE... SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.1 What is the scope and purpose of the National Health Service Corps scholarship program? These regulations apply to...

  1. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Health Service Corps scholarship program? 62.1 Section 62.1 Public Health PUBLIC HEALTH SERVICE... SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.1 What is the scope and purpose of the National Health Service Corps scholarship program? These regulations apply to...

  2. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Health Service Corps scholarship program? 62.1 Section 62.1 Public Health PUBLIC HEALTH SERVICE... SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.1 What is the scope and purpose of the National Health Service Corps scholarship program? These regulations apply to...

  3. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Health Service Corps scholarship program? 62.1 Section 62.1 Public Health PUBLIC HEALTH SERVICE... SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.1 What is the scope and purpose of the National Health Service Corps scholarship program? These regulations apply to...

  4. 75 FR 25887 - Order of Suspension of Trading; In the Matter of Alyn Corp., American HealthChoice, Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-10

    ... Stellar Energy, Inc. (n/k/a Tara Gold Resources Corp.), Americare Health Scan, Inc. (f/k/a United Products..., Inc. (n/k/a Tara Gold Resources Corp.) because it has not filed any periodic reports since September...

  5. 42 CFR 23.9 - What must an entity to which National Health Service Corps personnel are assigned (i.e., a...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What must an entity to which National Health Service Corps personnel are assigned (i.e., a National Health Service Corps site) charge for the provision... Service Corps Personnel § 23.9 What must an entity to which National Health Service Corps personnel...

  6. 42 CFR 23.9 - What must an entity to which National Health Service Corps personnel are assigned (i.e., a...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false What must an entity to which National Health Service Corps personnel are assigned (i.e., a National Health Service Corps site) charge for the provision... Service Corps Personnel § 23.9 What must an entity to which National Health Service Corps personnel...

  7. Holding up the oral health safety net: the role of National Health Service Corps alumni dentists in North Carolina.

    PubMed

    Bhatavadekar, Neel B; Rozier, R Gary; Konrad, Thomas R

    2011-06-01

    Access to oral health care among low income populations is a growing problem. The National Health Service Corps (NHSC) might increase the supply of dentists motivated to provide services for this population.   To determine if North Carolina dentists who began a service obligation with the NHSC in 1990-1999 continued to provide care for underserved populations and if they differ from non-NHSC alumni primary care dentists who started practice in the state during that same period.   All 19 NHSC alumni and 50 comparison dentists were surveyed by mail. NHSC alumni also responded to selected items in a telephone follow-up interview. The two groups were compared using difference of means tests and multivariate contingency tables.   National Health Service Corps alumni were more likely to be African-American (38%vs. 10%), work in safety net practices (84%vs. 23%), and see more publicly insured patients (60%vs. 19%) than comparison dentists. Yet their job satisfaction was comparable to non-NHSC alumni dentists. Analyses suggested that current practice in safety net settings is affected by dentists' race, altruistic motivations and previous NHSC participation. CONCLUSION AND POLICY IMPLICATION:  Targeted recruitment of African-American dentists and others wanting to work in underserved communities could amplify the effectiveness of the financial incentive of NHSC loan repayment and induce dentists to remain in 'safety net' settings. © 2011 FDI World Dental Federation.

  8. Fine-Grained Access Control for Electronic Health Record Systems

    NASA Astrophysics Data System (ADS)

    Hue, Pham Thi Bach; Wohlgemuth, Sven; Echizen, Isao; Thuy, Dong Thi Bich; Thuc, Nguyen Dinh

    There needs to be a strategy for securing the privacy of patients when exchanging health records between various entities over the Internet. Despite the fact that health care providers such as Google Health and Microsoft Corp.'s Health Vault comply with the U.S Health Insurance Portability and Accountability Act (HIPAA), the privacy of patients is still at risk. Several encryption schemes and access control mechanisms have been suggested to protect the disclosure of a patient's health record especially from unauthorized entities. However, by implementing these approaches, data owners are not capable of controlling and protecting the disclosure of the individual sensitive attributes of their health records. This raises the need to adopt a secure mechanism to protect personal information against unauthorized disclosure. Therefore, we propose a new Fine-grained Access Control (FGAC) mechanism that is based on subkeys, which would allow a data owner to further control the access to his data at the column-level. We also propose a new mechanism to efficiently reduce the number of keys maintained by a data owner in cases when the users have different access privileges to different columns of the data being shared.

  9. 76 FR 13438 - AccessTel, Inc., American Asset Management Corp., DME Interactive Holdings, Inc., DocuPort, Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-11

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION AccessTel, Inc., American Asset Management Corp., DME Interactive Holdings, Inc., DocuPort, Inc... is a lack of current and accurate information concerning the securities of DME Interactive...

  10. [The concepts of health access].

    PubMed

    Sanchez, Raquel Maia; Ciconelli, Rozana Mesquita

    2012-03-01

    This article describes four dimensions of health access-availability, acceptability, ability to pay and information-correlating these dimensions to indicators and discussing the complexity of the concept of access. For a study of these four dimensions, searches were conducted using the PubMed/MEDLINE, LILACS, SciELO, and World Health Organization Library & Information Networks for Knowledge (WHOLIS) databases. Large-circulation media vehicles, such as The Economist, The Washington Post, and the BBC network were also searched. The concept of health access has become more complex with time. The first analyses, carried out in the 1970s, suggested a strong emphasis on geographical (availability) and financial (ability to pay) aspects. More recently, the literature has focused on less tangible aspects, such as cultural, educational, and socioeconomic issues, incorporating the element of acceptability into the notion of health access. The literature also shows that information provides the starting point for access to health, in association with health empowerment and literacy for health care decision-making. The study concludes that improvements in access to health and the guarantee of equity will not be achieved by initiatives focusing on health care systems alone, but rather will depend on intersectoral actions and social and economic policies aimed at eliminating income and education differences.

  11. 42 CFR 23.8 - What operational requirements apply to an entity to which National Health Service Corps personnel...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What operational requirements apply to an entity to which National Health Service Corps personnel are assigned? 23.8 Section 23.8 Public Health PUBLIC... Assignment of National Health Service Corps Personnel § 23.8 What operational requirements apply to an entity...

  12. The U.S. Public Health Service Commissioned Corps: a need for engineers.

    PubMed

    Holcomb, W F

    2000-12-01

    In 1798, President John Adams signed the bill creating the Marine Hospital Service to medically care for U.S. merchant seamen. That agency is known today as the U.S. Public Health Service (PHS). In 1918, the PHS Commissioned Corps commissioned sanitary engineers in the Reserve Corps, and in 1930, President Herbert Hoover signed the Parker Act authorizing sanitary engineers to be part of the regular Commissioned Corps. During the world war years, PHS engineers were detailed to improve sanitation for military bases in the United States and abroad. In the 1960s, most PHS engineers served in the Indian Health Service, upgrading sanitation facilities for American Indians and Alaskan Natives. During the 1970s, PHS engineers were involved in providing an integrated and coordinated attack on environmental issues. Today, PHS engineers are involved with many aspects of public health protection and have been detailed around the world to provide emergency assistance in the wake of disasters.

  13. The viability of hearing protection device fit-testing at navy and marine corps accession points.

    PubMed

    Federman, Jeremy; Duhon, Christon

    2016-01-01

    The viability of hearing protection device (HPD) verification (i.e., fit-testing) on a large scale was investigated to address this gap in a military accession environment. Personal Attenuation Ratings (PARs) following self-fitted (SELF-Fit) HPDs were acquired from 320 US Marine Corps training recruits (87.5% male, 12.5% female) across four test protocols (1-, 3-, 5-, and 7- frequency). SELF-Fit failures received follow-up to assess potential causes. Follow-up PARs were acquired (Experimenter fit [EXP-Fit], followed by Subject re-fit [SUB Re-Fit]). EXP-Fit was intended to provide a perception (dubbed "ear canal muscle memory") of what a correctly fitted HPD should feel like. SUB Re-Fit was completed following EXP-Fit to determine whether a training recruit could duplicate EXP-Fit on her/his own without assistance. A one-way analysis of variance (ANOVA) (N = 320) showed that SELF-Fit means differed significantly between protocols (P < 0.001). Post-hoc analyses showed that the 1-freq SELF-Fit mean was significantly lower than all other protocols (P < 0.03) by 5.6 dB or more. No difference was found between the multi-frequency protocols. For recruits who were followed up with EXP-Fit (n = 79), across all protocols, a significant (P < 0.001) mean improvement of 25.68 dB (10.99) was found, but PARs did not differ (P = 0.99) between EXP-Fit protocols. For recruits in the 3-freq and 5-freq protocol groups who experienced all three PAR test methods (n = 33), PAR methods differed (P < 0.001) but no method by protocol interaction was found (P = 0.46). Post hoc tests showed that both EXP-Fit and SUB Re-Fit had significantly better attenuation than SELF-Fit (P < 0.001), but no difference was found between EXPFit and SUB Re-Fit (P = 0.59). For SELF-Fit, the 1-freq protocol resulted in a 35% pass rate, whereas the 3-, 5-, and 7-freq protocols resulted in >60% pass rates. Results showed that once recruits experienced how HPDs should

  14. The Viability of Hearing Protection Device Fit-Testing at Navy and Marine Corps Accession Points

    PubMed Central

    Federman, Jeremy; Duhon, Christon

    2016-01-01

    Introduction: The viability of hearing protection device (HPD) verification (i.e., fit-testing) on a large scale was investigated to address this gap in a military accession environment. Materials and Methods: Personal Attenuation Ratings (PARs) following self-fitted (SELF-Fit) HPDs were acquired from 320 US Marine Corps training recruits (87.5% male, 12.5% female) across four test protocols (1-, 3-, 5-, and 7- frequency). SELF-Fit failures received follow-up to assess potential causes. Follow-up PARs were acquired (Experimenter fit [EXP-Fit], followed by Subject re-fit [SUB Re-Fit]). EXP-Fit was intended to provide a perception (dubbed “ear canal muscle memory”) of what a correctly fitted HPD should feel like. SUB Re-Fit was completed following EXP-Fit to determine whether a training recruit could duplicate EXP-Fit on her/his own without assistance. Results: A one-way analysis of variance (ANOVA) (N=320) showed that SELF-Fit means differed significantly between protocols (P < 0.001). Post-hoc analyses showed that the 1-freq SELF-Fit mean was significantly lower than all other protocols (P < 0.03) by 5.6 dB or more. No difference was found between the multi-frequency protocols. For recruits who were followed up with EXP-Fit (n=79), across all protocols, a significant (P < 0.001) mean improvement of 25.68 dB (10.99) was found, but PARs did not differ (P = 0.99) between EXP-Fit protocols. For recruits in the 3-freq and 5-freq protocol groups who experienced all three PAR test methods (n=33), PAR methods differed (P < 0.001) but no method by protocol interaction was found (P = 0.46). Post hoc tests showed that both EXP-Fit and SUB Re-Fit had significantly better attenuation than SELF-Fit (P < 0.001), but no difference was found between EXPFit and SUB Re-Fit (P = 0.59). For SELF-Fit, the 1-freq protocol resulted in a 35% pass rate, whereas the 3-, 5-, and 7-freq protocols resulted in >60% pass rates. Results showed that once recruits experienced how HPDs should

  15. 78 FR 42803 - Comment Request for Information Collection for Job Corps Health Questionnaire (OMB Control No...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-17

    ... Employment and Training Administration Comment Request for Information Collection for Job Corps Health Questionnaire (OMB Control No. 1205-0033, Extension With Minor Revisions) AGENCY: Employment and Training Administration (ETA), Labor. ACTION: Notice. SUMMARY: The Department of Labor, as part of its continuing...

  16. Study of Public Health Service (PHS) Scholarship Recipients and National Health Service Corps (NHSC) Participants. Final Report.

    ERIC Educational Resources Information Center

    Association of American Medical Colleges, Washington, DC.

    In order to aid the Public Health Service in selecting scholarship recipients who will help to correct the current physician speciality and geographic maldistribution problems, this study compares specific characteristics of PHS scholarship recipients to medical students and to physicians participating in the National Health Service Corps (NHSC).…

  17. 77 FR 4332 - Recruitment of Sites for Assignment of National Health Service Corps Loan Repayors (FY 2012)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-27

    ... serving as Corps members (i.e. Federal employees or Private Practice Assignees), as well as NHSC LRP... assignment of Corps members; (d) made unsuccessful efforts to recruit health care providers; (e) a reasonable... the NHSC. The NHSC site approval is good for a period of 3 years from the date of approval. Entities...

  18. The Effect of Active Duty Presence on High Quality Enlisted Accessions in the Marine Corps

    DTIC Science & Technology

    2016-12-01

    areas for sales, advertising, or even employee recruiting . In a 1989 article, Sleight and Leventhal explore the advantages of geodemographics (GD) in... recruiting , recruiting , geographic information system, geospatial analysis 15. NUMBER OF PAGES 103 16. PRICE CODE 17. SECURITY CLASSIFICATION OF...7 B. MARINE CORPS RECRUITING ...........................................................7 1

  19. Impact of Title VII training programs on community health center staffing and national health service corps participation.

    PubMed

    Rittenhouse, Diane R; Fryer, George E; Phillips, Robert L; Miyoshi, Thomas; Nielsen, Christine; Goodman, David C; Grumbach, Kevin

    2008-01-01

    Community health centers (CHCs) are a critical component of the health care safety net. President Bush's recent effort to expand CHC capacity coincides with difficulty recruiting primary care physicians and substantial cuts in federal grant programs designed to prepare and motivate physicians to practice in underserved settings. This article examines the association between physicians' attendance in training programs funded by Health Resources and Services Administration (HRSA) Title VII Section 747 Primary Care Training Grants and 2 outcome variables: work in a CHC and participation in the National Health Service Corps Loan Repayment Program (NHSC LRP). We linked the 2004 American Medical Association Physician Master-file to HRSA Title VII grants files, Medicare claims data, and data from the NHSC. We then conducted retrospective analyses to compare the proportions of physicians working in CHCs among physicians who either had or had not attended Title VII-funded medical schools or residency programs and to determine the association between having attended Title VII-funded residency programs and subsequent NHSC LRP participation. Three percent (5,934) of physicians who had attended Title VII-funded medical schools worked in CHCs in 2001-2003, compared with 1.9% of physicians who attended medical schools without Title VII funding (P<.001). We found a similar association between Title VII funding during residency and subsequent work in CHCs. These associations remained significant (P<.001) in logistic regression models controlling for NHSC participation, public vs private medical school, residency completion date, and physician sex. A strong association was also found between attending Title VII-funded residency programs and participation in the NHSC LRP, controlling for year completed training, physician sex, and private vs public medical school. Continued federal support of Title VII training grant programs is consistent with federal efforts to increase

  20. The role of the US Army Veterinary Corps in military family pet health.

    PubMed

    Vincent-Johnson, Nancy A

    2013-01-01

    Even though privately-owned pet care is a lower priority mission than military working dog care, food inspection,and the public health mission, it is still very important,and the one that many Veterinary Corps officers, civil-ian veterinarians, and technicians enjoy the most. The vast majority of veterinarians and technicians went into veterinary medicine because of a love for animals. It is fulfilling to offer guidance to a client with a new puppy or kitten, see a sick pet improve after treatment, and interact with dozens of animals and clients in a day. The services provided by the Army Veterinary Corps in car-ing for pets has expanded over the years and the standard of care has improved as well. It is truly a privilege to serve those who dedicate themselves to the protection of our Nation. The Army Veterinary Corps is indeed proud to provide care to the pets of Warfighters of the Army,Navy, Marine Corps, Air Force, and Coast Guard; their family members; and our military retirees.

  1. Singapore Armed Forces Medical Corps-Ministry of Health clinical practice guidelines: management of heat injury.

    PubMed

    Lee, L; Fock, K M; Lim, C L F; Ong, E H M; Poon, B H; Pwee, K H; O'Muircheartaigh, C R; Seet, B; Tan, C L B; Teoh, C S

    2010-10-01

    The Singapore Armed Forces (SAF) Medical Corps and the Ministry of Health (MOH) have published clinical practice guidelines on Management of Heat Injury to provide doctors and patients in Singapore with evidence-based guidance on the prevention and clinical management of exertional heat injuries. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the SAF Medical Corps-MOH clinical practice guidelines on Management of Heat Injury, for the information of readers of the Singapore Medical Journal. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/mohcorp/publications.aspx?id=25178. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

  2. Suspension of enrollment in the Federal Employees Health Benefits (FEHB) Program for Peace Corps volunteers. Final rule.

    PubMed

    2006-11-17

    The Office of Personnel Management is issuing a final regulation to allow Peace Corps volunteers who are FEHB Program enrolled annuitants, survivors, and former spouses to suspend their FEHB enrollments and then return to the FEHB Program during the Open Season, or return to FEHB coverage immediately, if they involuntarily lose health benefits coverage under the Peace Corps. The intent of this final rule is to allow these beneficiaries to avoid the expense of continuing to pay FEHB Program premiums while they have other health coverage as Peace Corps volunteers, without endangering their ability to return to the FEHB Program in the future.

  3. Health Professions Education/Nurse Training and National Health Service Corps, 1981. Hearing Before the Committee on Labor and Human Resources, United States Senate, Ninety-Seventh Congress, First Session on S. 799 [and] S. 801 (April 8, 1981).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    This congressional report contains testimony pertaining to two Senate bills (S. 99 and S. 801) dealing with health professions education and nurse training and with the National Health Service Corps. (The National Health Service Corps Bill, S. 801, provides for redefining health manpower shortage areas, using the Corps only where there is…

  4. National Health Service Corps Improvement Act of 2013

    THOMAS, 113th Congress

    Sen. Pryor, Mark L. [D-AR

    2013-08-01

    Senate - 08/01/2013 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  5. National Health Service Corps Improvement Act of 2012

    THOMAS, 112th Congress

    Sen. Pryor, Mark L. [D-AR

    2012-03-15

    Senate - 03/15/2012 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  6. Behaviors and Knowledge of HealthCorps New York City High School Students: Nutrition, Mental Health, and Physical Activity.

    PubMed

    Heo, Moonseong; Irvin, Erica; Ostrovsky, Natania; Isasi, Carmen; Blank, Arthur E; Lounsbury, David W; Fredericks, Lynn; Yom, Tiana; Ginsberg, Mindy; Hayes, Shawn; Wylie-Rosett, Judith

    2016-02-01

    HealthCorps provides school wellness programming using curricula to promote changes in nutrition, mental health, and physical activity behaviors. The research objective was to evaluate effects of implementing its curricula on nutrition, mental health, and physical activity knowledge and behavior. Pre- and postsurvey data were collected (N = 2255) during the 2012-2013 academic year from 14 New York City public high schools. An 18-item knowledge questionnaire addressed 3 domains; 26 behavioral items were analyzed by factor analysis to identify 6 behavior domains, breakfast being a seventh 1-item domain. We examined the effects stratified by sex, applying mixed-effects models to take into account clustering effects of schools and participants adjusted for age. The HealthCorps program significantly increased all 3 knowledge domains (p < .05), and significantly changed several key behavioral domains. Boys significantly increased fruits/vegetables intake (p = .03). Girls increased acceptance of new fruits/vegetables (p = .03) and breakfast consumption (p = .04), and decreased sugar-sweetened beverages and energy dense food intake (p = .03). The associations between knowledge and behavior were stronger in boys than girls. The HealthCorps program significantly increased participants' knowledge on nutrition, mental health, and physical activity. It also improved several key behavioral domains, which are targets of the 2010 Dietary Guidelines to address obesity in youth. © 2016, American School Health Association.

  7. Engaging Student Health Organizations in Reducing Health Disparities in Underserved Communities through Volunteerism: Developing a Student Health Corps

    PubMed Central

    Mays, Vickie M.; Ly, Lichin; Allen, Erica; Young, Sophia

    2013-01-01

    One underutilized method for reducing health disparities and training culturally competent health care workers is the engagement of undergraduate student health organizations in conducting health screenings, promotion, and health education outreach activities in in underserved racial/ethnic communities. We conducted a needs assessment of 14 predominantly racial/ethnic minority undergraduate student-run health organizations. The 14 organizations annually served approximately 12,425 people (67% Hispanic, 25% African American, 6.33% Asian Pacific Islander), predominantly at health fairs within Los Angeles County (averaging 138 attendees). Student organizations provided screenings on general health conditions and diseases, with less emphasis on behavioral risk factors (e.g., drinking, smoking). Organizations indicated a need for increased and affordable trainings in preventive health screenings and help in understanding target populations’ needs. Universities are in an excellent position to train, supervise, and organize volunteer health corps in order to engage students in reducing health disparities and to train culturally competent health care providers. PMID:19648716

  8. Behaviors and Knowledge of HealthCorps New York City High School Students: Nutrition, Mental Health and Physical Activity

    PubMed Central

    Moonseong, Heo; Erica, Irvin; Natania, Ostrovsky; Carmen, Isasi; Shawn, Hayes; Judith, Wylie-Rosett

    2015-01-01

    BACKGROUND HealthCorps provides school wellness programming using curricula to promote changes in nutrition, mental health and physical activity behaviors. The research objective was to evaluate effects of implementing its curricula on nutrition, mental health and physical activity knowledge and behavior. METHODS Pre- and post-survey data were collected (N = 2255) during the 2012-13 academic year from 14 New York City public high schools. An 18-item knowledge questionnaire addressed 3 domains; 26 behavioral items were analyzed by factor analysis to identify 6 behavior domains, breakfast being a seventh one-item domain. We examined the effects stratified by sex, applying mixed-effects models to take into account clustering effects of schools and participants adjusted for age. RESULTS The HealthCorps program significantly increased all 3 knowledge domains (p < .05), and significantly changed several key behavioral domains. Boys significantly increased fruits/vegetables intake (p = .03). Girls increased acceptance of new fruits/vegetables (p = .03) and breakfast consumption (p = .04), and decreased sugar-sweetened beverages and energy dense food intake (p = .03). The associations between knowledge and behavior were stronger in boys than girls. CONCLUSION The HealthCorps program significantly increased participants’ knowledge on nutrition, mental health and physical activity. It also improved several key behavioral domains, which are targets of the 2010 Dietary Guidelines to address obesity in youth. PMID:26762819

  9. 42 CFR 23.6 - What are the criteria for determining the entities to which National Health Service Corps...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... health manpower shortage area. (b) In assigning National Health Service Corps personnel to serve in a health manpower shortage area, the Secretary will seek to assign personnel who have those characteristics which will increase the probability of their remaining to serve in the health manpower shortage area...

  10. 42 CFR 23.6 - What are the criteria for determining the entities to which National Health Service Corps...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... health manpower shortage area. (b) In assigning National Health Service Corps personnel to serve in a health manpower shortage area, the Secretary will seek to assign personnel who have those characteristics which will increase the probability of their remaining to serve in the health manpower shortage area...

  11. 42 CFR 23.6 - What are the criteria for determining the entities to which National Health Service Corps...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... health manpower shortage area. (b) In assigning National Health Service Corps personnel to serve in a health manpower shortage area, the Secretary will seek to assign personnel who have those characteristics which will increase the probability of their remaining to serve in the health manpower shortage area...

  12. 42 CFR 23.6 - What are the criteria for determining the entities to which National Health Service Corps...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... health manpower shortage area. (b) In assigning National Health Service Corps personnel to serve in a health manpower shortage area, the Secretary will seek to assign personnel who have those characteristics which will increase the probability of their remaining to serve in the health manpower shortage area...

  13. 42 CFR 23.6 - What are the criteria for determining the entities to which National Health Service Corps...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... health manpower shortage area. (b) In assigning National Health Service Corps personnel to serve in a health manpower shortage area, the Secretary will seek to assign personnel who have those characteristics which will increase the probability of their remaining to serve in the health manpower shortage area...

  14. Accessibility: global gateway to health literacy.

    PubMed

    Perlow, Ellen

    2010-01-01

    Health literacy, cited as essential to achieving Healthy People 2010's goals to "increase quality and years of healthy life" and to "eliminate health disparities," is defined by Healthy People as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." Accessibility, by definition, the aforementioned "capacity to obtain," thus is health literacy's primary prerequisite. Accessibility's designation as the global gateway to health literacy is predicated also on life's realities: global aging and climate change, war and terrorism, and life-extending medical and technological advances. People with diverse access needs are health professionals' raison d'être. However, accessibility, consummately cross-cultural and universal, is virtually absent as a topic of health promotion and practice research and scholarly discussion of health literacy and equity. A call to action to place accessibility in its rightful premier position on the profession's agenda is issued.

  15. Health Care Access among Deaf People

    ERIC Educational Resources Information Center

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

  16. Health Care Access among Deaf People

    ERIC Educational Resources Information Center

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

  17. Marketing Public Health Through Older Adult Volunteering: Experience Corps as a Social Marketing Intervention

    PubMed Central

    Tanner, Elizabeth K.; Seeman, Teresa E.; Xue, Qian-Li; Rebok, George W.; Frick, Kevin D.; Carlson, Michelle C.; Wang, Tao; Piferi, Rachel L.; McGill, Sylvia; Whitfield, Keith E.; Fried, Linda P.

    2010-01-01

    Objectives. We present a social marketing conceptual framework for Experience Corps Baltimore City (EC) in which the desired health outcome is not the promoted product or behavior. We also demonstrate the feasibility of a social marketing–based recruitment campaign for the first year of the Baltimore Experience Corps Trial (BECT), a randomized, controlled trial of the health benefits of EC participation for older adults. Methods. We recruited older adults from the Baltimore, MD, area. Participants randomized to the intervention were placed in public schools in volunteer roles designed to increase healthy behaviors. We examined the effectiveness of a recruitment message that appealed to generativity (i.e., to make a difference for the next generation), rather than potential health benefits. Results. Among the 155 participants recruited in the first year of the BECT, the average age was 69 years; 87% were women and 85% were African American. Participants reported primarily generative motives as their reason for interest in the BECT. Conclusions. Public health interventions embedded in civic engagement have the potential to engage older adults who might not respond to a direct appeal to improve their health. PMID:20167888

  18. Marketing public health through older adult volunteering: Experience Corps as a social marketing intervention.

    PubMed

    Tan, Erwin J; Tanner, Elizabeth K; Seeman, Teresa E; Xue, Qian-Li; Rebok, George W; Frick, Kevin D; Carlson, Michelle C; Wang, Tao; Piferi, Rachel L; McGill, Sylvia; Whitfield, Keith E; Fried, Linda P

    2010-04-01

    We present a social marketing conceptual framework for Experience Corps Baltimore City (EC) in which the desired health outcome is not the promoted product or behavior. We also demonstrate the feasibility of a social marketing-based recruitment campaign for the first year of the Baltimore Experience Corps Trial (BECT), a randomized, controlled trial of the health benefits of EC participation for older adults. We recruited older adults from the Baltimore, MD, area. Participants randomized to the intervention were placed in public schools in volunteer roles designed to increase healthy behaviors. We examined the effectiveness of a recruitment message that appealed to generativity (i.e., to make a difference for the next generation), rather than potential health benefits. Among the 155 participants recruited in the first year of the BECT, the average age was 69 years; 87% were women and 85% were African American. Participants reported primarily generative motives as their reason for interest in the BECT. Public health interventions embedded in civic engagement have the potential to engage older adults who might not respond to a direct appeal to improve their health.

  19. Access to medicine and the dangers of patent linkage: lessons from Bayer Corp v. Union of India.

    PubMed

    Tsui, Mabel

    2011-03-01

    In February 2010, the Delhi High Court delivered its decision in Bayer Corp v Union of India in which Bayer had appealed against an August 2009 decision of the same court. Both decisions prevented Bayer from introducing the concept of patent linkage into India's drug regulatory regime. Bayer appealed to the Indian Supreme Court, the highest court in India, which agreed on 2 March 2010 to hear the appeal. Given that India is regarded as a global pharmaceutical manufacturer of generic medications, how its judiciary and government perceive their international obligations has a significant impact on the global access to medicines regime. In rejecting the application of patent linkage, the case provides an opportunity for India to further acknowledge its international human rights obligations.

  20. Empowering immigrant youth in Chicago: utilizing CBPR to document the impact of a Youth Health Service Corps program.

    PubMed

    Ferrera, Maria J; Sacks, Tina K; Perez, Miriam; Nixon, John P; Asis, Dale; Coleman, Walter L

    2015-01-01

    Community-based participatory research (CBPR) is an approach that engages community residents with a goal of influencing change in community health systems, programs, or policies. As such, CBPR is particularly relevant to historically marginalized communities that often have not directly benefited from the knowledge research produces. This article analyzes a youth empowerment program, Chicago's Youth Health Service Corps, from a CBPR perspective. The purpose of this work was (1) to discuss Youth Health Service Corps as a health promotion program, (2) examine the use of CBPR within the immigrant community, and (3) discuss preliminary findings using a model on critical youth empowerment.

  1. Health Care Access Among Deaf People.

    PubMed

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health knowledge for deaf people including those with even higher risk of marginalization. Examples of approaches to improve access to health care, such as providing powerful and visually accessible communication through the use of sign language, the implementation of important communication technologies, and cultural awareness trainings for health professionals are discussed. Programs that raise health knowledge in Deaf communities and models of primary health care centers for deaf people are also presented. Published documents can empower deaf people to realize their right to enjoy the highest attainable standard of health.

  2. Effective access to health care in Mexico

    PubMed Central

    2014-01-01

    Background Effective access measures are intended to reflect progress toward universal health coverage. This study proposes an operative approach to measuring effective access: in addition to the lack of financial protection, the willingness to make out-of-pocket payments for health care signifies a lack of effective access to pre-paid services. Methods Using data from a nationally representative health survey in Mexico, effective access at the individual level was determined by combining financial protection and effective utilization of pre-paid health services as required. The measure of effective access was estimated overall, by sex, by socioeconomic level, and by federal state for 2006 and 2012. Results In 2012, 48.49% of the Mexican population had no effective access to health services. Though this represents an improvement since 2006, when 65.9% lacked effective access, it still constitutes a major challenge for the health system. Effective access in Mexico presents significant heterogeneity in terms of federal state and socioeconomic level. Conclusions Measuring effective access will contribute to better target strategies toward universal health coverage. The analysis presented here highlights a need to improve quality, availability, and opportuneness (location and time) of health services provision in Mexico. PMID:24758691

  3. Effective access to health care in Mexico.

    PubMed

    Gutiérrez, Juan Pablo; García-Saisó, Sebastián; Dolci, Germán Fajardo; Hernández Ávila, Mauricio

    2014-04-23

    Effective access measures are intended to reflect progress toward universal health coverage. This study proposes an operative approach to measuring effective access: in addition to the lack of financial protection, the willingness to make out-of-pocket payments for health care signifies a lack of effective access to pre-paid services. Using data from a nationally representative health survey in Mexico, effective access at the individual level was determined by combining financial protection and effective utilization of pre-paid health services as required. The measure of effective access was estimated overall, by sex, by socioeconomic level, and by federal state for 2006 and 2012. In 2012, 48.49% of the Mexican population had no effective access to health services. Though this represents an improvement since 2006, when 65.9% lacked effective access, it still constitutes a major challenge for the health system. Effective access in Mexico presents significant heterogeneity in terms of federal state and socioeconomic level. Measuring effective access will contribute to better target strategies toward universal health coverage. The analysis presented here highlights a need to improve quality, availability, and opportuneness (location and time) of health services provision in Mexico.

  4. Trends in new U.S. Marine Corps accessions during the recent conflicts in Iraq and Afghanistan.

    PubMed

    Horton, Jaime L; Phillips, Christopher J; White, Martin R; LeardMann, Cynthia A; Crum-Cianflone, Nancy F

    2014-01-01

    The objective of this study was to analyze trends in preservice characteristics among Marine Corps recruits during the recent operations in Iraq and Afghanistan. Recruits completed a confidential survey during their first week of training at the Marine Corps Recruit Depot in San Diego, California. Demographics, behaviors, and health information were analyzed for trends from 2001 to 2010 using the Cochran-Armitage trend test and F statistic. Data from 131,961 male recruits with a mean age of 19.8 years were analyzed. Overall, entry characteristics remained stable exhibiting only modest changes over the study period. Favorable trends included recent (2009-2010) improvements in body mass index and physical activity levels. Unfavorable trends included increases in smokeless tobacco and caffeine use, and angry outbursts. Although many recruit characteristics remained similar over the past decade, both favorable and unfavorable trends in sociobehavioral characteristics were noted. The ongoing assessment of preservice characteristics is important for detecting emerging trends over time. Findings may guide leadership's understanding of changes to help develop early-service trainings promoting a healthier force and potentially reducing future adverse outcomes. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  5. U.S. Public Health Service Commissioned Corps Pharmacists: Making a Difference in Advancing the Nation’s Health

    PubMed Central

    Flowers, Louis; Wick, Jeannette; Figg, William Douglas; McClelland, Robert H.; Shiber, Michael; Britton, James E.; Ngo, Diem-Kieu H.; Borders-Hemphill, Vicky; Mead, Christina; Zee, Jerry; Huntzinger, Paul

    2010-01-01

    Objective To describe how pharmacy officers in the Commissioned Corps are making a difference in protecting, promoting, and advancing health and safety of the Nation. Summary Pharmacists who serve in the Commissioned Corps of the United States Public Health Service fill roles that are considerably different than their counterparts in the private sector. Their work takes them out from behind the counter and into the world. Pharmacy officers advance the health and safety of the Nation by their involvement in the delivery of direct patient care to medically underserved people, national security, drug vigilance, research and policy-making endeavors. PHS pharmacists fill essential public health leadership and service roles throughout the U.S. Department of Health and Human Services (HHS) and certain non-HHS federal agencies and programs. The Federal Bureau of Prisons, Health Resources and Services Administration, Food and Drug Administration, United States Coast Guard, Indian Health Service, and National Institutes of Health are among the many federal agencies where pharmacy officers are assigned. Conclusion In each setting, pharmacists find traditional roles augmented with assignments and challenges that broaden the scope of their practice. PMID:19443327

  6. Child Health and Access to Medical Care

    ERIC Educational Resources Information Center

    Leininger, Lindsey; Levy, Helen

    2015-01-01

    It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health.…

  7. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services” under...

  8. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services” under...

  9. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services” under...

  10. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services” under...

  11. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services” under...

  12. Negotiating Access to Health Information to Promote Students' Health

    ERIC Educational Resources Information Center

    Radis, Molly E.; Updegrove, Stephen C.; Somsel, Anne; Crowley, Angela A.

    2016-01-01

    Access to student health information, such as immunizations, screenings, and care plans for chronic conditions, is essential for school nurses to fulfill their role in promoting students' health. School nurses typically encounter barriers to accessing health records and spend many hours attempting to retrieve health information. As a result,…

  13. Negotiating Access to Health Information to Promote Students' Health

    ERIC Educational Resources Information Center

    Radis, Molly E.; Updegrove, Stephen C.; Somsel, Anne; Crowley, Angela A.

    2016-01-01

    Access to student health information, such as immunizations, screenings, and care plans for chronic conditions, is essential for school nurses to fulfill their role in promoting students' health. School nurses typically encounter barriers to accessing health records and spend many hours attempting to retrieve health information. As a result,…

  14. Health-related challenges in United States Peace Corps Volunteers serving for two years in Madagascar.

    PubMed

    Leutscher, Peter D C; Bagley, Sandra W

    2003-01-01

    The United States Peace Corps has nearly 8000 Volunteers (PCVs) working in more than 70 countries, predominantly in the developing part of the world. The volunteers are challenged by many new and unfamiliar health problems, as a result of change in living conditions during their service. The goal of this study was to assess the health problems of PCVs in Madagascar, and to use this information to evaluate the effectiveness of the current PCV health support program. PCVs, finalizing their 2 years of service, were enrolled in the study. Data were retrieved from individual Peace Corps service medical records, the close of service (COS) physical evaluation, and a PCV questionnaire, which elicited additional self-reported health problems and concerns. Sixty-nine PCVs took part in the study. Median age at COS was 24 years (95% CI 23-26 years), and the male/female ratio was 1 : 3.6 (15 males and 54 females). Skin, gastrointestinal and respiratory infections constituted the three most common reported health problems. Among the registered parasitic infections were ova and parasites in the stool (42.0%), confirmed and presumptive malaria (15.9%) and schistosomiasis (11.6%). Female PCVs more frequently reported dermatologic manifestations than male PCVs: postadolescent acne (48.2% vs. 13.3%) and telogen hair loss (33.3% vs. 6.7%). Amenorrhea, as the most commonly reported menstrual alteration during service, was reported by 15 (27.7%) female PCVs. The PCVs in Madagascar encounter a broad range of health-related problems, most of which are preventable infectious diseases. Reinforcement of the preservice personal health-training curriculum later during service is needed. Reported dermatologic and menstrual disturbances in female subjects may be associated with stress-related estrogen imbalance. More studies are warranted to assess the stress impact of long-term travel on the female physiology.

  15. Preparation for Childbirth. A Health Workers Manual. Appropriate Technologies for Development. Peace Corps Information Collection & Exchange Reprint R-55.

    ERIC Educational Resources Information Center

    Hansen, Miriam; And Others

    This manual was developed to help Peace Corps volunteers who are serving as community health workers in developing nations to teach expectant mothers about pregnancy and childbirth. The material is organized in four sections corresponding to four prenatal classes plus a section on labor and delivery information for health care workers. Some of the…

  16. Medical Reserve Corps Volunteers’ Ability and Willingness to Report to Work for the Department of Health During Catastrophic Disasters

    DTIC Science & Technology

    2007-03-01

    Volunteer motivation, cognitive dissonance and the nature of self selected volunteers are examined as they relate to these findings and strategies to...TERMS Public Health Surge Capacity; Volunteer Motivation; Ability and Willingness; Cognitive Dissonance ; Medical Reserve Corps; Public Health...barriers and enablers to report to work were identified. Volunteer motivation, cognitive dissonance and the nature of self selected volunteers are

  17. Negotiating Access to Health Information to Promote Students' Health.

    PubMed

    Radis, Molly E; Updegrove, Stephen C; Somsel, Anne; Crowley, Angela A

    2016-04-01

    Access to student health information, such as immunizations, screenings, and care plans for chronic conditions, is essential for school nurses to fulfill their role in promoting students' health. School nurses typically encounter barriers to accessing health records and spend many hours attempting to retrieve health information. As a result, nurses' time is poorly utilized and students may suffer adverse outcomes including delayed school entry. In response to this pressing public health issue, a school medical advisor and director of school nurses in a local health department successfully negotiated access for school nurses to three health record systems: a state immunization tracking system, an electronic lead surveillance program, and an electronic health record system. This negotiation process is presented within a framework of the Theory of Diffusion of Innovation and provides a strategy for other school nurses seeking access to student health information. © The Author(s) 2015.

  18. Accessing Talent: The Foundation of a U.S. Army Officer Corps Strategy

    DTIC Science & Technology

    2010-02-01

    SSI) publications enjoy full academic freedom, provided they do not disclose classified information, jeopardize operations security, or misrepresent...does not display a currently valid OMB control number. 1. REPORT DATE FEB 2010 2. REPORT TYPE 3. DATES COVERED 00-00-2010 to 00-00-2010 4...is that across virtually all ethnographic and demographic segments in the United States, the current generation of accessions-age young people is

  19. Globalization, global health, and access to healthcare.

    PubMed

    Collins, Téa

    2003-01-01

    It is now commonly realized that the globalization of the world economy is shaping the patterns of global health, and that associated morbidity and mortality is affecting countries' ability to achieve economic growth. The globalization of public health has important implications for access to essential healthcare. The rise of inequalities among and within countries negatively affects access to healthcare. Poor people use healthcare services less frequently when sick than do the rich. The negative impact of globalization on access to healthcare is particularly well demonstrated in countries of transitional economies. No longer protected by a centralized health sector that provided free universal access to services for everyone, large segments of the populations in the transition period found themselves denied even the most basic medical services. Only countries where regulatory institutions are strong, domestic markets are competitive and social safety nets are in place, have a good chance to enjoy the health benefits of globalization.

  20. Best Practices for Addressing Combat Operational Stress and Other Behavioral Health Conditions in Marine Corps Substance Abuse Counseling Centers

    DTIC Science & Technology

    2010-08-02

    the base branch medical clinic and then off-base for PTSD treatment must be followed-up by a nurse practitioner. Due to the lack of a mental health ...process by which the Substance Abuse Counseling Centers (SACCs) address clients with stress concerns and mental health conditions stemming from...to document the current treatment approach for substance abuse clients with co-occurring mental health concerns at selected Marine Corps SACCs; and

  1. The Health Status of Women in the Military. An Epidemiological Study of Active Duty Navy and Marine Corps Personnel

    DTIC Science & Technology

    1995-08-24

    ANTISOCIAL PERSONALITY R60 failed to support children R38 moved to avoid paying rent 5.) Failure to plan ahead, or impulsive behavior R57...Abuse and Health Behaviors Among Military Personnel (7) , the 1992 DoD Survey of Military Medical Care Beneficiaries (8), and the 1989 Department of...their appropriation of health-related behaviors . Women’s health-risk and behavior issues are particularly salient in the U.S. Navy and Marine Corps

  2. 76 FR 41855 - In the Matter of Maxicare Health Plans, Inc., MetroConnect Inc., Microislet, Inc., Mobicom Corp...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... From the Federal Register Online via the Government Publishing Office ] SECURITIES AND EXCHANGE COMMISSION In the Matter of Maxicare Health Plans, Inc., MetroConnect Inc., Microislet, Inc., Mobicom Corp... that there is a lack of current and accurate information concerning the securities of MetroConnect...

  3. National Health Service Corps Staffing and the Growth of the Local Rural Non-NHSC Primary Care Physician Workforce

    ERIC Educational Resources Information Center

    Pathman, Donald E.; Fryer, George E., Jr.; Phillips, Robert L.; Smucny, John; Miyoshi, Thomas; Green, Larry A.

    2006-01-01

    Context: Beyond providing temporary staffing, National Health Service Corps (NHSC) clinicians are believed by some observers to contribute to the long-term growth of the non-NHSC physician workforce of the communities where they serve; others worry that NHSC clinicians compete with and impede the supply of other local physicians. Purpose: To…

  4. National Health Service Corps Staffing and the Growth of the Local Rural Non-NHSC Primary Care Physician Workforce

    ERIC Educational Resources Information Center

    Pathman, Donald E.; Fryer, George E., Jr.; Phillips, Robert L.; Smucny, John; Miyoshi, Thomas; Green, Larry A.

    2006-01-01

    Context: Beyond providing temporary staffing, National Health Service Corps (NHSC) clinicians are believed by some observers to contribute to the long-term growth of the non-NHSC physician workforce of the communities where they serve; others worry that NHSC clinicians compete with and impede the supply of other local physicians. Purpose: To…

  5. Caring for the underserved: current practice of alumni of the National Health Service Corps.

    PubMed

    Porterfield, Deborah S; Konrad, Thomas R; Porter, Carol Q; Leysieffer, Kirsten; Martinez, Rose M; Niska, Richard; Wells, Barbara; Potter, Frank

    2003-05-01

    The objective of this study was to examine the number and characteristics of National Health Service Corps (NHSC) alumni who currently practice with an underserved population. The study design was a cross-sectional survey mailed in 1998 to a sample of 2,160 alumni. The response rate was 58.9 percent; overall, 52.5 percent of respondents reported currently working with the underserved. In bivariate analyses, retention in practice with the underserved was associated with several clinician and service experience variables. In a logistic regression model, higher initial desire to work with the underserved, older age, job satisfaction, and higher salary were associated with current service. The authors conclude that more than half of the NHSC alumni responding to the survey reported working with an underserved population in 1998. Associations between clinician and service experience characteristics and retention in practice with the underserved can inform policy and research to improve retention.

  6. Physician assistants and nurse practitioners in the National Health Service Corps.

    PubMed

    Pathman, Donald E; Konrad, Thomas R; Hooker, Roderick S

    2014-12-01

    This study describes the experiences of physician assistants (PAs) and nurse practitioners (NPs) in the National Health Service Corps' (NHSC) loan repayment program in 2010. In 2011, a stratified random sample of NHSC clinicians was surveyed. Data from the 148 PA and 137 NP respondents were analyzed (52.4% response rate). PAs were younger than NPs (mean age 31 versus 35 years), less often female (68% versus 91%), and more often carried educational debt over $100,000 (56% versus 24%). Both groups were serving in states familiar to them and within communities where they felt accepted. The groups were generally satisfied on most measures of work, with PAs more satisfied than NPs on some measures. The NHSC's PAs and NPs are well matched to communities and satisfied with their work. Maximizing their NHSC experiences and retention requires recognizing their differences in demographics, debt, and areas of job satisfaction.

  7. Open Access to essential health care information

    PubMed Central

    Stokes, Christabel EL; Pandey, Manoj

    2004-01-01

    Open Access publishing is a valuable resource for the synthesis and distribution of essential health care information. This article discusses the potential benefits of Open Access, specifically in terms of Low and Middle Income (LAMI) countries in which there is currently a lack of informed health care providers – mainly a consequence of poor availability to information. We propose that without copyright restrictions, Open Access facilitates distribution of the most relevant research and health care information. Furthermore, we suggest that the technology and infrastructure that has been put in place for Open Access could be used to publish download-able manuals, guides or basic handbooks created by healthcare providers in LAMI countries. PMID:15575959

  8. The European Medical Corps: first Public Health Team mission and future perspectives.

    PubMed

    Haussig, Joana M; Severi, Ettore; Baum, Jonathan Hj; Vanlerberghe, Veerle; Laiseca, Amparo; Defrance, Laurent; Brailescu, Cristina; Coulombier, Denis; Jansa, Josep

    2017-09-14

    The 2013-2016 Ebola epidemic in West Africa challenged traditional international mechanisms for public health team mobilisation to control outbreaks. Consequently, in February 2016, the European Union (EU) launched the European Medical Corps (EMC), a mechanism developed in collaboration with the World Health Organization (WHO) to rapidly deploy teams and equipment in response to public health emergencies inside and outside the EU. Public Health Teams (PHTs), a component of the EMC, consist of experts in communicable disease prevention and control from participating countries and the European Centre for Disease Prevention and Control (ECDC), to support affected countries and WHO in risk assessment and outbreak response. The European Commission's Directorate-General European Civil Protection and Humanitarian Aid Operations and Directorate-General Health and Food Safety, and ECDC, plan and support deployments. The first EMC-PHT deployment took place in May 2016, with a team sent to Angola for a yellow fever outbreak. The aims were to evaluate transmission risks to local populations and EU citizens in Angola, the risk of regional spread and importation into the EU, and to advise Angolan and EU authorities on control measures. International actors should gain awareness of the EMC, its response capacities and the means for requesting assistance. This article is copyright of The Authors, 2017.

  9. [Accessibility of health services for users].

    PubMed

    Sousa-Fragoso, M A; Villarreal-Ríos, E

    2000-01-01

    To measure the accessibility to health services and determine a model to explain this accessibility. All states of the Mexican Republic were included. The measurement of accessibility considers the availability of resources and the perception of barriers. Place of residence, education, participation in the work forces and household conditions were included in the model. The average of availability resources was 64.59% sd 15.68 (range 42 to 100) and the average corresponding to perception of barriers, 87.61% SD 4.04 (range 79.23 to 95.65). Accessibility was 71.50% SD 10.74 (range 56 to 96). The states with highest accessibility were the Federal District and Baja California Sur and the lowest, Chiapas and Oaxaca. The model included education and labor participation (R2 = 0.67, p < 0.05). Accessibility was determined by socioeconomic factors.

  10. Facilitating consumer access to health information.

    PubMed

    Snowdon, Anne; Schnarr, Karin; Alessi, Charles

    2014-01-01

    The lead paper from Zelmer and Hagens details the substantive evolution occurring in health information technologies that has the potential to transform the relationship between consumers, health practitioners and health systems. In this commentary, the authors suggest that Canada is experiencing a shift in consumer behaviour toward a desire to actively manage one's health and wellness that is being facilitated through the advent of health applications on mobile and online technologies platforms. The result is that Canadians are now able to create personalized health solutions based on their individual health values and goals. However, before Canadians are able to derive a personal health benefit from these rapid changes in information technology, they require and are increasingly demanding greater real-time access to their own health information to better inform decision-making, as well as interoperability between their personal health tracking systems and those of their health practitioner team.

