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Sample records for accessing health services

  1. Communication Access to Health and Social Services

    ERIC Educational Resources Information Center

    Parr, Susie; Pound, Carole; Hewitt, Alan

    2006-01-01

    This article describes the efforts of a group of people in the United Kingdom at Connect-the communication disability network-to make health and social services more communicatively accessible to people with aphasia. The project involved listening to people with aphasia talk about their experiences with health and social care services and working…

  2. [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. PMID:26235780

  3. Health services accessibility among Spanish elderly.

    PubMed

    Fernández-Mayoralas, G; Rodríguez, V; Rojo, F

    2000-01-01

    The paper aims to identify the variables that best explain the use of health services by people aged 65 and over in Spain. The data comes from the 1993 Spanish National Health Survey (ENSE 93). The conceptual framework is the model proposed by Andersen, who suggests that utilisation is a function of predisposition to use the services, the ability to use them and of need. A bivariate and multivariate analysis (SPSS-X Discriminant Procedure) is conducted to define the predictors that best discriminate users and non-users. The use of each health service is explained by a different set of variables. The need variables play a more important role in predicting the use of non-discretionary services that are more closely related to healing processes (medical consultations, emergencies and hospitalisation). The predisposing and enabling variables are more relevant in explaining the use of dental services, indicating a certain degree of inequity of these discretionary services. PMID:10622691

  4. [Health services accessibility in a city of Northeast Brazil].

    PubMed

    Cunha, Alcione Brasileiro Oliveira; Vieira-da-Silva, Ligia Maria

    2010-04-01

    In order to analyze the implementation of measures targeting accessibility to primary health care in a municipality (county) in the State of Bahia, Brazil, a single case study was performed with two levels of analysis: system and services organization. The data were obtained from semi-structured interviews, observation of routine care, and document analysis. Of the four health units analyzed, three showed intermediate-level implementation of measures targeting accessibility. The Family Health Units showed better performance, due to measures for patient reception and referral to specialized services, but they revealed problems with scheduling of appointments. Despite having defined primary care as the portal of entry into the system and the implementation of a help desk for setting appointments with specialists, there are persistent organizational barriers in the municipality. A specific policy is recommended to improve accessibility, aimed at organization of the services supply in order to change the health care model. PMID:20512213

  5. Access of rural AFDC Medicaid beneficiaries to mental health services.

    PubMed

    Lambert, D; Agger, M S

    1995-01-01

    This article examines geographic differences in the use of mental health services among Aid to Families with Dependent Children (AFDC)-eligible Medicaid beneficiaries in Maine. Findings indicate that rural AFDC beneficiaries have significantly lower utilization of mental health services than urban beneficiaries. Specialty mental health providers account for the majority of ambulatory visits for both rural and urban beneficiaries. However, rural beneficiaries rely more on primary-care providers than do urban beneficiaries. Differences in use are largely explained by variations in the supply of specialty mental health providers. This finding supports the long-held assumption that lower supply is a barrier to access to mental health services in rural areas. PMID:10153467

  6. Accessibility to tuberculosis treatment: assessment of health service performance.

    PubMed

    Arakawa, Tiemi; Arcêncio, Ricardo Alexandre; Scatolin, Beatriz Estuque; Scatena, Lúcia Marina; Ruffino-Netto, Antônio; Villa, Tereza Cristina Scatena

    2011-01-01

    The aim of this study was to assess the accessibility of patients to the treatment of tuberculosis in Ribeirão Preto, countryside of São Paulo State. Evaluation study type, with a quantity approach. Interviews with 100 patients initiated on anti-tuberculosis chemotherapy between 2006-2007 were conducted, using a structured questionnaire based on the Primary Care Assessment Tool (PCAT). Data were analyzed through variance analysis. There was a positive feedback regarding to organizational accessibility, however, the performance of health services has been unsatisfactory in providing transportation vouchers and in addressing the need to use transport for displacement to the health unit, resulting in indirect costs to patients. The services with the highest number of patients treated were those with higher irregularity in the conduct of home visits, showing that the availability of resources (human, material and