  11. Child Health and Access to Medical Care.

    PubMed

    Leininger, Lindsey; Levy, Helen

    2015-01-01

    It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health. Nonetheless, they find that, on the whole, policies to improve access indeed improve children's health, with the caveat that context plays a big role-medical care "matters more at some times, or for some children, than others." Focusing on studies that can plausibly show a causal effect between policies to increase access and better health for children, and starting from an economic framework, they consider both the demand for and the supply of health care. On the demand side, they examine what happens when the government expands public insurance programs (such as Medicaid), or when parents are offered financial incentives to take their children to preventive appointments. On the supply side, they look at what happens when public insurance programs increase the payments that they offer to health-care providers, or when health-care providers are placed directly in schools where children spend their days. They also examine how the Affordable Care Act is likely to affect children's access to medical care. Leininger and Levy reach three main conclusions. First, despite tremendous progress in recent decades, not all children have insurance coverage, and immigrant children are especially vulnerable. Second, insurance coverage alone doesn't guarantee access to care, and insured children may still face barriers to getting the care they need. Finally, as this issue of Future of Children demonstrates, access to care is only one of the factors that policy makers should consider as they seek to make the nation's children healthier.

  12. Child Health and Access to Medical Care

    PubMed Central

    Leininger, Lindsey; Levy, Helen

    2016-01-01

    It might seem strange to ask whether increasing access to medical care can improve children’s health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children’s health. Nonetheless, they find that, on the whole, policies to improve access indeed improve children’s health, with the caveat that context plays a big role—medical care “matters more at some times, or for some children, than others.” Focusing on studies that can plausibly show a causal effect between policies to increase access and better health for children, and starting from an economic framework, they consider both the demand for and the supply of health care. On the demand side, they examine what happens when the government expands public insurance programs (such as Medicaid), or when parents are offered financial incentives to take their children to preventive appointments. On the supply side, they look at what happens when public insurance programs increase the payments that they offer to health-care providers, or when health-care providers are placed directly in schools where children spend their days. They also examine how the Affordable Care Act is likely to affect children’s access to medical care. Leininger and Levy reach three main conclusions. First, despite tremendous progress in recent decades, not all children have insurance coverage, and immigrant children are especially vulnerable. Second, insurance coverage alone doesn’t guarantee access to care, and insured children may still face barriers to getting the care they need. Finally, as this issue of Future of Children demonstrates, access to care is only one of the factors that policy makers should consider as they seek to make the nation’s children healthier. PMID:27516723

  13. Experience Corps: design of an intergenerational program to boost social capital and promote the health of an aging society.

    PubMed

    Glass, Thomas A; Freedman, Marc; Carlson, Michelle C; Hill, Joel; Frick, Kevin D; Ialongo, Nick; McGill, Sylvia; Rebok, George W; Seeman, Teresa; Tielsch, James M; Wasik, Barbara A; Zeger, Scott; Fried, Linda P

    2004-03-01

    Population aging portends a crisis of resources and values. Desired solutions could include intergenerational strategies to harness the untapped potential of older adults to address societal needs and to generate health improvements for older adults. Despite the desire of many older adults to remain socially engaged and productive, the creation of productive roles has lagged. This report describes the conceptual framework and major design features of a new model of health promotion for older adults called Experience Corps. Experience Corps operates at, and leads to benefits across, multiple levels, including individuals, schools, and the larger community. At the individual level, we propose a model based on Erikson's concept of generativity to explain how and why Experience Corps works. At the level of schools, we propose a parallel model based on social capital. Experience Corps is a volunteer service program designed to improve the lives of urban children and to yield health improvement for older persons. It illustrates how population aging creates new opportunities to address difficult social problems. This article explores how the linkage of concepts at multiple levels motivates a potentially cost-effective, feasible, and high-impact program.

  14. Health-care access as a social determinant of health.

    PubMed

    McGibbon, Elizabeth; Etowa, Josephine; McPherson, Charmaine

    2008-09-01

    The social determinants of health (SDH) are recognized as important indicators of health and well-being. Health-care services (primary, secondary, tertiary care) have not until recently been considered an SDH. Inequities in access to health care are changing this view. These inequities include barriers faced by certain population groups at point of care, such as the lack of cultural competence of health-care providers. The authors show how a social justice perspective can help nurses understand how to link inequities in access to poorer health outcomes, and they call on nurses to break the cycle of oppression that contributes to these inequities.

  15. Epidemiological surveillance in Peace Corps Volunteers: a model for monitoring health in temporary residents of developing countries.

    PubMed

    Bernard, K W; Graitcer, P L; van der Vlugt, T; Moran, J S; Pulley, K M

    1989-03-01

    In 1985, the US Peace Corps developed a computerized epidemiological surveillance system to monitor health trends in over 5500 Peace Corps Volunteers working in development projects in 62 countries worldwide. Data on 31 health conditions and events are collected monthly from each country; quarterly and annual incidence rates are then calculated, and the analysed data are distributed. In 1987, the most commonly reported health problems were diarrhoea (unclassified), 48 cases per 100 volunteers per year; amoebiasis, 24 per 100 volunteers per year; injuries, 20 per 100 volunteers per year; bacterial skin infections, 19 per 100 volunteers per year; and giardiasis 17 per 100 volunteers per year. Tracking each of these common problems, as well as other selected health conditions, guides design of more specific studies and disease control efforts. Health problems with very low rates (less than 1.0/100 volunteers/year) include hepatitis, schistosomiasis, non-falciparum malaria, and filariasis. The epidemiological surveillance system provides the health data needed to plan, implement, and evaluate health programmes for Peace Corps Volunteers, and provides a model for surveillance in other groups of temporary and permanent residents of developing countries.

  16. Comprehensive Employment and Training Act of 1973. Job Corps Health Program. A Working Document for Standing Orders. Part 1. Standing Orders for Health Personnel.

    ERIC Educational Resources Information Center

    Employment and Training Administration (DOL), Washington, DC.

    Developed as the first of a two-part supplement to Technical Supplement Q for Standing Orders (TS-Q), this handbook of standing orders was designed to help health personnel at Comprehensive Employment and Training Act (CETA) Job Corps health centers meet the federal requirement that each center have a set of written standing orders on how to…

  17. Contextualizing immigrant access to health resources.

    PubMed

    Yang, Joshua S

    2010-06-01

    A vast majority of our understanding of immigrant health centers around traits of individuals and groups. While useful, current approaches to research on immigrant health decontextualize the experience of immigrants in the United States. This paper uses a historical case study of the Chinese community in San Francisco to develop a contextual framework to understand the levels of influence that impact the availability of health resources in immigrant communities. International, transnational, transcommunity, and enclave contexts have shaped health care access for Chinese immigrants in San Francisco. The conceptual framework provides a basis for future research, programmatic, and policy work that integrates individual and contextual factors in assessing and improving immigrant access to health resources.

  18. [Health services access survey for Colombian households].

    PubMed

    Arrivillaga, Marcela; Aristizabal, Juan Carlos; Pérez, Mauricio; Estrada, Victoria Eugenia

    The aim of this study was to design and validate a health services access survey for households in Colombia to provide a methodological tool that allows the country to accumulate evidence of real-life access conditions experienced by the Colombian population. A validation study with experts and a pilot study were performed. It was conducted in the municipality of Jamundi, located in the department of Valle del Cauca, Colombia. Probabilistic, multistage and stratified cluster sampling was carried out. The final sample was 215 households. The survey was composed of 63 questions divided into five modules: socio-demographic profile of the head of the household or adult informant, household socioeconomic profile, access to preventive services, access to curative and rehabilitative services and household out of pocket expenditure. In descriptive terms, the promotion of preventive services only reached 44%; the use of these services was always highest among children younger than one year old and up to the age of ten. The perceived need for emergency medical care and hospitalisation was between 82% and 85%, but 36% perceived the quality of care to be low or very low. Delays were experienced in medical visits with GPs and specialists. The designed survey is valid, relevant and representative of access to health services in Colombia. Empirically, the pilot showed institutional weaknesses in a municipality of the country, indicating that health coverage does not in practice mean real and effective access to health services. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. 42 CFR 23.9 - What must an entity to which National Health Service Corps personnel are assigned (i.e., a...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... health manpower shortage area for providing the services; and the charges for similar services by other practitioners or facilities in or nearby the health manpower shortage area. However, if assigned National Health... assigned National Health Service Corps personnel to individuals within the health manpower shortage area...

  20. 42 CFR 23.9 - What must an entity to which National Health Service Corps personnel are assigned (i.e., a...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... health manpower shortage area for providing the services; and the charges for similar services by other practitioners or facilities in or nearby the health manpower shortage area. However, if assigned National Health... assigned National Health Service Corps personnel to individuals within the health manpower shortage area...

  1. 42 CFR 23.9 - What must an entity to which National Health Service Corps personnel are assigned (i.e., a...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... health manpower shortage area for providing the services; and the charges for similar services by other practitioners or facilities in or nearby the health manpower shortage area. However, if assigned National Health... assigned National Health Service Corps personnel to individuals within the health manpower shortage area...

  2. Changes in Age-Adjusted Mortality Rates and Disparities for Rural Physician Shortage Areas Staffed by the National Health Service Corps: 1984-1998

    ERIC Educational Resources Information Center

    Pathman, Donald E.; Fryer, George E.; Green, Larry A.; Phillips, Robert L.

    2005-01-01

    This study assesses whether the National Health Service Corps's legislated goals to see health improve and health disparities lessen are being met in rural health professional shortage areas for a key population health indicator: age-adjusted mortality. In a descriptive study using a pre-post design with comparison groups, the authors calculated…

  3. Changes in Age-Adjusted Mortality Rates and Disparities for Rural Physician Shortage Areas Staffed by the National Health Service Corps: 1984-1998

    ERIC Educational Resources Information Center

    Pathman, Donald E.; Fryer, George E.; Green, Larry A.; Phillips, Robert L.

    2005-01-01

    Objective: This study assesses whether the National Health Service Corps's legislated goals to see health improve and health disparities lessen are being met in rural health professional shortage areas for a key population health indicator: age-adjusted mortality. Methods: In a descriptive study using a pre-post design with comparison groups, the…

  4. Changes in Age-Adjusted Mortality Rates and Disparities for Rural Physician Shortage Areas Staffed by the National Health Service Corps: 1984-1998

    ERIC Educational Resources Information Center

    Pathman, Donald E.; Fryer, George E.; Green, Larry A.; Phillips, Robert L.

    2005-01-01

    Objective: This study assesses whether the National Health Service Corps's legislated goals to see health improve and health disparities lessen are being met in rural health professional shortage areas for a key population health indicator: age-adjusted mortality. Methods: In a descriptive study using a pre-post design with comparison groups, the…

  5. Changes in Age-Adjusted Mortality Rates and Disparities for Rural Physician Shortage Areas Staffed by the National Health Service Corps: 1984-1998

    ERIC Educational Resources Information Center

    Pathman, Donald E.; Fryer, George E.; Green, Larry A.; Phillips, Robert L.

    2005-01-01

    This study assesses whether the National Health Service Corps's legislated goals to see health improve and health disparities lessen are being met in rural health professional shortage areas for a key population health indicator: age-adjusted mortality. In a descriptive study using a pre-post design with comparison groups, the authors calculated…

  6. Provision of care to the underserved populations by National Health Service Corps alumni dentists.

    PubMed

    Mofidi, Mahyar; Konrad, Thomas R; Porterfield, Deborah S; Niska, Richard; Wells, Barbara

    2002-01-01

    This study examined factors associated with dentists continuing to provide care to the underserved populations beyond their National Health Service Corps (NHSC) obligation period. Self-administered questionnaires were mailed in 1998 to 404 dentists who had completed their service obligation between 1980 and 1997. The outcome variable was dentist self-report of continuing to work with the underserved population past NHSC obligation. Among 249 respondents (62% response rate), 46 percent of alumni dentists continued to work with an underserved population. Multivariate analyses found that being an African American (odds ratio [OR] = 3.2), higher final salary during the NHSC assignment (OR = 1.2), and higher altruistic motivation to work with the underserved populations prior to entering NHSC (OR = 1.1) were significantly associated with continued service to the underserved populations. A small number of factors were associated with alumni NHSC dentists' decisions to continue to provide care for the underserved populations. Targeting African-American students and students interested in caring for the underserved may improve the long-term commitment of dentists to provide care for the underserved populations. Attention will also need to be given to increased salary as a potential intervention to increase the numbers of dentists who continue to serve the underserved populations.

  7. Health Literacy and Access to Care

    PubMed Central

    Janke, Alex

    2016-01-01

    Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forego needed care or to report difficulty finding a provider, even after controlling for other factors including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after controlling for other factors. The results show that in addition to any obstacles that low health literacy creates within the context of the clinical encounter, low health literacy also reduces the probability that people get in the door of the health care system in a timely way. PMID:27043757

  8. Health Literacy and Access to Care.

    PubMed

    Levy, Helen; Janke, Alex

    2016-01-01

    Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forgo needed care or to report difficulty finding a provider, even after we controlled for other factors, including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after we controlled for other factors. The results show that in addition to any obstacles that low health literacy creates within the context of the clinical encounter, low health literacy also reduces the probability that people get in the door of the health care system in a timely way.

  9. Relationship between health literacy, health information access, health behavior, and health status in Japanese people.

    PubMed

    Suka, Machi; Odajima, Takeshi; Okamoto, Masako; Sumitani, Masahiko; Igarashi, Ataru; Ishikawa, Hirono; Kusama, Makiko; Yamamoto, Michiko; Nakayama, Takeo; Sugimori, Hiroki

    2015-05-01

    To examine the relationship between health literacy (HL), health information access, health behavior, and health status in Japanese people. A questionnaire survey was conducted at six healthcare facilities in Japan. Eligible respondents aged 20-64 years (n=1218) were included. Path analysis with structural equation modeling was performed to test the hypothesis model linking HL to health information access, health behavior, and health status. The acceptable fitting model indicated that the pathways linking HL to health status consisted of two indirect paths; one intermediated by health information access and another intermediated by health behavior. Those with higher HL as measured by the 14-item Health Literacy Scale (HLS-14) were significantly more likely to get sufficient health information from multiple sources, less likely to have risky habits of smoking, regular drinking, and lack of exercise, and in turn, more likely to report good self-rated health. HL was significantly associated with health information access and health behavior in Japanese people. HL may play a key role in health promotion, even in highly educated countries like Japan. In order to enhance the effects of health promotion interventions, health professionals should aim at raising HL levels of their target population groups. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. [Access to health care for the destitute].

    PubMed

    Sourty-Le Guellec, M J; Paris, V

    1997-11-01

    An increasing proportion of low income people, in spite of receiving mandatory coverage, cannot afford supplementary insurance, and they cannot afford to advance payment for care which will lately be reimbursed, nor can they afford copayments. The results is that a growing proportion of French population is unable to access common care. Faced with this deteriorating situation, parallel delivery systems of care have been devised at a local level, facilities have been created, and health care providers volunteers to deliver health care to underserved populations. To estimate the extent of the phenomenon, CREDES carried out a specific survey at the national level. First we identified all health care providers or facilities accessible to the underserved. These include traditional providers or facilities, such as private physicians and hospitals which agree to provide "charity care". There are also new facilities created specifically to provide health care to the underserved. The second part of the survey covered the human resources, equipment and services offered at these specific facilities. It revealed the extensive participation by physicians and nursing staff generally on a voluntary basis and the special attention given to the reintegration of the underserved into the standard health care system through assistance with the necessary administrative procedures.

  11. Steps Towards Determining the Right Number of Dental Recruits the Navy Should Access to Meet the Projected Targets for Navy Dental Corps Officers

    DTIC Science & Technology

    2007-03-01

    United States Navy B.S., Southern Illinois University, 1999 Submitted in partial fulfillment of the requirements for the degree of MASTER... History ...........................................................................2 2. Dental Corps – War Time...BACKGROUND 1. Dental Corps History The Navy commissions professional Dentists into a staff corps community; they are identified as Dental Corps Officers

  12. [Effective access to health services: operationalizing universal health coverage].

    PubMed

    Fajardo-Dolci, Germán; Gutiérrez, Juan Pablo; García-Saisó, Sebastián

    2015-01-01

    The right to health and its operational form, as an organized social response to health: the right to health protection, are the mainstay for the global push towards universal health coverage. The path to achieve this goal is particular to each country and relates to the baseline and specific context in relation to what is feasible. In practical terms, universal coverage involves the correlation between demand and supply of services (promotion, prevention, and care), expressed by the ability for each individual to make use of services when these are required. In those terms universal coverage is then effective access. The objective of the paper is to explore the conceptualization of effective access to health services and propose a definition that allows its operationalization thereof. This definition considers key elements of supply and demand of services, including the availability of resources and adequate provision (quality), as well as barriers to use them.

  13. Health Literacy and Access to Kidney Transplantation

    PubMed Central

    Grubbs, Vanessa; Gregorich, Steven E.; Perez-Stable, Eliseo J.; Hsu, Chi-yuan

    2009-01-01

    Background and objectives: Few studies have examined health literacy in patients with end stage kidney disease. We hypothesized that inadequate health literacy in a hemodialysis population is common and is associated with poorer access to kidney transplant wait-lists. Design, setting, participants, & measurements: We enrolled 62 Black and White maintenance hemodialysis patients aged 18 to 75. We measured health literacy using the short form Test of Functional Health Literacy in Adults. Our primary outcomes were (1) time from dialysis start date to referral date for kidney transplant evaluation and (2) time from referral date to date placed on kidney transplant wait-list. We used Cox proportional hazard models to examine the association between health literacy (adequate versus inadequate) and our outcomes after controlling for demographics and co-morbid conditions. Results: Roughly one third (32.3%) of participants had inadequate health literacy. Forty-seven (75.8%) of participants were referred for transplant evaluation. Among those referred, 40 (85.1%) were wait-listed. Participants with inadequate health literacy had 78% lower hazard of referral for transplant evaluation than those with adequate health literacy (adjusted hazard ratio [AHR] 0.22; 95% confidence interval 0.08, 0.60; P = 0.003). The hazard ratio of being wait-listed by health literacy was not statistically different (AHR 0.80, 95% CI, 0.39, 1.61), P = 0.5). Conclusions: Inadequate health literacy is common in our hemodialysis patient population and is associated with a lower hazard of referral for transplant evaluation. Strategies to reduce the impact of health literacy on the kidney transplant process should be explored. PMID:19056617

  14. Sexual Health and Responsibility Program (SHARP): preventing HIV, STIs, and unplanned pregnancies in the navy and marine corps.

    PubMed

    MacDonald, Michael R Bob

    2013-01-01

    In 1999, the Navy and Marine Corps Public Health Center converted an HIV train-the-trainer program into a broader effort of preventing not just HIV, but also other sexually transmitted infections (STIs) and unplanned pregnancies. The premise for this broader approach was that a more comprehensive sexual health promotion message of STI, HIV, and unplanned pregnancy prevention is more likely to include at least one personally relevant concern for any given individual and is, therefore, more likely to be internalized and acted upon by the greatest number of individuals, and that risk reduction for any one of these consequences of sexual activity may reduce risk for all. This new effort was labeled the Sexual Health and Responsibility Program (SHARP). Within the Navy and Marine Corps, SHARP has become a focal and trusted source of sexual health promotion products, consultative services, and training, as well as a conduit for multidisciplinary collaboration and coordination. The existence of this central sexual health program normalizes integrated and comprehensive sexual health messages, enables efficiencies, promotes program and policy uniformity, and provides a forum for cross-organizational collaboration and continuous improvement.

  15. Sexual Health and Responsibility Program (SHARP): Preventing HIV, STIs, and Unplanned Pregnancies in the Navy and Marine Corps

    PubMed Central

    MacDonald, Michael R. (Bob)

    2013-01-01

    In 1999, the Navy and Marine Corps Public Health Center converted an HIV train-the-trainer program into a broader effort of preventing not just HIV, but also other sexually transmitted infections (STIs) and unplanned pregnancies. The premise for this broader approach was that a more comprehensive sexual health promotion message of STI, HIV, and unplanned pregnancy prevention is more likely to include at least one personally relevant concern for any given individual and is, therefore, more likely to be internalized and acted upon by the greatest number of individuals, and that risk reduction for any one of these consequences of sexual activity may reduce risk for all. This new effort was labeled the Sexual Health and Responsibility Program (SHARP). Within the Navy and Marine Corps, SHARP has become a focal and trusted source of sexual health promotion products, consultative services, and training, as well as a conduit for multidisciplinary collaboration and coordination. The existence of this central sexual health program normalizes integrated and comprehensive sexual health messages, enables efficiencies, promotes program and policy uniformity, and provides a forum for cross-organizational collaboration and continuous improvement. PMID:23450888

  16. Public access computing in health science libraries.

    PubMed

    Kehm, S

    1987-01-01

    Public access computing in health science libraries began with online computer-assisted instruction. Library-based collections and services have expanded with advances in microcomputing hardware and software. This growth presents problems: copyright, quality, instability in the publishing industry, and uncertainty about collection scope; librarians managing the new services require new skills to support their collections. Many find the cooperative efforts of several organizational units are required. Current trends in technology for the purpose of information management indicate that these services will continue to be a significant focus for libraries.

  17. Obstacles to dependent health care access in Oregon: health insurance or health care?

    PubMed

    Leichter, Howard

    2004-04-01

    In the 1980s, Oregon was one of a handful of "states that could not wait" for national health care reform. Oregon's chosen approach to reform was predicated on two widely accepted assumptions. First, universal access to health care is best achieved by universal access to health insurance. Second, universal access to health care could best be achieved, at least politically, by incrementally building upon the existing health care delivery and insurance system. This article questions both of these assumptions in light of Oregon's decade-long experience in trying to expand access to health care among its dependent population.

  18. [Accessible health information: a question of age?].

    PubMed

    Loos, E F

    2012-04-01

    Aging and digitalisation are important trends which have their impact on information accessibility. Accessible information about products and services is of crucial importance to ensure that all citizens can participate fully as active members of society. Senior citizens who have difficulties using new media run the risk of exclusion in today's information society. Not all senior citizens, however, encounter problems with new media. Not by a long shot. There is much to be said for 'aged heterogeneity', the concept that individual differences increase as people age. In two explorative qualitative case studies related to accessible health information--an important issue for senior citizens--that were conducted in the Netherlands, variables such as gender, education level and frequency of internet use were therefore included in the research design. In this paper, the most important results of these case studies will be discussed. Attention will be also paid to complementary theories (socialisation, life stages) which could explain differences in information search behaviour when using old or new media.

  19. [Access to health care and racial discrimination].

    PubMed

    Carde, Estelle

    2007-01-01

    Discrimination is defined as different, unfavourable and illegitimate treatment. This post-doctoral research was conducted on racial discrimination, specifically with respect to health care access. The authors observed and questioned during the course of semi-directed interviews, 175 health care professionals on-site at their workplaces (administrators, care providers, social workers) in metropolitan France and French Guiana. Based on a qualitative analysis of this material, three types of discriminatory practices were identified. The first two were rooted in the individual professional's perception of the patient's racial origin (illegitimatising and differentiation). The third was ingrained in institutional logic independent of the professionals' intentions (indirect discrimination). The article concludes with a series of recommendations which aim to combat these types of discrimination.

  20. Side Effects of Physical Training: Association of Fitness Improvement to Espirt de Corps, Performance, Health, and Attrition in Marine Corps Basic Training. Report No. 83-37.

    ERIC Educational Resources Information Center

    Vickers, R. R., Jr.

    Physical training is a significant element of Marine Corps basic training which may affect nonfitness basic training outcomes in addition to improving fitness. If so, physical training side effects should be considered when designing and evaluating physical training programs. This study capitalized on naturally occurring platoon differences in…

  1. [Access to health care for undocumented immigrants. Rights and practice].

    PubMed

    Hansen, Anne Rytter; Krasnik, Allan; Høg, Erling

    2006-09-04

    The purpose of this article is to illuminate undocumented immigrants' right to access to health care and their access in practice. Undocumented immigrants have a right to equal access to health care. Access to more than emergency health care in Denmark is dependent on immigration status. Medical doctors' duty to treat does not apply to non-emergency health needs, and the options existing in this situation remain ambiguous. In practice, undocumented immigrants in Denmark are able to receive more than emergency health care through unofficial networks of health care providers.

  2. Young Physicians in Rural Areas: The Impact of Service in the National Health Service Corps. Volume 2, Survey of Factors Influencing the Location Decision and Practice Patterns.

    ERIC Educational Resources Information Center

    Langwell, Kathryn; And Others

    A survey of young physicians in rural areas was conducted and information was gathered from other data sources and analyzed for three main purposes: (1) to evaluate the retention of National Health Service Corps (NHSC) alumni in Health Manpower Shortage Areas (HMSAs); (2) to document the distribution of NHSC alumni, Private Practice Option (PPO)…

  3. The Medical Reserve Corps as part of the federal medical and public health response in disaster settings.

    PubMed

    Frasca, Dominic R

    2010-09-01

    The Secretary of the Department of Health and Human Services (HHS), through the Office of the Assistant Secretary for Preparedness and Response (ASPR), coordinates federal Emergency Support Function (ESF) #8 preparedness, response, and recovery actions. To address these needs, the ASPR can draw on trained personnel from a variety of sources, both from within and outside HHS. Among the resources under the domain of HHS is the Medical Reserve Corps (MRC), directed by the Office of the Civilian Volunteer Medical Reserve Corps (OCVMRC) in the Office of the Surgeon General. MRC units are community based and function as a way to locally organize and utilize medical and public health professionals, such as physicians, nurses, pharmacists, dentists, veterinarians, and epidemiologists. Nonclinical volunteers, such as interpreters, chaplains, office workers, legal advisors, and others, can fill logistical and support roles in MRC units. This article discusses locally controlled (Hurricanes Gustav and Ike) and federalized (Hurricanes Katrina and Rita) MRC activations, and it describes the advantages of using medical volunteers in a large-scale disaster response setting.

  4. Universal Health Insurance and Health Care Access for Homeless Persons

    PubMed Central

    Ueng, Joanna J. M.; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A.

    2010-01-01

    Objectives. We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. Methods. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Results. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Conclusions. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored. PMID:20558789

  5. Universal health insurance and health care access for homeless persons.

    PubMed

    Hwang, Stephen W; Ueng, Joanna J M; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A

    2010-08-01

    We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored.

  6. Job Corps, AmeriCorps, and Peace Corps: An Overview.

    ERIC Educational Resources Information Center

    McCarron, Kevin

    2000-01-01

    Provides an overview of the Job Corps, AmeriCorps, and the Peace Corps including purpose, individual qualifications for entry, program highlights, and advantages and disadvantages of serving in one of them. (JOW)

  7. Seeking health information online: does limited healthcare access matter?

    PubMed Central

    Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

    2014-01-01

    Consumers facing barriers to healthcare access may use online health information seeking and online communication with physicians, but the empirical relationship has not been sufficiently analyzed. Our study examines the association of barriers to healthcare access with consumers’ health-related information searching on the internet, use of health chat groups, and email communication with physicians, using data from 27 210 adults from the 2009 National Health Interview Survey. Individuals with financial barriers to healthcare access, difficulty getting timely appointments with doctors, and conflicts in scheduling during clinic hours are more likely to search for general health information online than those without these access barriers. Those unable to get timely appointments with physicians are more likely to participate in health chat groups and email physicians. The internet may offer a low-cost source of health information and could help meet the heightened demand for health-related information among those facing access barriers to care. PMID:24948558

  8. Seeking health information online: does limited healthcare access matter?

    PubMed

    Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

    2014-01-01

    Consumers facing barriers to healthcare access may use online health information seeking and online communication with physicians, but the empirical relationship has not been sufficiently analyzed. Our study examines the association of barriers to healthcare access with consumers' health-related information searching on the internet, use of health chat groups, and email communication with physicians, using data from 27,210 adults from the 2009 National Health Interview Survey. Individuals with financial barriers to healthcare access, difficulty getting timely appointments with doctors, and conflicts in scheduling during clinic hours are more likely to search for general health information online than those without these access barriers. Those unable to get timely appointments with physicians are more likely to participate in health chat groups and email physicians. The internet may offer a low-cost source of health information and could help meet the heightened demand for health-related information among those facing access barriers to care.

  9. Perceived barriers to seeking mental health care among United States Marine Corps noncommissioned officers serving as gatekeepers for suicide prevention.

    PubMed

    VanSickle, Marcus; Werbel, Aaron; Perera, Kanchana; Pak, Kyna; DeYoung, Kathryn; Ghahramanlou-Holloway, Marjan

    2016-08-01

    Reducing mental health stigma and perceived barriers to care is a necessary strategy for addressing the public health problem of suicide among the United States Armed Forces. The purpose of this study was threefold: (a) to empirically evaluate the principal component structure of the Perceived Barriers to Care (PBTC) measure; (b) to gain an understanding of the perceived barriers to seeking mental health services among Marine Corps noncommissioned officers (NCOs) selected to participate in a primary suicide prevention training program, Never Leave a Marine Behind (NLMB); and (c) to explore the relationship among sex, education, prior exposure to suicide within one's military unit, and perceived barriers to seeking mental health services. The data for the PBTC (N = 1,758) were drawn from a previously performed pretest/posttest program evaluation study of the Marine Corp's NLMB program, which took place over 6 months in 2009 (April-October). The three highest perceptions of barriers to care reported by NCOs for their Marines were related to being embarrassed, having members of one's unit have less confidence in the Marine, and concerns about being treated differently by military unit leadership. Three principal components for PBTC were identified, accounting for approximately 59% of the total variance. Higher education and prior exposure to suicide within one's military unit significantly correlated with greater perceived barriers to care; sex was not significantly correlated with greater perceived barriers to care. Implications of these findings, in relation to future research, are further discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Health care access disparities among children entering kindergarten in Nevada.

    PubMed

    Fulkerson, Nadia Deashinta; Haff, Darlene R; Chino, Michelle

    2013-09-01

    The objective of this study was to advance our understanding and appreciation of the health status of young children in the state of Nevada in addition to their discrepancies in accessing health care. This study used the 2008-2009 Nevada Kindergarten Health Survey data of 11,073 children to assess both independent and combined effects of annual household income, race/ethnicity, primary language spoken in the family, rural/urban residence, and existing medical condition on access to health care. Annual household income was a significant predictor of access to health care, with middle and high income respondents having regular access to care compared to low income counterparts. Further, English proficiency was associated with access to health care, with English-speaking Hispanics over 2.5 times more likely to have regular access to care than Spanish-speaking Hispanics. Rural residents had decreased odds of access to preventive care and having a primary care provider, but unexpectedly, had increased odds of having access to dental care compared to urban residents. Finally, parents of children with no medical conditions were more likely to have access to care than those with a medical condition. The consequences for not addressing health care access issues include deteriorating health and well-being for vulnerable socio-demographic groups in the state. Altogether these findings suggest that programs and policies within the state must be sensitive to the specific needs of at risk groups, including minorities, those with low income, and regionally and linguistically isolated residents.

  11. A Conceptual Framework of Mapping Access to Health Care across EU Countries: The Patient Access Initiative.

    PubMed

    Souliotis, Kyriakos; Hasardzhiev, Stanimir; Agapidaki, Eirini

    Research evidence suggests that access to health care is the key influential factor for improved population health outcomes and health care system sustainability. Although the importance of addressing barriers in access to health care across European countries is well documented, little has been done to improve the situation. This is due to different definitions, approaches and policies, and partly due to persisting disparities in access within and between European countries. To bridge this gap, the Patient Access Partnership (PACT) developed (a) the '5As' definition of access, which details the five critical elements (adequacy, accessibility, affordability, appropriateness, and availability) of access to health care, (b) a multi-stakeholders' approach for mapping access, and (c) a 13-item questionnaire based on the 5As definition in an effort to address these obstacles and to identify best practices. These tools are expected to contribute effectively to addressing access barriers in practice, by suggesting a common framework and facilitating the exchange of knowledge and expertise, in order to improve access to health care between and within European countries.

  12. Access to health care and social protection.

    PubMed

    Martin, Philippe

    2012-06-01

    In France, the access to healthcare has been conceived as a social right and is mainly managed through the coverage of the population by the National Health Insurance, which is a part of the whole French social security scheme. This system was based on the so-called Bismarckian model, which implies that it requires full employment and solid family links, as the insured persons are the workers and their dependents. This paper examines the typical problems that this system has to face as far as the right to healthcare is concerned. First, it addresses the need to introduce some universal coverage programs, in order to integrate the excluded population. Then, it addresses the issue of financial sustainability as the structural weakness of the French system--in which healthcare is still mainly provided by private practice physicians and governed by the principle of freedom--leads to conceive and implement complex forms of regulations between the State, the Social security institutions and the healthcare providers.

  13. Health Care Access among Latinos: Implications for Social and Health Care Reforms

    ERIC Educational Resources Information Center

    Perez-Escamilla, Rafael

    2010-01-01

    According to the Institute of Medicine, health care access is defined as "the degree to which people are able to obtain appropriate care from the health care system in a timely manner." Two key components of health care access are medical insurance and having access to a usual source of health care. Recent national data show that 34% of Latino…

  14. Health Care Access among Latinos: Implications for Social and Health Care Reforms

    ERIC Educational Resources Information Center

    Perez-Escamilla, Rafael

    2010-01-01

    According to the Institute of Medicine, health care access is defined as "the degree to which people are able to obtain appropriate care from the health care system in a timely manner." Two key components of health care access are medical insurance and having access to a usual source of health care. Recent national data show that 34% of Latino…

  15. Evaluation of Web Accessibility of Consumer Health Information Websites

    PubMed Central

    Zeng, Xiaoming; Parmanto, Bambang

    2003-01-01

    The objectives of the study are to construct a comprehensive framework for web accessibility evaluation, to evaluate the current status of web accessibility of consumer health information websites and to investigate the relationship between web accessibility and property of the websites. We selected 108 consumer health information websites from the directory service of a Web search engine. We used Web accessibility specifications to construct a framework for the measurement of Web Accessibility Barriers (WAB) of website. We found that none of the websites is completely accessible to people with disabilities, but governmental and educational health information websites exhibit better performance on web accessibility than other categories of websites. We also found that the correlation between the WAB score and the popularity of a website is statistically significant. PMID:14728272

  16. Health websites: accessibility and usability for American sign language users.

    PubMed

    Kushalnagar, Poorna; Naturale, Joan; Paludneviciene, Raylene; Smith, Scott R; Werfel, Emily; Doolittle, Richard; Jacobs, Stephen; DeCaro, James

    2015-01-01

    To date, there have been efforts toward creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our article focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users' perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (n = 32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to (a) navigation to find the task, (b) website usability, and (c) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This article also describes the participants' preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users.

  17. Health Websites: Accessibility and Usability for American Sign Language Users

    PubMed Central

    Kushalnagar, Poorna; Naturale, Joan; Paludneviciene, Raylene; Smith, Scott R.; Werfel, Emily; Doolittle, Richard; Jacobs, Stephen; DeCaro, James

    2015-01-01

    To date, there have been efforts towards creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our paper focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users’ perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (N=32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to: 1) navigation to find the task, 2) website usability, and 3) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This paper also describes the participants’ preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users. PMID:24901350

  18. Identifying Health Consumers' eHealth Literacy to Decrease Disparities in Accessing eHealth Information.

    PubMed

    Park, Hyejin; Cormier, Eileen; Gordon, Glenna; Baeg, Jung Hoon

    2016-02-01

    The increasing amount of health information available on the Internet highlights the importance of eHealth literacy skills for health consumers. Low eHealth literacy results in disparities in health consumers' ability to access and use eHealth information. The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that healthcare professionals can effectively address skills gaps in health consumers' ability to access and use high-quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth Literacy Scale was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high- from low-quality information were considerably less. The findings suggest the need for eHealth education and support to health consumers from healthcare professionals, in particular, how to access and evaluate the quality of health information.

  19. An Analysis of the Effects of Accession Source as a Predictor of Success of Navy Nurse Corps Officers

    DTIC Science & Technology

    1998-03-01

    in the NC in FY93. This accession source is a financial assistance program for students enrolled in baccalaureate nursing education , and is the most...masters degree-granting nursing education program and be licensed as a registered professional nurse. In the past, graduates of accredited three...year diploma-granting nursing education programs with appropriate licensure were also accepted. Additionally, a graduate from an accredited associate

  20. Access to Oral Health Care: The Role of Federally Qualified Health Centers in Addressing Disparities and Expanding Access

    PubMed Central

    Shi, Leiyu; Hayashi, Arthur Seiji; Sharma, Ravi; Daly, Charles; Ngo-Metzger, Quyen

    2013-01-01

    Objectives. We examined utilization, unmet need, and satisfaction with oral health services among Federally Qualified Health Center patients. We examined correlates of unmet need to guide efforts to increase access to oral health services among underserved populations. Methods. Using the 2009 Health Center Patient Survey, we performed multivariate logistic regressions to examine factors associated with access to dental care at health centers, unmet need, and patient experience. Results. We found no racial or ethnic disparities in access to timely oral health care among health center patients; however, uninsured patients and those whose insurance does not provide dental coverage experienced restricted access and greater unmet need. Slightly more than half of health center patients had a dental visit in the past year, but 1 in 7 reported that their most recent visit was at least 5 years ago. Among health center patients who accessed dental care at their health center, satisfaction was high. Conclusions. These results underscore the critical role that health centers play in national efforts to improve oral health status and eliminate disparities in access to timely and appropriate dental services. PMID:23327254

  1. 76 FR 46305 - Eligibility Criteria for Sites Recruiting National Health Service Corps Scholars

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-02

    ... Designation, Bureau of Health Professions, HRSA; (2) not deny requested health care services, or discriminate... medical care, mental health, and/or oral health services to a primary medical care, mental health, or dental HPSA of greatest shortage, respectively; (2) are part of a system of care that provides a...

  2. Local Health Department Activities to Ensure Access to Care

    PubMed Central

    Luo, Huabin; Sotnikov, Sergey; Shah, Gulzar

    2016-01-01

    Background Local health departments (LHDs) can play an important role in linking people to personal health services and ensuring the provision of health care when it is otherwise unavailable. However, the extent to which LHDs are involved in ensuring access to health care in its jurisdictions is not well known. Purpose To provide nationally representative estimates of LHD involvement in specific activities to ensure access to healthcare services and to assess their association with macro-environment/community and LHD capacity and process characteristics. Methods Data used were from the 2010 National Profile of Local Health Departments Study, Area Resource Files, and the Association of State and Territorial Health Officials’ 2010 Profile of State Public Health Agencies Survey. Data were analyzed in 2012. Results Approximately 66.0% of LHDs conducted activities to ensure access to medical care, 45.9% to dental care, and 32.0% to behavioral health care. About 28% of LHDs had not conducted activities to ensure access to health care in their jurisdictions in 2010. LHDs with higher per capita expenditures and larger jurisdiction population sizes were more likely to provide access to care services (p <0.05). Conclusions There is substantial variation in LHD engagement in activities to ensure access to care. Differences in LHD capacity and the needs of the communities in which they are located may account for this variation. Further research is needed to determine whether this variation is associated with adverse population health outcomes. PMID:24237913

  3. Promoting Ecological Health Resilience for Minority Youth: Enhancing Health Care Access through the School Health Center.

    ERIC Educational Resources Information Center

    Clauss-Ehlers, Caroline C. C.

    2003-01-01

    Discusses the demographic realities of children of color in the U.S., with a focus on health care needs and access issues that have an enormous influence on health status. An ecologic model is presented that incorporates cultural values and community structures into the school health center. (Contains 50 references.) (GCP)

  4. The challenges in making electronic health records accessible to patients

    PubMed Central

    Beard, Leslie; Schein, Rebecca; Morra, Dante; Wilson, Kumanan

    2011-01-01

    It is becoming increasingly apparent that there is a tension between growing consumer demands for access to information and a healthcare system that may not be prepared to meet these demands. Designing an effective solution for this problem will require a thorough understanding of the barriers that now stand in the way of giving patients electronic access to their health data. This paper reviews the following challenges related to the sharing of electronic health records: cost and security concerns, problems in assigning responsibilities and rights among the various players, liability issues and tensions between flexible access to data and flexible access to physicians. PMID:22120207

  5. International Affairs: Building an Infrastructure for International Health Promotion and Disease Prevention: The Peace Corps Fellows Program.

    ERIC Educational Resources Information Center

    Gudmundsen, Anne M.

    1989-01-01

    An agreement between the College of Nursing at Texas Woman's University and the Peace Corps was negotiated to include two years of Peace Corps service with work leading to a master's or doctoral degree in nursing. A brief description of a student assigned to Banjul, Gambia, is presented. (MLW)

  6. Health Care Access and Utilization after the 2010 Pakistan Floods.

    PubMed

    Jacquet, Gabrielle A; Kirsch, Thomas; Durrani, Aqsa; Sauer, Lauren; Doocy, Shannon

    2016-10-01

    Introduction The 2010 floods submerged more than one-fifth of Pakistan's land area and affected more than 20 million people. Over 1.6 million homes were damaged or destroyed and 2,946 direct injuries and 1,985 deaths were reported. Infrastructure damage was widespread, including critical disruptions to the power and transportation networks. Hypothesis Damage and loss of critical infrastructure will affect the population's ability to seek and access adequate health care for years to come. This study sought to evaluate factors associated with access to health care in the aftermath of the 2010 Pakistan floods. A population-proportional, randomized cluster-sampling survey method with 80 clusters of 20 (1,600) households of the flood-affected population was used. Heads of households were surveyed approximately six months after flood onset. Multivariate analysis was used to determine significance. A total of 77.8% of households reported needing health services within the first month after the floods. Household characteristics, including rural residence location, large household size, and lower pre- and post-flood income, were significantly associated (P<.05) with inadequate access to health care after the disaster. Households with inadequate access to health care were more likely to have a death or injury in the household. Significantly higher odds of inadequate access to health care were observed in rural populations (adjusted OR 4.26; 95% CI, 1.89-9.61). Adequate health care access after the 2010 Pakistani floods was associated with urban residence location, suggesting that locating health care providers in rural areas may be difficult. Access to health services also was associated with post-flood income level, suggesting health resources are not readily available to households suffering great income losses. Jacquet GA , Kirsch T , Durrani A , Sauer L , Doocy S . Health care access and utilization after the 2010 Pakistan floods. Prehosp Disaster Med. 2016;31(5):485-491.

  7. Health Care Access, Use, and Satisfaction Among Disabled Medicaid Beneficiaries

    PubMed Central

    Coughlin, Teresa A.; Long, Sharon K.; Kendall, Stephanie

    2002-01-01

    Despite being a vulnerable and costly population, little is known about disabled Medicaid beneficiaries. Using data from a 1999-2000 survey, we describe the population and their health care experiences in terms of access, use, and satisfaction with care. Results indicate that disabled beneficiaries are a unique population with wide-ranging circumstances and health conditions. Our results on access to care were indeterminate: by some measures, they had good access, but by others they did not. Beneficiaries' assessments of their health care were more clear: The bulk of the sample rated one or more area of care as being fair or poor. PMID:12690698

  8. Demographic differences in body composition of Navy and Marine Corps personnel: findings from the perception of wellness and readiness assessment.

    PubMed

    Graham, W F; Hourani, L L; Sorenson, D; Yuan, H

    2000-01-01

    With the recent increase in women's representation in the military, baseline physical measurement data are needed to help set appropriate accession and retention standards and to design useful prevention and intervention programs in the areas of physical fitness and health. This study incorporated several body composition indices to obtain anthropometric data for a representative sample of 1,292 active duty Navy and Marine Corps women and men. It also assessed the extent to which personnel met weight-for-height and body fat standards. The prevalence of overweight was considerably lower among Marine Corps women compared with Navy women and was slightly less for Marine Corps men compared with their Navy counterparts. Between one-fifth and one-third of military personnel exceeded Navy/Marine Corps weight-for-height standards. Navy women tended to meet weight standards more often than Navy men. Fewer Marine Corps women than men were overweight, but more exceeded their weight-for-height standards.

  9. Access of primary and secondary literature by health personnel in an academic health center: implications for open access.

    PubMed

    Maggio, Lauren A; Steinberg, Ryan M; Moorhead, Laura; O'Brien, Bridget; Willinsky, John

    2013-07-01

    The research sought to ascertain the types and quantity of research evidence accessed by health personnel through PubMed and UpToDate in a university medical center over the course of a year in order to better estimate the impact that increasing levels of open access to biomedical research can be expected to have on clinical practice in the years ahead. Web log data were gathered from the 5,042 health personnel working in the Stanford University Hospitals (SUH) during 2011. Data were analyzed for access to the primary literature (abstracts and full-text) through PubMed and UpToDate and to the secondary literature, represented by UpToDate (research summaries), to establish the frequency and nature of literature consulted. In 2011, SUH health personnel accessed 81,851 primary literature articles and visited UpToDate 110,336 times. Almost a third of the articles (24,529) accessed were reviews. Twenty percent (16,187) of the articles viewed were published in 2011. When it is available, health personnel in a clinical care setting frequently access the primary literature. While further studies are needed, this preliminary finding speaks to the value of the National Institutes of Health public access policy and the need for medical librarians and educators to prepare health personnel for increasing public access to medical research.

  10. Access of primary and secondary literature by health personnel in an academic health center: implications for open access*

    PubMed Central

    Steinberg, Ryan M.; Moorhead, Laura; O'Brien, Bridget; Willinsky, John

    2013-01-01

    Purpose: The research sought to ascertain the types and quantity of research evidence accessed by health personnel through PubMed and UpToDate in a university medical center over the course of a year in order to better estimate the impact that increasing levels of open access to biomedical research can be expected to have on clinical practice in the years ahead. Methods: Web log data were gathered from the 5,042 health personnel working in the Stanford University Hospitals (SUH) during 2011. Data were analyzed for access to the primary literature (abstracts and full-text) through PubMed and UpToDate and to the secondary literature, represented by UpToDate (research summaries), to establish the frequency and nature of literature consulted. Results: In 2011, SUH health personnel accessed 81,851 primary literature articles and visited UpToDate 110,336 times. Almost a third of the articles (24,529) accessed were reviews. Twenty percent (16,187) of the articles viewed were published in 2011. Conclusion: When it is available, health personnel in a clinical care setting frequently access the primary literature. While further studies are needed, this preliminary finding speaks to the value of the National Institutes of Health public access policy and the need for medical librarians and educators to prepare health personnel for increasing public access to medical research. PMID:23930091

  11. Enhancing access to health information in Africa: a librarian's perspective.

    PubMed

    Gathoni, Nasra

    2012-01-01

    In recent years, tremendous progress has been made toward providing health information in Africa, in part because of technological advancements. Nevertheless, ensuring that information is accessible, comprehensible, and usable remains problematic, and there remain needs in many settings to address issues such as computer skills, literacy, and the infrastructure to access information. To determine how librarians might play a more strategic role in meeting information needs of health professionals in Africa, the author reviewed key components of information systems pertinent to knowledge management for the health sector, including access to global online resources, capacity to use computer technology for information retrieval, information literacy, and the potential for professional networks to play a role in improving access to and use of information. The author concluded that, in regions that lack adequate information systems, librarians could apply their knowledge and skills to facilitate access and use by information seekers. Ensuring access to and use of health information can also be achieved by engaging organizations and associations working to enhance access to health information, such as the Association for Health Information and Libraries in Africa. These groups can provide assistance through training, dissemination, information repackaging, and other approaches known to improve information literacy.

  12. Migrant's access to preventive health services in five EU countries.

    PubMed

    Rosano, Aldo; Dauvrin, Marie; Buttigieg, Sandra C; Ronda, Elena; Tafforeau, Jean; Dias, Sonia

    2017-08-23

    Preventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants' access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants' access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries. Information from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries. Migrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non-EU migrants. The findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing

  13. Coordinating research and practice: challenges testing messages to increase medical reserve corps participation in local health department activities.

    PubMed

    Klaiman, Tamar; Higdon, Melissa; Galarce, Ezequiel

    2013-04-01

    Local health departments (LHDs) increasingly depend on volunteers, often Medical Reserve Corps (MRC) volunteers, to assist with a variety of functions. While LHDs have extensive lists of volunteers, only about 10 % are actively involved in LHD activities. Psychological literature has shown that well-designed messages can motivate behavior among individuals. Key to this theory is the concept of "framing," defined as the influence the characterization of an issue can have on its understanding. Research has been conducted on how to frame and disseminate both political and public health messages to alter individual behavior. We aimed to design and test appropriate evidence-based messages to increase volunteer participation rates in LHD flu clinics. After inviting over 900 MRC units to participate during the 2011-2012 influenza season, five were able to collect and report data to the research team. Using a randomized trial design, we tested messages among the five participating MRC units consisting of a total of 2,020 volunteers. Chi Square analysis showed no difference in attendance between those who received either of the test messages versus the control message (p = .305). Our small sample size of MRC units likely biased our sample and reduced the external validity of our study. Our experience in conducting research with MRC coordinators and volunteers highlights the challenges of conducting research with practitioners who lack the time, infrastructure and resources necessary to work with researchers. There is a strong need for more supportive infrastructure for conducting research with practitioners.

  14. 78 FR 38061 - Recruitment of Sites for Assignment of Corps Personnel Obligated Under the National Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    ... are authorized for the assignment of NHSC scholars who are primary care physicians, family nurse... January 1, 2014, for placements January 1, 2014, through June 30, 2014; (2) not deny requested health care...) provide primary medical care, mental health, and/or oral health services to a primary medical care, mental...

  15. 75 FR 36102 - Recruitment of Sites for Assignment of National Health Service Corps (NHSC) Personnel Obligated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-24

    ... through the Private Practice Option. Eligible HPSAs and Entities To be eligible to receive assignment of... applications for assignment of NHSC members goes to sites that: (1) Provide primary medical care, mental health, and/or oral health services to a primary medical care, mental health, or dental HPSA of...

  16. West Bank barrier decreases access to schools and health services.

    PubMed

    Qato, Dima; Doocy, Shannon; Tsuchida, Deborah; Greenough, P Gregg; Burnham, Gilbert

    2007-01-01

    In 2001, the Israeli government announced the construction of the West Bank barrier. The stated purpose of construction to prevent attacks by Palestinians on Israeli citizens. In a subsequent advisory opinion, the International Court of Justice decided the wall would block access to health care and education, and was "contrary to international law". The Barrier, with its limited number of gates, has been criticized by humanitarian agencies for limiting access of Palestinians to employment, health care, and education, but was defended by the Israeli government as an important security measure. A survey of key informants was conducted in May 2004 at 78 health facilities and 121 schools in the northern West Bank districts ofJenin, Qalqilya, and Tulkarem, in order to assess the impact of the Barrier on access and use of health and educational services. The Barrier negatively affected access to education and health care, in terms of statistically significant increases in distance and travel time to schools and health facilities. In several areas, service utilization, assessed by weekly visits to health facilities and student enrollment, was affected by barrier construction, although these findings were not statistically significant. A significant decrease in staff attendance was observed at health facilities and schools. The Barrier may have long-term effects on access and utilization of health and educational services among Palestinians in the northern West Bank.

  17. Patient-centred access to health care: conceptualising access at the interface of health systems and populations

    PubMed Central

    2013-01-01

    Background Access is central to the performance of health care systems around the world. However, access to health care remains a complex notion as exemplified in the variety of interpretations of the concept across authors. The aim of this paper is to suggest a conceptualisation of access to health care describing broad dimensions and determinants that integrate demand and supply-side-factors and enabling the operationalisation of access to health care all along the process of obtaining care and benefiting from the services. Methods A synthesis of the published literature on the conceptualisation of access has been performed. The most cited frameworks served as a basis to develop a revised conceptual framework. Results Here, we view access as the opportunity to identify healthcare needs, to seek healthcare services, to reach, to obtain or use health care services, and to actually have a need for services fulfilled. We conceptualise five dimensions of accessibility: 1) Approachability; 2) Acceptability; 3) Availability and accommodation; 4) Affordability; 5) Appropriateness. In this framework, five corresponding abilities of populations interact with the dimensions of accessibility to generate access. Five corollary dimensions of abilities include: 1) Ability to perceive; 2) Ability to seek; 3) Ability to reach; 4) Ability to pay; and 5) Ability to engage. Conclusions This paper explains the comprehensiveness and dynamic nature of this conceptualisation of access to care and identifies relevant determinants that can have an impact on access from a multilevel perspective where factors related to health systems, institutions, organisations and providers are considered with factors at the individual, household, community, and population levels. PMID:23496984

  18. Social capital and health care access: a systematic review.

    PubMed

    Derose, Kathryn Pitkin; Varda, Danielle M

    2009-06-01

    There is a growing interest in community-level characteristics such as social capital and its relationship to health care access. To assess the rigor with which this construct has been empirically applied in research on health care access, a systematic review was conducted. A total of 2,396 abstracts were reviewed, and 21 met the criteria of examining some measure of social capital and its effects on health care access. The review found a lack of congruence in how social capital was measured and interpreted and a general inconsistency in findings, which made it difficult to draw firm conclusions about the effects of social capital on health care access. Insights from the social network literature can help improve the conceptual and measurement problems. Future work should distinguish among bonding, bridging, and linking social capital and their sources and benefits, and examine whether three dimensions of social capital actually exist: cognitive, behavioral, and structural.

  19. Finland's strategy and implementation of citizens' access to health information.

    PubMed

    Ruotsalainen, Pekka; Iivari, Anna-Kaisa; Doupi, Persephone

    2008-01-01

    The strategy for utilizing information technology in the field of social welfare and health care in Finland was published in 1996. It was redefined in the year 2006. This updated strategy defined basic principles how digitized EHRs should be stored, accessed, disclosed and archived. The strategy together with new legislation opened the right to patients and citizens to access their own EHRs, ePrescriptions and audit-logs via the Internet. A national WEB-service platform forms the base for both public and private eHealth applications. National identification and PKI-services cover health professionals, patients and entities. Citizen's consent management is provided at national level. The access to personal health information is managed using rules derived from legislation. The roll-out of the national health information infrastructure with citizen access to personal health information should by law be finalized before the end of 2011. The implementation of the NHII is demanding, but the real challenge is to clearly understand what the impacts of citizen access to personal health information are and to what direction this kind of services should be developed. At the present state, the Finnish EHR-archive contains only information created by a health professional. Citizens' eHealth services can not be limited to the use of regulated EHR data and ePrescriptions. For health promotion, proactive prevention and health prediction more comprehensive information is needed. Therefore the next step is to develop legislation and to build a trusted environment for the use and access of heterogeneous health and welfare information.

  20. Personalized medicine and access to health care: potential for inequitable access?

    PubMed

    McClellan, Kelly A; Avard, Denise; Simard, Jacques; Knoppers, Bartha M

    2013-02-01

    Personalized medicine promises that an individual's genetic information will be increasingly used to prioritize access to health care. Use of genetic information to inform medical decision making, however, raises questions as to whether such use could be inequitable. Using breast cancer genetic risk prediction models as an example, on the surface clinical use of genetic information is consistent with the tools provided by evidence-based medicine, representing a means to equitably distribute limited health-care resources. However, at present, given limitations inherent to the tools themselves, and the mechanisms surrounding their implementation, it becomes clear that reliance on an individual's genetic information as part of medical decision making could serve as a vehicle through which disparities are perpetuated under public and private health-care delivery models. The potential for inequities arising from using genetic information to determine access to health care has been rarely discussed. Yet, it raises legal and ethical questions distinct from those raised surrounding genetic discrimination in employment or access to private insurance. Given the increasing role personalized medicine is forecast to play in the provision of health care, addressing a broader view of what constitutes genetic discrimination, one that occurs along a continuum and includes inequitable access, will be needed during the implementation of new applications based on individual genetic profiles. Only by anticipating and addressing the potential for inequitable access to health care occurring from using genetic information will we move closer to realizing the goal of personalized medicine: to improve the health of individuals.

  1. [Immigrants' access to health care in Spain: a review].

    PubMed

    Llop-Gironés, Alba; Vargas Lorenzo, Ingrid; Garcia-Subirats, Irene; Aller, Marta-Beatriz; Vázquez Navarrete, María Luisa

    2014-01-01

    An important proportion of the population in Spain is immigrant and the international literature indicates their inadequate access to health services. The objective is to contribute to improving the knowledge on access to health care of the immigrant population in Spain. Review of original papers published (1998-2012) on access to health services of the immigrant population in Spain published in Medline and MEDES. Out of 319 studies, 20 were selected, applying predefined criteria. The results were analyzed using the Aday and Andersen framework. Among the publications, 13 quantitative studies analysed differences in health care use between the immigrant and the native population, and 7 studied determinants of access of immigrants. Studies showed less use of specialized care by immigrants, higher use of emergency care and no differences in the use of primary care between groups. Five quantitative articles on determinants of access focused on factors related to the immigrant population (sex, age, educational level and holding private health insurance), but without observing clear patterns. The two qualitative studies analyzed factors related to health services, describing access to healthcare barriers such as the limited provision of information or the requirements for personal health card. Access to health care in immigrants has been scarcely studied, using different approaches and the barely analysed factors related to the services. No clear patterns were observed, as differences depend on the classification of migrants according to country of origin and the level of care. However, studies showed less use of specialized care by immigrants, higher use of emergency care and the existence of determinants of access different to their needs.

  2. 78 FR 9705 - National Advisory Council on the National Health Service Corps; Request for Nominations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-11

    ..., customer service, marketing, organizational partnerships, research, and clinical practice. We are looking..., dentists, mid-level professionals (i.e., nurses, physician assistants), mental or behavioral health...

  3. Access to health care and community social capital.

    PubMed

    Hendryx, Michael S; Ahern, Melissa M; Lovrich, Nicholas P; McCurdy, Arthur H

    2002-02-01

    To test the hypothesis that variation in reported access to health care is positively related to the level of social capital present in a community. The 1996 Household Survey of the Community Tracking Study, drawn from 22 metropolitan statistical areas across the United States (n = 19,672). Additional data for the 22 communities are from a 1996 multicity broadcast media marketing database, including key social capital indicators, the 1997 National Profile of Local Health Departments survey, and Interstudy, American Hospital Association, and American Medical Association sources. The design is cross-sectional. Self-reported access to care problems is the dependent variable. Independent variables include individual sociodemographic variables, community-level health sector variables, and social capital variables. Data are merged from the various sources and weighted to be population representative and are analyzed using hierarchical categorical modeling. Persons who live in metropolitan statistical areas featuring higher levels of social capital report fewer problems accessing health care. A higher HMO penetration rate in a metropolitan statistical area was also associated with fewer access problems. Other health sector variables were not related to health care access. The results observed for 22 major U.S. cities are consistent with the hypothesis that community social capital enables better access to care, perhaps through improving community accountability mechanisms.

  4. Family Health Care Accessibility Act of 2011

    THOMAS, 112th Congress

    Sen. Thune, John [R-SD

    2011-05-25

    Senate - 05/25/2011 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  5. Family Health Care Accessibility Act of 2013

    THOMAS, 113th Congress

    Sen. Thune, John [R-SD

    2013-05-15

    Senate - 05/15/2013 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  6. Confidentiality and access to sexual health services.

    PubMed

    Ryder, Nathan; McNulty, Anna M

    2009-06-01

    Confidentiality concerns are often described as barriers to seeking sexual health care. There has been little research describing the relative importance of confidentiality to clients of sexual health clinics, and whether members of high-risk groups have greater concerns. This study aimed to determine the importance of confidentiality and anonymity to clients of a public sexual health clinic, and determine associations with gender and sexuality. A self-administered questionnaire was offered to consecutive new English-speaking clients in October and November 2007. Participants were asked to describe the reasons for presenting, likelihood of disclosing identifying information, and concern should specific people and agencies become aware of their attendance. Of 350 eligible clients, 270 (77%) participated in the survey. Expert care was included in the top three reasons for choosing a sexual health clinic rather than a general practitioner by over half of participants, while confidentiality and cost were each included in the top three reasons by one-third of respondents respectively. Over 90% of clients reported they were likely to give accurate identifying information to the clinic. Participants were comfortable with disclosure of information to other health-care workers but became increasingly unwilling for information to be shared with services not directly involved in their care. Overall there were few associations with gender or sexuality. Clients choose to attend our clinic for a variety of reasons, with confidentiality and anonymity being of lesser importance than competence and cost. Confidentiality is important to the majority of clients, whereas few desire anonymity. Most clients would accept information being shared with other health services, suggesting that confidentiality may not be a barrier to the use of electronic health records in sexual health clinics.

  7. Patient Access to Their Health Record Using Open Source EHR.

    PubMed

    Chelsom, John; Dogar, Naveed

    2015-01-01

    In both Europe and North America, patients are beginning to gain access to their health records in electronic form. Using the open source cityEHR as an example, we have focussed on the needs of clinical users to gather requirements for patient access and have implemented these requirements in a new application called cityEHR-PA. The development of a separate application for patient access was necessary to address requirements for security and ease of use. The use of open standards throughout the design of the EHR allows the possibility of third parties to develop applications for patient access, consuming the individual patient record extracted from the full EHR.

  8. Semantically Enriched Data Access Policies in eHealth.

    PubMed

    Drozdowicz, Michał; Ganzha, Maria; Paprzycki, Marcin

    2016-11-01

    Internet of Things (IoT) requires novel solutions to facilitate autonomous, though controlled, resource access. Access policies have to facilitate interactions between heterogeneous entities (devices and humans). Here, we focus our attention on access control in eHealth. We propose an approach based on enriching policies, based on well-known and widely-used eXtensible Access Control Markup Language, with semantics. In the paper we describe an implementation of a Policy Information Point integrated with the HL7 Security and Privacy Ontology.

  9. Health research, fair benefits and access to medicines.

    PubMed

    Lertsithichai, Panuwat

    2006-04-01

    Access to medicines within the context of health research is viewed as a negotiation for 'fair benefits" where it is judged by the host country that access to medicines is the most important and desirable benefit. Research ethics committees in the host country, both local and central, are set to be key players in that determination. However, access to medicines, or "reasonable availability" of medicines in research ethics guidelines, may be difficult to achieve in practice. In extreme cases, the problem of access to medicines may need to be viewed as a global problem, beyond the negotiations within the fair benefits framework.

  10. 77 FR 22329 - Recruitment of Sites for Assignment of Corps Personnel Obligated Under the National Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-13

    ... the teaching takes place in a HRSA-funded Teaching Health Center (THC) (see Sec. 340H of the U.S. Public Health Service Act, 42 United States Code Sec. 256h). Teaching activities in a HRSA-funded THC...

  11. 78 FR 39738 - National Advisory Council on the National Health Service Corps; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-02

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National... retention resources, and partnerships. The public can join the meeting via audio conference call on the date... INFORMATION CONTACT: Njeri Jones, Bureau of Clinician Recruitment and Service, Health Resources and...

  12. Immigrants’ Access to Health Insurance: No Equality without Awareness

    PubMed Central

    Dzúrová, Dagmar; Winkler, Petr; Drbohlav, Dušan

    2014-01-01

    The Czech government has identified commercial health insurance as one of the major problems for migrants’ access to health care. Non-EU immigrants are eligible for public health insurance only if they have employee status or permanent residency. The present study examined migrants’ access to the public health insurance system in Czechia. A cross-sectional survey of 909 immigrants from Ukraine and Vietnam was conducted in March and May 2013, and binary logistic regression was applied in data analysis. Among immigrants entitled to Czech public health insurance due to permanent residency/asylum, 30% were out of the public health insurance system, and of those entitled by their employment status, 50% were out of the system. Migrants with a poor knowledge of the Czech language are more likely to remain excluded from the system of public health insurance. Instead, they either remain in the commercial health insurance system or they simultaneously pay for both commercial and public health insurance, which is highly disadvantageous. Since there are no reasonable grounds to stay outside the public health insurance, it is concluded that it is lack of awareness that keeps eligible immigrants from entering the system. It is suggested that no equal access to health care exists without sufficient awareness about health care system. PMID:25026082

  13. Immigrants' access to health insurance: no equality without awareness.

    PubMed

    Dzúrová, Dagmar; Winkler, Petr; Drbohlav, Dušan

    2014-07-14

    The Czech government has identified commercial health insurance as one of the major problems for migrants' access to health care. Non-EU immigrants are eligible for public health insurance only if they have employee status or permanent residency. The present study examined migrants' access to the public health insurance system in Czechia. A cross-sectional survey of 909 immigrants from Ukraine and Vietnam was conducted in March and May 2013, and binary logistic regression was applied in data analysis. Among immigrants entitled to Czech public health insurance due to permanent residency/asylum, 30% were out of the public health insurance system, and of those entitled by their employment status, 50% were out of the system. Migrants with a poor knowledge of the Czech language are more likely to remain excluded from the system of public health insurance. Instead, they either remain in the commercial health insurance system or they simultaneously pay for both commercial and public health insurance, which is highly disadvantageous. Since there are no reasonable grounds to stay outside the public health insurance, it is concluded that it is lack of awareness that keeps eligible immigrants from entering the system. It is suggested that no equal access to health care exists without sufficient awareness about health care system.

  14. Engaging older adults in high impact volunteering that enhances health: recruitment and retention in The Experience Corps Baltimore.

    PubMed

    Martinez, Iveris L; Frick, Kevin; Glass, Thomas A; Carlson, Michelle; Tanner, Elizabeth; Ricks, Michelle; Fried, Linda P

    2006-09-01

    Engagement in social and generative activities has benefits for the well-being of older adults; hence, methods for broadly engaging them in such activities are desired. Experience Corps Baltimore, a social model for health promotion for older adult volunteers in public schools, offers insight to such successful recruitment and retention. We report on data over a 4-year period in Baltimore City, Maryland, and describe a five-stage screening process implemented to recruit a diverse group of senior volunteers who would remain in the program for at least 1 year. The sample consisted of 443 older adults expressing an interest in and screened for volunteering. Comparisons were made with Chi-square and Fisher's t-test between those who entered the program and those who did not and those who were retained in the program. Gender, race, age group, and prior volunteering were significant in ultimate volunteer service in the schools. Overall, 38% of 443 persons recruited entered the schools; 94% of participants were over 60 years (p = 0.05) with a mean age of 69 years; 90% were women (p = 0.03), and 93% African-American (p = 0.005); 57% had not volunteered in the past year (p = 0.004). Ninety-two percent were retained in the first year; 80% returned a second year. Among the latter, 83% had <12 years of education (p = 0.001). Participants remained in the program for a second year of volunteering regardless of baseline MMSE score, self-reported health, and motivation for volunteering. In conclusion, it is possible to recruit and retain a diverse pool of older adults to participate in a high-intensity volunteer program, including non-traditional volunteers. Of special note is the success in recruiting African-American women and those with lower education, who may particularly benefit from health promotion.

  15. Engaging Older Adults in High Impact Volunteering that Enhances Health: Recruitment and Retention in the Experience Corps® Baltimore

    PubMed Central

    Frick, Kevin; Glass, Thomas A.; Carlson, Michelle; Tanner, Elizabeth; Ricks, Michelle; Fried, Linda P.

    2006-01-01

    Engagement in social and generative activities has benefits for the well-being of older adults; hence, methods for broadly engaging them in such activities are desired. Experience Corps Baltimore, a social model for health promotion for older adult volunteers in public schools, offers insight to such successful recruitment and retention. We report on data over a 4-year period in Baltimore City, Maryland, and describe a five-stage screening process implemented to recruit a diverse group of senior volunteers who would remain in the program for at least 1 year. The sample consisted of 443 older adults expressing an interest in and screened for volunteering. Comparisons were made with Chi-square and Fisher’s t-test between those who entered the program and those who did not and those who were retained in the program. Gender, race, age group, and prior volunteering were significant in ultimate volunteer service in the schools. Overall, 38% of 443 persons recruited entered the schools; 94% of participants were over 60 years (p = 0.05) with a mean age of 69 years; 90% were women (p = 0.03), and 93% African-American (p = 0.005); 57% had not volunteered in the past year (p = 0.004). Ninety-two percent were retained in the first year; 80% returned a second year. Among the latter, 83% had <12 years of education (p = 0.001). Participants remained in the program for a second year of volunteering regardless of baseline MMSE score, self-reported health, and motivation for volunteering. In conclusion, it is possible to recruit and retain a diverse pool of older adults to participate in a high-intensity volunteer program, including non-traditional volunteers. Of special note is the success in recruiting African-American women and those with lower education, who may particularly benefit from health promotion. PMID:16758336

  16. Effects of ParentCorps in Prekindergarten on Child Mental Health and Academic Performance: Follow-up of a Randomized Clinical Trial Through 8 Years of Age.

    PubMed

    Brotman, Laurie Miller; Dawson-McClure, Spring; Kamboukos, Dimitra; Huang, Keng-Yen; Calzada, Esther J; Goldfeld, Keith; Petkova, Eva

    2016-12-01

    Low-income minority children living in urban neighborhoods are at high risk for mental health problems and underachievement. ParentCorps, a family-centered, school-based intervention in prekindergarten, improves parenting and school readiness (ie, self-regulation and preacademic skills) in 2 randomized clinical trials. The longer-term effect on child mental health and academic performance is not known. To examine whether ParentCorps delivered as an enhancement to prekindergarten programs in high-poverty urban schools leads to fewer mental health problems and increased academic performance in the early elementary school years. This is a 3-year follow-up study of a cluster randomized clinical trial of ParentCorps in public schools with prekindergarten programs in New York City. Ten elementary schools serving a primarily low-income, black student population were randomized in 2005, and 4 consecutive cohorts of prekindergarten students were enrolled from September 12, 2005, through December 31, 2008. We report follow-up for the 3 cohorts enrolled after the initial year of implementation. Data analysis was performed from September 1, 2014, to December 31, 2015. ParentCorps included professional development for prekindergarten and kindergarten teachers and a program for parents and prekindergarten students (13 two-hour group sessions delivered after school by teachers and mental health professionals). Annual teacher ratings of mental health problems and academic performance and standardized tests of academic achievement in kindergarten and second grade by testers masked to the intervention or control group randomization. A total of 1050 children (4 years old; 518 boys [49.3%] and 532 girls [50.7%]) in 99 prekindergarten classrooms participated in the trial (88.1% of the prekindergarten population), with 792 students enrolled from 2006 to 2008. Most families in the follow-up study (421 [69.6%]) were low income; 680 (85.9%) identified as non-Latino black, 78 (9.8%) as

  17. Health Care Access and Health Behaviors Among Men Who Have Sex With Men: The Cost of Health Disparities

    ERIC Educational Resources Information Center

    McKirnan, David J.; Du Bois, Steve N.; Alvy, Lisa M.; Jones, Kyle

    2013-01-01

    Men who have sex with men (MSM) appear to experience barriers to health care compared with general population men. This report examines individual differences in health care access within a diverse sample of urban MSM ("N" = 871). The authors examined demographic differences in health care access and the relation between access and…

  18. Health Care Access and Health Behaviors Among Men Who Have Sex With Men: The Cost of Health Disparities

    ERIC Educational Resources Information Center

    McKirnan, David J.; Du Bois, Steve N.; Alvy, Lisa M.; Jones, Kyle

    2013-01-01

    Men who have sex with men (MSM) appear to experience barriers to health care compared with general population men. This report examines individual differences in health care access within a diverse sample of urban MSM ("N" = 871). The authors examined demographic differences in health care access and the relation between access and…

  19. Electronic health records access during a disaster.

    PubMed

    Morchel, Herman; Raheem, Murad; Stevens, Lee

    2014-01-01

    As has been demonstrated previously, medical care providers that employ an electronic health records (EHR) system provide more appropriate, cost effective care. Those providers are also better positioned than those who rely on paper records to recover if their facility is damaged as a result of severe storms, fires, or other events. The events surrounding Superstorm Sandy in 2012 made it apparent that, with relatively little additional effort and investment, health care providers with EHR systems may be able to use those systems for patient care purposes even during disasters that result in damage to buildings and facilities, widespread power outages, or both.

  20. Electronic Health Records Access During a Disaster

    PubMed Central

    Morchel, Herman; Raheem, Murad; Stevens, Lee

    2014-01-01

    As has been demonstrated previously, medical care providers that employ an electronic health records (EHR) system provide more appropriate, cost effective care. Those providers are also better positioned than those who rely on paper records to recover if their facility is damaged as a result of severe storms, fires, or other events. The events surrounding Superstorm Sandy in 2012 made it apparent that, with relatively little additional effort and investment, health care providers with EHR systems may be able to use those systems for patient care purposes even during disasters that result in damage to buildings and facilities, widespread power outages, or both. PMID:24683443

  1. Role of Primary Health Care in Ensuring Access to Medicines

    PubMed Central

    Sambala, Evanson Z; Sapsed, Susan; Mkandawire, Mercy L

    2010-01-01

    To examine ways of ensuring access to health services within the framework of primary health care (PHC), since the goal of PHC to make universal health care available to all people has become increasingly neglected amid emerging themes of globalization, trade, and foreign policy. From a public health point of view, we argue that the premise of PHC can unlock barriers to health care services and contribute greatly to determining collective health through the promotion of universal basic health services. PHC has the most sophisticated and organized infrastructure, theories, and political principles, with which it can deal adequately with the issues of inequity, inequality, and social injustice which emerge from negative economic externalities and neo-liberal economic policies. Addressing these issues, especially the complex social and political influences that restrict access to medicines, may require the integration of different health initiatives into PHC. Based on current systems, PHC remains the only conventional health delivery service that can deal with resilient public health problems adequately. However, to strengthen its ability to do so, we propose the revitalization of PHC to incorporate scholarship that promotes human rights, partnerships, research and development, advocacy, and national drug policies. The concept of PHC can improve access; however, this will require the urgent interplay among theoretical, practical, political, and sociological influences arising from the economic, social, and political determinants of ill health in an era of globalization. PMID:20564760

  2. Access to medicines from a health system perspective

    PubMed Central

    Bigdeli, Maryam; Jacobs, Bart; Tomson, Goran; Laing, Richard; Ghaffar, Abdul; Dujardin, Bruno; Van Damme, Wim

    2013-01-01

    Most health system strengthening interventions ignore interconnections between systems components. In particular, complex relationships between medicines and health financing, human resources, health information and service delivery are not given sufficient consideration. As a consequence, populations' access to medicines (ATM) is addressed mainly through fragmented, often vertical approaches usually focusing on supply, unrelated to the wider issue of access to health services and interventions. The objective of this article is to embed ATM in a health system perspective. For this purpose, we perform a structured literature review: we examine existing ATM frameworks, review determinants of ATM and define at which level of the health system they are likely to occur; we analyse to which extent existing ATM frameworks take into account access constraints at different levels of the health system. Our findings suggest that ATM barriers are complex and interconnected as they occur at multiple levels of the health system. Existing ATM frameworks only partially address the full range of ATM barriers. We propose three essential paradigm shifts that take into account complex and dynamic relationships between medicines and other components of the health system. A holistic view of demand-side constraints in tandem with consideration of multiple and dynamic relationships between medicines and other health system resources should be applied; it should be recognized that determinants of ATM are rooted in national, regional and international contexts. These are schematized in a new framework proposing a health system perspective on ATM. PMID:23174879

  3. Family Health Care Accessibility Act of 2010

    THOMAS, 111th Congress

    Rep. Murphy, Tim [R-PA-18

    2009-03-26

    09/24/2010 Received in the Senate and Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  4. Family Health Care Accessibility Act of 2010

    THOMAS, 111th Congress

    Rep. Murphy, Tim [R-PA-18

    2009-03-26

    Senate - 09/24/2010 Received in the Senate and Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  5. Family Health Care Accessibility Act of 2010

    THOMAS, 111th Congress

    Rep. Murphy, Tim [R-PA-18

    2009-03-26

    09/24/2010 Received in the Senate and Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  6. Detecting Inappropriate Access to Electronic Health Records Using Collaborative Filtering.

    PubMed

    Menon, Aditya Krishna; Jiang, Xiaoqian; Kim, Jihoon; Vaidya, Jaideep; Ohno-Machado, Lucila

    2014-04-01

    Many healthcare facilities enforce security on their electronic health records (EHRs) through a corrective mechanism: some staff nominally have almost unrestricted access to the records, but there is a strict ex post facto audit process for inappropriate accesses, i.e., accesses that violate the facility's security and privacy policies. This process is inefficient, as each suspicious access has to be reviewed by a security expert, and is purely retrospective, as it occurs after damage may have been incurred. This motivates automated approaches based on machine learning using historical data. Previous attempts at such a system have successfully applied supervised learning models to this end, such as SVMs and logistic regression. While providing benefits over manual auditing, these approaches ignore the identity of the users and patients involved in a record access. Therefore, they cannot exploit the fact that a patient whose record was previously involved in a violation has an increased risk of being involved in a future violation. Motivated by this, in this paper, we propose a collaborative filtering inspired approach to predicting inappropriate accesses. Our solution integrates both explicit and latent features for staff and patients, the latter acting as a personalized "finger-print" based on historical access patterns. The proposed method, when applied to real EHR access data from two tertiary hospitals and a file-access dataset from Amazon, shows not only significantly improved performance compared to existing methods, but also provides insights as to what indicates an inappropriate access.

  7. Detecting Inappropriate Access to Electronic Health Records Using Collaborative Filtering

    PubMed Central

    Menon, Aditya Krishna; Jiang, Xiaoqian; Kim, Jihoon; Vaidya, Jaideep; Ohno-Machado, Lucila

    2013-01-01

    Many healthcare facilities enforce security on their electronic health records (EHRs) through a corrective mechanism: some staff nominally have almost unrestricted access to the records, but there is a strict ex post facto audit process for inappropriate accesses, i.e., accesses that violate the facility’s security and privacy policies. This process is inefficient, as each suspicious access has to be reviewed by a security expert, and is purely retrospective, as it occurs after damage may have been incurred. This motivates automated approaches based on machine learning using historical data. Previous attempts at such a system have successfully applied supervised learning models to this end, such as SVMs and logistic regression. While providing benefits over manual auditing, these approaches ignore the identity of the users and patients involved in a record access. Therefore, they cannot exploit the fact that a patient whose record was previously involved in a violation has an increased risk of being involved in a future violation. Motivated by this, in this paper, we propose a collaborative filtering inspired approach to predicting inappropriate accesses. Our solution integrates both explicit and latent features for staff and patients, the latter acting as a personalized “finger-print” based on historical access patterns. The proposed method, when applied to real EHR access data from two tertiary hospitals and a file-access dataset from Amazon, shows not only significantly improved performance compared to existing methods, but also provides insights as to what indicates an inappropriate access. PMID:24683293

  8. Maternal health care in India: access and demand determinants.

    PubMed

    Arokiasamy, Perianaygam; Pradhan, Jalandhar

    2013-10-01

    In this paper, we assess the degree to which the observed consistency in maternal health-care utilization can be accounted for by social and economic demand determinants at individual and household level on the one hand and community access to health services in terms of health, road and education facilities on the other. Data from the three rounds of national family health survey of India (NFHS-1, -2 and -3) conducted in 1992–93, 1998–99 and 2005–06 are used in this analysis. The results of the analysis are presented in two sections. First, statewise profiles of maternal health-care utilization from NFHS-1, -2 and -3 are presented to compare the trends. Second, the influence of demand and access factors estimated from multi-level logistic regression models are presented for selected states of India. Results reveal that inequalities in maternal health-care utilization by socio-economic status have narrowed because of the impact of complementing factors of greater community access, and social and economical advancement in the south Indian states, where overall maternal health-care coverage is at the top end of the scale. In contrast, in the demographically lagging northern states of India, which are at the bottom end of the health coverage scale, both access and socio-economic demand determinants indicate greater inequalities in maternal health-care utilization. Lack of access to health care, slow progress in socio-economic conditions and cultural constraints are major determinants of poor maternal health-care coverage among Indian states.

  9. Access to Health Care. Vol. 1, Nos. 1-2.

    ERIC Educational Resources Information Center

    Griss, Bob

    1988-01-01

    The problems of access, adequacy, and affordability of health insurance for persons with severe chronic conditions are analyzed. Part 1 defines the target population by considering conceptual and methodological issues, and examines statistics from various national surveys. Part 2 examines the distribution of health insurance throughout the…

  10. Immigrant Health in Rural Maryland: A Qualitative Study of Major Barriers to Health Care Access.

    PubMed

    Sangaramoorthy, Thurka; Guevara, Emilia M

    2016-04-11

    Immigration to rural areas in new receiving communities like Maryland's Eastern Shore is growing. Despite a rapid rise in immigration and diminishing health system resources, little attention has been focused on barriers to health care access in this region for immigrants. A total of 33 in-depth key informant interviews with providers and immigrants were conducted. Qualitative analysis employing a constant comparison approach was used to explore emergent themes related to barriers to health care access for a growing immigrant population. Participants perceived limited health care resources, lack of health insurance coverage, high health expenditures, language barriers, and non-citizenship status as barriers to immigrants' access of health care. Findings imply that immigrants living and working on the rural Eastern Shore face serious barriers to health care access. Additional work on immigrant health in rural areas and the impacts of immigration to rural health systems are needed.

  11. Universal access: making health systems work for women

    PubMed Central

    2012-01-01

    Universal coverage by health services is one of the core obligations that any legitimate government should fulfil vis-à-vis its citizens. However, universal coverage may not in itself ensure universal access to health care. Among the many challenges to ensuring universal coverage as well as access to health care are structural inequalities by caste, race, ethnicity and gender. Based on a review of published literature and applying a gender-analysis framework, this paper highlights ways in which the policies aimed at promoting universal coverage may not benefit women to the same extent as men because of gender-based differentials and inequalities in societies. It also explores how ‘gender-blind’ organisation and delivery of health care services may deny universal access to women even when universal coverage has been nominally achieved. The paper then makes recommendations for addressing these. PMID:22992384

  12. Rural Health Care Access and Policy in Developing Countries.

    PubMed

    Strasser, Roger; Kam, Sophia M; Regalado, Sophie M

    2016-01-01

    Compared to their urban counterparts, rural and remote inhabitants experience lower life expectancy and poorer health status. Nowhere is the worldwide shortage of health professionals more pronounced than in rural areas of developing countries. Sub-Saharan Africa (SSA) includes a disproportionately large number of developing countries; therefore, this article explores SSA in depth as an example. Using the conceptual framework of access to primary health care, sustainable rural health service models, rural health workforce supply, and policy implications, this article presents a review of the academic and gray literature as the basis for recommendations designed to achieve greater health equity. An alternative international standard for health professional education is recommended. Decision makers should draw upon the expertise of communities to identify community-specific health priorities and should build capacity to enable the recruitment and training of local students from underserviced areas to deliver quality health care in rural community settings.

  13. [How do immigrant women access health services in the Basque Country? Perceptions of health professionals].

    PubMed

    Pérez-Urdiales, Iratxe; Goicolea, Isabel

    2017-09-12

    To determine the perception of health professionals working in alternative health centres on the barriers and facilitators in the access by immigrant women to general public health services and sexual and reproductive health in the Basque Country. Basque Country. Analysis of qualitative content based on 11 individual interviews. Health professionals working in alternative health centres of Primary Care and sexual and reproductive health. Data collection was performed between September and December 2015 in four alternative health centres. After transcription, the units of meaning, codes and categories were identified. Four categories emerged from the analysis, which represented how the characteristics of immigrant women (Tell me how you are and I will tell you how to access), the attitude of the administrative and health staff ("When they are already taken care of"), the functioning of the health system (Inflexible, passive and needs-responsive health system), and health policies ("If you do not meet the requirements, you do not go in. The law is the law") influence access to health services of immigrant women. This study shows that there are a considerable number of barriers and few facilitators to the access by immigrant women to public health and sexual and reproductive health services in the Basque Country. The alternative health centres were presented as favouring the improvement of the health of the immigrant population and in their access. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  14. The Digital Health Divide: Evaluating Online Health Information Access and Use among Older Adults

    ERIC Educational Resources Information Center

    Hall, Amanda K.; Bernhardt, Jay M.; Dodd, Virginia; Vollrath, Morgan W.

    2015-01-01

    Objective: Innovations in health information technology (HIT) provide opportunities to reduce health care spending, improve quality of care, and improve health outcomes for older adults. However, concerns relating to older adults' limited access and use of HIT, including use of the Internet for health information, fuel the digital health divide…

  15. The Digital Health Divide: Evaluating Online Health Information Access and Use among Older Adults

    ERIC Educational Resources Information Center

    Hall, Amanda K.; Bernhardt, Jay M.; Dodd, Virginia; Vollrath, Morgan W.

    2015-01-01

    Objective: Innovations in health information technology (HIT) provide opportunities to reduce health care spending, improve quality of care, and improve health outcomes for older adults. However, concerns relating to older adults' limited access and use of HIT, including use of the Internet for health information, fuel the digital health divide…

  16. Competition, gatekeeping, and health care access.

    PubMed

    Godager, Geir; Iversen, Tor; Ma, Ching-to Albert

    2015-01-01

    We study gatekeeping physicians' referrals of patients to specialty care. We derive theoretical results when competition in the physician market intensifies. First, due to competitive pressure, physicians refer patients to specialty care more often. Second, physicians earn more by treating patients themselves, so refer patients to specialty care less often. We assess empirically the overall effect of competition with data from a 2008-2009 Norwegian survey, National Health Insurance Administration, and Statistics Norway. From the data we construct three measures of competition: the number of open primary physician practices with and without population adjustment, and the Herfindahl-Hirschman index. The empirical results suggest that competition has negligible or small positive effects on referrals overall. Our results do not support the policy claim that increasing the number of primary care physicians reduces secondary care. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. 76 FR 30023 - Pamlico Sound and Adjacent Waters, NC; Danger Zones for Marine Corps Operations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-24

    ... Zones for Marine Corps Operations AGENCY: United States Army Corps of Engineers, DoD. ACTION: Final rule... States Marine Corps. DATES: Effective date: June 23, 2011. FOR FURTHER INFORMATION CONTACT: Mr. David... danger zone will enable the Marine Corps to control access and movement of persons, vessels and objects...

  18. Traveling Towards Disease: Transportation Barriers to Health Care Access

    PubMed Central

    Gerber, Ben S.; Sharp, Lisa K.

    2014-01-01

    Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes. PMID:23543372

  19. Traveling towards disease: transportation barriers to health care access.

    PubMed

    Syed, Samina T; Gerber, Ben S; Sharp, Lisa K

    2013-10-01

    Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes.

  20. Emergency access authorization for personally controlled online health care data.

    PubMed

    Chen, Tingting; Zhong, Sheng

    2012-02-01

    Personally controlled health records (PCHR) systems have emerged to allow patients to control their own medical data. In a PCHR system, all the access privileges to a patient's data are granted by the patient. However, in many emergency cases, it is impossible for the patient to participate in access authorization on site when immediate medical treatment is needed. To solve the emergency access authorization problem in the absence of patients, we consider two cases: a) the requester is already in the PCHR system but has not obtained the access privilege of the patient's health records, and b) the requester does not even have an account in the PCHR system to submit its request. For each of the two cases, we present a method for emergency access authorization, utilizing the weighted voting and source authentication cryptographic techniques. Our methods provide an effective, secure and private solution for emergency access authorization, that makes the existing PCHR system frameworks more practical and thus improves the patients' experiences of health care when using PCHR systems. We have implemented a prototype system as a proof of concept.

  1. Improving children's access to health care: the role of decategorization.

    PubMed Central

    Hughes, D. C.; Halfon, N.; Brindis, C. D.; Newacheck, P. W.

    1996-01-01

    Far too many children in this country are unable to obtain the health care they need because of barriers that prohibit easy access. Among the most significant obstacles are financial barriers, including lack of adequate health insurance and inadequate funding of programs for low-income children and those with special health-care needs. Another set of "non-financial" barriers are related to the categorical nature of addressing children's health-care needs, which impedes access by increasing the complexity and burden of seeking care and discourages providers from providing care. Decategorization represents an appealing partial remedy to these problems because it can lead to fundamental and lasting changes in financing and delivering health services. The greatest appeal of decategorization is its potential to improve access to care with the expenditure of little or no new funds. Decategorization also holds considerable risk. Depending on how it is designed and implemented, decategorization may lead to diminished access to care by serving as a foil for budget cuts or by undermining essential standards of care. However, these risks do not negate the value of exploring decategorization as an approach that can be taken today to better organize services and ensure that existing resources adequately meet children's needs. In this report we examine the role of decategorization as a mechanism for removing the barriers to care that are created by categorical funding of health programs. PMID:8982519

  2. Experience Corps: A dual trial to promote the health of older adults and children's academic success

    PubMed Central

    Fried, Linda P.; Carlson, Michelle C.; McGill, Sylvia; Seeman, Teresa; Xue, Qian-Li; Frick, Kevin; Tan, Erwin; Tanner, Elizabeth K.; Barron, Jeremy; Frangakis, Constantine; Piferi, Rachel; Martinez, Iveris; Gruenewald, Tara; Martin, Barbara K.; Berry-Vaughn, Laprisha; Stewart, John; Dickersin, Kay; Willging, Paul R.; Rebok, George W.

    2014-01-01

    Background As the population ages, older adults are seeking meaningful, and impactful, post-retirement roles. As a society, improving the health of people throughout longer lives is a major public health goal. This paper presents the design and rationale for an effectiveness trial of Experience Corps™, an intervention created to address both these needs. This trial evaluates (1) whether senior volunteer roles within Experience Corps™ beneficially impact children's academic achievement and classroom behavior in public elementary schools and (2) impact on the health of volunteers. Methods Dual evaluations of (1) an intention-to-treat trial randomizing eligible adults 60 and older to volunteer service in Experience Corps™, or to a control arm of usual volunteering opportunities, and (2) a comparison of eligible public elementary schools receiving Experience Corps™ to matched, eligible control schools in a 1:1 control:intervention school ratio. Outcomes For older adults, the primary outcome is decreased disability in mobility and Instrumental Activities of Daily Living (IADL). Secondary outcomes are decreased frailty, falls, and memory loss; slowed loss of strength, balance, walking speed, cortical plasticity, and executive function; objective performance of IADLs; and increased social and psychological engagement. For children, primary outcomes are improved reading achievement and classroom behavior in Kindergarten through the 3rd grade; secondary outcomes are improvements in school climate, teacher morale and retention, and teacher perceptions of older adults. Summary This trial incorporates principles and practices of community-based participatory research and evaluates the dual benefit of a single intervention, versus usual opportunities, for two generations: older adults and children. PMID:23680986

  3. Experience Corps: a dual trial to promote the health of older adults and children's academic success.

    PubMed

    Fried, Linda P; Carlson, Michelle C; McGill, Sylvia; Seeman, Teresa; Xue, Qian-Li; Frick, Kevin; Tan, Erwin; Tanner, Elizabeth K; Barron, Jeremy; Frangakis, Constantine; Piferi, Rachel; Martinez, Iveris; Gruenewald, Tara; Martin, Barbara K; Berry-Vaughn, Laprisha; Stewart, John; Dickersin, Kay; Willging, Paul R; Rebok, George W

    2013-09-01

    As the population ages, older adults are seeking meaningful, and impactful, post-retirement roles. As a society, improving the health of people throughout longer lives is a major public health goal. This paper presents the design and rationale for an effectiveness trial of Experience Corps™, an intervention created to address both these needs. This trial evaluates (1) whether senior volunteer roles within Experience Corps™ beneficially impact children's academic achievement and classroom behavior in public elementary schools and (2) impact on the health of volunteers. Dual evaluations of (1) an intention-to-treat trial randomizing eligible adults 60 and older to volunteer service in Experience Corps™, or to a control arm of usual volunteering opportunities, and (2) a comparison of eligible public elementary schools receiving Experience Corps™ to matched, eligible control schools in a 1:1 control:intervention school ratio. For older adults, the primary outcome is decreased disability in mobility and Instrumental Activities of Daily Living (IADL). Secondary outcomes are decreased frailty, falls, and memory loss; slowed loss of strength, balance, walking speed, cortical plasticity, and executive function; objective performance of IADLs; and increased social and psychological engagement. For children, primary outcomes are improved reading achievement and classroom behavior in Kindergarten through the 3rd grade; secondary outcomes are improvements in school climate, teacher morale and retention, and teacher perceptions of older adults. This trial incorporates principles and practices of community-based participatory research and evaluates the dual benefit of a single intervention, versus usual opportunities, for two generations: older adults and children. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Women's access to health care: the legal framework.

    PubMed

    Cook, R J; Ngwena, C G

    2006-09-01

    The Millennium Development Goals set ambitious targets for women's health, including reductions in maternal and child mortality and combating the spread of HIV/AIDS. The law, which historically has often obstructed women's access to the health care they require, has a dynamic potential to ensure women's access that is being progressively realized. This paper identifies three legal principles that are key to advancing women's reproductive and sexual health. First, law should require that care be evidence-based, reflecting medical and social science rather than, for instance, religious ideology or morality. Second, legal guidance should be clear and transparent, so that service providers and patients know their responsibilities and entitlements without litigation to resolve uncertainties. Third, law should provide applicable measures to ensure fairness in women's access to services, both general services and those only women require. Legal developments are addressed that illustrate how law can advance women's equality, and social justice.

  5. Investigating impacts of positional error on potential health care accessibility.

    PubMed

    Bell, Scott; Wilson, Kathi; Shah, Tayyab Ikram; Gersher, Sarina; Elliott, Tina

    2012-04-01

    Accessibility to health services at the local or community level is an effective approach to measuring health care delivery in various constituencies in Canada and the United States. GIS and spatial methods play an important role in measuring potential access to health services. The Three-Step Floating Catchment Area (3SFCA) method is a GIS based procedure developed to calculate potential (spatial) accessibility as a ratio of primary health care (PHC) providers to the surrounding population in urban settings. This method uses PHC provider locations in textual/address format supplied by local, regional, or national health authorities. An automated geocoding procedure is normally used to convert such addresses to a pair of geographic coordinates. The accuracy of geocoding depends on the type of reference data and the amount of value-added effort applied. This research investigates the success and accuracy of six geocoding methods as well as how geocoding error affects the 3SFCA method. ArcGIS software is used for geocoding and spatial accessibility estimation. Results will focus on two implications of geocoding: (1) the success and accuracy of different automated and value-added geocoding; and (2) the implications of these geocoding methods for GIS-based methods that generalise results based on location data. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Improving awareness, accountability, and access through health coaching

    PubMed Central

    Liddy, Clare; Johnston, Sharon; Irving, Hannah; Nash, Kate; Ward, Natalie

    2015-01-01

    Abstract Objective To assess patients’ experiences with and perceptions of health coaching as part of their ongoing care. Design A qualitative research design using semistructured interviews that were recorded and transcribed verbatim. Setting Ottawa, Ont. Participants Eleven patients (> 18 years of age) enrolled in a health coaching pilot program who were at risk of or diagnosed with type 2 diabetes. Methods Patients’ perspectives were assessed with semistructured interviews. Interviews were conducted with 11 patients at the end of the pilot program, using a stratified sampling approach to ensure maximum variation. Main findings All patients found the overall experience with the health coaching program to be positive. Patients believed the health coaching program was effective in increasing awareness of how diabetes affected their bodies and health, in building accountability for their health-related actions, and in improving access to care and other health resources. Conclusion Patients perceive one-on-one health coaching as an acceptable intervention in their ongoing care. Patients enrolled in the health coaching pilot program believed that there was an improvement in access to care, health literacy, and accountability, all factors considered to be precursors to behavioural change. PMID:25932483

  7. Access to specialty mental health services among women in California.

    PubMed

    Kimerling, Rachel; Baumrind, Nikki

    2005-06-01

    The Anderson behavioral model was used to investigate racial and ethnic disparities in access to specialty mental health services among women in California as well as factors that might account for such disparities. The study was a cross-sectional examination of a probability sample of 3,750 California women. The main indicators of access to services were perceived need, service seeking, and service use. Multivariate models were constructed that accounted for need and enabling and demographic variables. Significant racial and ethnic variations in access to specialty mental health services were observed. African-American, Hispanic, and Asian women were significantly less likely to use specialty mental health services than white women. Multivariate analyses showed that Hispanic and Asian women were less likely than white women to report perceived need, even after frequent mental distress had been taken into account. Among women with perceived need, African-American and Asian women were less likely than white women to seek mental health services after differences in insurance status had been taken into account. Among women who sought services, Hispanic women were less likely than white women to obtain services after adjustment for the effects of poverty. Need and enabling factors did not entirely account for the observed disparities in access to services. Additional research is needed to identify gender- and culture-specific models for access to mental health services in order to decrease disparities in access. Factors such as perceived need and decisions to seek services are important factors that should be emphasized in future studies.

  8. PEACE CORPS, CONGRESSIONAL PRESENTATION, FISCAL YEAR 1967.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC.

    THIS REPORT TO CONGRESS DISCUSSES THE HISTORY, FINANCIAL POLICY, VOLUNTEER PROGRAMS, AND RATIONALE OF THE PEACE CORPS, WITH EMPHASIS ON PLANS TO IMPROVE TRAINING AND EXPAND ITS PROGRAM. PEACE CORPS TEACHING, COMMUNITY DEVELOPMENT, AGRICULTURAL DEVELOPMENT, AND HEALTH EDUCATION IN VARIOUS DEVELOPING COUNTRIES ARE REVIEWED AND EVALUATED. A PROPOSAL…

  9. Barriers to information access among county health department employees.

    PubMed

    Merrill, Jacqueline; Rockoff, Maxine; Bakken, Suzanne; Caldwell, Michael

    2007-10-11

    As part of a study to explore information use, 137 public health employees responded to the question: What are the main barriers that you face in accessing information you need to do your job? 74% of employees indicated 154 barriers. Of these 65% were related to technology or resources. Fewer barriers related to time (24%) and communication (13%). Efforts to address resource and technology barriers could improve how information is used by public health employees.

  10. [Health care access barriers and facilitators: a qualitative systematic review].

    PubMed

    Hirmas Adauy, Macarena; Poffald Angulo, Lucy; Jasmen Sepúlveda, Anita María; Aguilera Sanhueza, Ximena; Delgado Becerra, Iris; Vega Morales, Jeanette

    2013-03-01

    To determine whether health care access barriers and facilitators cut across different populations, countries, and pathologies, and if so, at which stages of health care access they occur most frequently. A qualitative systematic review of literature published between 2000 and 2010 was undertaken drawing on six international sources: Fuente Académica, MEDLINE (full-text), Academic Search Complete (a full-text multidisciplinary academic database), PubMed, SciELO, and LILACS. Scientific appraisal guidelines from the Critical Appraisal Skills Programme Español (CASPe) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) were applied. Gray literature was also reviewed. From the review of scientific literature, 19 of 1 160 articles and 8 of 12 gray literature documents were selected. A total of 230 barriers and 35 facilitators were identified in countries with different contexts and degrees of development. The 230 barriers were classified according to the Tanahashi framework: 25 corresponded to availability, 67 to access, 87 to acceptability, and 51 to contact. Most of the barriers were related to acceptability and access. The facilitating elements that were identified had to do with personal factors, the provider-client relationship, social support, knowledge about diseases, and adaptation of the services to patients. The barriers and facilitators were seen mostly in people who initiated contact with the health systems, and they occurred at all stages of health care access. Only a few of the studies looked at people who did not initiate contact with the health services. The barriers and facilitators identified were socially determined and largely a reflection of existing social inequities in the countries. To reduce or eliminate them, joint action with other non-health sectors will be necessary.

  11. [Inequities in access to information and inequities in health].

    PubMed

    Filho, Alberto Pellegrini

    2002-01-01

    This piece presents evidence that inequities in information are an important determinant of health inequities and that eliminating these inequities in access to information, especially by using new information and communication technologies (ICTs), could represent a significant advance in terms of guaranteeing the right to health for all. The piece reviews the most important international scientific research findings on the determinants of the health of populations, emphasizing the role of socioeconomic inequities and of deteriorating social capital as factors that worsen health conditions. It is noteworthy that Latin America has both socioeconomic inequities and major sectors of the population living in poverty. Among the fundamental strategies for overcoming the inequalities and the poverty are greater participation by the poor in civic life and the strengthening of social capital. The contribution that the new ICTs could make to these strategies is analyzed, and the Virtual Health Library (VHL) is discussed. Coordinated by the Latin American and Caribbean Center on Health Sciences Information (BIREME), the VHL is a contribution by the Pan American Health Organization that takes advantage of the potential of ICTs to democratize information and knowledge and consequently promote equity in health. The "digital gap" is discussed as something that can produce inequity itself and also increase other inequities, including ones in health. Prospects are discussed for overcoming this gap, emphasizing the role that governments and international organizations should play in order to expand access to the global public good that information for social development is.

  12. Nursing workloads in family health: implications for universal access1

    PubMed Central

    de Pires, Denise Elvira Pires; Machado, Rosani Ramos; Soratto, Jacks; Scherer, Magda dos Anjos; Gonçalves, Ana Sofia Resque; Trindade, Letícia Lima

    2016-01-01

    Objective to identify the workloads of nursing professionals of the Family Health Strategy, considering its implications for the effectiveness of universal access. Method qualitative study with nursing professionals of the Family Health Strategy of the South, Central West and North regions of Brazil, using methodological triangulation. For the analysis, resources of the Atlas.ti software and Thematic Content Analysis were associated; and the data were interpreted based on the labor process and workloads as theorical approaches. Results the way of working in the Family Health Strategy has predominantly resulted in an increase in the workloads of the nursing professionals, with emphasis on the work overload, excess of demand, problems in the physical infrastructure of the units and failures in the care network, which hinders its effectiveness as a preferred strategy to achieve universal access to health. On the other hand, teamwork, affinity for the work performed, bond with the user, and effectiveness of the assistance contributed to reduce their workloads. Conclusions investments on elements that reduce the nursing workloads, such as changes in working conditions and management, can contribute to the effectiveness of the Family Health Strategy and achieving the goal of universal access to health. PMID:27027679

  13. Preventing Health Damaging Behaviors and Negative Health Outcomes in Army and Marine Corps Personnel during the First Tour of Duty

    DTIC Science & Technology

    2007-01-01

    sexual violence defined as violence within one’s personal (dating or marital) relationships. The common thread through these negative health outcomes is...personal sexual violence . This research also seeks to establish the best training practices for educating young troops about health issues that impact

  14. Deported Mexican migrants: health status and access to care.

    PubMed

    Fernández-Niño, Julián Alfredo; Ramírez-Valdés, Carlos Jacobo; Cerecero-Garcia, Diego; Bojorquez-Chapela, Ietza

    2014-06-01

    OBJECTIVE To describe the health status and access to care of forced-return Mexican migrants deported through the Mexico-United States border and to compare it with the situation of voluntary-return migrants. METHODS Secondary data analysis from the Survey on Migration in Mexico's Northern Border from 2012. This is a continuous survey, designed to describe migration flows between Mexico and the United States, with a mobile-population sampling design. We analyzed indicators of health and access to care among deported migrants, and compare them with voluntary-return migrants. Our analysis sample included 2,680 voluntary-return migrants, and 6,862 deportees. We employ an ordinal multiple logistic regression model, to compare the adjusted odds of having worst self-reported health between the studied groups. RESULTS As compared to voluntary-return migrants, deportees were less likely to have medical insurance in the United States (OR = 0.05; 95%CI 0.04;0.06). In the regression model a poorer self-perceived health was found to be associated with having been deported (OR = 1.71, 95%CI 1.52;1.92), as well as age (OR = 1.03, 95%CI 1.02;1.03) and years of education (OR = 0.94 95%CI 0.93;0.95). CONCLUSIONS According to our results, deportees had less access to care while in the United States, as compared with voluntary-return migrants. Our results also showed an independent and statistically significant association between deportation and having poorer self-perceived health. To promote the health and access to care of deported Mexican migrants coming back from the United States, new health and social policies are required.

  15. Deported Mexican migrants: health status and access to care

    PubMed Central

    Fernández-Niño, Julián Alfredo; Ramírez-Valdés, Carlos Jacobo; Cerecero-Garcia, Diego; Bojorquez-Chapela, Ietza

    2014-01-01

    OBJECTIVE To describe the health status and access to care of forced-return Mexican migrants deported through the Mexico-United States border and to compare it with the situation of voluntary-return migrants. METHODS Secondary data analysis from the Survey on Migration in Mexico’s Northern Border from 2012. This is a continuous survey, designed to describe migration flows between Mexico and the United States, with a mobile-population sampling design. We analyzed indicators of health and access to care among deported migrants, and compare them with voluntary-return migrants. Our analysis sample included 2,680 voluntary-return migrants, and 6,862 deportees. We employ an ordinal multiple logistic regression model, to compare the adjusted odds of having worst self-reported health between the studied groups. RESULTS As compared to voluntary-return migrants, deportees were less likely to have medical insurance in the United States (OR = 0.05; 95%CI 0.04;0.06). In the regression model a poorer self-perceived health was found to be associated with having been deported (OR = 1.71, 95%CI 1.52;1.92), as well as age (OR = 1.03, 95%CI 1.02;1.03) and years of education (OR = 0.94 95%CI 0.93;0.95). CONCLUSIONS According to our results, deportees had less access to care while in the United States, as compared with voluntary-return migrants. Our results also showed an independent and statistically significant association between deportation and having poorer self-perceived health. To promote the health and access to care of deported Mexican migrants coming back from the United States, new health and social policies are required. PMID:25119943

  16. The health periodicals database: full-text access to consumer and technical health information.

    PubMed

    Lingle, V A

    1990-01-01

    The HEALTH PERIODICALS DATABASE, produced by the Information Access Company, is a unique online file which provides full-text access to both general interest health-related literature and key technical resources in the medical field. Available on DIALOG and CompuServe, the database is described as a useful tool for information on the health, fitness, and nutrition industries. Special features of the database are reviewed and comparisons are made with resources of similar scope.

  17. Progressive segmented health insurance: Colombian health reform and access to health services.

    PubMed

    Ruiz, Fernando; Amaya, Liliana; Venegas, Stella

    2007-01-01

    Equal access for poor populations to health services is a comprehensive objective for any health reform. The Colombian health reform addressed this issue through a segmented progressive social health insurance approach. The strategy was to assure universal coverage expanding the population covered through payroll linked insurance, and implementing a subsidized insurance program for the poorest populations, those not affiliated through formal employment. A prospective study was performed to follow-up health service utilization and out-of-pocket expenses using a cohort design. It was representative of four Colombian cities (Cendex Health Services Use and Expenditure Study, 2001). A four part econometric model was applied. The model related medical service utilization and medication with different socioeconomic, geographic, and risk associated variables. Results showed that subsidized health insurance improves health service utilization and reduces the financial burden for the poorest, as compared to those non-insured. Other social health insurance schemes preserved high utilization with variable out-of-pocket expenditures. Family and age conditions have significant effect on medical service utilization. Geographic variables play a significant role in hospital inpatient service utilization. Both, geographic and income variables also have significant impact on out-of-pocket expenses. Projected utilization rates and a simulation favor a dual policy for two-stage income segmented insurance to progress towards the universal insurance goal.

  18. Health service access and utilization among Syrian refugees in Jordan.

    PubMed

    Doocy, Shannon; Lyles, Emily; Akhu-Zaheya, Laila; Burton, Ann; Burnham, Gilbert

    2016-07-14

    The influx of Syrian refugees into Jordan presents an immense burden to the Jordanian health system. Changing lifestyles and aging populations are shifting the global disease burden towards increased non-infectious diseases including chronic conditions, co-morbidities, and injuries which are more complicated and costly to manage. The strain placed on health systems threatens the ability to ensure the health needs of both refugees and host country populations are adequately addressed. In light of the increasing challenges facing host governments and humanitarian actors to meet health needs of Syrian refugees and affected host communities, this study was undertaken to assess utilization of health services among Syrian refugees in non-camp settings. A survey of Syrian refugees in Jordan was undertaken in June 2014 to characterize health seeking behaviors and issues related to accessing care. A cluster design with probability proportional to size sampling was used to attain a nationally representative sample of 1550 non-camp Syrian refugee households. Differences in household characteristics by geographic region, facility type, and sector utilized were examined using chi-square and t-test methods. Care-seeking was high with 86.1 % of households reporting an adult sought medical care the last time it was needed. Approximately half (51.5 %) of services were sought from public sector facilities, 38.7 % in private facilities, and 9.8 % in charity/NGO facilities. Among adult care seekers, 87.4 % were prescribed medication during the most recent visit, 89.8 % of which obtained the medication. Overall, 51.8 % of households reported out-of-pocket expenditures for the consultation or medications at the most recent visit (mean US$39.9, median US$4.2). Despite high levels of care-seeking, cost was an important barrier to health service access for Syrian refugees in Jordan. The cessation of free access to health care since the time of the survey is likely to have worsened

  19. [Access to care, access to rights, and health education: stakes of the global management fo patients].

    PubMed

    Moutel, G; Hervé, C

    2001-04-21

    Together with primary care physicians, the public health clinic of the Max Fourestier Hospital (Nanterre, France) initiated a pilot experience within the framework of its access to health care network (ADES). In addition to full access to traditional health care, patients who agree to participate in this unique network benefit from a medical and social risk screening and prevention program. This program is proposed to all patients who, by definition, have one or more medical or social risk factors. At each visit, targeted history taking and the physical exam can lead to individualized propositions for a global approach to screening and prevention, whatever the initial reason for consulting. In addition, patients who require permanent care benefit from the dose link between the medical care and social care teams. Over the last year, this experience has involved 3430 consultations in a polyvalent clinic that has provided global care including health education and screening for health risks. Our analysis of the medical and ethical issues involved points out the importance of a global approach to health care.

  20. [Gender, equality, and health services access: an empirical approximation].

    PubMed

    Gómez Gómez, Elsa

    2002-01-01

    This piece describes the conceptual framework and the objectives that guided a research initiative in the Region of the Americas that was called "Gender, Equity, and Access to Health Services" and that was sponsored in 2001 by the Pan American Health Organization. The piece does not summarize the results of the six projects that were carried under the initiative, whose analyses have not all been completed. Instead, the piece discusses some of the foundations of the initiative and provides a general introduction to the country studies that were done. The six studies were done in Barbados/Jamaica, Brazil, Chile, Colombia, Ecuador, and Peru. The primary objective of the initiative was to stimulate the use of existing quantitative information in the countries, with the goal of starting a process of systematically documenting two things: 1) the unfair, unnecessary, and avoidable inequalities between men and women in their access to health care and 2) the linkages between those inequalities and other socioeconomic factors. The concept of gender equity that guided this examination of health care was not the usual one calling for the equal distribution of resources. Rather, it was the notion that resources should be allocated differentially, according to the particular needs of men and of women, and that persons should pay for health services according to their economic ability rather than their risk level. The starting point for the initiative was the premise that gender inequities in utilizing and paying for health care result from gender differences in the macroeconomic and microeconomic distribution of resources. The piece concludes that achieving equity in health care access will require a better understanding of the gender needs and gender barriers that are linked to social structures and health systems.

  1. Public access and use of health research: an exploratory study of the National Institutes of Health (NIH) Public Access Policy using interviews and surveys of health personnel.

    PubMed

    O'Keeffe, Jamie; Willinsky, John; Maggio, Lauren

    2011-11-21

    In 2008, the National Institutes of Health (NIH) Public Access Policy mandated open access for publications resulting from NIH funding (following a 12-month embargo). The large increase in access to research that will take place in the years to come has potential implications for evidence-based practice (EBP) and lifelong learning for health personnel. This study assesses health personnel's current use of research to establish whether grounds exist for expecting, preparing for, and further measuring the impact of the NIH Public Access Policy on health care quality and outcomes in light of time constraints and existing information resources. In all, 14 interviews and 90 surveys of health personnel were conducted at a community-based clinic and an independent teaching hospital in 2010. Health personnel were asked about the research sources they consulted and the frequency with which they consulted these sources, as well as motivation and search strategies used to locate articles, perceived level of access to research, and knowledge of the NIH Public Access Policy. In terms of current access to health information, 65% (57/88) of the health personnel reported being satisfied, while 32% (28/88) reported feeling underserved. Among the sources health personnel reported that they relied upon and consulted weekly, 83% (73/88) reported turning to colleagues, 77% (67/87) reported using synthesized information resources (eg, UpToDate and Cochrane Systematic Reviews), while 32% (28/88) reported that they consulted primary research literature. The dominant resources health personnel consulted when actively searching for health information were Google and Wikipedia, while 27% (24/89) reported using PubMed weekly. The most prevalent reason given for accessing research on a weekly basis, reported by 35% (31/88) of survey respondents, was to help a specific patient, while 31% (26/84) were motivated by general interest in research. The results provide grounds for expecting the NIH

  2. The Western New York Health Resources Project: developing access to local health information.

    PubMed Central

    Gray, S A; O'Shea, R; Petty, M E; Loonsk, J

    1998-01-01

    The Western New York Health Resources Project was created to fill a gap in online access to local health information resources describing the health of a defined geographic area. The project sought to identify and describe information scattered among many institutions, agencies, and individuals, and to create a database that would be widely accessible. The project proceeded in three phases with initial phases supported by grant funding. This paper describes the database development and selection of content, and concludes that a national online network of local health data representing the various geographic regions of the United States would contribute to the quality of health care in general. PMID:9681168

  3. Authorisation and access control for electronic health record systems.

    PubMed

    Blobel, Bernd

    2004-03-31

    Enabling the shared care paradigm, centralised or even decentralised electronic health record (EHR) systems increasingly become core applications in hospital information systems and health networks. For realising multipurpose use and reuse as well as inter-operability at knowledge level, EHR have to meet special architectural requirements. The component-oriented and model-based architecture should meet international standards. Especially in extended health networks realising inter-organisational communication and co-operation, authorisation cannot be organised at user level anymore. Therefore, models, methods and tools must be established to allow formal and structured policy definition, policy agreements, role definition, authorisation and access control. Based on the author's international engagement in EHR architecture and security standards referring to the revision of CEN ENV 13606, the GEHR/open EHR approach, HL7 and CORBA, models for health-specific and EHR-related roles, for authorisation management and access control have been developed. The basic concept is the separation of structural roles defining organisational entity-to-entity relationships and enabling specific acts on the one hand, and functional roles bound to specific activities and realising rights and duties on the other hand. Aggregation of organisational, functional, informational and technological components follows specific rules. Using UML and XML, the principles as well as some examples for analysis, design, implementation and maintenance of policy and authorisation management as well as access control have been practically implemented.

  4. Disparities in precarious workers' health care access in South Korea.

    PubMed

    Min, Jin-Young; Park, Shin-Goo; Hwang, Sang Hee; Min, Kyoung-Bok

    2016-12-01

    This study explored whether precarious workers have difficulties in health care access as compared with non-precarious workers. The 2008 Korean Community Health Survey data were used for this study. Information was obtained on 51,322 participants (40,514 non-precarious workers and 10,808 precarious workers). Precarious workers were defined as part-time or contingent workers. Precarious workers had significantly higher risk of limited access to hospitals (OR = 1.14; 95% CI: 1.06-1.22) and dentists (OR = 1.28; 95% CI: 1.21-1.36) than non-precarious workers; disparities in doctor contacts among precarious workers were mostly linked to not having enough money. The risk of not receiving preventive care-medical checkups (OR = 0.52; 95% CI: 0.49-0.55) or cancer screenings (OR = 0.82; 95% CI: 0.77-0.86)-was also significantly elevated among precarious workers. We found that precarious workers had more difficulty accessing health care or receiving health checkups or cancer screenings than their non-precarious counterparts. Am. J. Ind. Med. 59:1136-1144, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. Effect of the Affordable Care Act on Health Care Access.

    PubMed

    Glied, Sherry; Ma, Stephanie; Borja, Anais A

    2017-05-01

    ISSUE: The Affordable Care Act's (ACA) coverage provisions have extended health insurance coverage to millions of Americans. While the effects of the Medicaid expansion and marketplace establishments on coverage have been well studied, the resulting effects of coverage on access to health care remain unclear. GOAL: To examine how the 2014 coverage expansions affected health care access following the first open enrollment period of October 2013 to March 2014. METHODS: Analysis of data from the National Health Interview Survey (NHIS) and the Behavioral Risk Factor Surveillance System (BRFSS). FINDINGS AND CONCLUSIONS: We find that gaining insurance coverage through the expansions decreased the probability of not receiving medical care by between 20.9 percent and 25 percent. Gaining insurance coverage also increased the probability of having a usual place of care by between 47.1 percent and 86.5 percent. These findings suggest that not only has the ACA decreased the number of uninsured Americans, but has substantially improved access to care for those who gained coverage.

  6. [Stigma: Barrier to Access to Mental Health Services].

    PubMed

    Campo-Arias, Adalberto; Oviedo, Heidi Celina; Herazo, Edwin

    2014-01-01

    The perceived stigma represents a sociocultural barrier to access mental health services and prevents individuals who meet criteria for a mental disorder the possibility of receiving comprehensive and integred care. To update institutional mechanisms by which stigma related to mental disorders, perceived and perpetrated, acts as a barrier to mental health access. Stigma as a barrier to access to mental health services is due to a reduction in service requests, the allocation of limited resources to mental health, the systematic process of impoverishment of the people who suffer a mental disorder, increased risk of crime, and implications in contact with the legal system, and the invisibility of the vulnerability of these people. Structured awareness and education programs are needed to promote awareness about mental disorders, promote community-based psychosocial rehabilitation, and reintegration into productive life process. In Colombia, the frequency and variables associated with the stigma of mental disorders needs to be studied. This knowledge will enable the implementation of measures to promote the social and labor inclusion of people who meet the criteria for mental disorders. Copyright © 2014 Asociación Colombiana de Psiquiatría. All rights reserved.

  7. Health status indices and access to medical care.

    PubMed Central

    Andersen, R

    1978-01-01

    This paper examines the uses of some health status indices in measuring equity of access to medical care. Empirical examples are provided using data from national surveys of the U.S. population conducted from 1964 through 1976. A simple indicator, mean number of physician visits, suggests that between 1963 and 1976 the poor improved their position relative to the rest of the population and, indeed, currently enjoy the highest level of access. However, a second measure, the use-disability ratio indicates that the poor may still receive less care relative to their need. A third measure, the symptoms-response ratio suggests how norms of appropriate behavior might be incorporated into an access measure. PMID:645994

  8. Leveraging the cloud for electronic health record access.

    PubMed

    Coats, Brian; Acharya, Subrata

    2014-01-01

    Healthcare providers are under increasing pressure to enable widespread access to their electronic health record (EHR) systems for the patients they serve; the meaningful use incentive programs are perhaps the most significant driver encouraging this access. Elsewhere, the cloud has become extremely efficient and successful at establishing digital identities for individuals and making them interoperable across heterogeneous systems. As the healthcare industry contemplates providing patients access to their EHRs, the solution should leverage existing cloud investment, not duplicate it. Through an analysis of industry standards and similar work being performed in other industries, a trust framework has been derived for exchanging identity information. This research lays out a comprehensive structure that healthcare providers can easily use to integrate their EHRs with the cloud for identity validation, while meeting compliance guidelines for security and privacy. Further, this research has been implemented at a large regional hospital, yielding immediate and tangible improvements.

  9. Leveraging the Cloud for Electronic Health Record Access

    PubMed Central

    Coats, Brian; Acharya, Subrata

    2014-01-01

    Healthcare providers are under increasing pressure to enable widespread access to their electronic health record (EHR) systems for the patients they serve; the meaningful use incentive programs are perhaps the most significant driver encouraging this access. Elsewhere, the cloud has become extremely efficient and successful at establishing digital identities for individuals and making them interoperable across heterogeneous systems. As the healthcare industry contemplates providing patients access to their EHRs, the solution should leverage existing cloud investment, not duplicate it. Through an analysis of industry standards and similar work being performed in other industries, a trust framework has been derived for exchanging identity information. This research lays out a comprehensive structure that healthcare providers can easily use to integrate their EHRs with the cloud for identity validation, while meeting compliance guidelines for security and privacy. Further, this research has been implemented at a large regional hospital, yielding immediate and tangible improvements. PMID:24808814

  10. Marine Corps Equities in the Arctic

    DTIC Science & Technology

    2013-04-18

    capability and no surface combatant ships are reinforced for operations in a sea-ice environment . The Marine Corps may execute a sea control mission in the...increasingly accessible Arctic and develop concepts for the employment of amphibious forces in an Arctic environment . Under the Single Naval Battle concept, a...operations in a sea-ice environment . The Marine Corps may execute a sea control mission in the Arctic to make up for the sea services capability

  11. Enhancing Health Literacy through Accessing Health Information, Products, and Services: An Exercise for Children and Adolescents

    ERIC Educational Resources Information Center

    Brey, Rebecca A.; Clark, Susan E.; Wantz, Molly S.

    2007-01-01

    The second National Health Education Standard states the importance of student demonstration of the ability to access valid health information and services. The teaching technique presented in this article provides an opportunity for children and adolescents to develop their health literacy and advocacy skills by contributing to a class resource…

  12. Equity in Access to Health Promotion and Risk Reduction Services: Implications for Elder Health.

    ERIC Educational Resources Information Center

    Smith, Nancy H.; Howze, Elizabeth Harper

    Although there is a national emphasis on health promotion and preventive practices, questions remain regarding the equity of access to these services by low income and minority groups, and the implications of inequities for elder health. Data from a systematic survey of 500 public and private providers of health promotion services in northern…

  13. Predicting Health Care Utilization among Latinos: Health Locus of Control Beliefs or Access Factors?

    ERIC Educational Resources Information Center

    De Jesus, Maria; Xiao, Chenyang

    2014-01-01

    There are two competing research explanations to account for Latinos' underutilization of health services relative to non-Latino Whites in the United States. One hypothesis examines the impact of health locus of control (HLOC) beliefs, while the other focuses on the role of access factors on health care use. To date, the relative strength of…

  14. Predicting Health Care Utilization among Latinos: Health Locus of Control Beliefs or Access Factors?

    ERIC Educational Resources Information Center

    De Jesus, Maria; Xiao, Chenyang

    2014-01-01

    There are two competing research explanations to account for Latinos' underutilization of health services relative to non-Latino Whites in the United States. One hypothesis examines the impact of health locus of control (HLOC) beliefs, while the other focuses on the role of access factors on health care use. To date, the relative strength of…

  15. Telemental Health Technology in Deaf and General Mental-Health Services: Access and Use

    ERIC Educational Resources Information Center

    Austen, Sally; McGrath, Melissa

    2006-01-01

    Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or…

  16. Preventing Health Damaging Behaviors and Negative Health Outcomes in Army and Marine Corps Personnel During the First Tour of Duty

    DTIC Science & Technology

    2005-01-01

    troops’ risk for STIs, UIPs, alcohol/substance misuse, and sexual violence . Given current trends toward integrated military training of males and females...armed force include high rates of sexually transmitted infections (STIs), unintended pregnancies (UIPs), misuse of alcohol/substances, and sexual ... violence . The common thread through these negative health outcomes is volitional behavior. Such behaviors not only result in illness or injury, but also

  17. Latinos' Access to Online and Formal Mental Health Support.

    PubMed

    Parra-Cardona, José Rubén; DeAndrea, David C

    2016-04-01

    Research on mental health services disparities affecting minority populations of the USA tends to neglect online mental health support (OMHS). The main objective of this study was to investigate online mental health support and help-seeking of Latino citizens living in US communities by estimating associations linking OMHS with a selection of individual and community variables. In addition, the extent to which unmet mental health treatment needs among adults are associated with key variables was examined. Variables of interest included economic resources, health insurance and coverage, confidentiality, perceived stigma, and accessibility. Data are from 39,630 Latino adult participants in the National Surveys on Drug Use and Health (NSDUH), 2004-2010. Results indicate that for every 10,000 US Latino adults, fewer than 25 individuals received recent OMHS, as compared to a recently published estimate of 270-330 per 10,000 for the US population generally. Among Latinos with self-described unmet mental health needs, an estimated 40% identified cost of treatment as a prominent barrier that explained why they had not received formal mental health treatment services. Research and policy health disparities implications are discussed.

  18. Learning Relational Policies from Electronic Health Record Access Logs

    PubMed Central

    Malin, Bradley; Nyemba, Steve; Paulett, John

    2011-01-01

    Modern healthcare organizations (HCOs) are composed of complex dynamic teams to ensure clinical operations are executed in a quick and competent manner. At the same time, the fluid nature of such environments hinders administrators' efforts to define access control policies that appropriately balance patient privacy and healthcare functions. Manual efforts to define these policies are labor-intensive and error-prone, often resulting in systems that endow certain care providers with overly broad access to patients' medical records while restricting other providers from legitimate and timely use. In this work, we propose an alternative method to generate these policies by automatically mining usage patterns from electronic health record (EHR) systems. EHR systems are increasingly being integrated into clinical environments and our approach is designed to be generalizable across HCOs, thus assisting in the design and evaluation of local access control policies. Our technique, which is grounded in data mining and social network analysis theory, extracts a statistical model of the organization from the access logs of its EHRs. In doing so, our approach enables the review of predefined policies, as well as the discovery of unknown behaviors. We evaluate our approach with five months of access logs from the Vanderbilt University Medical Center and confirm the existence of stable social structures and intuitive business operations. Additionally, we demonstrate that there is significant turnover in the interactions between users in the HCO and that policies learned at the department level afford greater stability over time. PMID:21277996

  19. Open-access community child health clinics: the everyday experience of parents and child health nurses.

    PubMed

    Kearney, Lauren; Fulbrook, Paul

    2012-03-01

    In Australia, Community Child Health Services (CCHS) is the primary health care service which seeks to strengthen and support families, prevent illness and manage risks. Several nursing models of care exist within CCHS, and limited research has investigated which is the best way to provide child health surveillance and parenting support during the early years. This study qualitatively explored the everyday lived experience of parents and child health nurses involved with an open-access (appointment-free, parent-led) group child health surveillance clinic. Findings showed that participants considered the open-access clinic provided a helpful and supportive way of delivering child health surveillance and parental support to families with infants aged 0-18 months, without identified risk factors. The perspectives of multiple parents, nurses and other health workers found it effective, flexible and parent-directed, which may be in contrast to some traditional individual appointment child health surveillance methods.

  20. Massachusetts health reform and access for children with special health care needs.

    PubMed

    Smith, Anna Jo; Chien, Alyna T

    2014-08-01

    Children with special health care needs (CSHCN) face unique challenges in accessing affordable health care. Massachusetts implemented major health reform in 2006; little is known about the impact of this state's health reform on uninsurance, access to care, and financial protection for privately and publicly insured CSHCN. We used a difference-in-differences (DD) approach to compare uninsurance, access to primary and specialty care, and financial protection in Massachusetts versus other states and Washington, DC before and after Massachusetts health reform. Parent-reported data were used from the 2005-2006 and 2009-2010 National Survey of Children with Special Health Care Needs and adjusted for age, gender, race/ethnicity, non-English language at home, and functional difficulties. Postreform, living in Massachusetts was not associated with significant decreases in uninsurance or increases in access to primary care for CSHCN. For privately insured CSHCN, Massachusetts was associated with increased access to specialists (DD = 6.0%; P ≤ .001) postreform. For publicly insured CSHCN, however, there was a significant decrease in access to prescription medications (DD = -7.2%; P = .003) postreform. Living in Massachusetts postreform was not associated with significant changes in financial protection compared with privately or publicly insured CSHCN in other states. Massachusetts health reform likely improved access to specialists for privately insured CSHCN but did not decrease instances of uninsurance, increase access to primary care, or improve financial protection for CSHCN in general. Comparable provisions within the Affordable Care Act may produce similarly modest outcomes for CSHCN. Copyright © 2014 by the American Academy of Pediatrics.

  1. Access to Addiction Pharmacotherapy in Private Health Plans.

    PubMed

    Reif, Sharon; Horgan, Constance M; Hodgkin, Dominic; Matteucci, Ann-Marie; Creedon, Timothy B; Stewart, Maureen T

    2016-07-01

    An increasing number of medications are available to treat addictions. To understand access to addiction medications, it is essential to consider the role of private health plans. To contain medication expenditures, most U.S. health plans use cost-sharing and administrative controls, which may impact physicians' prescribing and patients' use of addiction medications. This study identified health plan approaches to manage access to and utilization of addiction medications (oral and injectable naltrexone, acamprosate, and buprenorphine). Data are from a nationally representative survey of private health plans in 2010 (n=385 plans, 935 products; response rate 89%), compared to the same survey in 2003. The study assessed formulary inclusion, prior authorization, step therapy, overall restrictiveness, and if and how health plans encourage pharmacotherapy. Formulary exclusions were rare in 2010, with acamprosate excluded most often, by only 9% of products. Injectable naltrexone was covered by 96% of products. Prior authorization was common for injectable naltrexone (85%) and rare for acamprosate (3%). Step therapy policies were used only for injectable naltrexone (41%) and acamprosate (20%). Several medications were often on the most expensive tier. Changes since 2003 include fewer exclusions, yet increased use of other management approaches. Most health plans encourage use of addiction pharmacotherapy, and use a variety of methods to do so. Management of addiction medications has increased over time but it is not ubiquitous. However, health plans now also include all medications on formularies and encourage providers to use them, indicating that they value addiction pharmacotherapy as an evidence-based practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Access to Addiction Pharmacotherapy in Private Health Plans

    PubMed Central

    Reif, Sharon; Horgan, Constance M.; Hodgkin, Dominic; Matteucci, Ann-Marie; Creedon, Timothy B.; Stewart, Maureen T.

    2016-01-01

    Background An increasing number of medications are available to treat addictions. To understand access to addiction medications, it is essential to consider the role of private health plans. To contain medication expenditures, most U.S. health plans use cost-sharing and administrative controls, which may impact physicians' prescribing and patients' use of addiction medications. This study identified health plan approaches to manage access to and utilization of addiction medications (oral and injectable naltrexone, acamprosate, and buprenorphine). Methods Data are from a nationally representative survey of private health plans in 2010 (n=385 plans, 935 products; response rate 89%), compared to the same survey in 2003. The study assessed formulary inclusion, prior authorization, step therapy, overall restrictiveness, and if and how health plans encourage pharmacotherapy. Results Formulary exclusions were rare in 2010, with acamprosate excluded most often, by only 9% of products. Injectable naltrexone was covered by 96% of products. Prior authorization was common for injectable naltrexone (85%) and rare for acamprosate (3%). Step therapy policies were used only for injectable naltrexone (41%) and acamprosate (20%). Several medications were often on the most expensive tier. Changes since 2003 include fewer exclusions, yet increased use of other management approaches. Most health plans encourage use of addiction pharmacotherapy, and use a variety of methods to do so. Conclusions Management of addiction medications has increased over time but it is not ubiquitous. However, health plans now also include all medications on formularies and encourage providers to use them, indicating they value addiction pharmacotherapy as an evidence-based practice. PMID:27211993

  3. Access to health services for undocumented immigrants in Apulia.

    PubMed

    Brindicci, G; Trillo, G; Santoro, C R; Volpe, A; Monno, L; Angarano, G

    2015-04-01

    This paper, part of a larger epidemiological study carried out between 2004 and 2010, analyzed immigrants frequenting the largest Apulian regional hospital (Bari Policlinico). Our aim was to evaluate the perception on the part of undocumented immigrants of their rights of access to the National Health Care services and whether this privilege is actually utilized. An anonymous multi-language questionnaire was distributed to all patients with STP (code number for temporary presence of foreigners) at the immigrant outpatient Infectious Diseases Clinic of Bari from June 2009 to June 2010. Questions were related to nationality, date of arrival in Italy, use of health facilities in the 2 years prior to the compilation of the questionnaire, and their understanding of STP. The patients were also screened for infectious diseases (HIV-Ab, HBsAg, HCV-Ab, VDRL, TPHA and Mantoux). A total of 256/272 patients completed the questionnaire; the meaning of STP was unknown to 156/256 (60.9%) patients, only 54/256 (21%) knew the exact meaning of STP and only 42/54 (76.6%) of the latter knew how long STP was valid. Moreover, 128/256 (50.7%) were aware that doctors from the emergency unit were not allowed to notify police regarding presence of illegal immigrants. Regarding clinical data 3% were HIV+ (8/256), 5% (13 patients) positive for TPHA, 5% for HBsAg, 2% were HCV (five patients). A >10 mm diameter infiltrate of Mantoux test was noted for 44% of patients. A lower prevalence than expected for infections such as HIV, HBV or HCV was noted for immigrants compared to data from their countries of origin. At present, large-scale political solutions to the challenges of facilitating access to health facilities for undocumented immigrants are lacking in Italy. The development of communication systems is fundamental to improving access to health services and to creating links between immigrants and the healthcare system.

  4. Economics of health care access and delivery projects

    NASA Astrophysics Data System (ADS)

    Tanenhaus, Robert

    1995-10-01

    This article updates and quantifies the costs and net government savings of two of three new technological projects introduced in last year's proceedings ('Use of Technology to Reduce Health Costs,' pp. 196-7). The projects are microcomputer video for medical outreach and ride tracking. The projects focus on maintaining or improving the delivery of and access to health care, while reducing cost significantly, by enabling more efficient or effective practices. As calculated to date, IMI currently estimates the two projects can save federal and state governments up to 180 million net per year, i.e., 20 million from microcomputer video for medical outreach and $160 million from ride tracking. (IMI is currently calculating the cost and savings of the third project, health care card system.) The article begins with a summary of each project, includes new accomplishments and participating organizations and lists the costs, savings categories and calculated savings.

  5. MATCH: Metadata Access Tool for Climate and Health Datasets

    DOE Data Explorer

    MATCH is a searchable clearinghouse of publicly available Federal metadata (i.e. data about data) and links to datasets. Most metadata on MATCH pertain to geospatial data sets ranging from local to global scales. The goals of MATCH are to: 1) Provide an easily accessible clearinghouse of relevant Federal metadata on climate and health that will increase efficiency in solving research problems; 2) Promote application of research and information to understand, mitigate, and adapt to the health effects of climate change; 3) Facilitate multidirectional communication among interested stakeholders to inform and shape Federal research directions; 4) Encourage collaboration among traditional and non-traditional partners in development of new initiatives to address emerging climate and health issues. [copied from http://match.globalchange.gov/geoportal/catalog/content/about.page

  6. Bridging the gap from availability to accessibility: providing health and mental health services in schools.

    PubMed

    Manning, Amy R

    2009-01-01

    The state of child and adolescent overall health in the United States evidences the need for both prevention and treatment. Although much time and energy has been spent in recent years discussing and improving health benefit coverage and affordability for children, physical access to services has not kept pace with these changes. This article will introduce four major physical health issues (obesity, diabetes, asthma, and teen pregnancy/STD) and five key mental health issues (suicide, depression, ADHD, aggression, and violence) facing young people today. In an effort to answer the question, "What can be done?" school-based health clinics and their impact on health and educational outcomes are examined.

  7. Measuring Access to Continuing Professional Education among the Health Workers in Ghana: Constructing an Index

    ERIC Educational Resources Information Center

    Aiga, Hirotsugu

    2006-01-01

    To measure the levels of access to continuing professional education (CPE) among the health workers, an index (continuing professional education access index: CEAI) was constructed. The CEAI is composed of six indicators: (I) availability of CPE; (II) distribution of CPE; (III) informational access; (IV) geographical access; (V) economic access;…

  8. A rights-based approach to accessing health determinants.

    PubMed

    Perkins, Fran

    2009-03-01

    This commentary summarizes the experience and learnings from a site visit in May 2008 to a drop-in centre for vulnerable women in downtown Cairo run by El-Shehab Institution for Comprehensive Development, which provides street outreach for the prevention of Sexually Transmitted Infection (STI). The Centre successfully provides services and support for women, many of who are displaced or refugees and are from the most marginalized areas in Cairo. Through a rights-based approach to the work, the Centre helps people living in the slums fight and win the right to access clean water, sewerage and electrical power in their communities. An individual-based approach to human rights is also used. In the last year El-Shehab have helped 67 women go to court and win their marriage rights from husbands who have abandoned them. Their approach is an example of a successful way to achieve access to basic health determinants.

  9. Access Control Model for Sharing Composite Electronic Health Records

    NASA Astrophysics Data System (ADS)

    Jin, Jing; Ahn, Gail-Joon; Covington, Michael J.; Zhang, Xinwen

    The adoption of electronically formatted medical records, so called Electronic Health Records (EHRs), has become extremely important in healthcare systems to enable the exchange of medical information among stakeholders. An EHR generally consists of data with different types and sensitivity degrees which must be selectively shared based on the need-to-know principle. Security mechanisms are required to guarantee that only authorized users have access to specific portions of such critical record for legitimate purposes. In this paper, we propose a novel approach for modelling access control scheme for composite EHRs. Our model formulates the semantics and structural composition of an EHR document, from which we introduce a notion of authorized zones of the composite EHR at different granularity levels, taking into consideration of several important criteria such as data types, intended purposes and information sensitivities.

  10. Survey: Hospitalization Access for Patients of Migrant Health Centers and Combined Migrant and Community Health Centers.

    ERIC Educational Resources Information Center

    Smith, David R.; And Others

    1987-01-01

    A study of migrant health centers' access to hospitals uncovered financial barriers to private hospital care when the patient was indigent or without health insurance. This may be exacerbated as private hospitals expand in states with many migrants. Cooperative efforts between public and private institutions are in order. (VM)

  11. A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions

    PubMed Central

    2011-01-01

    Background This paper analyses the relationship between public perceptions of access to general practitioners (GPs) surgeries and hospitals against health status, car ownership and geographic distance. In so doing it explores the different dimensions associated with facility access and accessibility. Methods Data on difficulties experienced in accessing health services, respondent health status and car ownership were collected through an attitudes survey. Road distances to the nearest service were calculated for each respondent using a GIS. Difficulty was related to geographic distance, health status and car ownership using logistic generalized linear models. A Geographically Weighted Regression (GWR) was used to explore the spatial non-stationarity in the results. Results Respondent long term illness, reported bad health and non-car ownership were found to be significant predictors of difficulty in accessing GPs and hospitals. Geographic distance was not a significant predictor of difficulty in accessing hospitals but was for GPs. GWR identified the spatial (local) variation in these global relationships indicating locations where the predictive strength of the independent variables was higher or lower than the global trend. The impacts of bad health and non-car ownership on the difficulties experienced in accessing health services varied spatially across the study area, whilst the impacts of geographic distance did not. Conclusions Difficulty in accessing different health facilities was found to be significantly related to health status and car ownership, whilst the impact of geographic distance depends on the service in question. GWR showed how these relationships were varied across the study area. This study demonstrates that the notion of access is a multi-dimensional concept, whose composition varies with location, according to the facility being considered and the health and socio-economic status of the individual concerned. PMID:21787394

  12. Access to health care in the Scandinavian countries: ethical aspects.

    PubMed

    Holm, S; Liss, P E; Norheim, O F

    1999-01-01

    The health care systems are fairly similar in the Scandinavian countries. The exact details vary, but in all three countries the system is almost exclusively publicly funded through taxation, and most (or all) hospitals are also publicly owned and managed. The countries also have a fairly strong primary care sector (even though it varies between the countries), with family physicians to various degrees acting as gatekeepers to specialist services. In Denmark most of the GP services are free. For the patient in Norway and Sweden there are out-of-pocket co-payments for GP consultations, with upper limits, but consultations for children are free. Hospital treatment is free in Denmark while the other countries use a system with out-of-pocket co-payment. There is a very strong public commitment to access to high quality health care for all. Solidarity and equality form the ideological basis for the Scandinavian welfare state. Means testing, for instance, has been widely rejected in the Scandinavian countries on the grounds that public services should not stigmatise any particular group. Solidarity also means devoting special consideration to the needs of those who have less chance than others of making their voices heard or exercising their rights. Issues of limited access are now, however, challenging the thinking about a health care system based on solidarity.

  13. Health information in Italian public health websites: moving from inaccessibility to accessibility.

    PubMed

    Mancini, Cristina; Zedda, Monica; Barbaro, Annarita

    2005-12-01

    In January 2004, the Italian government passed new legislation designed to give people with disabilities access to online services. Starting from the new legislation requirements, the purpose of this study is to investigate whether Italian Local Health Authorities websites are accessible to users with different abilities. One hundred and seventy websites were analysed evaluating their compliance to the World Wide Web Consortium (W3C) Priority 1 guidelines via a combination of appropriate accessibility testing methods. This review was carried out twice: the first time it took place between the end of 2003 and May-June 2004. The same survey was repeated again in December 2004, after the issuing of the draft of the Implementation Regulations for The Stanca Law in July 2004. In this second survey, all the websites analysed before were checked again to establish if some measures to make those sites accessible were taken. Seventy-six per cent of the analysed websites fail to satisfy the most basic W3C requirements, but Italian Local Health Authorities websites are likely to present significant improvements to access for some disabled user groups: the number of accessible websites increased consistently between the first and the second review. It seems that awareness of web accessibility issues is increasing among developers of health information websites because of law enforcement. Recommendations for future research and development are offered.

  14. The role of school health centers in health care access and client outcomes.

    PubMed

    Soleimanpour, Samira; Geierstanger, Sara P; Kaller, Shelly; McCarter, Virginia; Brindis, Claire D

    2010-09-01

    We describe the impact of school health centers in Alameda County, California, on adolescents' access to care and their mental and physical health outcomes. We used a multimethod evaluation of 12 school health centers to track data on clients (n=7410), services, and provider-reported outcomes; client pre-post surveys (n=286); and student focus groups (n=105 participants). School health centers were the most commonly reported source of medical (30%), family planning (63%), and counseling (31%) services for clients. Mental health providers reported significant improvements (P<.05) from baseline to follow-up in clients' presenting concerns and resiliency factors. Medical providers and clients also reported general improvements in reproductive health, particularly in the use of birth control other than condoms. Student focus group participants noted that school health centers helped improve access to services students might not seek out otherwise, particularly counseling and family planning services. Furthermore, students noted that they liked school health centers because of their confidentiality, free services, convenience, and youth-friendly staff. School health centers increase access to care and improve mental health, resiliency, and contraceptive use.

  15. The Role of School Health Centers in Health Care Access and Client Outcomes

    PubMed Central

    Geierstanger, Sara P.; Kaller, Shelly; McCarter, Virginia; Brindis, Claire D.

    2010-01-01

    Objectives. We describe the impact of school health centers in Alameda County, California, on adolescents' access to care and their mental and physical health outcomes. Methods. We used a multimethod evaluation of 12 school health centers to track data on clients (n = 7410), services, and provider-reported outcomes; client pre–post surveys (n = 286); and student focus groups (n = 105 participants). Results. School health centers were the most commonly reported source of medical (30%), family planning (63%), and counseling (31%) services for clients. Mental health providers reported significant improvements (P < .05) from baseline to follow-up in clients' presenting concerns and resiliency factors. Medical providers and clients also reported general improvements in reproductive health, particularly in the use of birth control other than condoms. Student focus group participants noted that school health centers helped improve access to services students might not seek out otherwise, particularly counseling and family planning services. Furthermore, students noted that they liked school health centers because of their confidentiality, free services, convenience, and youth-friendly staff. Conclusions. School health centers increase access to care and improve mental health, resiliency, and contraceptive use. PMID:20634445

  16. Urban girls, internet use, and accessing health information

    PubMed

    Borzekowski; Rickert

    2000-05-01

    Background: With the burgeoning growth of the Internet, many have raised concerns over whether and how underserved populations might be included in the Information Revolution. This study examines how urban adolescent girls access the Internet and whether it is a viable source for health information.Methods: During Fall 1999 in New York City, 176 girls completed an anonymous survey where half were from a private high school (N = 86) and the other half were patients at a health clinic serving ethnically diverse and disadvantaged youth (N = 90). Data were analyzed to provide information on how urban girls use the Internet.Results: Internet use was widespread; 99% of the high school and 83% of the clinic girls said they used this medium (p <.001). On frequency, 32% of high school girls compared to 13% of the clinic girls used the Internet 6-7 days/wk (p <.001). Among the high school girls, 30% indicated that they used the Internet less than 30 min/wk and another 18% reported using the Internet more than 5 hrs/wk. Among clinic girls, 51% used the Internet less than 30 min/wk while 9% reported more than 5 hrs/wk. Comfort levels differed with 20% of the high school compared to 10% of the clinic girls reporting "extreme" comfort using the Internet (p <.001).Urban girls accessed the Web from multiple locales. Almost all (98%) of the high school girls compared to 45% of the clinic girls reported that they used the Internet from home (p <.001). Most high school girls (82%) used the Internet at school compared to 63% of the clinic girls currently in school (p <.05). More clinic girls used the Internet at another family member's house (28% vs. 14%, p <.05). Similar percentages of high school and clinic girls used the Internet at a friend's house (46%), the library (31%), or a community center (3%).With similar rates among high school and clinic girls, 44% reported that they had tried to get health information from the Web. Of these (N = 74), 50% said that they got information

  17. Analysis of the Effects Special Pays Have on Retention in the Medical Service Corps

    DTIC Science & Technology

    2011-03-01

    and Medical Service Corps Professions Officers Special Pays. OPNAV Instruction 7220.17 (December 28, 2005). Special Pay for Medical Corps, Dental ...health and industrial hygiene officers. The specialties focused on in this study, the specialties that receive a special pay, are all located in the...level. 2. OPNAV Instruction 7220.17 The overarching instruction that establishes special pays for Medical Corps, Dental Corps, Medical Service Corps

  18. Access, equity and the role of rights in health care.

    PubMed

    Newdick, Chris; Derrett, Sarah

    2006-09-01

    Modern health care rhetoric promotes choice and individual patient rights as dominant values. Yet we also accept that in any regime constrained by finite resources, difficult choices between patients are inevitable. How can we balance rights to liberty, on the one hand, with equity in the allocation of scarce resources on the other? For example, the duty of health authorities to allocate resources is a duty owed to the community as a whole, rather than to specific individuals. Macro-duties of this nature are founded on the notion of equity and fairness amongst individuals rather than personal liberty. They presume that if hard choices have to be made, they will be resolved according to fair and consistent principles which treat equal cases equally, and unequal cases unequally. In this paper, we argue for greater clarity and candour in the health care rights debate. With this in mind, we discuss (1) private and public rights, (2) negative and positive rights, (3) procedural and substantive rights, (4) sustainable health care rights and (5) the New Zealand booking system for prioritising access to elective services. This system aims to consider: individual need and ability to benefit alongside the resources made available to elective health services in an attempt to give the principles of equity practical effect. We describe a continuum on which the merits of those, sometimes competing, values--liberty and equity--can be evaluated and assessed.

  19. Health care utilisation and problems in accessing health care of female undocumented immigrants in the Netherlands

    PubMed Central

    Loeffen, Maartje J.; van den Muijsenbergh, Maria E.; Lagro-Janssen, Antoine L. M.

    2010-01-01

    Objective To obtain information about the actual use of health care facilities by undocumented women and to identify obstacles they experience in accessing health care facilities. Methods A mixed methods study, with structured questionnaires and semi-structured interviews, was chosen to obtain a complete understanding. One-hundred undocumented women were recruited. Diversity was sought according to age, origin and reason for being undocumented. Results Undocumented female immigrants have unmet health care needs (56%) and low health care utilisation. Sixty-nine per cent of the women reported obstacles in accessing health care facilities. These included many personal obstacles such as shame, fear and/or lack of information. Poor language proficiency (OR 0.28;. CI 0.09–0.90) reduces utilisation of primary health care services. Conclusion Health care utilisation of undocumented women is low. Undocumented women refrain from seeking health care because of personal obstacles. These women need to be identified and informed about their rights, the health care system and the duty of professional confidentiality of doctors. Finally, institutional obstacles to access care should be removed since they strengthen reluctance to seek help. PMID:20502936

  20. Health care utilisation and problems in accessing health care of female undocumented immigrants in the Netherlands.

    PubMed

    Schoevers, Marianne A; Loeffen, Maartje J; van den Muijsenbergh, Maria E; Lagro-Janssen, Antoine L M

    2010-10-01

    To obtain information about the actual use of health care facilities by undocumented women and to identify obstacles they experience in accessing health care facilities. A mixed methods study, with structured questionnaires and semi-structured interviews, was chosen to obtain a complete understanding. One-hundred undocumented women were recruited. Diversity was sought according to age, origin and reason for being undocumented. Undocumented female immigrants have unmet health care needs (56%) and low health care utilisation. Sixty-nine per cent of the women reported obstacles in accessing health care facilities. These included many personal obstacles such as shame, fear and/or lack of information. Poor language proficiency (OR 0.28;. CI 0.09-0.90) reduces utilisation of primary health care services. Health care utilisation of undocumented women is low. Undocumented women refrain from seeking health care because of personal obstacles. These women need to be identified and informed about their rights, the health care system and the duty of professional confidentiality of doctors. Finally, institutional obstacles to access care should be removed since they strengthen reluctance to seek help.

  1. Health insurance and access to care among welfare leavers.

    PubMed

    Danziger, Sheldon; Davis, Matthew M; Orzol, Sean; Pollack, Harold A

    2008-01-01

    This analysis explores the effects of the 1996 welfare reform on health insurance coverage and access to care among former recipients of cash aid. Using panel data from the Women's Employment Study, which conducted five interviews between 1997 and 2003 in one Michigan county, we find that 25% of welfare leavers lacked health insurance coverage in fall 2003. Uninsured adults were significantly more likely than others to report that they could not afford a medical or dental visit during the year prior to the 2003 interview. Fixed-effect logistic regression analysis indicates that women who had been off the welfare rolls for at least 12 months (the duration of transitional Medicaid) were significantly more likely to be uninsured than women who had made more recent welfare exits, and were significantly more likely to report financial obstacles to the receipt of medical and dental care.

  2. Childhood Immunization and Access to Health Care: Evidence From Nepal.

    PubMed

    Devkota, Satis; Panda, Bibhudutta

    2016-03-01

    This article examines the effect of access to health care center, in terms of travel time, on childhood immunization in Nepal using the 2004 and 2011 waves of the Nepal Living Standards Measurement Surveys. We employ probit and instrumental variable probit estimation methods to estimate the causal effect of travel time on the probability of immunization. Results indicate that travel time to the nearest health center displays a significant negative association with the probability of immunization (coefficient = -0.015,P< .05). Furthermore, the effect of travel time tends to be stronger in rural and distant areas of Nepal's mountain and hill regions. The results suggest that policy interventions should increase the number of mobile clinics in rural villages and provide conditional cash transfer to incentivize immunization coverage at the household level. In addition, household income, parental education, ethnicity, and household location emerge as important determinants of immunization in Nepal.

  3. 75 FR 17799 - AB Liquidating Corp. (f/k/a Adaptive Broadband Corp.), Globalnet Corp., Greenland Corp...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-07

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION AB Liquidating Corp. (f/k/a Adaptive Broadband Corp.), Globalnet Corp., Greenland Corp., Kera... there is a lack of current and accurate information concerning the securities of AB Liquidating Corp....

  4. 75 FR 72841 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Job Corps...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-26

    ...; Job Corps Health Questionnaire ACTION: Notice. SUMMARY: The Department of Labor (DOL) hereby announces... request (ICR) titled, ``Job Corps Health Questionnaire,'' to the Office of Management and Budget (OMB) for... . SUPPLEMENTARY INFORMATION: This ICR requests information on the health status of an applicant to the Job Corps...

  5. Geography Matters: State-Level Variation in Children's Oral Health Care Access and Oral Health Status

    PubMed Central

    Fisher-Owens, Susan A.; Soobader, Mah-J; Gansky, Stuart A.; Isong, Inyang A.; Weintraub, Jane A.; Platt, Larry J.; Newacheck, Paul W.

    2016-01-01

    Objectives To ascertain differences across states in children's oral health care access and oral health status and the factors that contribute to those differences Study Design Observational study using cross-sectional surveys Methods Using the 2007 National Survey of Children's Health, we examined state variation in parent's report of children's oral health care access (absence of a preventive dental visit) and oral health status. We assessed the unadjusted prevalences of these outcomes, then adjusted with child-, family-, and neighborhood-level variables using logistic regression; these results are presented directly and graphically. Using multilevel analysis, we then calculated the degree to which child-, family-, and community-level variables explained state variation. Finally, we quantified the influence of state-level variables on state variation. Results Unadjusted rates of no preventive dental care ranged 9.0-26.8% (mean 17.5%), with little impact of adjusting (10.3-26.7%). Almost 9% of population had fair/poor oral health; unadjusted range 4.1-14.5%. Adjusting analyses affected fair/poor oral health more than access (5.7-10.7%). Child, family and community factors explained ~¼ of the state variation in no preventive visit and ~½ of fair/poor oral health. State-level factors further contributed to explaining up to a third of residual state variation. Conclusion Geography matters: where a child lives has a large impact on his or her access to oral health care and oral health status, even after adjusting for child, family, community, and state variables. As state-level variation persists, other factors and richer data are needed to clarify the variation and drive changes for more egalitarian and overall improved oral health. PMID:26995567

  6. Access to Health Care and Religion among Young American Men

    PubMed Central

    Gillum, R. Frank; Jarrett, Nicole; Obisesan, Thomas O.

    2009-01-01

    In order to elucidate cultural correlates of utilization of primary health services by young adult men, we investigated religion in which one was raised and service utilization. Using data from a national survey we tested the hypothesis that religion raised predicts access to and utilization of a regular medical care provider, examinations, HIV and other STD testing and counseling at ages 18–44 years in men born between 1958 and 1984. We also hypothesized that religion raised would be more predictive of utilization for Hispanic Americans and non-Hispanic Black Americans than for non-Hispanic White Americans. The study included a national sample of 4276 men aged 18–44 years. Descriptive and multivariate statistics were used to assess the hypotheses using data on religion raised and responses to 14 items assessing health care access and utilization. Compared to those raised in no religion, those raised mainline Protestant were more likely (p < 0.01) to report a usual source of care (67% vs. 79%), health insurance coverage (66% vs. 80%) and physical examination (43% vs. 48%). Religion raised was not associated with testicular exams, STD counseling or HIV testing. In multivariate analyses controlling for confounders, significant associations of religion raised with insurance coverage, a physician as usual source of care and physical examination remained which varied by race/ethnicity. In conclusion, although religion is a core aspect of culture that deserves further study as a possible determinant of health care utilization, we were not able to document any consistent pattern of significant association even in a population with high rates of religious participation. PMID:20049258

  7. Access to health care and religion among young American men.

    PubMed

    Gillum, R Frank; Jarrett, Nicole; Obisesan, Thomas O

    2009-12-01

    In order to elucidate cultural correlates of utilization of primary health services by young adult men, we investigated religion in which one was raised and service utilization. Using data from a national survey we tested the hypothesis that religion raised predicts access to and utilization of a regular medical care provider, examinations, HIV and other STD testing and counseling at ages 18-44 years in men born between 1958 and 1984. We also hypothesized that religion raised would be more predictive of utilization for Hispanic Americans and non-Hispanic Black Americans than for non-Hispanic White Americans. The study included a national sample of 4276 men aged 18-44 years. Descriptive and multivariate statistics were used to assess the hypotheses using data on religion raised and responses to 14 items assessing health care access and utilization. Compared to those raised in no religion, those raised mainline Protestant were more likely (p < 0.01) to report a usual source of care (67% vs. 79%), health insurance coverage (66% vs. 80%) and physical examination (43% vs. 48%). Religion raised was not associated with testicular exams, STD counseling or HIV testing. In multivariate analyses controlling for confounders, significant associations of religion raised with insurance coverage, a physician as usual source of care and physical examination remained which varied by race/ethnicity. In conclusion, although religion is a core aspect of culture that deserves further study as a possible determinant of health care utilization, we were not able to document any consistent pattern of significant association even in a population with high rates of religious participation.

  8. Adolescent health care: improving access by school-based service.

    PubMed

    Gonzales, C; Mulligan, D; Kaufman, A; Davis, S; Hunt, K; Kalishman, N; Wallerstein, N

    1985-10-01

    Participants in this discussion of the potential of school-based health care services for adolescents included family medicine physicians, school health coordinators, a school nurse, and a community worker. It was noted that health care for adolescents tends to be either inaccessible or underutilized, largely because of a lack of sensitivity to adolescent culture and values. An ideal service for adolescents would offer immediate services for crises, strict confidentiality, ready access to prescribed medications, a sliding-scale scheme, and a staff that is tolerant of divergent values and life-styles. School-based pilot adolescent clinics have been established by the University of New Mexico's Department of Family, Community, and Emergency Medicine to test the community-oriented health care model. On-site clinics provide urgent medical care, family planning, pregnancy testing, psychological counseling, alcohol and drug counseling, and classroom health education. Experience with these programs has demonstrated the necessity for an alliance among the health team and the school administration, parents, and students. Financial, ethical, and political factors can serve as constraints to school-based programs. In some cases, school administrators have been resistant to the provision of contraception to students on school grounds and parents have been unwilling to accept the adolescent's right to confidentiality. These problems in part stem from having 2 separate systems, each with its own values, orientation, and responsibilities, housed in 1 facility. In addition, there have been problems generating awareness of the school-based clinic among students. Health education theater groups, peer counseling, and student-run community services have been effective, however, in increasing student participation. It has been helpful to mold clinic services to meet the needs identified by teenagers themselves. There is an interest not only in curative services, but in services focused

  9. Free and Reduced Rate Periodicals for Peace Corps Volunteers. 1995.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC.

    This list of free and reduced rate periodicals is compiled by the office of Information Collection Exchange (ICE) to provide Peace Corps volunteers access to information on periodicals which can be of use during their term of service. Detailed instructions are provided on ordering periodicals which are distributed by ICE to Peace Corps in-country…

  10. Free and Reduced Rate Periodicals for Peace Corps Volunteers. 1996.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC.

    This list of free and reduced rate periodicals is compiled by the office of Information Collection Exchange (ICE) to provide Peace Corps volunteers access to information on periodicals which can be of use during their term of service. Detailed instructions are provided on ordering periodicals which are distributed by ICE to Peace Corps in-country…

  11. Depression and suicide ideation among students accessing campus health care.

    PubMed

    Mackenzie, Sara; Wiegel, Jennifer R; Mundt, Marlon; Brown, David; Saewyc, Elizabeth; Heiligenstein, Eric; Harahan, Brian; Fleming, Michael

    2011-01-01

    Depression and suicide are of increasing concern on college campuses. This article presents data from the College Health Intervention Projects on the frequency of depression and suicide ideation among 1,622 college students who accessed primary care services in 4 university clinics in the Midwest, Northwest, and Canada. Students completed the Beck Depression Inventory and other measures related to exercise patterns, alcohol use, sensation seeking, and violence. The frequency of depression was similar for men (25%) and women (26%). Thought of suicide was higher for men (13%) than women (10%). Tobacco use, emotional abuse, and unwanted sexual encounters were all associated with screening positive for depression. "Days of exercise per week" was inversely associated with screening positive for depression. Because the majority of students access campus-based student health centers, medical providers can serve a key role in early identification and intervention. With every 4th student reporting symptoms of depression and every 10th student having suicidal thoughts, such interventions are needed.

  12. Effect of health insurance type on access to care.

    PubMed

    Froelich, John M; Beck, Ryan; Novicoff, Wendy M; Saleh, K J

    2013-10-01

    Growing orthopedic and nonorthopedic literature illustrates the point that having health insurance does not equal having access to care. The goal of this study was to evaluate the burden placed on patients to gain access to outpatient orthopedic care. For this study, burden was quantified as the distance traveled by the patient to be seen in clinic. This study was a retrospective review of all new patient encounters at an adult orthopedic outpatient clinic in an academic tertiary referral center over 1 calendar year. All patients were stratified into 4 categories: commercial/private insurance, Medic-aid, Medicare, and uninsured/private pay. The average distance traveled by each patient to the center was then calculated based on the patient's billing zip code. Patient visits were further stratified based on whether the patients were seen by 1 of 3 different categories of providers: general orthopedics/adult reconstruction, spine, and sports/upper extremity. The study group comprised 774 (31.1%) Medicaid patients, 653 (26.2%) Medicare patients, 917 (36.8%) commercial/private insurance patients, and 146 (5.9%) uninsured/private pay patients. The average 1-way distance traveled was 36.2 miles for Medicaid patients, 21.3 miles for Medicare patients, 24.1 miles for commercial/private insurance patients, and 25.3 miles for uninsured/private pay patients (P<.00). Subgroup analysis noted a statistical difference in distance traveled for the general orthopedics/adult reconstruction and sports/upper extremity groups. The study's findings suggest that having insurance does not equal access to outpatient orthopedic care at a single institution. The specific burdens that each group faces to gain access to care are unclear.

  13. Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

    PubMed Central

    Bryant-Lukosius, Denise; Valaitis, Ruta; Martin-Misener, Ruth; Donald, Faith; Peña, Laura Morán; Brousseau, Linda

    2017-01-01

    ABSTRACT Objective: to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries. PMID:28146177

  14. Access to health: women's status and utilization of maternal health services in Nepal.

    PubMed

    Sharma, Sharad Kumar; Sawangdee, Yothin; Sirirassamee, Buppha

    2007-09-01

    With the objective of reducing maternal and neonatal mortality, the Safe Motherhood Program was implemented in Nepal in 1997. It was launched as a priority programme during the ninth five-year plan period, 1997-2002, with the aim of increasing women's access to health care and raising their status. This paper examines the association of access to health services and women's status with utilization of prenatal, delivery, and postnatal care during the plan period. The 1996 Nepal Family Health Survey and the 2001 Nepal Demographic and Health Survey data were pooled and the likelihood of women's using maternal health care was examined in 2001 in comparison with 1996. Multiple logistic regression analysis indicates that the utilization of maternal health services increased over the period. Programme interventions such as outreach worker's visits, radio programmes on maternal health, maternal health information disseminated through various mass media sources and raising women's status through education were able to explain the observed change in utilization. Health worker visits and educational status of women showed a large association, but radio programmes and other mass media information were only partially successful in increasing use of maternal health services. Socioeconomic and demographic variables such as household economic status, number of living children and place of residence showed stronger association with use of maternal health services then did intervention programmes.

  15. AccessMod 3.0: computing geographic coverage and accessibility to health care services using anisotropic movement of patients

    PubMed Central

    Ray, Nicolas; Ebener, Steeve

    2008-01-01

    Background Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial) coverage, which is an important measure for assessing the degree of accessibility of a health care network. Results This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.×, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation) that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on geographic coverage

  16. Sexual Orientation Differences in Adolescent Health Care Access and Health-Promoting Physician Advice.

    PubMed

    Luk, Jeremy W; Gilman, Stephen E; Haynie, Denise L; Simons-Morton, Bruce G

    2017-08-19

    Physician screening and advice on health-related behaviors are an integral part of adolescent health care. Sexual minority adolescents encounter more barriers to health services; yet, no prior research has examined whether they also experience disparity in physician screening and advice. We examined possible sexual orientation disparities in health care access, physician screening, and advice on six health-related behaviors. Data were from a national sample of U.S. adolescents who participated in wave 2 of the NEXT Generation Health Study (n = 2023). Poisson regressions were conducted separately for males and females to estimate sexual orientation differences in health care access and health-related screening and advice. Compared with heterosexual males, sexual minority males were more likely to report unmet medical needs in the past year (adjusted relative risk [ARR] = 2.23) but did not differ with respect to receiving physician advice concerning health-related behaviors. Compared with heterosexual females, sexual minority females were more likely to report no routine physical checkup in the past year (ARR = 1.67) but were more likely to receive physician advice to reduce or stop drinking, smoking, drug use, increase physical activity, and improve diet (ARRs = 1.56-1.99), even after controlling for corresponding health-related behaviors. Sexual minority females were also more likely to receive advice about risk associated with sexual behavior (ARR = 1.35) and advice to avoid sexually transmitted diseases (ARR = 1.49). Both sexual minority males and females experienced disparities in some aspects of health care access. Improved health-promoting advice would better serve sexual minority males. Published by Elsevier Inc.

  17. People's perspective on access to health care services in a rural district of Nepal.

    PubMed

    Paudel, R; Upadhyaya, T; Pahari, D P

    2012-01-01

    Over the past several decades, Nepal has attempted to increase the access of health care services, however progress toward achieving high coverage of health care services in rural communities is still low. Therefore this study attempts to provide a perspective on access to basic health care services in government health facility. Descriptive cross-sectional study with quantitative and qualitative methods was designed and applied to identify the access to health care services. The study population were people who were sick within three months prior to the study where basic sampling unit was household. Total sample size was 96 through the application of simple random sampling method. Bivariate analysis with 95% confidence interval was used to identify the association of variables with access to health care services. Among the total population, 28% of households in the study area received health care services at government health facility. The reasons for not accessing health care were insufficient drugs (61%), distance (22%), staff unavailability (19%), sickness (9%), money (7%), and facility hours (4%). Sex, ethnicity and distance were found significantly associated with access to health care services. Less than one third of households had access to health care services in government health facility. Addressing the important factors such as drug problems, staff unavailability, long distance to health institutions and inconvenient health facility hours may help to increase access to health care services at government health facility.

  18. Reproductive health status, knowledge, and access to health care among female migrants in Shanghai, China.

    PubMed

    Feng, Wang; Ren, Ping; Shaokang, Zhan; Anan, Shen

    2005-09-01

    As the largest labour flow in human history, the recent rise in migration in China has opened up unprecedented opportunities for millions of Chinese to rearrange their lives. At the same time, this process has also posed great challenges to Chinese migrants, especially female migrants, who not only face a bias against 'outsiders' but also have a greater need for reproductive health-related services in their migratory destinations. Based on data collected via multiple sources in Shanghai, China's largest metropolis, this study profiles the changing characteristics of female migrants, presents data on self-reported symptoms of reproductive health-related problems and knowledge on reproductive health issues, compares maternal and child health measures between migrants and local residents, and examines factors related to reproductive health knowledge and migrants' access to health care in urban China. Results of this study show a relatively low level of self-reported reproductive health problems among female migrants, coupled with a relatively high level of ignorance in knowledge related to STD. Both self-reported health status and knowledge of reproductive health are related to migrants' educational attainment and length of stay in the urban destination. This study also finds ample evidence that female migrants' access to urban health care is limited by a number of institutional barriers.

  19. Exploring the drivers of health and healthcare access in Zambian prisons: a health systems approach

    PubMed Central

    Topp, Stephanie M.; Moonga, Clement N.; Luo, Nkandu; Kaingu, Michael; Chileshe, Chisela; Magwende, George; Heymann, S. Jody; Henostroza, German

    2016-01-01

    Background Prison populations in sub-Saharan Africa (SSA) experience a high burden of disease and poor access to health care. Although it is generally understood that environmental conditions are dire and contribute to disease spread, evidence of how environmental conditions interact with facility-level social and institutional factors is lacking. This study aimed to unpack the nature of interactions and their influence on health and healthcare access in the Zambian prison setting. Methods We conducted in-depth interviews of a clustered random sample of 79 male prisoners across four prisons, as well as 32 prison officers, policy makers and health care workers. Largely inductive thematic analysis was guided by the concepts of dynamic interaction and emergent behaviour, drawn from the theory of complex adaptive systems. Results A majority of inmates, as well as facility-based officers reported anxiety linked to overcrowding, sanitation, infectious disease transmission, nutrition and coercion. Due in part to differential wealth of inmates and their support networks on entering prison, and in part to the accumulation of authority and material wealth within prison, we found enormous inequity in the standard of living among prisoners at each site. In the context of such inequities, failure of the Zambian prison system to provide basic necessities (including adequate and appropriate forms of nutrition, or access to quality health care) contributed to high rates of inmate-led and officer-led coercion with direct implications for health and access to healthcare. Conclusions This systems-oriented analysis provides a more comprehensive picture of the way resource shortages and human interactions within Zambian prisons interact and affect inmate and officer health. While not a panacea, our findings highlight some strategic entry-points for important upstream and downstream reforms including urgent improvement in the availability of human resources for health; strengthening of

  20. Universal Access to Health and Universal Health Coverage: identification of nursing research priorities in Latin America

    PubMed Central

    Cassiani, Silvia Helena De Bortoli; Bassalobre-Garcia, Alessandra; Reveiz, Ludovic

    2015-01-01

    Objective: To estabilish a regional list for nursing research priorities in health systems and services in the Region of the Americas based on the concepts of Universal Access to Health and Universal Health Coverage. Method: five-stage consensus process: systematic review of literature; appraisal of resulting questions and topics; ranking of the items by graduate program coordinators; discussion and ranking amongst a forum of researchers and public health leaders; and consultation with the Ministries of Health of the Pan American Health Organization's member states. Results: the resulting list of nursing research priorities consists of 276 study questions/ topics, which are sorted into 14 subcategories distributed into six major categories: 1. Policies and education of nursing human resources; 2. Structure, organization and dynamics of health systems and services; 3. Science, technology, innovation, and information systems in public health; 4. Financing of health systems and services; 5. Health policies, governance, and social control; and 6. Social studies in the health field. Conclusion: the list of nursing research priorities is expected to serve as guidance and support for nursing research on health systems and services across Latin America. Not only researchers, but also Ministries of Health, leaders in public health, and research funding agencies are encouraged to use the results of this list to help inform research-funding decisions. PMID:26487014

  1. Web application to access U.S. Army Corps of Engineers Civil Works and Restoration Projects information for the Rio Grande Basin, southern Colorado, New Mexico, and Texas

    USGS Publications Warehouse

    Archuleta, Christy-Ann M.; Eames, Deanna R.

    2009-01-01

    The Rio Grande Civil Works and Restoration Projects Web Application, developed by the U.S. Geological Survey in cooperation with the U.S. Army Corps of Engineers (USACE) Albuquerque District, is designed to provide publicly available information through the Internet about civil works and restoration projects in the Rio Grande Basin. Since 1942, USACE Albuquerque District responsibilities have included building facilities for the U.S. Army and U.S. Air Force, providing flood protection, supplying water for power and public recreation, participating in fire remediation, protecting and restoring wetlands and other natural resources, and supporting other government agencies with engineering, contracting, and project management services. In the process of conducting this vast array of engineering work, the need arose for easily tracking the locations of and providing information about projects to stakeholders and the public. This fact sheet introduces a Web application developed to enable users to visualize locations and search for information about USACE (and some other Federal, State, and local) projects in the Rio Grande Basin in southern Colorado, New Mexico, and Texas.

  2. The Colombian health insurance system and its effect on access to health care.

    PubMed

    Alvarez, Luz Stella; Salmon, J Warren; Swartzman, Dan

    2011-01-01

    In 1993, the Colombian government sought to reform its health care system under the guidance of international financial institutions (the World Bank and International Monetary Fund). These institutions maintain that individual private health insurance systems are more appropriate than previously established national public health structures for overcoming inequities in health care in developing countries. The reforms carried out following international financial institution guidelines are known as "neoliberal reforms." This qualitative study explores consumer health choices and associated factors, based on interviews with citizens living in Medellin, Colombia, in 2005-2006. The results show that most study participants belonging to low-income and middle-income strata, even with medical expense subsidies, faced significant barriers to accessing health care. Only upper-income participants reported a selection of different options without barriers, such as complementary and alternative medicines, along with private Western biomedicine. This study is unique in that the informal health system is linked to overall neo-liberal policy change.

  3. 75 FR 22424 - Avalotis Corp.; Grant of a Permanent Variance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-28

    ... Occupational Safety and Health Administration Avalotis Corp.; Grant of a Permanent Variance AGENCY: Occupational Safety and Health Administration (OSHA), Department of Labor. ACTION: Notice of a grant of a permanent variance. SUMMARY: This notice announces the grant of a permanent variance to Avalotis Corp...

  4. Perceived Barriers to Health Care Access among Rural Older Adults: A Qualitative Study

    ERIC Educational Resources Information Center

    Goins, R. Turner; Williams, Kimberly A.; Carter, Mary W.; Spencer, S. Melinda; Solovieva, Tatiana

    2005-01-01

    Context: Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access. Purpose: To examine what barriers rural elders report when accessing needed health…

  5. Perceived Barriers to Health Care Access Among Rural Older Adults: A Qualitative Study

    ERIC Educational Resources Information Center

    Goins, R. Turner; Williams, Kimberly A.; Carter, Mary W.; Spencer, S. Melinda; Solovieva, Tatiana

    2005-01-01

    Context: Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access. Purpose: To examine what barriers rural elders report when accessing needed health…

  6. Perceived Barriers to Health Care Access among Rural Older Adults: A Qualitative Study

    ERIC Educational Resources Information Center

    Goins, R. Turner; Williams, Kimberly A.; Carter, Mary W.; Spencer, S. Melinda; Solovieva, Tatiana

    2005-01-01

    Context: Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access. Purpose: To examine what barriers rural elders report when accessing needed health…

  7. Perceived Barriers to Health Care Access Among Rural Older Adults: A Qualitative Study

    ERIC Educational Resources Information Center

    Goins, R. Turner; Williams, Kimberly A.; Carter, Mary W.; Spencer, S. Melinda; Solovieva, Tatiana

    2005-01-01

    Context: Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access. Purpose: To examine what barriers rural elders report when accessing needed health…

  8. Equity in health care access to: assessing the urban health insurance reform in China.

    PubMed

    Liu, Gordon G; Zhao, Zhongyun; Cai, Renhua; Yamada, Tetsuji; Yamada, Tadashi

    2002-11-01

    This study evaluates changes in access to health care in response to the pilot experiment of urban health insurance reform in China. The pilot reform began in Zhenjiang and Jiujiang cities in 1994, followed by an expansion to 57 other cities in 1996, and finally to a nationwide campaign in the end of 1998. Specifically, this study examines the pre- and post-reform changes in the likelihood of obtaining various health care services across sub-population groups with different socioeconomic status and health conditions, in an attempt to shed light on the impact of reform on both vertical and horizontal equity measures in health care utilization. Empirical estimates were obtained in an econometric model using data from the annual surveys conducted in Zhenjiang City from 1994 through 1996. The main findings are as follows. Before the insurance reform, the likelihood of obtaining basic care at outpatient setting was much higher for those with higher income, education, and job status at work, indicating a significant measure of horizontal inequity against the lower socioeconomic groups. On the other hand, there was no evidence suggesting vertical inequity against people of chronic disease conditions in access to care at various settings. After the reform, the new insurance plan led to a significant increase in outpatient care utilization by the lower socioeconomic groups, making a great contribution to achieving horizontal equity in access to basic care. The new plan also has maintained the measure of vertical equity in the use of all types of care. Despite reform, people with poor socioeconomic status continue to be disadvantaged in accessing expensive and advanced diagnostic technologies. In conclusion, the reform model has demonstrated promising advantages over pre-reform insurance programs in many aspects, especially in the improvement of equity in access to basic care provided at outpatient settings. It also appears to be more efficient overall in allocating health

  9. Community health agency administrators' access to public health data for program planning, evaluation, and grant preparation.

    PubMed

    Lane, Sandra D; Cashman, Donna M; Keefe, Robert H; Narine, Lutchmie; Ducre, Bradford; Chesna, Sharon; Hall, Meghan; Oliver, David

    2017-02-01

    The Affordable Care Act mandates that public health data be made available for community agency use. Having access to such data allows community agencies to tailor interventions, evaluations, and funding requests more effectively. This study, jointly undertaken by Syracuse University faculty and students with the New York State Perinatal Association, sought to understand community agencies' access to requests for governmental data, as well as to identify areas for improving data access. Results from this survey of administrators from 43 agencies in New York State found that only one-half of their requests for data were successful. Difficulties in obtaining access to needed data included fiscal and staffing constraints of the state-level agencies that house the data, as well as possible overinterpretation of confidentiality policies. In addition, some of community agency respondents reported that their staff lacked skills in data analysis and would benefit from training in epidemiology and quantitative evaluation.

  10. Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing.

    PubMed

    Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.

  11. Using Social Determinants of Health to Link Health Workforce Diversity, Care Quality and Access, and Health Disparities to Achieve Health Equity in Nursing

    PubMed Central

    Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators—health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work—both within and outside the nursing field—that is necessary to answer these important but largely unanswered questions. PMID:24385662

  12. Analysis of Minority Officer Recruiting in the U.S. Marine Corps

    DTIC Science & Technology

    2011-03-01

    108 Juliann Vachon , “Marine Corps Commandant says Afghanistan is Top Priority,” The Beaufort Gazette, 15 November 2010. Accessed 20 November...Update of Marine Corps Officer Recruiting Structure Study. Alexandria, VA: Center for Naval Analyses. Lim, Nelson, Michelle Cho and Kimberly...Procurement Manual, Volume 3, Officer Procurement. Washington, DC: Headquarters, Marine Corps. Vachon , Juliann. 2010. “Marine Corps Commandant

  13. Youth Conservation Corps Guidance.

    ERIC Educational Resources Information Center

    Fish and Wildlife Service (Dept. of Interior), Washington, DC.

    This document provides guidelines for operating Youth Conservation Corps programs under both the Fish and Wildlife Service and the National Park Service. The guide contains 11 units that cover the following topics: (1) enrollees; (2) enrollee payroll; (3) enrollee problems; (4) Youth Conservation Corps staff; (5) accounting; (6) operations; (7)…

  14. GeoCorps America

    NASA Astrophysics Data System (ADS)

    Dawson, M.

    2011-12-01

    GeoCorps America, a program of the Geological Society of America's (GSA) Education and Outreach Department, provides short-term geoscience jobs in America's most amazing public lands. These jobs are hosted on federal lands managed by GeoCorps' three partner agencies: the National Park Service (NPS), the U.S. Forest Service (USFS), and the Bureau of Land Management (BLM). Agency staff submit to GSA position descriptions that help meet their geoscience needs. GSA advertises the positions online, recruits applicants from its 24,000+ members, and coordinates the placement of the candidates selected by agency staff. The typical GeoCorps position lasts for three months, pays a stipend of $2,750, and provides either free housing or a housing allowance. Some GeoCorps positions are classified as "Guest Scientist" positions, which generally last longer, involve larger payments, and require a higher level of expertise. Most GeoCorps positions occur during the spring/summer, but an increasing number of positions are being offered during the fall/winter. GeoCorps positions are open to geoscientists of all levels, from undergraduates through retired professionals. GeoCorps projects involve field and laboratory-based geoscience research, but some projects focus on developing educational programs and materials for staff, volunteers, and the public. The subject areas covered by GeoCorps projects include geology, hydrology, paleontology, mapping/GIS, soils, geo-hazards, cave/karst science, and more. GeoCorps positions have taken place at over 125 different locations nationwide, including Grand Canyon National Park, Sierra National Forest, and Craters of the Moon National Monument. In 2011, GeoCorps began offering GeoCorps Diversity Internships and GeoCorps American Indian Internships. The introduction of these programs doubled the level of diversity among GeoCorps participants. This increase in diversity is helping GSA and its partner agencies in meeting its mutual goal of

  15. Health Care Access for Adults With Intellectual and Developmental Disabilities: A Scoping Review.

    PubMed

    Williamson, Heather J; Contreras, Graciela M; Rodriguez, Erica S; Smith, Jennifer M; Perkins, Elizabeth A

    2017-10-01

    Adults with intellectual and/or developmental disabilities (IDD) often experience health disparities. To address disparities, Healthy People 2020 includes specific disability and health goals focused on improving health care access. The study's purpose was to review the literature exploring health care access for adults with IDD to identify opportunities for occupational therapy research and practice. A scoping review was completed of articles discussing health care access among adults with IDD in the United States. Thirty-seven articles met the inclusion criteria. Results are framed using the ecology of human performance theory identifying person and environmental issues affecting health care access of adults with IDD. Opportunities exist for occupational therapy to improve participation and health of adults with IDD through engaging in research and practice efforts addressing health care access. Occupational therapy could develop interventions to establish skills and abilities and recommend changes to the health care environment.

  16. An Analysis of the Populations of the Air Force's Medical and Professional Officer Corps.

    PubMed

    Keating, Edward G; Massey, Hugh G; Mele, Judith D; Mundell, Benjamin F

    2012-01-01

    Since the advent of the all-volunteer force, one of the foremost personnel challenges of the U.S. Air Force has been recruiting and retaining an adequate number of medical and professional officers in the Air Force's seven medical and professional officer corps: the Biomedical Sciences Corps (BSC), the Chaplain Corps, the Dental Corps, the Judge Advocate General (JAG) Corps (attorneys), the Medical Corps (physicians), the Medical Service Corps (MSC), and the Nurse Corps. For each of these corps, there are highly similar jobs in the private sector, so attracting and retaining these corps' officers is a constant challenge. This article analyzes all seven Air Force medical and professional officer corps and their relative statuses with regard to end strengths, accession levels, promotion flow, and attrition since the late 1970s. The authors find that recent accession and retention trends have been most adverse in the Air Force's Nurse Corps, while the MSC and the JAG Corps appear to have the most stable populations.

  17. Primary health care use and health care accessibility among adolescents in the United Arab Emirates.

    PubMed

    Barakat-Haddad, C; Siddiqua, A

    2015-05-19

    This study examined primary health care use and accessibility among adolescents living in the United Arab Emirates. In a cross-sectional study, we collected health care use, sociodemographic and residential data for a sample of 6363 adolescents. Logistic regression modelling was used to examine predictors of health care use. The most-consulted health professionals were dentists or orthodontists, family doctors and eye specialists. Local adolescents were more likely to attend public clinics/hospitals than private facilities, while the opposite was true for expatriates. In the previous 12 months 22.6% of the participants had not obtained the health care they needed and 19.5% had not had a routine health check-up. Common reasons for not obtaining care were busy schedules, dislike/fear of doctors and long waiting times. Predictors of not obtaining needed care included nationality and income, while those for having a routine check-up were mother's education and car ownership. Improvements to the health care sector may increase health care accessibility among adolescents.

  18. 42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., private organizations and individuals; (iii) The need of the health manpower shortage area for health... personnel. (2) A significant percentage of the individuals who are located in the health manpower shortage... the health manpower shortage area and the area's cost-of-living index. (b) The Secretary may waive in...

  19. 42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., private organizations and individuals; (iii) The need of the health manpower shortage area for health... personnel. (2) A significant percentage of the individuals who are located in the health manpower shortage... the health manpower shortage area and the area's cost-of-living index. (b) The Secretary may waive in...

  20. 42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., private organizations and individuals; (iii) The need of the health manpower shortage area for health... personnel. (2) A significant percentage of the individuals who are located in the health manpower shortage... the health manpower shortage area and the area's cost-of-living index. (b) The Secretary may waive in...

  1. 42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., private organizations and individuals; (iii) The need of the health manpower shortage area for health... personnel. (2) A significant percentage of the individuals who are located in the health manpower shortage... the health manpower shortage area and the area's cost-of-living index. (b) The Secretary may waive in...

  2. 42 CFR 23.10 - Under what circumstances may a National Health Service Corps site's reimbursement obligation to...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., private organizations and individuals; (iii) The need of the health manpower shortage area for health... personnel. (2) A significant percentage of the individuals who are located in the health manpower shortage... the health manpower shortage area and the area's cost-of-living index. (b) The Secretary may waive in...

  3. 42 CFR 23.8 - What operational requirements apply to an entity to which National Health Service Corps personnel...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... site must: (a) Operate a health care delivery system within a planned or existing community structure to assure: (1) The provision of high quality comprehensive health care; (2) To the extent feasible, full professional health care coverage for the health manpower shortage area; (3) Continuum of care...

  4. 42 CFR 23.8 - What operational requirements apply to an entity to which National Health Service Corps personnel...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... site must: (a) Operate a health care delivery system within a planned or existing community structure to assure: (1) The provision of high quality comprehensive health care; (2) To the extent feasible, full professional health care coverage for the health manpower shortage area; (3) Continuum of care...

  5. 42 CFR 23.8 - What operational requirements apply to an entity to which National Health Service Corps personnel...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... site must: (a) Operate a health care delivery system within a planned or existing community structure to assure: (1) The provision of high quality comprehensive health care; (2) To the extent feasible, full professional health care coverage for the health manpower shortage area; (3) Continuum of care...

  6. 42 CFR 23.8 - What operational requirements apply to an entity to which National Health Service Corps personnel...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... site must: (a) Operate a health care delivery system within a planned or existing community structure to assure: (1) The provision of high quality comprehensive health care; (2) To the extent feasible, full professional health care coverage for the health manpower shortage area; (3) Continuum of care...

  7. Restrictions on undocumented immigrants' access to health services: the public health implications of welfare reform.

    PubMed

    Kullgren, Jeffrey T

    2003-10-01

    The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 greatly restricts the provision of many federal, state, and local public services to undocumented immigrants. These restrictions have prompted intense debates about the provision of free and discounted primary and preventive health care-services and have placed significant burdens on institutions that serve large undocumented immigrant populations. Intended to serve as a tool for reducing illegal immigration and protecting public resources, federal restrictions on undocumented immigrants' access to publicly financed health services unduly burden health care providers and threaten the public's health. These deleterious effects warrant the public health community's support of strategies designed to sustain provision of health services irrespective of immigration status.

  8. The digital divide in public e-health: barriers to accessibility and privacy in state health department websites.

    PubMed

    West, Darrell M; Miller, Edward Alan

    2006-08-01

    State health departments have placed a tremendous amount of information, data, and services online in recent years. With the significant increase in online resources at official health sites, though, have come questions concerning equity of access and the confidentiality of electronic medical materials. This paper reports on an examination of public health department websites maintained by the 50 state governments. Using a content analysis of health department sites undertaken each year from 2000 to 2005, we investigate several dimensions of accessibility and privacy: readability levels, disability access, non-English accessibility, and the presence of privacy and security statements. We argue that although progress has been made at improving the accessibility and confidentiality of health department electronic resources, there remains much work to be done to ensure quality access for all Americans in the area of public e-health.

  9. Telecommunications as a means to access health information: an exploratory study of migrants in australia.

    PubMed

    Greenstock, Louise; Woodward-Kron, Robyn; Fraser, Catriona; Bingham, Amie; Naccarella, Lucio; Elliott, Kristine; Morris, Michal

    2012-12-28

    Health policies increasingly promote e-health developments (e.g., consumers' access to online health information) to engage patients in their health care. In order to make these developments available for culturally and socially diverse communities, not only do Internet accessibility, literacy and e-health literacy need to be taken into account, but consumers' preferences and information seeking behaviours for accessing health information have also to be understood. These considerations are crucial when designing major new health policy directions, especially for migration destination countries with culturally diverse populations, such as Australia. The aim of this study was to examine how people from a culturally and linguistically diverse (CALD) community use telecommunications (phone, mobile, Internet) to access health information. A case study was conducted using a questionnaire exploring the use of telecommunications to access health information among CALD people. The study was carried out at a community health centre in a socially and economically disadvantaged area of Melbourne, a city of 4 million people with a large CALD and migrant population. Questionnaires were translated into three languages and interpreters were provided. Fifty-nine questionnaires were completed by users of the community health centre. Most of the CALD participants did not have access to the Internet at home and very few reported using telecommunications to access health information. The findings of the study suggest that telecommunications are not necessarily perceived to be an important channel for accessing health information by members of the CALD community.

  10. Telecommunications as a Means to Access Health Information: An Exploratory Study of Migrants in Australia

    PubMed Central

    Greenstock, Louise; Woodward-Kron, Robyn; Fraser, Catriona; Bingham, Amie; Naccarella, Lucio; Elliott, Kristine; Morris, Michal

    2012-01-01

    Background Health policies increasingly promote e-health developments (e.g., consumers’ access to online health information) to engage patients in their health care. In order to make these developments available for culturally and socially diverse communities, not only do Internet accessibility, literacy and e-health literacy need to be taken into account, but consumers’ preferences and information seeking behaviours for accessing health information have also to be understood. These considerations are crucial when designing major new health policy directions, especially for migration destination countries with culturally diverse populations, such as Australia. The aim of this study was to examine how people from a culturally and linguistically diverse (CALD) community use telecommunications (phone, mobile, Internet) to access health information. Design and Methods A case study was conducted using a questionnaire exploring the use of telecommunications to access health information among CALD people. The study was carried out at a community health centre in a socially and economically disadvantaged area of Melbourne, a city of 4 million people with a large CALD and migrant population. Questionnaires were translated into three languages and interpreters were provided. Fifty-nine questionnaires were completed by users of the community health centre. Results Most of the CALD participants did not have access to the Internet at home and very few reported using telecommunications to access health information. Conclusions The findings of the study suggest that telecommunications are not necessarily perceived to be an important channel for accessing health information by members of the CALD community. PMID:25170467

  11. [European integration and health policies: repercussions of the internal European Market on access to health services].

    PubMed

    Guimarães, Luisa; Giovanella, Lígia

    2006-09-01

    This article explores the health policy repercussions of countries' regional integration into the European Union. The aim is to review the regulation of access in other countries, with the conclusion of the single European market and the free circulation of persons, services, goods, and capital. The article begins by reviewing the various forms of integration and describes the expansion and institutionalization of Community agencies. The repercussions of European integration on health policies and regulation of access are analyzed. Market impacts on health result from Treaty directives and internal policy adjustments to free circulation. Health services access is gradually regulated and granted by rulings. Projects along borders illustrate the dynamics where differences are used to achieve comprehensive care. In the oldest integration experience, the market regulation has generated intentional and non-intentional impacts on the health policies of member states, regardless of the organizational model. Knowledge and analysis of this experience signals challenges for the Southern Cone Common Market (Mercosur) and adds to future debates and decisions.

  12. Health Care In The Suburbs: An Analysis Of Suburban Poverty And Health Care Access.

    PubMed

    Schnake-Mahl, Alina S; Sommers, Benjamin D

    2017-10-01

    There are 16.9 million Americans living in poverty in the suburbs-more than in cities or rural communities. Despite recent increases in suburban poverty, the perception of the suburbs as areas of uniform affluence remains, and there has been little research into health care barriers experienced by people living in these areas. The objectives of this study were to compare patterns of insurance coverage and health care access in suburban, urban, and rural areas using national survey data from 2005 to 2015 and to compare outcomes by geography before and after the Affordable Care Act took effect. We found that nearly 40 percent of the uninsured population lived in suburban areas. Though unadjusted rates of health care access were better in suburban areas, compared to urban and rural communities, this advantage was greatly reduced after income and other demographics are accounted for. Overall, a substantial portion of the US population residing in the suburbs lacked health insurance and experienced difficulties accessing care. Increased policy attention is needed to address these challenges for vulnerable populations living in the suburbs. Project HOPE—The People-to-People Health Foundation, Inc.

  13. ‘More health for the money’: an analytical framework for access to health care through microfinance and savings groups

    PubMed Central

    Saha, Somen

    2014-01-01

    The main contributors to inequities in health relates to widespread poverty. Health cannot be achieved without addressing the social determinants of health, and the answer does not lie in the health sector alone. One of the potential pathways to address vulnerabilities linked to poverty, social exclusion, and empowerment of women is aligning health programmes with empowerment interventions linked to access to capital through microfinance and self-help groups. This paper presents a framework to analyse combined health and financial interventions through microfinance programmes in reducing barriers to access health care. If properly designed and ethically managed such integrated programmes can provide more health for the money spent on health care. PMID:25364028

  14. 'More health for the money': an analytical framework for access to health care through microfinance and savings groups.

    PubMed

    Saha, Somen

    2014-10-01

    The main contributors to inequities in health relates to widespread poverty. Health cannot be achieved without addressing the social determinants of health, and the answer does not lie in the health sector alone. One of the potential pathways to address vulnerabilities linked to poverty, social exclusion, and empowerment of women is aligning health programmes with empowerment interventions linked to access to capital through microfinance and self-help groups. This paper presents a framework to analyse combined health and financial interventions through microfinance programmes in reducing barriers to access health care. If properly designed and ethically managed such integrated programmes can provide more health for the money spent on health care.

  15. E-health: potential benefits and challenges in providing and accessing sexual health services

    PubMed Central

    2013-01-01

    Background E-health has become a burgeoning field in which health professionals and health consumers create and seek information. E-health refers to internet-based health care and information delivery and seeks to improve health service locally, regionally and worldwide. E-sexual health presents new opportunities to provide online sexual health services irrespective of gender, age, sexual orientation and location. Discussion The paper used the dimensions of the RE-AIM model (reach, efficacy, adoption, implementation and maintenance) as a guiding principle to discuss potentials of E-health in providing and accessing sexual health services. There are important issues in relation to utilising and providing online sexual health services. For healthcare providers, e-health can act as an opportunity to enhance their clients’ sexual health care by facilitating communication with full privacy and confidentiality, reducing administrative costs and improving efficiency and flexibility as well as market sexual health services and products. Sexual health is one of the common health topics which both younger and older people explore on the internet and they increasingly prefer sexual health education to be interactive, non-discriminate and anonymous. This commentary presents and discusses the benefits of e-sexual health and provides recommendations towards addressing some of the emerging challenges. Future directions The provision of sexual health services can be enhanced through E-health technology. Doing this can empower consumers to engage with information technology to enhance their sexual health knowledge and quality of life and address some of the stigma associated with diversity in sexualities and sexual health experiences. In addition, e-sexual health may better support and enhance the relationship between consumers and their health care providers across different locations. However, a systematic and focused approach to research and the application of findings in

  16. Access to Transportation and Health Care Utilization in a Rural Region

    ERIC Educational Resources Information Center

    Arcury, Thomas A.; Preisser, John S.; Gesler, Wilbert M.; Powers, James M.

    2005-01-01

    Access to transportation to transverse the large distances between residences and health services in rural settings is a necessity. However, little research has examined directly access to transportation in analyses of rural health care utilization. This analysis addresses the association of transportation and health care utilization in a rural…

  17. The Healthy Web--Access to Online Health Information for Individuals with Disabilities

    ERIC Educational Resources Information Center

    Geiger, Brian; Evans, R. R.; Cellitti, M. A.; Smith, K. Hogan; O'Neal, Marcia R.; Firsing, S. L., III; Chandan, P.

    2011-01-01

    Background: The Internet can be an invaluable resource for obtaining health information by people with disabilities. Although valid and reliable information is available, previous research revealed barriers to accessing health information online. Health education specialists have the responsibilities to insure that it is accessible to all users.…

  18. Experiences, practices and barriers to accessing health information: A qualitative study.

    PubMed

    Scantlebury, Arabella; Booth, Alison; Hanley, Bec

    2017-07-01

    With technology advancements making vast amounts of health information available whenever and wherever it is required, there is a growing need to understand how this information is being accessed and used. Our aim was to explore patients/public and health professionals' experiences, practices and preferences for accessing health information. Focus groups were conducted with 35 healthcare professionals (31 nurses and 4 allied health professionals) and 14 patients/members of the public. Semi-structured interviews were conducted with 5 consultants, who were unable to attend the focus groups. Data collection took place between March and May 2013 and all data were analysed thematically. Health professionals and patients/members of the public reported primarily accessing health information to inform their decision making for providing and seeking treatment respectively. For all participants the internet was the primary mechanism for accessing health information, with health professionals' access affected by open access charges; time constraints and access to computers. Variation in how patients/members of the public and health professionals appraise the quality of information also emerged, with a range of techniques for assessing quality reported. There was a clear preference for accessing health information online within our sample. Given that this information is central to both patient and health professionals' decision making, it is essential that these individuals are basing their decisions on high quality information. Findings from this study have implications for educationalists, health professionals, policymakers and the public. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Differences in Access to Care among Students Using School-Based Health Centers

    ERIC Educational Resources Information Center

    Parasuraman, Sarika Rane; Shi, Leiyu

    2015-01-01

    Health care reform has changed the landscape for the nation's health safety net, and school-based health centers (SBHCs) remain an important part of this system. However, few large-scale studies have been conducted to assess their impact on access to care. This study investigated differences in access among a nationally representative sample of…

  20. 76 FR 56503 - Agency Information Collection Activity (VSO Access to VHA Electronic Health Records) Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-13

    ... AFFAIRS Agency Information Collection Activity (VSO Access to VHA Electronic Health Records) Under OMB... INFORMATION: Title: VSO Access to VHA Electronic Health Records, VA Form 10- 0400. OMB Control Number: 2900... recorded in VHA electronic health records system. An agency may not conduct or sponsor, and a person is not...

  1. Federal Civil Rights Policy and Mental Health Treatment Access for Persons with Limited English Proficiency

    ERIC Educational Resources Information Center

    Snowden, Lonnie R.; Masland, Mary; Guerrero, Rachel

    2007-01-01

    As noted in the supplement to the U.S. Surgeon General's report on mental health (U.S. Department of Health and Human Services, 2001), overcoming language access barriers associated with limited English proficiency (LEP) should help to eliminate racial and ethnic disparities in mental health care access and quality. Federal policy requires…

  2. Federal Civil Rights Policy and Mental Health Treatment Access for Persons with Limited English Proficiency

    ERIC Educational Resources Information Center

    Snowden, Lonnie R.; Masland, Mary; Guerrero, Rachel

    2007-01-01

    As noted in the supplement to the U.S. Surgeon General's report on mental health (U.S. Department of Health and Human Services, 2001), overcoming language access barriers associated with limited English proficiency (LEP) should help to eliminate racial and ethnic disparities in mental health care access and quality. Federal policy requires…

  3. Differences in Access to Care among Students Using School-Based Health Centers

    ERIC Educational Resources Information Center

    Parasuraman, Sarika Rane; Shi, Leiyu

    2015-01-01

    Health care reform has changed the landscape for the nation's health safety net, and school-based health centers (SBHCs) remain an important part of this system. However, few large-scale studies have been conducted to assess their impact on access to care. This study investigated differences in access among a nationally representative sample of…

  4. Accessibility and the Canadian health care system: squaring perceptions and realities.

    PubMed

    Wilson, Kathi; Rosenberg, Mark W

    2004-02-01

    The 1984 Canada Health Act (CHA) is the major piece of Federal legislation that governs health care accessibility in the provinces and territories. According to the CHA, all provinces and territories in Canada must uphold five principles in order to receive federal funding for health care (universality, comprehensiveness, portability, public administration, and accessibility). In Canada, there are competing views among policy makers and consumers about how the CHA's principle of accessibility should be defined, interpreted and used in delivering health care. During the 1990s, the health care perceptions of Canadians and their health care behaviours were measured through both public opinion polls and Statistics Canada's National Population Health Survey (NPHS). The goal of this paper is to examine perceptions of accessibility in public opinion polls and actual accessibility as measured through the NPHS. Public opinion polls demonstrate that while Canadians want to preserve the principles of the CHA, a majority of Canadians are losing confidence in their health care system. In contrast, the results from the NPHS reveal that only 6% of Canadians aged 25 years and older have experienced accessibility problems. Among those who report access problems, the barriers to accessibility are linked to specific socio-economic, socio-demographic and health characteristics of individuals. We discuss these findings in the context of the current debates surrounding accessibility within the CHA and the Canadian health care system.

  5. Reducing disparities in the access and use of Internet health information. a discussion paper.

    PubMed

    Gilmour, Jean A

    2007-09-01

    Internet health information is rated highly by users and is used to compensate for gaps in health information provided by health professionals. Greater understanding of health issues and changes to personal health management has been reported as a consequence of Internet use. However, there are significant disparities in the access and use of Internet health information linked to income, education and ethnicity. In this paper a case is presented that on-line health information particularly benefits the already privileged in terms of health care; well-educated people with access to economic resources. Several intervention points are suggested to improve Internet health information accessibility and use for all population groups. Interventions at an institutional level include improving equity of Internet access through the provision of free services at strategic sites and improving the readability and cultural acceptability of health information. Individually focused interventions involve skill development to enable effective navigation of Internet sites, identification of patient and families' information needs and support to develop evaluation skills. The effectiveness of these interventions in reducing disparities is reliant on nurses and other health professionals' expertise in accessing, evaluating and using Internet health information in their clinical practise. On-line health information is a powerful medium for quick and dynamic knowledge distribution. The challenge for nurses and other health professionals is directing that knowledge to the groups most disadvantaged in the current health care systems, with an agenda of reducing inequalities in access to health information.

  6. Repository on maternal child health: Health portal to improve access to information on maternal child health in India

    PubMed Central

    2013-01-01

    Background Quality and essential health information is considered one of the most cost-effective interventions to improve health for a developing country. Healthcare portals have revolutionalized access to health information and knowledge using the Internet and related technologies, but their usage is far from satisfactory in India. This article describes a health portal developed in India aimed at providing one-stop access to efficiently search, organize and share maternal child health information relevant from public health perspective in the country. Methods The portal ‘Repository on Maternal Child Health’ was developed using an open source content management system and standardized processes were followed for collection, selection, categorization and presentation of resource materials. Its usage is evaluated using key performance indicators obtained from Google Analytics, and quality assessed using a standardized checklist of knowledge management. The results are discussed in relation to improving quality and access to health information. Results The portal was launched in July 2010 and provides free access to full-text of 900 resource materials categorized under specific topics and themes. During the subsequent 18 months, 52,798 visits were registered from 174 countries across the world, and more than three-fourth visits were from India alone. Nearly 44,000 unique visitors visited the website and spent an average time of 4 minutes 26 seconds. The overall bounce rate was 27.6%. An increase in the number of unique visitors was found to be significantly associated with an increase in the average time on site (p-value 0.01), increase in the web traffic through search engines (p-value 0.00), and decrease in the bounce rate (p-value 0.03). There was a high degree of agreement between the two experts regarding quality assessment carried out under the three domains of knowledge access, knowledge creation and knowledge transfer (Kappa statistic 0.72). Conclusions

  7. Technical Health Training Manual. Volume 1. Training for Development. Peace Corps Information Collection & Exchange Training Manual No. T-35a.

    ERIC Educational Resources Information Center

    Clark, Mari; And Others

    This manual is designed as a resource for trainers who provide preservice training, either in-country or state-side, to health specialists and generalists assigned to health projects at the community and clinical levels. The training is intended to assist the volunteer in developing knowledge and skill in the areas of primary health care and the…

  8. Technical Health Training Manual. Volume 2. Training for Development. Peace Corps Information Collection & Exchange Training Manual No. T-35a.

    ERIC Educational Resources Information Center

    Clark, Mari; And Others

    This manual is designed as a resource for trainers who provide preservice training, either in-country or state-side, to health specialists and generalists assigned to health projects at the community and clinical levels. The training is intended to assist the volunteer in developing knowledge and skill in the areas of primary health care and the…

  9. Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

    PubMed

    Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

    2017-02-01

    We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record

  10. Transforming patient and family access to medical information: utilisation patterns of a patient-accessible electronic health record.

    PubMed

    Burke, Redmond P; Rossi, Anthony F; Wilner, Bryan R; Hannan, Robert L; Zabinsky, Jennifer A; White, Jeffrey A

    2010-10-01

    The purpose of this study was to evaluate the utilisation of a web-based multimedia patient-accessible electronic health record, for patients with congenital cardiac disease. This was a prospective analysis of patients undergoing congenital cardiac surgery at a single institution from 1 September, 2006 to 1 February, 2009. After meetings with hospital administration, physicians, nurses, and patients, we configured a subset of the cardiac program's web-based clinical electronic health record for patient and family access. The Electronic Health Record continuously measured frequency and time of logins, logins during and between hospitalisations, and page views by type (imaging versus textual data). Of the first 270 patients offered access to the system, 252 became users (93% adoption rate). System uptime was 99.9%, and no security breaches were reported. Users accessed the system more often while the patients were in hospital (67% of total logins) than after discharge (33% of total logins). The maximum number of logins by a family was 440, and the minimum was 1. The average number of logins per family was 25. Imaging data were viewed significantly more frequently than textual data (p 0.001). A total of 12 patients died during the study period and 11 members of their families continued to access their Electronic Health Records after the date of death. A web-based Patient Accessible Electronic Health Record was designed for patients with congenital cardiac disease. The adoption rate was high, and utilisation patterns suggest that the Electronic Health Record could become a useful tool for health information exchange.

  11. Influences of asthma on reported health indicators and access to health care among children.

    PubMed

    Kodjebacheva, Gergana Damianova; Sabo, Tina; Parker, Shan

    2016-02-01

    Studies on the influences of pediatric asthma on health and access to health care were conducted in limited geographic areas or age groups. To investigate associations of asthma with health, use of medical care, mental health or educational services, activity limitations, problems in paying bills, and frustrations in obtaining health care among children in the United States. Caregivers reported children's conditions. Logistic regression models were adjusted for sociodemographic factors in the nationally representative 2011/2012 National Survey of Children's Health. Of the 91,116 children 0 to 17 years old, 14.6% had reported asthma. Of children 0 to 17 years old with asthma, 21.2% were non-Hispanic black. Of children 0 to 17 years old without asthma, 12.2% were non-Hispanic black. In children 0 to 17 years old, compared with children without asthma, children with asthma had an increased odds to have reported fair or poor health, receive more medical care, mental health, and educational services than usual, have activity limitations, have medical bills that the family had problems paying (odds ratio 1.5, 95% confidence interval 1.3-1.7), and have caregivers who were frustrated in obtaining care (odds ratio 1.5, 95% confidence interval 1.2-1.7). The odds ratios for the associations between asthma and all outcomes were higher in the 0- to 5-year-old compared with the 6- to 17-year-old group. When adjusting for sociodemographic variables, caregivers have problems paying bills and obtaining health care services for their child. To develop age-appropriate interventions, more research is needed to understand why families have difficulties accessing health care. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  12. Navy Nurse Corps manpower management model.

    PubMed

    Kinstler, Daniel P; Johnson, Raymond W; Richter, Anke; Kocher, Kathryn

    2008-01-01

    The Navy Nurse Corps is part of a team of professionals that provides high quality, economical health care to approximately 700,000 active duty Navy and Marine Corps members, as well as 2.6 million retired and family members. Navy Nurse Corps manpower management efficiency is critical to providing this care. This paper aims to focus on manpower planning in the Navy Nurse Corps. The Nurse Corps manages personnel primarily through the recruitment process, drawing on multiple hiring sources. Promotion rates at the lowest two ranks are mandated, but not at the higher ranks. Retention rates vary across pay grades. Using these promotion and attrition rates, a Markov model was constructed to model the personnel flow of junior nurse corps officers. Hiring sources were shown to have a statistically significant effect on promotion and retention rates. However, these effects were not found to be practically significant in the Markov model. Only small improvements in rank imbalances are possible given current recruiting guidelines. Allowing greater flexibility in recruiting practices, fewer recruits would generate a 25 percent reduction in rank imbalances, but result in understaffing. Recruiting different ranks at entry would generate a 65 percent reduction in rank imbalances without understaffing issues. Policies adjusting promotion and retention rates are more powerful in controlling personnel flows than adjusting hiring sources. These policies are the only means for addressing the fundamental sources of rank imbalances in the Navy Nurse Corps arising from current manpower guidelines. The paper shows that modeling to improve manpower management may enable the Navy Nurse Corps to more efficiently fulfill its mandate for high-quality healthcare.

  13. Access to health care: the role of a community based health insurance in Kenya

    PubMed Central

    Mwaura, Judy Wanja; Pongpanich, Sathirakorn

    2012-01-01

    Background Out-of-pocket payments create financial barriers to health care access. There is an increasing interest in the role of community based health insurance schemes in improving equity and access of the poor to essential health care. The aim of this study was to assess the impact of Jamii Bora Health Insurance on access to health care among the urban poor. Methods Data was obtained from the household health interview survey in Kibera and Mathare slums, which consisted of 420 respondents, aged 18 and above who were registered as members of Jamii Bora Trust. The members of Jamii Bora Trust were divided into two groups the insured and the non-insured. Results In total, 17.9% respondents were hospitalized and women (19.6%) were more likely to be admitted than men (14.7%). Those in the poorest quintile had the highest probability of admission (18.1%). Those with secondary school education, large household size, and aged 50 and above also had slightly greater probability of admission (p<0.25). 86% of admissions among the insured respondents were covered JBHI and those in the poorest quintile were more likely to use the JBHI benefit. Results from the logistic regression revealed that the probability of being admitted, whether overall admission or admission covered by the JBHI benefit was determined by the presence of chronic condition (p<0.01). Conclusion Utilization and take up of the JBHI benefits was high. Overall, JBHI favoured the members in the lower income quintiles who were more likely to use health care services covered by the JBHI scheme. PMID:22891093

  14. Access to primary health care services for Indigenous peoples: A framework synthesis.

    PubMed

    Davy, Carol; Harfield, Stephen; McArthur, Alexa; Munn, Zachary; Brown, Alex

    2016-09-30

    Indigenous peoples often find it difficult to access appropriate mainstream primary health care services. Securing access to primary health care services requires more than just services that are situated within easy reach. Ensuring the accessibility of health care for Indigenous peoples who are often faced with a vast array of additional barriers including experiences of discrimination and racism, can be complex. This framework synthesis aimed to identify issues that hindered Indigenous peoples from accessing primary health care and then explore how, if at all, these were addressed by Indigenous health care services. To be included in this framework synthesis papers must have presented findings focused on access to (factors relating to Indigenous peoples, their families and their communities) or accessibility of Indigenous primary health care services. Findings were imported into NVivo and a framework analysis undertaken whereby findings were coded to and then thematically analysed using Levesque and colleague's accessibility framework. Issues relating to the cultural and social determinants of health such as unemployment and low levels of education influenced whether Indigenous patients, their families and communities were able to access health care. Indigenous health care services addressed these issues in a number of ways including the provision of transport to and from appointments, a reduction in health care costs for people on low incomes and close consultation with, if not the direct involvement of, community members in identifying and then addressing health care needs. Indigenous health care services appear to be best placed to overcome both the social and cultural determinants of health which hamper Indigenous peoples from accessing health care. Findings of this synthesis also suggest that Levesque and colleague's accessibility framework should be broadened to include factors related to the health care system such as funding.

  15. Rural women's access to health care in Bangladesh: swimming against the tide?

    PubMed

    Hossen, Md Abul; Westhues, Anne

    2011-01-01

    Large segments of the population in developing countries are deprived of a fundamental right: access to basic health care. The problem of access to health care is particularly acute in Bangladesh. One crucial determinant of health seeking among rural women is the accessibility of medical care and barriers to care that may develop because of location, financial requirements, bureaucratic responses to the patient, social distance between client and provider, and the sex of providers. This article argues that to increase accessibility fundamental changes are required not only in resource allocation but also in the very structure of health services delivery.

  16. Strategies to improve indigenous access for urban and regional populations to health services.

    PubMed

    Hayman, Noel

    2010-01-01

    Lack of appropriate health service provision for Aboriginal and Torres Strait people still remains and important social determinant of ill health. Historically, health services have been absent or inappropriate. Cultural factors, financial factors and distance from health services have been important barriers limiting Indigenous access to mainstream health services. The Inala Indigenous Health Service, a mainstream health service has been able to improve Indigenous access from 12 Aboriginal and Torres Strait Islander patients in 1995 to 4000 patients in 2009, and approximately 1200 doctor consultations each month. Community consultation and participation were the main ingredients to improving indigenous access to the service. With improved access the Inala Indigenous Health Service has been able to analyse 413 Adult Health Checks aged 15-54 years. The Adult Health Checks provide an opportunity to evaluate health status, identifying chronic disease risk factors and for implementing preventive care. The Inala Indigenous Health Service has access to the Healthy for Life Program, a Commonwealth funded quality improvement program that has improved health outcomes for patients over the past three years. All primary health care services working in Aboriginal and Torres Strait Islander health settings should have access to funded continuous quality improvement activities. Copyright 2010 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier B.V. All rights reserved.

  17. Scholarship Program: 1979-80 Report to Congress. Report of the Secretary of Health and Human Services on the Administration of the National Health Service Corps Scholarship Program as Required by Section 751(i) of Title VII of the Public Health Service Act, as Amended, December 12, 1979.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHHS/PHS), Hyattsville, MD.

    The status of the National Health Service Corps Scholarship Program is examined in this third annual report with cumulative data from inception of the program. The scholarship award includes the payment of a monthly stipend, tuition and fees, and other educational expenses in a federal program of service-conditional awards for students of…

  18. [Barriers in access and utilization of health services among immigrants: the perspective of health professionals].

    PubMed

    Dias, Sónia; Gama, Ana; Silva, António Carlos; Cargaleiro, Helena; Martins, Maria O

    2011-01-01

    The growing international migration has reinforcing the importance of a greater adequacy of health services in order to respond effectively to immigrants' needs. Previous studies indicate that several difficulties in the access and utilization of health services persist for some immigrant groups. The objective of this study was to understand the perspective of different health professionals' groups about the barriers in access and utilization of services by immigrants. In a transversal study a questionnaire was applied to 320 primary health care professionals of Lisbon and Tagus Valley. Differences between professional groups were analysed using the Kruskal-Wallis test. To determine which groups diverged more in their perceptions, mean ranks of each group were compared. Of the total participants, 64.2% evaluated their knowledge and competencies to deal with immigrants as reasonable however, 15.2% evaluated it as bad. Around one third of professionals admitted to be unaware of the legislation which regulates migrants' access to services. The largest proportion considered that, at the individual level, the frequent change of residence, the lack of economic resources, the cultural and religious beliefs and traditions, the fear of denunciation when the immigrant is undocumented, the lack of knowledge about legislation and services, and the linguistic differences influence access and utilization of health services. Most considered as barriers at the professionals' and services' level the limited sociocultural skills, the complex bureaucratic procedures, the cost and the lack of interpreters. The divergences in the perception of these factors occurred mainly between office workers and the other professionals. The perceptions of health professionals about the barriers in access and utilization of services by immigrants highlight opportunities for intervention in the context of cultural diversity. Given the different perceptions among the professional groups, which may be

  19. Exploring the drivers of health and healthcare access in Zambian prisons: a health systems approach.

    PubMed

    Topp, Stephanie M; Moonga, Clement N; Luo, Nkandu; Kaingu, Michael; Chileshe, Chisela; Magwende, George; Heymann, S Jody; Henostroza, German

    2016-11-01

    Prison populations in sub-Saharan Africa (SSA) experience a high burden of disease and poor access to health care. Although it is generally understood that environmental conditions are dire and contribute to disease spread, evidence of how environmental conditions interact with facility-level social and institutional factors is lacking. This study aimed to unpack the nature of interactions and their influence on health and healthcare access in the Zambian prison setting. We conducted in-depth interviews of a clustered random sample of 79 male prisoners across four prisons, as well as 32 prison officers, policy makers and health care workers. Largely inductive thematic analysis was guided by the concepts of dynamic interaction and emergent behaviour, drawn from the theory of complex adaptive systems. A majority of inmates, as well as facility-based officers reported anxiety linked to overcrowding, sanitation, infectious disease transmission, nutrition and coercion. Due in part to differential wealth of inmates and their support networks on entering prison, and in part to the accumulation of authority and material wealth within prison, we found enormous inequity in the standard of living among prisoners at each site. In the context of such inequities, failure of the Zambian prison system to provide basic necessities (including adequate and appropriate forms of nutrition, or access to quality health care) contributed to high rates of inmate-led and officer-led coercion with direct implications for health and access to healthcare. This systems-oriented analysis provides a more comprehensive picture of the way resource shortages and human interactions within Zambian prisons interact and affect inmate and officer health. While not a panacea, our findings highlight some strategic entry-points for important upstream and downstream reforms including urgent improvement in the availability of human resources for health; strengthening of facility-based health services systems

  20. Was access to health care easy for immigrants in Spain? The perspectives of health personnel in Catalonia and Andalusia.

    PubMed

    Vázquez, María-Luisa; Vargas, Ingrid; Jaramillo, Daniel López; Porthé, Victoria; López-Fernández, Luis Andrés; Vargas, Hernán; Bosch, Lola; Hernández, Silvia S; Azarola, Ainhoa Ruiz

    2016-04-01

    Until April 2012, all Spanish citizens were entitled to health care and policies had been developed at national and regional level to remove potential barriers of access, however, evidence suggested problems of access for immigrants. In order to identify factors affecting immigrants' access to health care, we conducted a qualitative study based on individual interviews with healthcare managers (n=27) and professionals (n=65) in Catalonia and Andalusia, before the policy change that restricted access for some groups. A thematic analysis was carried out. Health professionals considered access to health care "easy" for immigrants and similar to access for autochthons in both regions. Clear barriers were identified to enter the health system (in obtaining the health card) and in using services, indicating a mismatch between the characteristics of services and those of immigrants. Results did not differ among regions, except for in Catalonia, where access to care was considered harder for users without a health card, due to the fees charged, and in general, because of the distance to primary health care in rural areas. In conclusion, despite the universal coverage granted by the Spanish healthcare system and developed health policies, a number of barriers in access emerged that would require implementing the existing policies. However, the measures taken in the context of the economic crisis are pointing in the opposite direction, towards maintaining or increasing barriers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Women's access to health care in Ghana: effects of education, residence, lineage and self-determination.

    PubMed

    Boateng, John; Flanagan, Constance

    2008-01-01

    Women's physical and psychological access to health care was analyzed using the 2003 Ghana Demographic and Health Survey (GDHS), a nationally representative study for monitoring population and health in Ghana. Female respondents from the 2133 cases in the couple's data set were used in this study. Women's level of education was positively related to physical but not to psychological access to health care. Residing in an urban area was positively related to both types of access. Matriliny consistently showed positive effects on physical access. In addition to these demographic factors, both physical and psychological access were positively related to women's self-determination, i.e., women's right and ability to make real choices about their lives including their health, fertility, sexuality, childcare and all areas where women are denied autonomy and dignity in their identities as women. Self-determination factors both mediated the effects of background factors on access and added explanatory power to the models.

  2. Overcoming barriers to health service access: influencing the demand side.

    PubMed

    Ensor, Tim; Cooper, Stephanie

    2004-03-01

    Evidence suggests that demand-side barriers may be as important as supply factors in deterring patients from obtaining treatment. Yet relatively little attention is given, either by policy makers or researchers, to ways of minimizing their effect. These barriers are likely to be more important for the poor and other vulnerable groups, where the costs of access, lack of information and cultural barriers impede them from benefiting from public spending. Demand barriers present in low- and middle-income countries and evidence on the effectiveness of interventions to overcome these obstacles are reviewed. Demand barriers are also shown to be important in richer countries, particularly among vulnerable groups. This suggests that while barriers are plentiful, there is a dearth of evidence on ways to reduce them. Where evidence does exist, the data and methodology for evaluating effectiveness and cost-effectiveness is insufficient. An increased focus on obtaining robust evidence on effective interventions could yield high returns. The likely nature of the interventions means that pragmatic policy routes that go beyond the traditional boundaries of the public health sector are required for implementing the findings.

  3. Gunton Corp. Information Sheet

    EPA Pesticide Factsheets

    Gunton Corp. (the Company) is located in Bedford Heights, Ohio, and Pottstown, Pennsylvania. The settlement involves renovation activities conducted at properties constructed prior to 1978, located in several cities in Pennsylvania.

  4. How do government health departments in Australia access health economics advice to inform decisions for health? A survey.

    PubMed

    Madden, Lynne; King, Lesley; Shiell, Alan

    2009-04-09

    Government anticipates that health economic analysis will contribute to evidence-based policy development. Early examples in Australia where this expectation has been met include the economic evaluations of breast and cervical screening. However, the level of integration of health economics within health services that require this advice appears uneven. We sought to describe how government health departments in Australia use specialist health economic advice to inform policy and planning and the mechanisms through which they access this advice. Information describing the arrangements for gaining health economics input into health decision-making was sought through interviews with a purposeful sample of economists and non-economists employed by all departments of health in Australia (state, territories and national). The survey was undertaken in August 2004. To aid interpretation of the results eight health economic functions were identified. As a comparison, four other government departments in NSW provided information about their access to economic advice. All health departments except one reported being current users of health economics expertise. A variety of arrangements were described to source this, from building organisational capacity with self-sufficient in-house units to forging links with external sources. However, specialist positions for economists or health economists employed within health were few. A framework mapping these arrangements for sourcing advice with the eight common health economic functions to be met is presented. All other non-health government departments approached accessed economic advice, with three having in-house units. A small health economics capacity in Australia has been established over the past 30 years through a variety of structural and strategic mechanisms. Health departments value health economic advice and use a variety of arrangements to obtain this. These arrangements have strengths and weaknesses depending upon the

  5. How do government health departments in Australia access health economics advice to inform decisions for health? A survey

    PubMed Central

    Madden, Lynne; King, Lesley; Shiell, Alan

    2009-01-01

    Background Government anticipates that health economic analysis will contribute to evidence-based policy development. Early examples in Australia where this expectation has been met include the economic evaluations of breast and cervical screening. However, the level of integration of health economics within health services that require this advice appears uneven. We sought to describe how government health departments in Australia use specialist health economic advice to inform policy and planning and the mechanisms through which they access this advice. Methods Information describing the arrangements for gaining health economics input into health decision-making was sought through interviews with a purposeful sample of economists and non-economists employed by all departments of health in Australia (state, territories and national). The survey was undertaken in August 2004. To aid interpretation of the results eight health economic functions were identified. As a comparison, four other government departments in NSW provided information about their access to economic advice. Results All health departments except one reported being current users of health economics expertise. A variety of arrangements were described to source this, from building organisational capacity with self-sufficient in-house units to forging links with external sources. However, specialist positions for economists or health economists employed within health were few. A framework mapping these arrangements for sourcing advice with the eight common health economic functions to be met is presented. All other non-health government departments approached accessed economic advice, with three having in-house units. Discussion A small health economics capacity in Australia has been established over the past 30 years through a variety of structural and strategic mechanisms. Health departments value health economic advice and use a variety of arrangements to obtain this. These arrangements have

  6. Assessing potential spatial accessibility of health services in rural China: a case study of Donghai county

    PubMed Central

    2013-01-01

    Introduction There is a great health services disparity between urban and rural areas in China. The percentage of people who are unable to access health services due to long travel times increases. This paper takes Donghai County as the study unit to analyse areas with physician shortages and characteristics of the potential spatial accessibility of health services. We analyse how the unequal health services resources distribution and the New Cooperative Medical Scheme affect the potential spatial accessibility of health services in Donghai County. We also give some advice on how to alleviate the unequal spatial accessibility of health services in areas that are more remote and isolated. Methods The shortest traffic times of from hospitals to villages are calculated with an O-D matrix of GIS extension model. This paper applies an enhanced two-step floating catchment area (E2SFCA) method to study the spatial accessibility of health services and to determine areas with physician shortages in Donghai County. The sensitivity of the E2SFCA for assessing variation in the spatial accessibility of health services is checked using different impedance coefficient valuesa. Geostatistical Analyst model and spatial analyst method is used to analyse the spatial pattern and the edge effect of potential spatial accessibility of health services. Results The results show that 69% of villages have access to lower potential spatial accessibility of health services than the average for Donghai County, and 79% of the village scores are lower than the average for Jiangsu Province. The potential spatial accessibility of health services diminishes greatly from the centre of the county to outlying areas. Using a smaller impedance coefficient leads to greater disparity among the villages. The spatial accessibility of health services is greater along highway in the county. Conclusions Most of villages are in underserved health services areas. An unequal distribution of health service

  7. 32 CFR 631.17 - Marine Corps policy.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Marine Corps policy. 631.17 Section 631.17... Marine Corps policy. (a) Within CONUS. (1) Commanders may request authority from Headquarters, Marine...). (ii) In conjunction with military operations. (iii) To safeguard the health, and welfare of...

  8. 32 CFR 631.17 - Marine Corps policy.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Marine Corps policy. 631.17 Section 631.17... Marine Corps policy. (a) Within CONUS. (1) Commanders may request authority from Headquarters, Marine...). (ii) In conjunction with military operations. (iii) To safeguard the health, and welfare of...

  9. 32 CFR 631.17 - Marine Corps policy.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Marine Corps policy. 631.17 Section 631.17... Marine Corps policy. (a) Within CONUS. (1) Commanders may request authority from Headquarters, Marine...). (ii) In conjunction with military operations. (iii) To safeguard the health, and welfare of...

  10. How the Affordable Care Act will affect access to health care in North Carolina.

    PubMed

    Ricketts, Thomas C

    2013-01-01

    Reforming health care in the United States often focuses on improving access to care by removing financial barriers and bringing practitioners closer to patients. This article reviews the provisions of the Patient Protection and Affordable Care Act of 2010 (ACA) that are intended to improve access and discusses how the ACA will change access to care for Americans.

  11. College students' preferences for health care providers when accessing sexual health resources.

    PubMed

    Garcia, Carolyn M; Lechner, Kate E; Frerich, Ellen A; Lust, Katherine A; Eisenberg, Marla E

    2014-01-01

    Many emerging adults (18-25 year olds) report unmet health needs and disproportionately experience problems such as sexually transmitted infections. This study was conducted to examine college students' perceptions of health care providers, specifically in the context of accessing sexual health resources. Students (N = 52) were recruited from five diverse colleges in one state to participate in a one-to-one interview that involved walking and virtually exploring resources on and near campus. Interviews were conducted from May to November 2010. Open-ended one-to-one interview questions. Inductive qualitative analysis yielded six themes summarizing students' perceptions of provider characteristics, health care resources, the role of their peers, and students' suggestions for strengthening health care services. Importantly, students consider a variety of staff-and their student peers-to be resources for sexual health information and services. Findings emphasize the importance of collaboration between health service staff and broader campus staff because students often turn to campus staff initially. Postsecondary students welcome opportunities to know a provider through interactive websites that include details about providers on campus; their decisions to seek sexual health care services are influenced by their perceptions of providers' characteristics and interpersonal skills. © 2014 Wiley Periodicals, Inc.

  12. College Students’ Preferences for Health Care Providers when Accessing Sexual Health Resources

    PubMed Central

    Garcia, Carolyn M.; Lechner, Kate E.; Frerich, Ellen A.; Lust, Katherine A.; Eisenberg, Marla E.

    2017-01-01

    Objective Many emerging adults (18–25 year olds) report unmet health needs and disproportionately experience problems such as sexually transmitted infections. This study was conducted to examine college students’ perceptions of health care providers, specifically in the context of accessing sexual health resources. Design and Sample Students (N=52) were recruited from five diverse colleges in one state to participate in a one-to-one interview that involved walking and virtually exploring resources on and near campus. Interviews were conducted from May to November 2010. Results Inductive qualitative analysis yielded six themes summarizing students’ perceptions of provider characteristics, health care resources, the role of their peers, and students’ suggestions for strengthening health care services. Importantly, students consider a variety of staff—and their student peers—to be resources for sexual health information and services. Conclusions Findings emphasize the importance of collaboration between health service staff and broader campus staff because students often turn to campus staff initially. Post-secondary students welcome opportunities to know a provider through interactive websites that include details about providers on campus; their decisions to seek sexual health care services are influenced by their perceptions of providers’ characteristics and interpersonal skills. PMID:25159532

  13. Internet access for delivery of health information to South Australians older than 50.

    PubMed

    Wilson, Carlene; Flight, Ingrid; Hart, Elizabeth; Turnbull, Deborah; Cole, Steve; Young, Graeme

    2008-04-01

    An exploratory study to determine the proportion of people aged 50-76 years who have Internet access, the location of this access, predictive characteristics of such access, and preparedness to receive unsolicited health information through this medium. A random sample of 1,000 South Australians was identified from the Australian Electoral Commission roll and contacted by telephone in 2006. They were invited to answer questions about their access to the Internet and attitude towards receiving unsolicited health information via the Internet. Of those contacted, 41% provided information. Of this group, 59% indicated that they had Internet access, mostly at home. Men were more likely than women to have home access (p<0.05). Higher educational achievement, higher economic status and younger age were all significantly associated with access. Of those who had access, 65% would be willing to receive health information through the Internet. More than half the population older than 50 years has access to the Internet at some location, and there is a general acceptance of the possibility of receiving health-promoting material via this medium. However, delivery via the Internet alone would disadvantage those who are less educated, less financially well off and older. It is likely that a generational change in the entire nature of public communication will influence the efficiency and effectiveness of preventive health promotion delivery via the Internet. In order to facilitate improved health outcomes, issues of disparity of access must be addressed.

  14. 78 FR 43959 - In the Matter of First Georgia Community Corp., FLO Corp., Florida Community Banks, Inc., In...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-22

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION In the Matter of First Georgia Community Corp., FLO Corp., Florida Community Banks, Inc., In Touch Media Group, Inc., and NHS Health Solutions, Inc.; Order of Suspension of Trading July 18, 2013. It appears to the Securities and...

  15. Undocumented Immigrants and Access to Health Care: Making a Case for Policy Reform.

    PubMed

    Edward, Jean

    2014-02-01

    The growth in undocumented immigration in the United States has garnered increasing interest in the arenas of immigration and health care policy reform. Undocumented immigrants are restricted from accessing public health and social service as a result of their immigration status. The Patient Protection and Affordability Care Act restricts undocumented immigrants from participating in state exchange insurance market places, further limiting them from accessing equitable health care services. This commentary calls for comprehensive policy reform that expands access to health care for undocumented immigrants based on an analysis of immigrant health policies and their impact on health care expenditures, public health, and the role of health care providers. The intersectional nature of immigration and health care policy emphasizes the need for nurse policymakers to advocate for comprehensive policy reform aimed at improving the health and well-being of immigrants and the nation as a whole. © The Author(s) 2014 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

  16. Does Advanced Access improve access to primary health care? Questionnaire survey of patients.

    PubMed

    Salisbury, Chris; Goodall, Stephen; Montgomery, Alan A; Pickin, D Mark; Edwards, Sarah; Sampson, Fiona; Simons, Lucy; Lattimer, Val

    2007-08-01

    General practices in England have been encouraged to introduce Advanced Access, but there is no robust evidence that this is associated with improved access in ways that matter to patients. To compare priorities and experiences of patients consulting in practices which do or do not operate Advanced Access. Patient questionnaire survey. Forty-seven practices in 12 primary care trust areas of England. Questionnaire administered when patients consulted. Of 12,825 eligible patients, 10,821 (84%) responded. Most (70%) were consulting about a problem they had had for at least 'a few weeks'. Patients obtained their current appointment sooner in Advanced Access practices, but were less likely to have been able to book in advance. They could usually see a doctor more quickly than those in control practices, but were no more satisfied overall with the appointment system. The top priority for patients was to be seen on a day of choice rather than to be seen quickly, but different patient groups had different priorities. Patients in Advanced Access practices were no more or less likely to obtain an appointment that matched their priorities than those in control practices. Patients in both types of practice experienced problems making contact by telephone. Patients are seen more quickly in Advanced Access practices, but speed of access is less important to patients than choice of appointment; this may be because most consultations are about long-standing problems. Appointment systems need to be flexible to accommodate the different needs of different patient groups.

  17. Accessibility of health information on the internet to the visually impaired user.

    PubMed

    Lüchtenberg, Marc; Kuhli-Hattenbach, Claudia; Sinangin, Yesim; Ohrloff, Christian; Schalnus, Rainer

    2008-01-01

    Web sites containing health information should be accessible to visually impaired persons. 139 web sites containing medical information addressing laymen or patients were evaluated with respect to their accessibility. A quantitative checklist which is based upon the Web Content Accessibility Guidelines of the World Wide Web Consortium (W3C) was used. Only 18% (15 sites) achieved WAI (Web Accessibility Initiative) level A or AA. WAI level AA was reached by only 1% (1 site) of the web sites. None of the web sites reached level AAA; 82% of the assessed web sites offering consumer health information are not fully accessible to visually impaired persons. The accessibility of web-based health content to visually impaired users should be improved. Health information on the web should at least meet the requirements of priority 1 (level A), preferably priority 2 (level AA) of the W3C guidelines. (c) 2008 S. Karger AG, Basel

  18. [Persisting health and health access inequalities in Mexican indigenous population, 2006-2012].

    PubMed

    Leyva-Flores, René; Infante-Xibille, César; Gutiérrez, Juan Pablo; Quintino-Pérez, Frida

    2013-01-01

    To analyze socioeconomic, health conditions and access to health services of Mexican indigenous population between 2006 and 2012. A comparative analysis was done between indigenous and non indigenous population, using the information from th National Health and Nutrition Survey (2006 and 2012). 60% of the indigenous population was allocated at the poorest socioeconomic level in 2012 despite the implementation of social programs. The Seguro Popular increased its coverage from 14 to 61.9% in indigenous population. The increase observed in coverage in no indigenous population was from 10 to 35.7%. Nevertheless, no increase was observed in the utilization of healthcare services between indigenous and non indigenous population. The access to hospital services for childbirth delivery increased from 63.8 to 76.4% in indigenous population. However there is an important difference with non indigenous population (93.9%). The increase in the coverage of the Seguro Popular in Mexico has had heterogeneous results in the utilization of health care services. Other social programs such a Oportunidades have not had an impact to alleviate poverty in indigenous groups.

  19. Postpolio Survivors: Needs for and Access to Social and Health Care Services.

    ERIC Educational Resources Information Center

    Foster, Larry W.; And Others

    1993-01-01

    Needs assessment survey of 268 polio survivors explored incidence of postpolio syndrome and perceived need for and access to social and health care services. Large proportion of respondents reported experiencing postpolio syndrome. Most perceived that they had no access to knowledgeable physicians or social and health care services, and most were…

  20. Improved Maternal and Child Health Care Access in a Rural Community.

    ERIC Educational Resources Information Center

    Carcillo, Joseph A.; And Others

    1995-01-01

    Describes an underserved rural community in which health care initiatives increased access to comprehensive care. Over a 3-year period, increased accessibility to maternal and child health care also increased use of preventive services, thus decreasing emergency room visits and hospitalizations as well as low birth weight, risk of congenital…

  1. Ensuring Rights: Improving Access to Sexual and Reproductive Health Services for Female International Students in Australia

    ERIC Educational Resources Information Center

    Poljski, Carolyn; Quiazon, Regina; Tran, Chau

    2014-01-01

    Drawing on the research and advocacy work being conducted by the Multicultural Centre for Women's Health (MCWH), a national community-based organization in Victoria, Australia, the paper analyzes female international students' experiences with accessing sexual and reproductive health information and services. Accessibility of sexual and…

  2. Improved Maternal and Child Health Care Access in a Rural Community.

    ERIC Educational Resources Information Center

    Carcillo, Joseph A.; And Others

    1995-01-01

    Describes an underserved rural community in which health care initiatives increased access to comprehensive care. Over a 3-year period, increased accessibility to maternal and child health care also increased use of preventive services, thus decreasing emergency room visits and hospitalizations as well as low birth weight, risk of congenital…

  3. Postpolio Survivors: Needs for and Access to Social and Health Care Services.

    ERIC Educational Resources Information Center

    Foster, Larry W.; And Others

    1993-01-01

    Needs assessment survey of 268 polio survivors explored incidence of postpolio syndrome and perceived need for and access to social and health care services. Large proportion of respondents reported experiencing postpolio syndrome. Most perceived that they had no access to knowledgeable physicians or social and health care services, and most were…

  4. Health Status and Health Service Access and Use Among Children in U.S. Immigrant Families

    PubMed Central

    Huang, Zhihuan Jennifer; Yu, Stella M.; Ledsky, Rebecca

    2006-01-01

    Objectives. We examined the health status and patterns of health care use of children in US immigrant families. Methods. Data from the 1999 National Survey of America’s Families were used to create 3 subgroups of immigrant children: US-born children with noncitizen parents, foreign-born children who were naturalized US citizens, and foreign-born children with noncitizen parents. Chi-square and logistic regression analyses were used to examine relationships between immigrant status and health access variables. Subgroup analyses were conducted with low-income families. Results. Foreign-born noncitizen children were 4 times more likely than children from native families to lack health insurance coverage and to have not visited a mental health specialist in the preceding year. They were 40% and 80% more likely to have not visited a doctor or dentist in the previous year and twice as likely to lack a usual source of care. US-born children with noncitizen parents were also at a disadvantage in many of these aspects of care. Conclusions. We found that, overall, children from immigrant families were in worse physical health than children from non-immigrant families and used health care services at a significantly lower frequency. PMID:16507736

  5. Access to Health Care: Does Neighborhood Residential Instability Matter?

    ERIC Educational Resources Information Center

    Kirby, James B.; Kaneda, Toshiko

    2006-01-01

    Many Americans do not have access to adequate medical care. Previous research on this problem focuses primarily on individual-level determinants of access such as income and insurance coverage. The role of community-level factors in helping or hindering individuals in obtaining needed medical care, however, has not received much attention. We…

  6. Access to Health Care: Does Neighborhood Residential Instability Matter?

    ERIC Educational Resources Information Center

    Kirby, James B.; Kaneda, Toshiko

    2006-01-01

    Many Americans do not have access to adequate medical care. Previous research on this problem focuses primarily on individual-level determinants of access such as income and insurance coverage. The role of community-level factors in helping or hindering individuals in obtaining needed medical care, however, has not received much attention. We…

  7. Accessibility

    EPA Pesticide Factsheets

    Federal laws, including Section 508 of the Rehabilitation Act, mandate that people with disabilities have access to the same information that someone without a disability would have. 508 standards cover electronic and information technology (EIT) products.

  8. Healthcare access and health beliefs of the indigenous peoples in remote Amazonian Peru.

    PubMed

    Brierley, Charlotte K; Suarez, Nicolas; Arora, Gitanjli; Graham, Devon

    2014-01-01

    Little is published about the health issues of traditional communities in the remote Peruvian Amazon. This study assessed healthcare access, health perceptions, and beliefs of the indigenous population along the Ampiyacu and Yaguasyacu rivers in north-eastern Peru. One hundred and seventy-nine adult inhabitants of 10 remote settlements attending health clinics were interviewed during a medical services trip in April 2012. Demographics, health status, access to healthcare, health education, sanitation, alcohol use, and smoke exposure were recorded. Our findings indicate that poverty, household overcrowding, and poor sanitation remain commonplace in this group. Furthermore, there are poor levels of health education and on-going barriers to accessing healthcare. Healthcare access and health education remain poor in the remote Peruvian Amazon. This combined with poverty and its sequelae render this population vulnerable to disease.

  9. Healthcare Access and Health Beliefs of the Indigenous Peoples in Remote Amazonian Peru

    PubMed Central

    Brierley, Charlotte K.; Suarez, Nicolas; Arora, Gitanjli; Graham, Devon

    2014-01-01

    Little is published about the health issues of traditional communities in the remote Peruvian Amazon. This study assessed healthcare access, health perceptions, and beliefs of the indigenous population along the Ampiyacu and Yaguasyacu rivers in north-eastern Peru. One hundred and seventy-nine adult inhabitants of 10 remote settlements attending health clinics were interviewed during a medical services trip in April 2012. Demographics, health status, access to healthcare, health education, sanitation, alcohol use, and smoke exposure were recorded. Our findings indicate that poverty, household overcrowding, and poor sanitation remain commonplace in this group. Furthermore, there are poor levels of health education and on-going barriers to accessing healthcare. Healthcare access and health education remain poor in the remote Peruvian Amazon. This combined with poverty and its sequelae render this population vulnerable to disease. PMID:24277789

  10. Pilot evaluation of a web-based intervention targeting sexual health service access.

    PubMed

    Brown, K E; Newby, K; Caley, M; Danahay, A; Kehal, I

    2016-04-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among 13-19-year olds are reported. A pre-post questionnaire-based design was used. Matched baseline and follow-up data were identified from 148 respondents aged 13-18 years. Outcome measures were self-reported service access, self-reported intention to access services and beliefs about services and service access identified through needs analysis. Objective service access data provided by local sexual health services were also analyzed. Analysis suggests the intervention had a significant positive effect on psychological barriers to and antecedents of service access among females. Males, who reported greater confidence in service access compared with females, significantly increased service access by time 2 follow-up. Available objective service access data support the assertion that the intervention may have led to increases in service access. There is real promise for this novel digital intervention. Further evaluation is planned as the model is licensed to and rolled out by other local authorities in the United Kingdom. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  11. Self-Rated Health and Health Care Access Associated With African American Men's Health Self-Efficacy.

    PubMed

    Thompson, Terry; Mitchell, Jamie A; Johnson-Lawrence, Vicki; Watkins, Daphne C; Modlin, Charles S

    2017-09-01

    Health self-efficacy, a measure of one's self-assurance in taking care of their own health, is known to contribute to a range of health outcomes that has been under examined among African American men. The purpose of this investigation was to identify and contextualize predictors of general health self-efficacy in this population. A cross-sectional sample of surveys from 558 African American was examined. These men were older than 18 years, could read and write English, and attended a hospital-based community health fair targeting minority men in 2011. The outcome of interest was health self-efficacy, which was assessed by asking, "Overall, how confident are you in your ability to take good care of your health?" Responses ranged from 1 ( not confident at all) to 5 ( completely confident). Covariates included age, self-rated health, health insurance status, having a regular physician, and being a smoker. The mean age of participants was 54.4 years, and 61.3% of participants indicated confidence in their ability to take good care of their health. Older age and being a smoker were inversely associated with the outcome. Good self-rated health, having health insurance, and having a regular doctor were positively associated with reports of health self-efficacy. Findings suggest that multiple points of connection to the health care system increase the likelihood of health self-efficacy for this sample and interventions to support older African American men who may evaluate their own health status as poor and who may face barriers to health care access are implicated.

  12. HEALTH CARE ACCESS AMONG HISPANIC IMMIGRANTS: ¿ALGUIEN ESTÁ ESCUCHANDO? [IS ANYBODY LISTENING?

    PubMed Central

    Pérez-Escamilla, Rafael; Garcia, Jonathan; Song, David

    2010-01-01

    This systematic review identified 77 studies to examine patterns and determinants of health care access among Hispanic immigrants (HI) living in the U.S. In spite of major mental and physical care needs, HI and their families are at very high risk of not having access to health care compared with non-immigrant Hispanics and non-Hispanic whites. Noncitizenship status is a major barrier for accessing health care due to program ineligibility and fear of stigma and deportation. Low English proficiency is also an important barrier to health care. Culturally appropriate community outreach programs relying heavily on community health workers, also known as promotoras, have improved health care access and quality. Mexico shares the health care cost for HIs living in bordering states, calling for a binational dialogue. Mixed-methods research is needed to better understand: a) the net influence of acculturation on migrant health; b) the role of informal (e.g., family) vs. formal (e.g. promotoras) social support at facilitating health care access; c) issues related to ‘single’ male migrant farm workers; d) the “Hispanic mortality paradox”; e) traditional healing and medicine among HI. Comprehensive health and immigration reforms are needed to respect the human right that HIs have to gain access to health care. PMID:21116464

  13. Development and Testing of a Conceptual Model Regarding Men's Access to Health Care.

    PubMed

    Leone, James E; Rovito, Michael J; Mullin, Elizabeth M; Mohammed, Shan D; Lee, Christina S

    2017-03-01

    Epidemiologic data suggest men often experience excessive morbidity and early mortality, possibly compromising family and community health over the lifespan. Moreover, the negative financial/economic consequences affected by poor male health outcomes also has been of great concern in the United States and abroad. Early and consistent access to preventative health care may improve health outcomes; however, men are far less likely to access these services. The purpose of this study was to understand what factors preclude men from accessing health care. We surveyed 485 participants using a 58-item online survey built from a conceptual model previously developed by the researchers using hegemonic masculinity theory, the theory of normative contentment, and the health belief model. For men, three items significantly ( ps < .05) predicted whether they had seen a health care provider in the past year: "I/Men do not access healthcare because I do not think there is anything wrong with me," "My health is only about me," and "I/Men do not access healthcare because most men in my family do not access healthcare." Other correlations of practical significance also were noted. Results suggest gender norms and masculine ideals may play a primary role in how men access preventative health care. Future programming targeting males should consider barriers and plan programs that are gender-sensitive in addition to being gender-specific. Clinical implications are discussed.

  14. 42 CFR 21.28 - Age requirements, Regular Corps, senior assistant grade and below.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Age requirements, Regular Corps, senior assistant grade and below. 21.28 Section 21.28 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... active service in the Commissioned Corps of the Public Health Service shall be increased by the period...

  15. 42 CFR 21.28 - Age requirements, Regular Corps, senior assistant grade and below.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Age requirements, Regular Corps, senior assistant grade and below. 21.28 Section 21.28 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... active service in the Commissioned Corps of the Public Health Service shall be increased by the period...

  16. 42 CFR 21.28 - Age requirements, Regular Corps, senior assistant grade and below.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Age requirements, Regular Corps, senior assistant grade and below. 21.28 Section 21.28 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... active service in the Commissioned Corps of the Public Health Service shall be increased by the period...

  17. 42 CFR 21.28 - Age requirements, Regular Corps, senior assistant grade and below.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Age requirements, Regular Corps, senior assistant grade and below. 21.28 Section 21.28 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... active service in the Commissioned Corps of the Public Health Service shall be increased by the period...

  18. Pilot Evaluation of a Web-Based Intervention Targeting Sexual Health Service Access

    ERIC Educational Resources Information Center

    Brown, K. E.; Newby, K.; Caley, M.; Danahay, A.; Kehal, I.

    2016-01-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among…

  19. Rural Health Care Information Access and the Use of the Internet: Opportunity for University Extension

    ERIC Educational Resources Information Center

    Das, Biswa R.; Leatherman, John C.; Bressers, Bonnie M.

    2015-01-01

    The Internet has potential for improving health information delivery and strengthening connections between rural populations and local health service providers. An exploratory case study six rural health care markets in Kansas showed that about 70% of adults use the Internet, with substantial use for accessing health information. While there are…

  20. Between the Cracks: Access to Physical Health Care in Children of the Working Poor.

    ERIC Educational Resources Information Center

    Tinsley, Barbara J.; Wang, Shirley J.; Kwasman, Alan; Green, Delores

    This study examined the demographic and psychological characteristics of the parents of a group of children with no access to health care, due to their status as "working poor" and thus denied either public or private health insurance whose children were referred for treatment for an acute health problem by a volunteer health care…

  1. Improving Access to Health Care for Foster Children: The Illinois Model

    ERIC Educational Resources Information Center

    Jaudes, Paula Kienberger; Bilaver, Lucy A.; Goerge, Robert M.; Masterson, James; Catania, Charles

    2004-01-01

    Children in foster care have lower health status than do their peers and limited access to health care. The Illinois Department of Children and Family Services developed HealthWorks, a separate primary care preferred provider system for children in foster care. This study compared claims data for children in HealthWorks with children not enrolled…

  2. Pilot Evaluation of a Web-Based Intervention Targeting Sexual Health Service Access

    ERIC Educational Resources Information Center

    Brown, K. E.; Newby, K.; Caley, M.; Danahay, A.; Kehal, I.

    2016-01-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among…

  3. Rural Health Care Information Access and the Use of the Internet: Opportunity for University Extension

    ERIC Educational Resources Information Center

    Das, Biswa R.; Leatherman, John C.; Bressers, Bonnie M.

    2015-01-01

    The Internet has potential for improving health information delivery and strengthening connections between rural populations and local health service providers. An exploratory case study six rural health care markets in Kansas showed that about 70% of adults use the Internet, with substantial use for accessing health information. While there are…

  4. Foregone Mental Health Care and Self-Reported Access Barriers among Adolescents

    ERIC Educational Resources Information Center

    Samargia, Luzette A.; Saewyc, Elizabeth M.; Elliott, Barbara A.

    2006-01-01

    Adolescents forego mental health care in spite of self-perceived needs for services; this presents a significant public health problem. Using data from the 2001 Adolescent Health Care Access Survey of 16-year-olds in Saint Louis County, Minnesota, we assessed barriers to mental health care among the 878 respondents who reported ever needing…

  5. Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas.

    PubMed

    Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

    2016-01-01

    Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In

  6. Using law to fight a silent epidemic: the role of health literacy in health care access, quality, & cost.

    PubMed

    Clark, Brietta

    2011-01-01

    The dominant rhetoric in the health care policy debate about cost has assumed an inherent tension between access and quality on the one hand, and cost effectiveness on the other; but an emerging discourse has challenged this narrative by presenting a more nuanced relationship between access, quality, and cost. This is reflected in the discourse surrounding health literacy, which is viewed as an important tool for achieving all three goals. Health literacy refers to one's ability to obtain, understand and use health information to make appropriate health decisions. Research shows that improving patients' health literacy can help overcome access barriers and empower patients to be better health care partners, which should lead to better health outcomes. Promoting health literacy can also reduce expenditures for unnecessary or inappropriate treatment. This explains why, as a policy matter, improving health literacy is an objective that has been embraced by almost every sector of the health care system. As a legal matter, however, the role of health literacy in ensuring quality and access is not as prominent. Although the health literacy movement is relatively young, it has roots in longstanding bioethical principles of patient autonomy, beneficence, and justice as well as the corresponding legal principles of informed consent, the right to quality care, and antidiscrimination. Assumptions and concerns about health literacy seem to do important, yet subtle work in these legal doctrines--influencing conclusions about patient understanding in informed consent cases, animating decisions about patient responsibility in malpractice cases, and underlying regulatory guidance concerning the quality of language assistance services that are necessary for meaningful access to care. Nonetheless, health literacy is not explicitly treated as a legally relevant factor in these doctrines. Moreover, there is no coherent legal framework for incorporating health literacy research that

  7. The role of social marketing in understanding access to primary health care services: perceptions and experiences.

    PubMed

    Akinci, Fevzi; Healey, Bernard J

    2004-01-01

    Using the concept of social marketing, this study examined the determinants of access to primary health care services in order to better understand the perceived access problems and unmet service needs of an entire city in Northeastern Pennsylvania. Consistent with previous research, lack of access to health insurance coverage represents an important financial barrier to access to health care services in this community. This study also highlights the role of perceived need in explaining the presence or absence of a physician consultation.While increased attention to access issues at the national level is important, there also needs to be more emphasis on collecting local data for local decision-making regarding access issues.

  8. Privacy, security and access with sensitive health information.

    PubMed

    Croll, Peter

    2010-01-01

    This chapter gives an educational overview of: * Confidentiality issues and the challenges faced; * The fundamental differences between privacy and security; * The different access control mechanisms; * The challenges of Internet security; * How 'safety and quality' relate to all the above.

  9. Access to safe legal abortion in Malaysia: women's insights and health sector response.

    PubMed

    Low, Wah-Yun; Tong, Wen-Ting; Wong, Yut-Lin; Jegasothy, Ravindran; Choong, Sim-Poey

    2015-01-01

    Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers.

  10. Citizens' Access to Their Digital Health Data in Eleven Countries - A Comparative Study.

    PubMed

    Nohr, Christian; Wong, Ming Chao; Turner, Paul; Almond, Helen; Parv, Liisa; Gilstad, Heidi; Koch, Sabine; Harðardóttir, Guðrún Auður; Hyppönen, Hannele; Marcilly, Romaric; Sheik, Aziz; Day, Karen; Kushniruk, Andre

    2016-01-01

    Governments around the world are actively promoting citizens electronic access to their health data as one of a number of ways to respond to the challenges of health care delivery in the 21st century. While numerous approaches have been utilized it is evident from cross-country comparisons that there are different conceptualizations of: both the expected and desired roles for citizens in the management of their own health; the benefits that will be delivered by citizen access and how these benefits should be measured and benchmarked over-time. This paper presents comparative analyses of the methods by which citizens are provided with access to their own health data across 11 countries. The paper aims to stimulate debate on electronic citizen access to health data and the challenges of measuring benefit as well as reflection on capacity of different citizens to engage with e-health.

  11. [Access to oral health services in children under twelve years of age in Peru, 2014].

    PubMed

    Hernández-Vásquez, Akram; Azañedo, Diego; Díaz-Seijas, Deysi; Bendezú-Quispe, Guido; Arroyo-Hernández, Hugo; Vilcarromero, Stalin; Agudelo-Suárez, Andrés A

    2016-01-01

    The aim of the study was to explore the patterns of dental health services access in children under twelve years of age in Peru. Data from 25,285 children under 12 years who participated in the Demographic and Family Health Survey of 2014 were reviewed. An exploratory spatial analysis was performed to project the proportions of children with access to dental health services, according to national regions, type of health service and urban or rural place of residence. The results show that of the total sample, 26.7% had access to dental health services in the last six months, 39.6% belonged to the age group 0-4 years, 40.6% lived in the Andean region and 58.3% lived in urban areas. The regions of Huancavelica, Apurimac, Ayacucho, Lima and Pasco had the highest percentages of access nationwide. In conclusion, there is low access to dental health services in the population under 12 years of age in Peru. The spatial distribution of access to dental health services allows regions to be identified and grouped according to similar access patterns, in order to better focus public health actions.

  12. Patient Accessible Electronic Health Records: Exploring Recommendations for Successful Implementation Strategies

    PubMed Central

    Urowitz, Sara; Apatu, Emma; DeLenardo, Claudette; Eysenbach, Gunther; Harth, Tamara; Pai, Howard; Leonard, Kevin J

    2008-01-01

    Background Providing patients with access to their electronic health records offers great promise to improve patient health and satisfaction with their care, as well to improve professional and organizational approaches to health care. Although many benefits have been identified, there are many questions about best practices for the implementation of patient accessible Electronic Health Records (EHRs). Objectives To develop recommendations to assist health care organizations in providing patients with access to EHRs in a meaningful, responsible, and responsive manner. Methods A Patient Accessible Electronic Health Record (PAEHR) Workshop was held with nationally and internationally renowned experts to explore issues related to providing patient access to the EHR and managing institutional change. Results The PAEHR Workshop was attended by 45 participants who discussed recommendations for the implementation of patient accessible EHRs. Recommendations were discussed under four subject domains: (1) providing patient access to the EHR, (2) maintaining privacy and confidentiality related to the PAEHR, (3) patient education and navigation of the PAEHR, and (4) strategies for managing institutional change. The discussion focused on the need for national infrastructure, clear definitions for privacy, security and confidentiality, flexible, interoperable solutions, and patient and professional education. In addition, there was a strong call for research into all domains of patient accessible EHRs to ensure the adoption of evidence-based practices. Conclusions Patient access to personal health information is a fundamental issue for patient engagement and empowerment. Health care professionals and organizations should consider the potential benefits and risks of patient access when developing EHR strategies. Flexible, standardized, and interoperable solutions must be integrated with outcomes-based research to activate effectively patients as partners in their health care

  13. Exposing some important barriers to health care access in the rural USA.

    PubMed

    Douthit, N; Kiv, S; Dwolatzky, T; Biswas, S

    2015-06-01

    To review research published before and after the passage of the Patient Protection and Affordable Care Act (2010) examining barriers in seeking or accessing health care in rural populations in the USA. This literature review was based on a comprehensive search for all literature researching rural health care provision and access in the USA. Pubmed, Proquest Allied Nursing and Health Literature, National Rural Health Association (NRHA) Resource Center and Google Scholar databases were searched using the Medical Subject Headings (MeSH) 'Rural Health Services' and 'Rural Health.' MeSH subtitle headings used were 'USA,' 'utilization,' 'trends' and 'supply and distribution.' Keywords added to the search parameters were 'access,' 'rural' and 'health care.' Searches in Google Scholar employed the phrases 'health care disparities in the USA,' inequalities in 'health care in the USA,' 'health care in rural USA' and 'access to health care in rural USA.' After eliminating non-relevant articles, 34 articles were included. Significant differences in health care access between rural and urban areas exist. Reluctance to seek health care in rural areas was based on cultural and financial constraints, often compounded by a scarcity of services, a lack of trained physicians, insufficient public transport, and poor availability of broadband internet services. Rural residents were found to have poorer health, with rural areas having difficulty in attracting and retaining physicians, and maintaining health services on a par with their urban counterparts. Rural and urban health care disparities require an ongoing program of reform with the aim to improve the provision of services, promote recruitment, training and career development of rural health care professionals, increase comprehensive health insurance coverage and engage rural residents and healthcare providers in health promotion. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights

  14. A Marine Corps Interwar Period Analysis and Implications for Today

    DTIC Science & Technology

    2013-03-01

    to keep the Marine Corps in the forefront of the nation’s political leadership and the American population. This is a great example of...Corps History,” Défense et Sécurité Internationale, No. 22 (February-March 2012): 20. 21 U.S. Marine Corps Air-Ground Museum, “The Alligator ...ormation (accessed December 2, 2012), 3. 49 Stephen M. Walt, “The End of the American Era?” The National Interest, No. 116, (November/December 2011

  15. PAHO'S Strategy for Universal Access to Health and Universal Health Coverage: implications for health services and hospitals in LAC.

    PubMed

    Holder, Reynaldo; Fabrega, Ricardo

    2015-01-01

    Moving towards Universal Access to Health and Universal Health Coverage (UAH/UHC) is an imperative task on the health agenda for the Americas. The Directing Council of the Pan American Health Organization (PAHO) recently approved resolution CD53.R14, titled Strategy for Universal Access to Health and Universal Health Coverage. From the perspective of the Region of the Americas, UAH/UHC "imply that all people and communities have access, without any kind of discrimination, to comprehensive, appropriate and timely, quality health services determined at the national level according to needs, as well as access to safe, affordable, effective, quality medicines, while ensuring that the use of these services does not expose users to financial hardship, especially groups in conditions of vulnerability". PAHO's strategic approach to UAH/UHC sets out four specific lines of action toward effective universal health systems. The first strategic line proposes: a) implementation of integrated health services delivery networks (IHDSNs) based on primary health care as the key strategy for reorganizing, redefining and improving healthcare services in general and the role of hospitals in particular; and b) increasing the response capacity of the first level of care. An important debate initiated in 2011 among hospital and healthcare managers in the region tried to redefine the role of hospitals in the context of IHSDNs and the emerging UAH/UHC movement. The debates resulted in agreements around three main propositions: 1) IHSDNs cannot be envisioned without hospitals; 2) The status-quo and current hospital organizational culture makes IHSDNs inviable; and 3) Without IHSDNs, hospitals will not be sustainable. This process, that predates the approval of PAHO's UAH/UHC resolution, now becomes more relevant with the recognition that UAH/UHC cannot be attained without a profound change in healthcare service and particularly in hospitals. In this context, a set of challenges both for

  16. Youth and caregiver access to peer advocates and satisfaction with mental health services.

    PubMed

    Radigan, Marleen; Wang, Rui; Chen, Yu; Xiang, Jiani

    2014-11-01

    Access to peer advocates is increasingly available to youth and their caregivers who are receiving services in the public mental health system. This study examines associations between reported access to a youth or family advocate and perceptions of satisfaction with mental health services. A cross-sectional survey of youth (N = 768) and caregivers (N = 1,231) who utilized public mental health services in New York State in 2012 was conducted. The survey includes items on access to youth or family advocates and degree of satisfaction with mental health services. A greater proportion of youth or caregivers with access to peer advocates compared to those without access responded positively on the satisfaction domains of access to services, appropriateness of services, participation in services and overall/global satisfaction. Access to peer advocates was also positively associated with agreement on the psychotropic medication comprehension domain for youth and on perceptions of child functioning and social connectedness for caregivers compared to those without access. This study adds to the growing understanding of the important role peer advocates play in engaging youth with mental health needs and their caregivers in mental health services.

  17. An issue of access: delivering equitable health care for newly arrived refugee children in Australia.

    PubMed

    Davidson, N; Skull, S; Burgner, D; Kelly, P; Raman, S; Silove, D; Steel, Z; Vora, R; Smith, M

    2004-01-01

    Newly arrived refugees and asylum seekers are faced with many difficulties in accessing effective health care when settling in Australia. Cultural, language and financial constraints, lack of awareness of available services, and lack of health provider understanding of the complex health concerns of refugees can all contribute to limiting access to health care. Understanding the complexities of a new health care system under these circumstances and finding a regular health provider may be difficult. In some cases there may be a fundamental distrust of government services. The different levels of health entitlements by visa category and (for some) detention on arrival in Australia may further complicate the provision and use of health services for providers and patients. Children are particularly at risk of suboptimal health care due to the impact of these factors combined with the effect of resettlement stresses on parents' ability to care for their children. Unaccompanied and separated children, and those in detention experience additional challenges in accessing care. This article aims to increase awareness among health professionals caring for refugee children of the challenges faced by this group in accessing and receiving effective health care in Australia. Particular consideration is given to the issues of equity, rights of asylum seekers, communication and cultural sensitivities in health care provision, and addressing barriers to health care. The aim of the paper is to alert practitioners to the complex issues surrounding the delivery of health care to refugee children and provide realistic recommendations to guide practice.

  18. Is it not time for health economists to rethink equity and access?

    PubMed

    Mooney, Gavin

    2009-04-01

    This article considers two key issues in health economics regarding the question of equity. First, why have health economists not resolved better the issue of what are equity and access? Second, the paper draws attention to the relative lack of analyses of equity concerns outside of health care. The question of whose values should prevail in equity is also addressed. On the first issue, there is an obsession with quantification in economics with the result that in analysing equity, in practice often 'use' has been substituted for 'access'. The problem of defining access has thereby been by-passed. This has taken the pressure off trying to research access per se. Second, what is meant by equity and access are in part culturally determined. The continued efforts of health economists to treat equity as some universal construct are misplaced. The lack of effort on the part of health economists to look at equity more broadly than health care equity is concerning. Certainly, to be pursued in practice, equity in both health and health care need a shift in resources, which will be opposed by those who exercise power over decision making in health care and in society more generally. Currently health economists' analyses say all too little about power and property rights in health care and in society. It is argued that the relevant citizens or communities which a health service serves are best placed to judge the access barriers they face and their relative heights. A useful definition of equity established by a citizens' jury in Perth, Australia is used to exemplify this point. It is concluded that the often all too simplistic equity goals adopted in health economics (and sometimes public health discourse) need to be challenged. For health economists, there is a need for more of us to get involved in the issues around inequalities, class and power and the impact of these on health.

  19. [Health inequality on results and access indicators for children in Mexico: analysis of national health surveys].

    PubMed

    Gutiérrez, Juan Pablo; García-Saisó, Sebastián; Espinosa-de la Peña, Rodrigo; Balandrán, Dulce Alejandra

    2016-01-01

    To analyze inequalities in health care indicators of children 0 to 9 years old in Mexico reporting gap and gradient measures. Cross-sectional analysis of national health surveys in 2000, 2006 and 2012, measuring absolute and relative gap measures as well as the Slope Index of Inequality for four health care indicators (vaccination, care for acute respiratory infections, care for acute diarrheal diseases, and care for accidents) with socioeconomic stratification, as well as absolute gaps by sex, urbanicity and ethnic background. Between 2000 and 2012, immunological equity was reached in Mexico, as well as elimination in the socioeconomic gap related to care for accidents; nevertheless, there is a persistent socioeconomic gap of care for acute respiratory infections that is also there regarding rural residence and indigenous population. In Mexico, there is a trend to the elimination of socioeconomic differences in the probability of receiving adequate health care among children, although some socioeconomic gaps remain in particular related to provision of services that require more participation of health personnel. There is a need to ensure homogenous access to effective services for all.

  20. Making Evidence on Health Policy Issues Accessible to the Media

    PubMed Central

    Roos, Noralou P.; O'Grady, Kathleen; Singer, Sharon Manson; Turczak, Shannon; Tapp, Camilla

    2012-01-01

    The media shape consumer expectations and interpretations of health interventions, influencing how people think about their need for care and the sustainability of the system. EvidenceNetwork.ca is a non-partisan, web-based project funded by the Canadian Institutes of Health Research and the Manitoba Health Research Council to make the latest evidence on controversial health policy issues available to the media. This website links journalists with health policy experts. We publish opinion pieces on current health policy issues in both French and English. We track who follows and uses the EvidenceNetwork.ca website and monitor the impact of our efforts. PMID:23968614

  1. Expanding federal funding to community health centers slows decline in access for low-income adults.

    PubMed

    McMorrow, Stacey; Zuckerman, Stephen

    2014-06-01

    To identify the impact of the Health Center Growth Initiative on access to care for low-income adults. Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000-2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001-2008). We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage. We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions. Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults. Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period. © Health Research and Educational Trust.

  2. Socioeconomic inequalities in the access to and quality of health care services

    PubMed Central

    Nunes, Bruno Pereira; Thumé, Elaine; Tomasi, Elaine; Duro, Suele Manjourany Silva; Facchini, Luiz Augusto

    2014-01-01

    OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in hours) in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services. PMID:26039400

  3. Formative Evaluation to Assess Communication Technology Access and Health Communication Preferences of Alaska Native People

    PubMed Central

    Robinson, Renee F.; Dillard, Denise A.; Hiratsuka, Vanessa Y.; Smith, Julia J.; Tierney, Steve; Avey, Jaedon P.; Buchwald, Dedra S.

    2016-01-01

    Objective Information technology can improve the quality, safety, and efficiency of healthcare delivery by improving provider and patient access to health information. We conducted a nonrandomized, cross-sectional, self-report survey to determine whether Alaska Native and American Indian (AN/AI) people have access to the health communication technologies available through a patient-centered medical home. Methods In 2011, we administered a self-report survey in an urban, tribally owned and operated primary care center serving AN/AI adults. Patients in the center’s waiting rooms completed the survey on paper; center staff completed it electronically. Results Approximately 98% (n = 654) of respondents reported computer access, 97% (n = 650) email access, and 94% (n = 631) mobile phone use. Among mobile phone users, 60% had Internet access through their phones. Rates of computer access (p = .011) and email use (p = .005) were higher among women than men, but we found no significant gender difference in mobile phone access to the Internet or text messaging. Respondents in the oldest age category (65–80 years of age) were significantly less likely to anticipate using the Internet to schedule appointments, refill medications, or communicate with their health care providers (all p < .001). Conclusion Information on use of health communication technologies enables administrators to deploy these technologies more efficiently to address health concerns in AN/AI communities. Our results will drive future research on health communication for chronic disease screening and health management. PMID:27169131

  4. Formative Evaluation to Assess Communication Technology Access and Health Communication Preferences of Alaska Native People.

    PubMed

    Robinson, Renee F; Dillard, Denise A; Hiratsuka, Vanessa Y; Smith, Julia J; Tierney, Steve; Avey, Jaedon P; Buchwald, Dedra S

    Information technology can improve the quality, safety, and efficiency of healthcare delivery by improving provider and patient access to health information. We conducted a nonrandomized, cross-sectional, self-report survey to determine whether Alaska Native and American Indian (AN/AI) people have access to the health communication technologies available through a patient-centered medical home. In 2011, we administered a self-report survey in an urban, tribally owned and operated primary care center serving AN/AI adults. Patients in the center's waiting rooms completed the survey on paper; center staff completed it electronically. Approximately 98% (n = 654) of respondents reported computer access, 97% (n = 650) email access, and 94% (n = 631) mobile phone use. Among mobile phone users, 60% had Internet access through their phones. Rates of computer access (p = .011) and email use (p = .005) were higher among women than men, but we found no significant gender difference in mobile phone access to the Internet or text messaging. Respondents in the oldest age category (65-80 years of age) were significantly less likely to anticipate using the Internet to schedule appointments, refill medications, or communicate with their health care providers (all p < .001). Information on use of health communication technologies enables administrators to deploy these technologies more efficiently to address health concerns in AN/AI communities. Our results will drive future research on health communication for chronic disease screening and health management.

  5. Effect of US Health Policies on Health Care Access for Marshallese Migrants

    PubMed Central

    Hallgren, Emily; Yamada, Seiji

    2015-01-01

    The Republic of the Marshall Islands is a sovereign nation previously under the administrative control of the United States. Since 1986, the Compacts of Free Association (COFA) between the Republic of the Marshall Islands and the United States allows Marshall Islands citizens to freely enter, lawfully reside, and work in the United States, and provides the United States exclusive military control of the region. When the COFA was signed, COFA migrants were eligible for Medicaid and other safety net programs. However, these migrants were excluded from benefits as a consequence of the Personal Responsibility and Work Opportunity Reconciliation Act. Currently, COFA migrants have limited access to health care benefits in the United States, which perpetuates health inequalities. PMID:25713965

  6. Moving toward universal access to health and universal health coverage: a review of comprehensive primary health care in Suriname.

    PubMed

    Larye, Stephanie; Goede, Hedwig; Barten, Francoise

    2015-06-01

    To provide an overview of comprehensive primary health care (CPHC) development and implementation in Suriname in peer-reviewed literature. Building on work funded by the Teasdale-Corti Global Health Research Partnership Program/People's Health Movement, the authors searched MEDLINE, the Cochrane Library, and POPLINE for articles focused on CPHC within the Surinamese context. Two authors independently reviewed abstracts and then jointly reviewed the selected abstracts. The final selection was completed using a data extraction form. The initial search resulted in 1 556 abstracts. The initial review identified 58 articles. Only three of the 58 articles met the inclusion criteria for the final review. The three selected articles provided partial overviews of CPHC in Suriname and examples of its implementation, with a focus on the service delivery network in the interior of the country, which was designed to improve rural access to basic health care services by training community members as service providers. They also included examples of how preparations for health reform in Suriname in the late 1990s and early 2000s, influenced by global neoliberal reforms, led to expectations that disparities in health status, design of health system components, and service provision related to differences in power and historical context (e.g., the influence of medical professionals, political parties/ethnic groups, and wealthier populations concentrated in urban areas) would be addressed. Given the focus on primary health care in the Americas and the notable developments that have occurred in Surinamese health policy and health care, particularly in health care reform, the paucity of published research on CPHC in Suriname was an unexpected finding that may be partly due to prioritizing research on disease control rather than health policy and systems research. The limited amount of scientific literature on this topic 1) prevents clear understanding of CPHC development and

  7. Children's Health in Washington, D.C.: Access and Health Challenges despite High Insurance Coverage Rates. Research Highlights

    ERIC Educational Resources Information Center

    Adamson, David M.

    2009-01-01

    In Washington, D.C., the vast majority of children have health insurance. Yet District children often lack sufficient access to medical care and face significant health threats from chronic conditions and risk factors such as exposure to violence in schools and neighborhoods. These findings emerged from an assessment of children's health in…

  8. English Proficiency and Access to Health Insurance in Hispanics Who Are Elderly: Implications for Adequate Health Care

    ERIC Educational Resources Information Center

    Caesar, Lena G.

    2006-01-01

    Medicare, as a publicly funded insurance program, has produced significant improvement in the overall health of America's elderly populations. However, health disparities still persist between Hispanic and non-Hispanic White populations in terms of overall access to health services. This study utilized data from the Hispanic Established Population…

  9. English Proficiency and Access to Health Insurance in Hispanics Who Are Elderly: Implications for Adequate Health Care

    ERIC Educational Resources Information Center

    Caesar, Lena G.

    2006-01-01

    Medicare, as a publicly funded insurance program, has produced significant improvement in the overall health of America's elderly populations. However, health disparities still persist between Hispanic and non-Hispanic White populations in terms of overall access to health services. This study utilized data from the Hispanic Established Population…

  10. Public health assessment for El Toro Marine Corps Air Station, Santa Ana, Orange County, California, Region 9. CERCLIS No. CA6170023208. Final report

    SciTech Connect

    Not Available

    1993-04-07

    El Toro Marine Corps Air Station is in Orange County, California, near the city of Irvine. The Marine Corps established El Toro in 1943, and it currently serves as the center for marine aviation operations on the Pacific Coast. El Toro Marine Corps Air Station was proposed for listing on EPA's National Priorities List (NPL) in 1989 because past operations and disposal practices contaminated local groundwater. Agricultural farm workers and well operators are exposed to contaminants in groundwater through unintentional ingestion of contaminated groundwater, dermal contact with contaminated groundwater, and inhalation of aerosolized groundwater contaminants. Future exposure could occur through two potable water wells that are located 10 miles downgradient of the contaminant plume. At the current rate of contaminant migration, those wells will be affected in one and a half to five years.

  11. Understanding observed and unobserved health care access and utilization disparities among US Latino adults.

    PubMed

    Vargas Bustamante, Arturo; Fang, Hai; Rizzo, John A; Ortega, Alexander N

    2009-10-01

    This study hypothesizes that differences in health care access and utilization exist across Latino adults (>18 years), with U.S. Latino adults of Mexican ancestry demonstrating the worst patterns of access and utilization. The analyses use the National Health Interview Survey (NHIS) data from 1999 to 2007 (N = 33,908). The authors first estimate the disparities in health care access and utilization among different categories of Latinos. They also implement Blinder-Oaxaca techniques to decompose disparities into observed and unobserved components, comparing Latinos of Mexican ancestry with non-Mexican Latinos. Latinos of Mexican ancestry consistently demonstrate lower health care access and utilization patterns than non-Mexican Latinos. Health insurance and region of residence were the most important factors that explained observable differences. In contrast, language and citizenship status were relatively unimportant. Although a significant share of these disparities may be explained by observed characteristics, disparities because of unobserved heterogeneity among the different Latino cohorts are also considerable.

  12. Government databases and public health research: facilitating access in the public interest.

    PubMed

    Adams, Carolyn; Allen, Judy

    2014-06-01

    Access to datasets of personal health information held by government agencies is essential to support public health research and to promote evidence-based public health policy development. Privacy legislation in Australia allows the use and disclosure of such information for public health research. However, access is not always forthcoming in a timely manner and the decision-making process undertaken by government data custodians is not always transparent. Given the public benefit in research using these health information datasets, this article suggests that it is time to recognise a right of access for approved research and that the decisions, and decision-making processes, of government data custodians should be subject to increased scrutiny. The article concludes that researchers should have an avenue of external review where access to information has been denied or unduly delayed.

  13. Web-Based Consumer Health Information: Public Access, Digital Division, and Remainders

    PubMed Central

    Lorence, Daniel; Park, Heeyoung

    2006-01-01

    Public access Internet portals and decreasing costs of personal computers have created a growing consensus that unequal access to information, or a “digital divide,” has largely disappeared for US consumers. A series of technology initiatives in the late 1990s were believed to have largely eliminated the divide. For healthcare patients, access to information is an essential part of the consumer-centric framework outlined in the recently proposed national health information initiative. Data from a recent study of health information-seeking behaviors on the Internet suggest that a “digitally underserved group” persists, effectively limiting the planned national health information infrastructure to wealthier Americans. PMID:16926743

  14. Unfinished business: the restoration of immigrant health access after welfare reform.

    PubMed

    Sherman, R

    1999-07-01

    One in ten Americans is a recent immigrant and, until 1996, even the poorest had access to health care through Medicaid. That changed radically with the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), the federal welfare reform law, which sharply restricted immigrant access to public benefits, including Medicaid. This issue of States of Health looks at PRWORA's impact--and what advocates and immigrants are doing to restore health care access for these newcomers, who are among the most vulnerable in our communities.

  15. Women and health reform: how national health care can enhance coverage, affordability, and access for women (examples from massachusetts).

    PubMed

    Fitzgerald, Therese; Cohen, Laura; Hyams, Tracey; Sullivan, Katherine M; Johnson, Paula A

    2014-01-01

    Massachusetts women have the highest rates of health insurance coverage in the nation and women's access to care has improved across all demographic groups. However, important challenges persist. As national health reform implementation moves forward under the Affordable Care Act (ACA), states will likely encounter many of the same women's health challenges experienced in Massachusetts over the past 7 years. A review of the literature and data analyses comparing health care services access, utilization, and cost, and health outcomes from Massachusetts pre- and post-2006 health care reform identified two key challenges in women's continuity of coverage and affordability. These areas are crucial for state and national policymakers to consider in improving women's health as they work to implement health care reform at the state and federal levels. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  16. Mental health and migration: depression, alcohol abuse, and access to health care among migrants in Central Asia.

    PubMed

    Ismayilova, Leyla; Lee, Hae Nim; Shaw, Stacey; El-Bassel, Nabila; Gilbert, Louisa; Terlikbayeva, Assel; Rozental, Yelena

    2014-12-01

    One-fifth of Kazakhstan's population is labor migrants working in poor conditions with limited legal rights. This paper examines self-rated health, mental health and access to health care among migrant workers. Using geo-mapping, a random sample of internal and external migrant market workers was selected in Almaty (N = 450). We used survey logistic regression adjusted for clustering of workers within stalls. Almost half of participants described their health as fair or poor and reported not seeing a doctor when needed, 6.2% had clinical depression and 8.7% met criteria for alcohol abuse. Female external migrants were at higher risk for poor health and underutilization of health services. High mobility was associated with depression among internal migrants and with alcohol abuse among female migrant workers. This study demonstrates the urgent need to address health and mental health needs and improve access to health care among labor migrants in Central Asia.

  17. Health care access, utilization, and problems in a sample of former foster children: a longitudinal investigation.

    PubMed

    Jones, Loring

    2014-01-01

    Three years of descriptive data that describe health problems and access to care for former foster youth are presented (n = 92). Findings were that most youths had health coverage at emancipation, but the proportion with coverage shrinks after three years to 57%. Youths generally reported good health despite the loss of Medicaid and increasing difficulties with access to care. However, mental health problems and substance abuse problems in the sample remained high over the three years of study. Most of the mental health and substance abuse problems remained untreated. The policy implications of findings are discussed.

  18. Peace Corps. Tenth Annual Report.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC.

    Projects, operations, and future plans are covered in this annual report for the tenth year of the Peace Corps. An overview focuses on Peace Corps success in providing technical assistance to aid development plans for the seventies and in responding to local needs as well as on its failures. The next section considers the Peace Corps response to…

  19. 20 CFR 638.502 - Job Corps basic education program.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... education program. The Job Corps Director shall prescribe or provide for basic education curricula to be... Educational Development (GED); (d) World of work; (e) Health education; (f) Driver education; and (g) English...

  20. 20 CFR 638.502 - Job Corps basic education program.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... education program. The Job Corps Director shall prescribe or provide for basic education curricula to be... Educational Development (GED); (d) World of work; (e) Health education; (f) Driver education; and (g) English...

  1. Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

    PubMed Central

    Uchôa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre; Fronteira, Inês Santos Estevinho; Coêlho, Ardigleusa Alves; Martiniano, Claudia Santos; Brandão, Isabel Cristina Araújo; Yamamura, Mellina; Maroto, Renata Melo

    2016-01-01

    Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil. PMID:26959332

  2. Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

    PubMed

    Uchôa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre; Fronteira, Inês Santos Estevinho; Coêlho, Ardigleusa Alves; Martiniano, Claudia Santos; Brandão, Isabel Cristina Araújo; Yamamura, Mellina; Maroto, Renata Melo

    2016-01-01

    to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil.

  3. Health care access for refugees and immigrants with precarious status: public health and human right challenges.

    PubMed

    Rousseau, Cécile; ter Kuile, Sonia; Munoz, Marie; Nadeau, Lucie; Ouimet, Marie-Jo; Kirmayer, Laurence; Crépeau, François

    2008-01-01

    Migration flux is being transformed by globalization, and the number of people with either undocumented or with a precarious status is growing in Canada. There are no epidemiological data on the health and social consequences of this situation, but clinicians working in primary care with migrants and refugees are increasingly worried about the associated morbidity. This commentary summarizes findings from a pilot study with health professionals in the Montreal area and suggests that the uninsured population predicament is a national problem. Although ethical and legal issues associated with data collection by clinicians, institutions and governments need to be examined, estimating the public health consequences and long-term cost associated with problems in access to health care due to migratory status should be a priority. Current regulations and administrative policies appear to be at odds with the principles of equal rights set out by the Canadian Charter of Rights and Freedoms and the UN Convention on the Rights of the Child. Beyond the commitment of individual clinicians, Canadian medical associations should take an advocacy role and scrutinize the ethical and medical implications of the present system.

  4. Are barriers in accessing health services in the Roma population associated with worse health status among Roma?

    PubMed

    Jarcuska, Pavol; Bobakova, Daniela; Uhrin, Jan; Bobak, Ladislav; Babinska, Ingrid; Kolarcik, Peter; Veselska, Zuzana; Madarasova Geckova, Andrea

    2013-06-01

    The health of Roma has been found to be poorer than that of the majority population. The aim of this study was to explore the differences between Roma and non-Roma regarding perceived barriers in accessing health services. Furthermore, we aimed to assess the association between self-rated health status and Roma ethnicity and explore to what degree barriers in accessing health services explain this association. We used data from the cross-sectional HepaMeta study conducted in 2011 in Slovakia. The final sample comprised 452 Roma (mean age 34.7; 35.2 % men) and 403 (mean age 33.5; 45.9 % men) non-Roma respondents. Roma ethnicity was found to be significantly associated with poorer self-rated health status. A considerable part of this association can be explained by barriers in accessing health services as perceived by Roma. Worse health in Roma is partially mediated by worse access to health services, apart from a large educational gap between Roma living in settlements and the majority population. Interventions should focus not only on health literacy among Roma but also on the health care system and health care professionals.

  5. A geographical perspective on access to sexual and reproductive health care for women in rural Africa

    PubMed Central

    Yao, Jing; Murray, Alan T.; Agadjanian, Victor

    2015-01-01

    Utilization of sexual and reproductive health (SRH) services can significantly impact health outcomes, such as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and vertical transmission of infectious diseases like HIV/AIDS. It has long been recognized that access to SRH services is essential to positive health outcomes, especially in rural areas of developing countries, where long distances as well as poor transportation conditions, can be potential barriers to health care acquisition. Improving accessibility of health services for target populations is therefore critical for specialized healthcare programs. Thus, understanding and evaluation of current access to health care is crucial. Combining spatial information using geographical information system (GIS) with population survey data, this study details a gravity model-based method to measure and evaluate access to SRH services in rural Mozambique, and analyzes potential geographic access to such services, using family planning as an example. Access is found to be a significant factor in reported behavior, superior to traditional distance-based indicators. Spatial disparities in geographic access among different population groups also appear to exist, likely affecting overall program success. PMID:24034952

  6. Assessment of technology access and preference for health education of a rural Hispanic community.

    PubMed

    Aguirre, Trina; Wilhelm, Susan; Joshi, Ashish

    2012-01-01

    In the United States, Hispanic populations tend to have higher incidences of chronic disease such as diabetes, cardiovascular disease, hypertension, obesity and hyperlipidemias [1]. They are also more likely to be underinsured or uninsured than other populations [2]. The purpose of this descriptive technology assessment survey study was to determine computer and internet access, skill level and health education information preferences of a rural Hispanic (primarily Mexican-American) population in the United States. Among the sample, 81% of individuals who answered the survey had a computer and internet access in their home. Nineteen percent did not have computers or internet access in their homes. Compared to the average 54% home internet access found by the Pew Hispanic Research Center the rural convenience sample in this study had a high percentage of technology access. Recommendations include using multimedia to improve the health information accessability among Hispanic persons.

  7. Accessibility Assessment of the Health Care Improvement Program in Rural Taiwan

    ERIC Educational Resources Information Center

    Tan, Hsiu-Fen; Tseng, Hung-Fu; Chang, Chen-Kang; Lin, Wender; Hsiao, Shih-Huai

    2005-01-01

    Context: An experimental Health Care Improvement Program (HCIP) was initiated by the Bureau of National Health Insurance in 1997 to improve the accessibility of health care in several rural, mountainous districts. Purpose: This longitudinal study evaluated service availability, utilization patterns, and effectiveness of services under the HCIP in…

  8. 45 CFR 164.524 - Access of individuals to protected health information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... protected health information about the individual in a designated record set, for as long as the protected health information is maintained in the designated record set, except for: (i) Psychotherapy notes; (ii... request for access is made by the individual's personal representative and a licensed health care...

  9. An Ecological Perspective on U.S. Latinos' Health Communication Behaviors, Access, and Outcomes

    ERIC Educational Resources Information Center

    Katz, Vikki S.; Ang, Alfonso; Suro, Roberto

    2012-01-01

    U.S. Latinos experience constrained access to formal health care resources, contributing to higher incidence of preventable diseases and chronic health conditions than the general population. The authors explore whether a rich set of informal health communication connections--to friends, family, radio, television, Internet, newspapers, magazines,…

  10. Access, utilization, and interest in mHealth applications among veterans receiving outpatient care for PTSD.

    PubMed

    Erbes, Christopher R; Stinson, Rebecca; Kuhn, Eric; Polusny, Melissa; Urban, Jessica; Hoffman, Julia; Ruzek, Josef I; Stepnowsky, Carl; Thorp, Steven R

    2014-11-01

    Mobile health (mHealth) refers to the use of mobile technology (e.g., smartphones) and software (i.e., applications) to facilitate or enhance health care. Several mHealth programs act as either stand-alone aids for Veterans with post-traumatic stress disorder (PTSD) or adjuncts to conventional psychotherapy approaches. Veterans enrolled in a Veterans Affairs outpatient treatment program for PTSD (N = 188) completed anonymous questionnaires that assessed Veterans' access to mHealth-capable devices and their utilization of and interest in mHealth programs for PTSD. The majority of respondents (n = 142, 76%) reported having access to a cell phone or tablet capable of running applications, but only a small group (n = 18) reported use of existing mHealth programs for PTSD. Age significantly predicted ownership of mHealth devices, but not utilization or interest in mHealth applications among device owners. Around 56% to 76% of respondents with access indicated that they were interested in trying mHealth programs for such issues as anger management, sleep hygiene, and management of anxiety symptoms. Findings from this sample suggest that Veterans have adequate access to, and interest in, using mHealth applications to warrant continued development and evaluation of mobile applications for the treatment of PTSD and other mental health conditions.

  11. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty...

  12. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty...

  13. Provider Perspectives on School-Based Mental Health for Urban Minority Youth: Access and Services

    ERIC Educational Resources Information Center

    Gamble, Brandon E.; Lambros, Katina M.

    2014-01-01

    This article provides results from a qualitative study on the efforts of school-based mental health providers (SBMHPs) who serve students in urban, suburban, and ethnically diverse settings to help families access quality mental health services. School-based mental health plays a key role in the provision of direct and indirect intervention…

  14. 28 CFR 115.382 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time...

  15. 28 CFR 115.382 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time...

  16. 28 CFR 115.282 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are...

  17. 28 CFR 115.382 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time...

  18. 28 CFR 115.282 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are...

  19. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty...

  20. 28 CFR 115.282 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are...

  1. An Ecological Perspective on U.S. Latinos' Health Communication Behaviors, Access, and Outcomes

    ERIC Educational Resources Information Center

    Katz, Vikki S.; Ang, Alfonso; Suro, Roberto

    2012-01-01

    U.S. Latinos experience constrained access to formal health care resources, contributing to higher incidence of preventable diseases and chronic health conditions than the general population. The authors explore whether a rich set of informal health communication connections--to friends, family, radio, television, Internet, newspapers, magazines,…

  2. A feasibility study using geographic access to general practices and routinely collected data in public health and health services research.

    PubMed

    Chong, Shanley; Byun, Roy; Jalaludin, Bin B

    2015-09-30

    Advances in geographic information systems (GIS) and increased availability of routinely collected data have the potential to contribute to public health and health services research. The aim of this feasibility study was to explore the use of GIS to measure access to general practices and its relationship to selected antenatal behaviours. We obtained the Perinatal Data Collection, 2004-2008, for South Western Sydney Local Health District from the New South Wales Ministry of Health. Using a GIS, we generated circular and polygon-based 1 km and 2 km road network buffers from a maternal residential address and then calculated the number of general practices within those buffers (density measures). Distances to general practices from maternal residences were also calculated in the GIS as another measure of geographic access to general practices (proximity measures). We used generalised estimating equations logistic regression to examine associations between access to general practices, and smoking during pregnancy and late first antenatal visit. The numbers of general practices within circular buffers were significantly greater than within polygon-based road network buffers. The average distance to the five closest general practices from a mother's residence was 2.3 km ± 3.0 km (median 1.4 km, range 0.05 km to 40.0 km). For two of the five measures of access, a higher number of general practices was associated with increased risk for late first antenatal visit. However, the associations were weak, with odds ratios very close to unity. Choice of metrics of geographic access to general practices did not alter the associations with smoking during pregnancy or late first antenatal visit. GIS can be used to quantify measures of geographic access to health services for public health and health services research. Geographic access to general practices was generally not associated with smoking during pregnancy or late first antenatal visit. GIS and routinely collected health

  3. Equity in Access to Health Care Services in Italy

    PubMed Central

    Glorioso, Valeria; Subramanian, S V

    2014-01-01

    Objective To provide new evidence on whether and how patterns of health care utilization deviate from horizontal equity in a country with a universal and egalitarian public health care system: Italy. Data Sources Secondary analysis of data from the Health Conditions and Health Care Utilization Survey 2005, conducted by the Italian National Institute of Statistics on a probability sample of the noninstitutionalized Italian population. Study Design Using multilevel logistic regression, we investigated how the probability of utilizing five health care services varies among individuals with equal health status but different SES. Data Collection/Extraction Respondents aged 18 or older at the interview time (n = 103,651). Principal Findings Overall, we found that use of primary care is inequitable in favor of the less well-off, hospitalization is equitable, and use of outpatient specialist care, basic medical tests, and diagnostic services is inequitable in favor of the well-off. Stratifying the analysis by health status, however, we found that the degree of inequity varies according to health status. Conclusions Despite its universal and egalitarian public health care system, Italy exhibits a significant degree of SES-related horizontal inequity in health services utilization. PMID:24949515

  4. [Determining Factors in the Access to Mental Health Services by the Adult Colombian Population].

    PubMed

    González, Lina María; Peñaloza, Rolando Enrique; Matallana, María Alexandra; Gil, Fabián; Gómez-Restrepo, Carlos; Landaeta, Angela Patricia Vega

    2016-12-01

    Access to mental health services by people with mental disorders has traditionally been limited, and is associated with attitudinal, social, and structural variables. To analyse the factors that determine access to mental health services by the adult population (18-44 years old) in Colombia, from the results obtained in the 2015 National Mental Health Survey. Analysis of variables of access to attention in mental health care for adults. The reasons for not consulting were classified as barriers of behavioural supply and demand. To analyse the factors associated with access to mental health services in the Colombian adult population, the use of health services in the last 12 months for emotional, nervous or mental health problems was taken into account, as well as associated variables such as demographic characteristics, occupational activity, affiliation to social security, and health status variables. The relationships between these variables were estimated using bivariate multinomial logistic regression models. Rural residence, being married, and having a chronic disease were associated with the decision to consult or not to consult the doctor. Further studies should be conducted to evaluate the situation as regards mental health care access, as well as to determine the potential factors associated with these limitations. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  5. Greater access to information on how to prevent oral cancer among elderly using primary health care.

    PubMed

    Martins, Andréa Maria Eleutério de Barros Lima; Barreto, Sandhi Maria; dos Santos-Neto, Pedro Eleutério; de Sá, Maria Aparecida Barbosa; Souza, João Gabriel Silva; Haikal, Desireé Sant'Ana; Ferreira e Ferreira, Efigenia; Pordeus, Isabela Almeida

    2015-07-01

    Educative actions are an important component of health promotion in Brazil's primary healthcare program, the Family Health Strategy (FHS). The efficacy of these actions is evidenced by compliance with healthy behaviors and in the reduction of rates of mortality and morbidity. The objective of this study was to identify whether access to information regarding the prevention of oral cancer is greater among elders whose residences are registered with the FHS. SPSS® was utilized to obtain estimates that were corrected for sample design, considering the magnitude of the associations between access to such information with personal determinants, the use and cost of healthcare, health-related behaviors and health outcomes. 58.9% of the 492 participating elders reported having access to such information. We verified that there was a greater chance for access among residents of houses registered by the FHS; those with greater per capita income (2.01/1.183.43); non-smokers (2.00/1.16-3.46); those that realized oral self-examination (6.35/3.46-11.64); and those that did not perceive discomfort in the mouth, head or neck (2.06/1.02-4.17). Access was greater among residents of homes registered by the FHS. Personal determinants of health, health-related behaviors and health outcomes are influenced or influence access to information regarding the prevention and management of oral diseases.

  6. Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda.

    PubMed

    Ahumuza, Sharon Eva; Matovu, Joseph K B; Ddamulira, John Bosco; Muhanguzi, Florence Kyoheirwe

    2014-08-02

    Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. This article presents the challenges faced by PWPDs in accessing sexual and reproductive health (SRH) services in Kampala, Uganda. This was a qualitative study that was conducted with male and female PWPDs in Kampala in 2007. Data on the challenges experienced by PWPDs in accessing SRH services were collected using in-depth interviews with 40 PWPDs and key informant interviews with 10 PWPDs' representatives, staff of agencies supporting PWPDs and health workers. All data were captured verbatim using an audio-tape recorder, entered into a Microsoft Word computer program and analyzed manually following a content thematic approach. The study findings show that PWPDs face a multitude of challenges in accessing SRH services including negative attitudes of service providers, long queues at health facilities, distant health facilities, high costs of services involved, unfriendly physical structures and the perception from able-bodied people that PWPDs should be asexual. People with physical disabilities (PWPDs) face health facility-related (service provider and facility-related challenges), economic and societal challenges in accessing SRH services. These findings call for a need to sensitize service providers on SRH needs of PWPDs for better support and for the government to enforce the provision of PWPD-friendly services in all health facilities.

  7. Public health potential of a disability tracking system: analysis of U.S. Navy and Marine Corps physical evaluation boards 2005-2006.

    PubMed

    Litow, C D R Francesca K; Krahl, Pamela L

    2007-12-01

    Clinical and demographic data in administrative disability tracking systems have the potential to support disability reduction programs. We analyzed recent Navy Physical Evaluation Board data, compared our findings with previous studies, and evaluated the quality of the case-tracking database as a public health information system. The overall rate of cases was 50% higher than in 2000 and 40% higher than the rate of new long-term group disability insurance claims. The most common diagnostic categories remain musculoskeletal disorders, injuries and poisonings, mental health conditions, and neurological syndromes. Diagnosis rates have increased in every category since 2000. The tracking system provided unprecedented timeliness and data accessibility, but fell short of its full potential as a public health tool due to poor information quality. Improved interface design and data entry processes combined with improved reporting capability will enhance its epidemiological value. Continued system improvement requires functional evaluation in conjunction with periodic data analysis.

  8. Access to Comprehensive School-Based Health Services for Children and Youth, 1995-1998.

    ERIC Educational Resources Information Center

    Access, 1998

    1998-01-01

    This document consists of 11 consecutive issues of the newsletter "Access," published across a four-year period. "Access" presents information on public policy and research of interest to school-based health programs (SBHC) for children and youth. The major topics covered by the newsletters are as follows: (1) a conference,…

  9. A Program to Improve Access to Health Care Among Mexican Immigrants in Rural Colorado

    ERIC Educational Resources Information Center

    Diaz-Perez, Maria de Jesus; Farley, Tillman; Cabanis, Clara Martin

    2004-01-01

    Migration to the United States from Mexico is increasing every year. Mexican immigrants tend to be poor, uninsured, monolingual Spanish speakers without adequate access to appropriate medical care. As a further barrier, many are also undocumented. This article describes a program developed to improve access to health care among Mexican immigrants…

  10. Understanding the Developing Role of Global Health Partnerships on Access to Medication: An STS Perspective

    ERIC Educational Resources Information Center

    Ngoasong, Michael Zisuh

    2010-01-01

    A conceptual framework for studying the role of global health partnerships (GHPs) in determining policy practices on access to medication is presented. Although GHPs are of a practical nature, they are implicitly theory informed. The narratives used by GHP partners in relating to access to medication have theoretical origins. Building on the…

  11. Access to healthful foods among an urban food insecure population: perceptions versus reality.

    PubMed

    Freedman, Darcy A; Bell, Bethany A

    2009-11-01

    The influence of local food environments on the risk for obesity is important overall, but may be particularly important for food insecure populations in urban settings. Access to healthful foods is most limited among racial and ethnic minorities and low-income populations; these same populations experience the highest rates of obesity and food insecurity. Few valid and reliable measures have been developed to assess the quality of local food environments. This research addresses this gap by introducing an inventory for measuring self-reported perceptions of food access and then compares the perceptions measure to objective assessments of local food environments. Data are focused on an urban population experiencing disproportionate rates of food insecurity. The four-item perceptions of food access inventory had high internal consistency (Cronbach's alpha = 0.80). Participants' perceptions of access to healthful foods mirrored the reality of their food environment; however, perceptions of access to alcohol and tobacco were less accurate. Findings suggest that people living in low-income, urban, minority, and food insecure communities can validly assess (in)access to healthful foods. Future research is needed to further validate the perceptions of food access measure introduced and, more importantly, to develop strategies for increasing access to healthful foods in food insecure contexts.

  12. Evaluation of consumer health website accessibility by users with sensory and physical disabilities.

    PubMed

    Chiang, Michael F; Starren, Justin

    2004-01-01

    Growth of the World Wide Web is beginning to create new opportunities for direct patient access to health care resources. At the same time, advances in medical care have produced demographic shifts in which an increasing number of patients have sensory and physical disabilities that may limit their ability to access these new information tools. This study uses automated and manual methods to measure the compliance of 30 popular consumer health websites with the World Wide Web Consortium (W3C) content accessibility guidelines. Among these 30 sites, 22 failed to satisfy at least one W3C Priority-1 accessibility checkpoint, making it impossible for some groups of disabled users to access information from them. All websites failed to satisfy at least one Priority-2 checkpoint, making it difficult for some groups to access information from the sites. These results suggest that accessibility of many consumer health websites to disabled users is very limited. The health informatics community must become more aware of this problem, particularly because many critical accessibility problems may be easily addressed if they are recognized

  13. A Program to Improve Access to Health Care Among Mexican Immigrants in Rural Colorado

    ERIC Educational Resources Information Center

    Diaz-Perez, Maria de Jesus; Farley, Tillman; Cabanis, Clara Martin

    2004-01-01

    Migration to the United States from Mexico is increasing every year. Mexican immigrants tend to be poor, uninsured, monolingual Spanish speakers without adequate access to appropriate medical care. As a further barrier, many are also undocumented. This article describes a program developed to improve access to health care among Mexican immigrants…

  14. Deaf Adolescents' Learning of Cardiovascular Health Information: Sources and Access Challenges.

    PubMed

    Smith, Scott R; Kushalnagar, Poorna; Hauser, Peter C

    2015-10-01

    Deaf individuals have more cardiovascular risks than the general population that are believed to be related to their cardiovascular health knowledge disparities. This phenomenological study describes where 20 deaf sign language-using adolescents from Rochester, New York, many who possess many positive characteristics to support their health literacy, learn cardiovascular health information and their lived experiences accessing health information. The goal is to ultimately use this information to improve the delivery of cardiovascular health education to this population and other deaf adolescents at a higher risk for weak health literacy. Deaf bilingual researchers interviewed deaf adolescents, transcribed and coded the data, and described the findings. Five major sources of cardiovascular health information were identified including family, health education teachers, healthcare providers, printed materials, and informal sources. Despite possessing advantageous characteristics contributing to stronger health literacy, study participants described significant challenges with accessing health information from each source. They also demonstrated inconsistencies in their cardiovascular health knowledge, especially regarding heart attack, stroke, and cholesterol. These findings suggest a great need for additional public funding to research deaf adolescents' informal health-related learning, develop accessible and culturally appropriate health surveys and health education programming, improve interpreter education, and disseminate information through social media. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Deaf Adolescents’ Learning of Cardiovascular Health Information: Sources and Access Challenges

    PubMed Central

    Smith, Scott R.; Kushalnagar, Poorna; Hauser, Peter C.

    2015-01-01

    Deaf individuals have more cardiovascular risks than the general population that are believed to be related to their cardiovascular health knowledge disparities. This phenomenological study describes where 20 deaf sign language-using adolescents from Rochester, New York, many who possess many positive characteristics to support their health literacy, learn cardiovascular health information and their lived experiences accessing health information. The goal is to ultimately use this information to improve the delivery of cardiovascular health education to this population and other deaf adolescents at a higher risk for weak health literacy. Deaf bilingual researchers interviewed deaf adolescents, transcribed and coded the data, and described the findings. Five major sources of cardiovascular health information were identified including family, health education teachers, healthcare providers, printed materials, and informal sources. Despite possessing advantageous characteristics contributing to stronger health literacy, study participants described significant challenges with accessing health information from each source. They also demonstrated inconsistencies in their cardiovascular health knowledge, especially regarding heart attack, stroke, and cholesterol. These findings suggest a great need for additional public funding to research deaf adolescents’ informal health-related learning, develop accessible and culturally appropriate health surveys and health education programming, improve interpreter education, and disseminate information through social media. PMID:26048900

  16. African Americans: Disparities in Health Care Access and Utilization

    ERIC Educational Resources Information Center

    Copeland, Valire Carr

    2005-01-01

    Despite remarkable improvements in the overall health of the nation during the past two decades, compelling evidence suggests that the nation's racial and ethnic minority Americans suffer increasing disparities in the incidence, prevalence, mortality, and burden of diseases and adverse health outcomes compared with white Americans. The 1998…

  17. African Americans: Disparities in Health Care Access and Utilization

    ERIC Educational Resources Information Center

    Copeland, Valire Carr

    2005-01-01

    Despite remarkable improvements in the overall health of the nation during the past two decades, compelling evidence suggests that the nation's racial and ethnic minority Americans suffer increasing disparities in the incidence, prevalence, mortality, and burden of diseases and adverse health outcomes compared with white Americans. The 1998…

  18. Mental health beliefs and barriers to accessing mental health services in youth aging out of foster care.

    PubMed

    Sakai, Christina; Mackie, Thomas I; Shetgiri, Rashmi; Franzen, Sara; Partap, Anu; Flores, Glenn; Leslie, Laurel K

    2014-01-01

    To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  19. Medical smart cards: health care access in your pocket.

    PubMed

    Krohn, R W

    2000-01-01

    The wallet-sized medical smart card, embedded with a programmable computer chip, stores and transmits a cardholder's clinical, insurance coverage and biographical information. When fully deployed, smart cards will conduct many functions at the point of care, from claims submission to medical records updates in real time. Ultimately, the smart card will make the individual patient record and all clinical and economic transactions within that patient log as portable, accessible and secure as an ATM account.

  20. An approach to access control in electronic health record.

    PubMed

    Sucurovic, Snezana

    2010-08-01

    OASIS is a non-for-profit consortium that drives the development convergence and adoption of open standards for the global information society. It involves more than 600 organizations and individuals as well as IT leaders Sun, Microsoft, IBM and Oracle. One of its standards is XACML which appeared a few years ago and now there are about 150,000 hits on Google. XACML (eXtensible Access Control Markup Language) is not technology related. Sun published in 2004 open source Sun XACML which is in compliance with XACML 1.0. specification and now works to make it comply with XACML 2.0. The heart of XACML are attributes values of defined type and name that is to be attached to a subject, a resource, an action and an environment in which a subject request action on resource. In that way XACML is to replace Role Based Access Control which dominated for years. The paper examines performances in CEN 13 606 and ISO 22 600 based healthcare system which uses XACML for access control.

  1. U.S. health policy and access to banked donor human milk.

    PubMed

    Arnold, Lois D W

    2008-12-01

    Abstract Barriers to the use of banked donor milk are numerous, and many patients are denied access to it because of lack of policy explicitly addressing its use. This examination of U.S. health policies, both governmental and professional, addressing child health and breastfeeding suggests where donor milk banking services should be included to fulfill the ethical principles of justice (fair access) and autonomy. The need for research to support future policy development is also highlighted.

  2. Developing a framework for understanding doctors' health access: a qualitative study of Australian GPs.

    PubMed

    Kay, Margaret; Mitchell, Geoffrey; Clavarino, Alexandra; Frank, Erica

    2012-01-01

    Health access behaviours of doctors need to be understood if the profession is to adequately respond to concerns raised about doctors' health. There has been limited investigation of these issues and most qualitative studies have focussed on doctors who have been seriously unwell. This research project was designed to explore doctors' attitudes to health access and the barriers they experience using six independently facilitated focus groups (37 general practitioners) in Brisbane, Australia. Themes that emerged using inductive thematic analysis were grouped into three key categories. The findings challenge current representations of doctors' health within the medical literature. Doctors in this study reported positive attitudes towards their own health care. Health access, however, was difficult because of the barriers they encountered. These barriers are described in detail revealing the rationale used by doctors seeking care. A framework of patient, provider and profession barrier domains is developed to enable a comparison between the health access barriers of the doctor and those experienced by the general community. The complexity is highlighted as the socio-cultural factors woven through these barrier domains are recognised. The potential for this framework to provide a structure for future interventions to enhance doctors' health access is discussed.

  3. Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability.

    PubMed

    Adair-Rohani, Heather; Zukor, Karen; Bonjour, Sophie; Wilburn, Susan; Kuesel, Annette C; Hebert, Ryan; Fletcher, Elaine R

    2013-08-01

    Access to electricity is critical to health care delivery and to the overarching goal of universal health coverage. Data on electricity access in health care facilities are rarely collected and have never been reported systematically in a multi-country study. We conducted a systematic review of available national data on electricity access in health care facilities in sub-Saharan Africa. We identified publicly-available data from nationally representative facility surveys through a systematic review of articles in PubMed, as well as through websites of development agencies, ministries of health, and national statistics bureaus. To be included in our analysis, data sets had to be collected in or after 2000, be nationally representative of a sub-Saharan African country, cover both public and private health facilities, and include a clear definition of electricity access. We identified 13 health facility surveys from 11 sub-Saharan African countries that met our inclusion criteria. On average, 26% of health facilities in the surveyed countries reported no access to electricity. Only 28% of health care facilities, on average, had reliable electricity among the 8 countries reporting data. Among 9 countries, an average of 7% of facilities relied solely on a generator. Electricity access in health care facilities increased by 1.5% annually in Kenya between 2004 and 2010, and by 4% annually in Rwanda between 2001 and 2007. Energy access for health care facilities in sub-Saharan African countries varies considerably. An urgent need exists to improve the geographic coverage, quality, and frequency of data collection on energy access in health care facilities. Standardized tools should be used to collect data on all sources of power and supply reliability. The United Nations Secretary-General's "Sustainable Energy for All" initiative provides an opportunity to comprehensively monitor energy access in health care facilities. Such evidence about electricity needs and gaps would

  4. Doctors as patients: a systematic review of doctors' health access and the barriers they experience

    PubMed Central

    Kay, Margaret; Mitchell, Geoffrey; Clavarino, Alexandra; Doust, Jenny

    2008-01-01

    Background The need to improve doctors' access to health care by reducing the barriers they experience has been regularly described in the literature, yet the barriers experienced are not well defined, despite the volume of expert opinion in this area. Aim To define what is known about doctors' access to health care from the data within the current literature. Design of study A systematic review of studies of doctors' health access. Method A systematic search of MEDLINE® and CINAHL, supplemented by citation searches and searches of the grey literature, identified both quantitative and qualitative studies. Two reviewers used specific criteria for inclusion of studies and quality assessment. The data were tabulated and analysed. Results Twenty-six articles met the inclusion criteria. The paucity of data and the overall poor quality of those data are highlighted. Despite this, many doctors appear to have a GP, but this does not ensure adequate health access. Systemic barriers to healthcare access (long hours and cultural issues) are more significant than individual barriers. Conclusion Expert opinion in this field is supported by poor-quality data. The current knowledge reveals important similarities between doctors and the general population in their healthcare access, especially with mental health issues. Understanding this may help the medical profession to respond to these issues of ‘doctors’ health' more effectively. PMID:18611318

  5. Training a US Army Chemical Corps Company in the Current Operating Environment

    DTIC Science & Technology

    2009-02-20

    tactical command post operations. 2    History The United States Army Chemical Corps began in the early 1900s during World War I due to a threat...1 US Army Chemical Corps History . http://www.chemical- corps.org/cmhist.htm (accessed December 15, 2008). 3...Despite these advances, the vast majority of the Chemical Corps’ equipment has remained unchanged since the 1980s and has become a dinosaur on the

  6. Topography adjacent to Signal Corps Radar (S.C.R.) 296 Station 5, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Topography adjacent to Signal Corps Radar (S.C.R.) 296 Station 5, showing conditions before construction, May 28, 1943, this drawing shows the Bonita Ridge access road retaining wall and general conditions at Bonita Ridge before the construction of Signal Corps Radar (S.C.R.) 296 Station 5 - Fort Barry, Signal Corps Radar 296, Station 5, Transmitter Building Foundation, Point Bonita, Marin Headlands, Sausalito, Marin County, CA

  7. mHealth: A Mechanism to Deliver More Accessible, More Effective Mental Health Care

    PubMed Central

    Price, Matthew; Yuen, Erica K.; Goetter, Elizabeth M.; Herbert, James D.; Forman, Evan M.; Acierno, Ron; Ruggiero, Kenneth J.

    2013-01-01

    The increased popularity and functionality of mobile devices has a number of implications for the delivery of mental health services. Effective use of mobile applications has the potential to (a) increase access to evidence-based care; (b) better inform consumers of care and more actively engage them in treatment; (c) increase the use of evidence-based practices; and (d) enhance care after formal treatment has concluded. The current paper presents an overview of the many potential uses of mobile applications as a means to facilitate ongoing care at various stages of treatment. Examples of current mobile applications in behavioural treatment and research are described, and the implications of such uses are discussed. Finally, we provide recommendations for methods to include mobile applications into current treatment and outline future directions for evaluation. PMID:23918764

  8. Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan

    PubMed Central

    Nic Carthaigh, Niamh; De Gryse, Benoit; Esmati, Abdul Sattar; Nizar, Barak; Van Overloop, Catherine; Fricke, Renzo; Bseiso, Jehan; Baker, Corinne; Decroo, Tom; Philips, Mit

    2015-01-01

    Background The Afghan population suffers from a long standing armed conflict. We investigated patients’ experiences of their access to and use of the health services. Methods Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member. Results To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year. Conclusions Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare. PMID:25492948

  9. Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan.

    PubMed

    Nic Carthaigh, Niamh; De Gryse, Benoit; Esmati, Abdul Sattar; Nizar, Barak; Van Overloop, Catherine; Fricke, Renzo; Bseiso, Jehan; Baker, Corinne; Decroo, Tom; Philips, Mit

    2015-05-01

    The Afghan population suffers from a long standing armed conflict. We investigated patients' experiences of their access to and use of the health services. Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member. To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year. Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  10. Neighbourhoods and health: a GIS approach to measuring community resource accessibility

    PubMed Central

    Pearce, Jamie; Witten, Karen; Bartie, Phil

    2006-01-01

    Objective Recent studies suggest an association between the contextual attributes of neighbourhoods and the health status of residents. However, there has been a scarcity of studies that have directly measured the material characteristics of neighbourhoods theorised to have an impact on health and health inequalities. This paper describes the development of an innovative methodology to measure geographical access to a range of community resources that have been empirically linked to health. Geographical information systems (GIS) were applied to develop precise measures of community resource accessibility for small areas at a national scale. Design Locational access to shopping, education, recreation, and health facilities was established for all 38 350 census meshblocks across New Zealand. Using GIS, distance measures were calculated from the population weighted centroid of each meshblock to 16 specific types of facilities theorised as potentially health related. From these data, indices of community resource accessibility for all New Zealand neighbourhoods were constructed. Results Clear regional variations in geographical accessibility to community resources exist across the country, particularly between urban and rural areas of New Zealand. For example, the average travel time to the nearest food shop ranged from less than one minute to more than 244 minutes. Noticeable differences were also apparent between neighbourhoods within urban areas. Conclusions Recent advances in GIS and computing capacity have made it feasible to directly measure access to health related community resources at the neighbourhood level. The construction of access indices for specific community resources will enable health researchers to examine with greater precision, variations in the material characteristics of neighbourhoods and the pathways through which neighbourhoods impact on specific health outcomes. PMID:16614327

  11. Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review.

    PubMed

    Alencar Albuquerque, Grayce; de Lima Garcia, Cintia; da Silva Quirino, Glauberto; Alves, Maria Juscinaide Henrique; Belém, Jameson Moreira; dos Santos Figueiredo, Francisco Winter; da Silva Paiva, Laércio; do Nascimento, Vânia Barbosa; da Silva Maciel, Érika; Valenti, Vitor Engrácia; de Abreu, Luiz Carlos; Adami, Fernando

    2016-01-14

    The relationship between users and health services is considered essential to strengthen the quality of care. However, the Lesbian, Gay, Bisexual, and Transgender population suffer from prejudice and discrimination in access and use of these services. This study aimed to identify the difficulties associated with homosexuality in access and utilization of health services. A systematic review conducted using PubMed, Cochrane, SciELO, and LILACS, considering the period from 2004 to 2014. The studies were evaluated according to predefined inclusion and exclusion criterias. Were included manuscripts written in English or Portuguese, articles examining the Lesbian, Gay, Bisexual, and Transgender population's access to health services and original articles with full text available online. The electronic databases search resulted in 667 studies, of which 14 met all inclusion criteria. Quantitative articles were predominant, showing the country of United States of America to be the largest producer of research on the topic. The studies reveal that the homosexual population have difficulties of access to health services as a result of heteronormative attitudes imposed by health professionals. The discriminatory attendance implies in human rights violations in access to health services. The non-heterosexual orientation was a determinant factor in the difficulties of accessing health care. A lot must still be achieved to ensure access to health services for sexual minorities, through the adoption of holistic and welcoming attitudes. The results of this study highlight the need for larger discussions about the theme, through new research and debates, with the aim of enhancing professionals and services for the health care of Lesbian, Gay, Bisexual, and Transgender Persons.

  12. Health care access and utilization among US-born and foreign-born Asian Americans.

    PubMed

    Ye, Jiali; Mack, Dominic; Fry-Johnson, Yvonne; Parker, Katrina

    2012-10-01

    Despite efforts to eliminate inequality in health and health care, disparities in health care access and utilization persist in the United States. The purpose of this study was to compare the access to care and use of health care services of US-born and foreign-born Asian Americans. We used aggregated data from the National Health Interview Survey (NHIS) from 2003 to 2005, including 2,500 participants who identified themselves as Asian. Associations between country of birth and reported access and utilization of care in the previous 12 months were examined. After controlling for covariates, being foreign-born was negatively related to indicators of access to care, including health insurance (OR = 0.29, 95%CI = 0.18-0.48), routine care access (OR = 0.52, 95%CI = 0.36-0.75), and sick care access [OR = 0.67, 95%CI = 0.47-0.96)]. Being foreign-born was also negatively related to all indicators of health care utilization (office visit: OR = 0.58, 95%CI = 0.41-0.81; seen/talked to a general doctor: OR = 0.69, 95%CI = 0.52-0.90; seen/talked to a specialist: OR = 0.42, 95%CI = 0.28-0.63) but ER visit (OR = 0.84, 95%CI = 0.59-1.20). There are substantial differences by country of birth in health care access and utilization among Asian Americans. Our findings emphasize the need for developing culturally sensitive health services and intervention programs for Asian communities.

  13. Commonsense Competition and Access to Health Insurance Act

    THOMAS, 113th Congress

    Sen. Warner, Mark R. [D-VA

    2014-03-27

    Senate - 03/27/2014 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  14. Access to Independent Health Insurance Advisors Act of 2012

    THOMAS, 112th Congress

    Sen. Landrieu, Mary L. [D-LA

    2012-04-17

    Senate - 04/17/2012 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  15. Access to Independent Health Insurance Advisors Act of 2012

    THOMAS, 112th Congress

    Sen. Landrieu, Mary L. [D-LA

    2012-02-02

    Senate - 02/02/2012 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  16. Access to Independent Health Insurance Advisors Act of 2013

    THOMAS, 113th Congress

    Sen. Landrieu, Mary L. [D-LA

    2013-03-21

    Senate - 03/21/2013 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  17. Accessing Your Health Information: Your Rights and Your Provider's Responsibilities

    MedlinePlus

    ... right to receive them in either electronic or paper form. Depending on your doctor's or hospital's policies, ... Many health care providers — particularly those still using paper-based systems — may not have all of your ...

  18. Rural Health Access and Improvement Act of 2009

    THOMAS, 111th Congress

    Sen. Bennet, Michael F. [D-CO

    2009-12-04

    Senate - 12/04/2009 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  19. Expanding Access to Mental Health Counselors: Evaluation of the TRICARE Demonstration

    DTIC Science & Technology

    2005-01-01

    Our evaluation was guided by a set of general hypotheses based on Avedis Donabedian’s model of structure, process, and outcomes of health care ...our multi- variable models to examine differences in self -reported mental health care need, barriers to access, and service utilization between...Federal Register FY fiscal year GAO Government Accounting Office HCSR Health Care Service Record HEDIS Health and Employer Data and Information Set

  20. When to allow or deny adult access to children's health records.

    PubMed

    Griffith, Richard; Tengnah, Cassam

    2013-03-01

    The Data Protection Act 1998, section 7, has long granted patients the right of access to their health records. The right is exercised by a subject access request and a person with parental responsibility may exercise this right on behalf of a child. However, once the child is considered Gillick competent then a subject access request to a child's records must only be granted with the consent of the child. In this article the author sets out the requirements for a subject access request and why community nurses and specialist practitioners must proceed with caution when a request is received in respect of a child from the age of 12 years.

  1. Understanding inequalities in access to health care services for aboriginal people: a call for nursing action.

    PubMed

    Cameron, Brenda L; Carmargo Plazas, Maria Del Pilar; Salas, Anna Santos; Bourque Bearskin, R Lisa; Hungler, Krista

    2014-01-01

    We present findings from an Access Research Initiative to reduce health disparities and promote equitable access with Aboriginal peoples in Canada. We employed Indigenous, interpretive, and participatory research methodologies in partnership with Aboriginal people. Participants reported stories of bullying, fear, intimidation, and lack of cultural understanding. This research reveals the urgent need to enhance the delivery of culturally appropriate practices in emergency. As nurses, if we wish to affect equity of access, then attention is required to structural injustices that act as barriers to access such as addressing the stigma, stereotyping, and discrimination experienced by Aboriginal people in this study.

  2. Adverse or acceptable: negotiating access to a post-apartheid health care contract

    PubMed Central

    2014-01-01

    Background As in many fragile and post-conflict countries, South Africa’s social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We consider implications for conceptualizing and promoting more inclusive, equitable health services in a post-conflict setting. Methods Using in-depth interviews with 45 patients and 67 providers, and field observations from twelve health facilities in one rural and two urban sub-districts, we explore access narratives of those seeking and delivering – negotiating - maternal health, tuberculosis and antiretroviral services in South Africa. Results Although South Africa’s right to access to health care is constitutionally guaranteed, in practice, a post-apartheid health care contract is not automatically or unconditionally inclusive. Access barriers, including poverty, an under-resourced, hierarchical health system, the nature of illness and treatment, and negative attitudes and actions, create conditions for insecure or adverse incorporation into this contract, or even exclusion (sometimes temporary) from health care services. Such barriers are exacerbated by differences in the expectations that patients and providers have of each other and the contract, leading to differing, potentially conflicting, identities of inclusion and exclusion: defaulting versus suffering patients, uncaring versus overstretched providers. Conversely, caring, respectful communication, individual acts of kindness, and institutional flexibility and leadership may mitigate key access barriers and limit threats to the contract, fostering more positive forms of inclusion and facilitating easier access to health care. Conclusions Building health in

  3. Adverse or acceptable: negotiating access to a post-apartheid health care contract.

    PubMed

    Harris, Bronwyn; Eyles, John; Penn-Kekana, Loveday; Thomas, Liz; Goudge, Jane

    2014-05-15

    As in many fragile and post-conflict countries, South Africa's social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We consider implications for conceptualizing and promoting more inclusive, equitable health services in a post-conflict setting. Using in-depth interviews with 45 patients and 67 providers, and field observations from twelve health facilities in one rural and two urban sub-districts, we explore access narratives of those seeking and delivering - negotiating - maternal health, tuberculosis and antiretroviral services in South Africa. Although South Africa's right to access to health care is constitutionally guaranteed, in practice, a post-apartheid health care contract is not automatically or unconditionally inclusive. Access barriers, including poverty, an under-resourced, hierarchical health system, the nature of illness and treatment, and negative attitudes and actions, create conditions for insecure or adverse incorporation into this contract, or even exclusion (sometimes temporary) from health care services. Such barriers are exacerbated by differences in the expectations that patients and providers have of each other and the contract, leading to differing, potentially conflicting, identities of inclusion and exclusion: defaulting versus suffering patients, uncaring versus overstretched providers. Conversely, caring, respectful communication, individual acts of kindness, and institutional flexibility and leadership may mitigate key access barriers and limit threats to the contract, fostering more positive forms of inclusion and facilitating easier access to health care. Building health in fragile and post-conflict societies requires

  4. Adding dental therapists to the health care team to improve access to oral health care for children.

    PubMed

    Nash, David A

    2009-01-01

    Oral Health in America: A Report of the Surgeon General, and the subsequent National Call to Action to Promote Oral Health, contributed significantly to raising awareness regarding the lack of access to oral health care by many Americans, especially minority and low-income populations, with resulting disparities in oral health. The problem is particularly acute among children. The current dental workforce in the United States is inadequate to meet the oral health care needs of children. It is inadequate in terms of numbers of dentists, as well as their geographic distribution, ethnicity, education, and practice orientation. Dental therapists, paraprofessionals trained in a 2 academic-year program of postsecondary education, have been employed internationally to improve access to oral health care for children. Research has documented that utilizing dental therapists is a cost-effective method of providing quality oral health care for children. Dental therapists have recently been introduced in Alaska by the Alaska Native Tribal Health Consortium. Dental therapists could potentially care for children in dental offices, public health clinics, and school systems, as well as in the offices of pediatricians and family physicians. Adding dental therapists to the health care team would be a significant strategy for improving access to care for children and reducing oral health disparities.

  5. Access to health care: solidarity and justice or egoism and injustice?

    PubMed

    Prudil, Lukas

    2008-09-01

    The aim of this paper is to answer the question whether there is a real demand for equal access to health care or--better--to medical care and which interest groups (patients, health care professionals, policy makers and others) are interested in equal access. The focus is on EU countries including recent case law from the European Court of Justice and the European Court of Human Rights. We discuss whether there is a need to have legislative safeguards to protect equal access to medical care and whether such norms really work. The paper concludes that some of the key players in medical care are not primarily governed by a real willingness to have equal and just access to medical care, but by rather egoistic approaches. It seems that policy makers and politicians are the only ones who, surprisingly, must at least formally call for and enforce equal access to medical care. Interests of other groups seem to be different.

  6. Why does asking questions change health behaviours? The mediating role of attitude accessibility

    PubMed Central

    Wood, Chantelle; Conner, Mark; Sandberg, Tracy; Godin, Gaston; Sheeran, Paschal

    2013-01-01

    Objective The question-behaviour effect (QBE) refers to the finding that measuring behavioural intentions increases performance of the relevant behaviour. This effect has been used to change health behaviours. The present research asks why the QBE occurs and evaluates one possible mediator – attitude accessibility. Design University staff and students (N = 151) were randomly assigned to an intention measurement condition where they reported their intentions to eat healthy foods, or to one of two control conditions. Main outcome measures Participants completed a response latency measure of attitude accessibility, before healthy eating behaviour was assessed unobtrusively using an objective measure of snacking. Results Intention measurement participants exhibited more accessible attitudes towards healthy foods, and were more likely to choose a healthy snack, relative to control participants. Furthermore, attitude accessibility mediated the relationship between intention measurement and behaviour. Conclusion This research demonstrates that increased attitude accessibility may explain the QBE, extending the findings of previous research to the domain of health behaviour. PMID:24245778

  7. Health service access across racial/ethnic groups of children in the child welfare system✩

    PubMed Central

    Hillemeier, Marianne M.; Bai, Yu; Belue, Rhonda

    2009-01-01

    Objective This study examined health service access among children of different racial/ethnic groups in the child welfare system in an attempt to identify and explain disparities. Methods Data were from the National Survey of Child and Adolescent Well-Being (NSCAW). N for descriptive statistics = 2,505. N for multiple regression model = 537. Measures reflected child health services need, access, and enabling factors. Chi-square and t tests were used to compare across racial/ethnic groups. A logistic regression model further explored the greatest disparity identified, that between non-Latino/a Black and White children in caseworker-reported access to counseling. Results In general, caseworker reports of health care service receipt did not differ across racial/ethnic groups. However, Latino/a children had better reported access to vision services than non-Latino/a White children, and counseling access was lower for non-Latino/a Black children than non-Latino/a White children. Caseworkers' self-reported efforts to facilitate service access did not vary by race/ethnicity for any type of health care. In the multiple regression model, both private health insurance and a lack of insurance were negatively associated with counseling access, while a history of sexual abuse, adolescence, and greater caseworker effort to secure services were positively associated with access. Race was just barely nonsignificant after controlling for other factors expected to affect access. Conclusions One possible reason why Black children are less likely to be identified as needing counseling is the fact that they are less likely than White children to have reports of sexual abuse, which strongly predicts counseling access. Practice implications First, child welfare practice may be more equitable than many believe, with generally comparable health service access reported across children's racial/ethnic groups. Second, caseworkers may be under-identifying need for counseling services among

  8. Reproductive health access among deployed U.S. servicewomen: a qualitative study.

    PubMed

    Manski, Ruth; Grindlay, Kate; Burns, Bridgit; Holt, Kelsey; Grossman, Daniel

    2014-06-01

    Servicewomen's reproductive health experiences during deployment are important given that the majority of women in the U.S. military are of reproductive age and that this population experiences a disproportionately high rate of unintended pregnancy. Few studies have explored women's reproductive health experiences and their perceived barriers and facilitators to health care access during deployment. From May 2011 to January 2012, we conducted 22 in-depth interviews with women in the U.S. military about their reproductive health experiences during deployment, including their access to health services. Participants identified a range of barriers to accessing medical care in deployment settings, including confidentiality concerns, lack of female providers, and health-seeking stigma, which were reported to disproportionately impact reproductive health access. Some participants experienced challenges obtaining contraceptive refills and specific contraceptive methods during deployment, and only a few participants received predeployment counseling on contraception, despite interest in both menstruation suppression and pregnancy prevention. These findings highlight several policy and practice changes that could be implemented to increase contraceptive access and reduce unintended pregnancy during deployment, including mandated screening for servicewomen's contraceptive needs before operational duty and at least annually, and increasing the number of female providers in deployed settings.

  9. Access control and privilege management in electronic health record: a systematic literature review.

    PubMed

    Jayabalan, Manoj; O'Daniel, Thomas

    2016-12-01

    This study presents a systematic literature review of access control for electronic health record systems to protect patient's privacy. Articles from 2006 to 2016 were extracted from the ACM Digital Library, IEEE Xplore Digital Library, Science Direct, MEDLINE, and MetaPress using broad eligibility criteria, and chosen for inclusion based on analysis of ISO22600. Cryptographic standards and methods were left outside the scope of this review. Three broad classes of models are being actively investigated and developed: access control for electronic health records, access control for interoperability, and access control for risk analysis. Traditional role-based access control models are extended with spatial, temporal, probabilistic, dynamic, and semantic aspects to capture contextual information and provide granular access control. Maintenance of audit trails and facilities for overriding normal roles to allow full access in emergency cases are common features. Access privilege frameworks utilizing ontology-based knowledge representation for defining the rules have attracted considerable interest, due to the higher level of abstraction that makes it possible to model domain knowledge and validate access requests efficiently.

  10. Digital divide and stability of access in African American women visiting urban public health centers.

    PubMed

    Haughton, Lorna Tanya; Kreuter, Matthew; Hall, Jasmine; Holt, Cheryl L; Wheetley, Eric

    2005-05-01

    This exploratory study examines access to communication technologies, its association with health-related variables and study attrition, and its stability over time in a study of lower income African American women visiting urban public health centers. Participants (n = 1,227) provided information about cancer-related behaviors in a baseline questionnaire that also assessed their e-mail and cell phone/pager access. Interviews conducted at 1-, 6-, and 18-month follow up determined attrition, and an e-mail message sent to participants at 6-month follow up determined stability of access. Fewer than 10% of women reported e-mail access; 26% reported cell/phone pager access. At 6-month follow up, 45% of e-mail accounts were inactive; accounts from pay access providers were more likely to be inactive than work- or school-based accounts (58% versus 25%). Cell phone/pager access was positively associated with mammography knowledge. Attrition rates were lower among women with access than among those without access. Priorities for future research based on these preliminary findings are discussed.

  11. Physical and Mental Health and Access to Care among Nonmetropolitan Veterans Health Administration Patients Younger than 65 Years

    ERIC Educational Resources Information Center

    West, Alan; Weeks, William B.

    2006-01-01

    Context: The 4.5 million military veterans treated by the Veterans Health Administration (VA) are believed to experience poorer physical and mental health than nonveterans. Furthermore, nonmetropolitan residents have less access to medical services, whether or not they are veterans in VA care. A direct comparison of metropolitan and…

  12. Physical and Mental Health and Access to Care among Nonmetropolitan Veterans Health Administration Patients Younger than 65 Years

    ERIC Educational Resources Information Center

    West, Alan; Weeks, William B.

    2006-01-01

    Context: The 4.5 million military veterans treated by the Veterans Health Administration (VA) are believed to experience poorer physical and mental health than nonveterans. Furthermore, nonmetropolitan residents have less access to medical services, whether or not they are veterans in VA care. A direct comparison of metropolitan and…

  13. Toward a New Model for Promoting Urban Children's Mental Health: Accessible, Effective, and Sustainable School-Based Mental Health Services

    ERIC Educational Resources Information Center

    Atkins, Marc S.; Graczyk, Patricia A.; Frazier, Stacy L.; Abdul-Adil, Jaleel

    2003-01-01

    A program of research related to school-based models for urban children's mental health is described, with a particular focus on improving access to services, promoting children's functioning, and providing for program sustainability. The first study in this series responded to the urgent need to engage more families in mental health services, and…

  14. Barriers to contraceptive access after health care reform: experiences of young adults in Massachusetts.

    PubMed

    Bessett, Danielle; Prager, Joanna; Havard, Julia; Murphy, Danielle J; Agénor, Madina; Foster, Angel M

    2015-01-01

    To explore how Massachusetts' 2006 health insurance reforms affected access to sexual and reproductive health (SRH) services for young adults. We conducted 11 focus group discussions across Massachusetts with 89 women and men aged 18 to 26 in 2009. Most young adults' primary interaction with the health system was for contraceptive and other SRH services, although they knew little about these services. Overall, health insurance literacy was low. Parents were primary decision makers in health insurance choices or assisted their adult children in choosing a plan. Ten percent of our sample was uninsured at the time of the discussion; a lack of knowledge about provisions in Chapter 58 rather than calculated risk analysis characterized periods of uninsurance. The dynamics of being transitionally uninsured, moving between health plans, and moving from a location defined by insurance companies as the coverage area limited consistent access to contraception. Notably, staying on parents' insurance through extended dependency, a provision unique to the post-reform context, had implications for confidentiality and access. Young adults' access to and utilization of contraceptive services in the post-reform period were challenged by unanticipated barriers related to information and privacy. The experience in Massachusetts offers instructive lessons for the implementation of national health care reform. Young adult-targeted efforts should address the challenges of health service utilization unique to this population. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  15. Access to and use of health services among undocumented Mexican immigrants in a US urban area.

    PubMed

    Nandi, Arijit; Galea, Sandro; Lopez, Gerald; Nandi, Vijay; Strongarone, Stacey; Ompad, Danielle C

    2008-11-01

    We assessed access to and use of health services among Mexican-born undocumented immigrants living in New York City in 2004. We used venue-based sampling to recruit participants from locations where undocumented immigrants were likely to congregate. Participants were 18 years or older, born in Mexico, and current residents of New York City. The main outcome measures were health insurance coverage, access to a regular health care provider, and emergency department care. In multivariable models, living in a residence with fewer other adults, linguistic acculturation, higher levels of formal income, higher levels of social support, and poor health were associated with health insurance coverage. Female gender, fewer children, arrival before 1997, higher levels of formal income, health insurance coverage, greater social support, and not reporting discrimination were associated with access to a regular health care provider. Higher levels of education, higher levels of formal income, and poor health were associated with emergency department care. Absent large-scale political solutions to the challenges of undocumented immigrants, policies that address factors shown to limit access to care may improve health among this growing population.

  16. Access to and Use of Health Services Among Undocumented Mexican Immigrants in a US Urban Area

    PubMed Central

    Nandi, Arijit; Lopez, Gerald; Nandi, Vijay; Strongarone, Stacey; Ompad, Danielle C.

    2008-01-01

    Objectives. We assessed access to and use of health services among Mexican-born undocumented immigrants living in New York City in 2004. Methods. We used venue-based sampling to recruit participants from locations where undocumented immigrants were likely to congregate. Participants were 18 years or older, born in Mexico, and current residents of New York City. The main outcome measures were health insurance coverage, access to a regular health care provider, and emergency department care. Results. In multivariable models, living in a residence with fewer other adults, linguistic acculturation, higher levels of formal income, higher levels of social support, and poor health were associated with health insurance coverage. Female gender, fewer children, arrival before 1997, higher levels of formal income, health insurance coverage, greater social support, and not reporting discrimination were associated with access to a regular health care provider. Higher levels of education, higher levels of formal income, and poor health were associated with emergency department care. Conclusions. Absent large-scale political solutions to the challenges of undocumented immigrants, policies that address factors shown to limit access to care may improve health among this growing population. PMID:18172155

  17. The impact of access to health services on prediabetes awareness: A population-based study.

    PubMed

    Campbell, Tonya J; Alberga, Amanda; Rosella, Laura C

    2016-12-01

    Research demonstrates that prediabetes awareness has important implications for participation in diabetes risk-reducing behaviors. We examined the impact of levels of access to health services on prediabetes awareness. In 2016, we conducted an analysis among U.S. adults with prediabetes using cross-sectional data from three cycles (2007-2008, 2009-2010, and 2011-2012) of the National Health and Nutrition Examination Survey. Participants aware and unaware of their prediabetes were classified as having full, partial, or no access to health services based on current health insurance coverage and having a routine place to go for health care. Multivariable logistic regression was used to estimate the association between access to health services and prediabetes awareness. Among a total sample of 2999U.S. adults with prediabetes, an estimated 92.0% were unaware of their prediabetes status. Participants that were unaware of their prediabetes tended to be younger, male, and were less likely to be obese or have a family history of diabetes. Having no access to health services significantly increased the odds of being prediabetes unaware (AOR: 2.65; 95% CI: 1.10-6.38). However, participants with insurance but no place of regular care had the greatest odds of being prediabetes unaware (AOR: 3.21; 95% CI: 1.21-8.55). These findings suggest that access to health services is a key factor for prediabetes awareness. Health policies and interventions should strive to ensure equitable access to health services in order to detect prediabetes, and promote awareness and engagement in risk-reducing behaviors to decrease the incidence of diabetes. Copyright © 2016. Published by Elsevier Inc.

  18. Opinion of patients on accessibility of primary health care centers in Siauliai region.

    PubMed

    Milasauskiene, Zemyna; Juodryte, Ida; Miseviciene, Irena; Boerma, Wienke; Rezgiene, Rasa

    2006-01-01

    This article presents the data about the accessibility of primary health care in Siauliai region and about factors related to the patients' perceived access to primary care. The survey was carried out in June 2004, in the context of a joint project of Kaunas University of Medicine and NIVEL, the Netherlands Institute of Health services research. Patients, treated in private and public health care centers in Siauliai region, took part in this survey. The majority of patients are positive about territorial accessibility of primary health care, indicating that it is easy to get to primary health care centers. Patients expressed a high level of satisfaction with the behavior of reception desk personnel. However, they are more critical about waiting time for the general practitioner's consultation: every third noted that they had to wait for far too long. The majority of respondents pointed out that general practitioners rooms and waiting corridors are convenient and comfortable, and that general practitioners have sufficient medical equipment. Most of the patients are very well informed and satisfied with the opening hours of primary health care centers. The main factors related to the patients' evaluations of primary health care accessibility were living place of patients and type of ownership of health care center. Patients living in the towns were less likely to evaluate the accessibility of primary health care centers positively, compared to those living in the city of Siauliai. Patients receiving health care services in private centers were much more positive about access to services than those receiving services in public centers.

  19. Access and Use: Improving Digital Multimedia Consumer Health Information.

    PubMed

    Thomas, Alex

    2016-01-01

    This project enabled novel organisational insight into the comparative utility of a portfolio of consumer health information content, by measuring patterns of attrition (abandonment) in content use. The project used as a case study the event activity log of a fully automated digital information kiosk, located in a community health facility. Direct measurements of the duration of content use were derived from the user interface activity recorded in the kiosk log, thus avoiding issues in using other approaches to collecting this type of data, such as sampling and observer bias. The distribution patterns of 1,383 durations of observed abandonments of use for twenty-eight discrete modules of health information content were visualised using Kaplan-Meir survival plots. Clear patterns of abandonment of content use were exhibited. The method of analysis is cost-effective, scalable and provides deep insight into the utility of health promotion content. The impact on the content producers, platform operators and service users is to improve organisational learning and thus increase the confidence in stakeholders that the service is continuously delivering high quality health and wellbeing benefits.

  20. Informal politics and inequity of access to health care in Lebanon

    PubMed Central

    2012-01-01

    Introduction Despite the importance of political institutions in shaping the social environment, the causal impact of politics on health care access and inequalities has been understudied. Even when considered, research tends to focus on the effects of formal macro-political institutions such as the welfare state. We investigate how micro-politics and informal institutions affect access to care. Methods This study uses a mixed-methods approach, combining findings from a household survey (n = 1789) and qualitative interviews (n = 310) in Lebanon. Multivariate logistic regression was employed in the analysis of the survey to examine the effect of political activism on access to health care while controlling for age, sex, socioeconomic status, religious commitment and piety. Results We note a significantly positive association between political activism and the probability of receiving health aid (p < .001), with an OR of 4.0 when comparing individuals with the highest political activity to those least active in our sample. Interviews with key informants also reveal that, although a form of “universal coverage” exists in Lebanon whereby any citizen is eligible for coverage of hospitalization fees and treatments, in practice, access to health services is used by political parties and politicians as a deliberate strategy to gain and reward political support from individuals and their families. Conclusions Individuals with higher political activism have better access to health services than others. Informal, micro-level political institutions can have an important impact on health care access and utilization, with potentially detrimental effects on the least politically connected. A truly universal health care system that provides access based on medical need rather than political affiliation is needed to help to alleviate growing health disparities in the Lebanese population. PMID:22571591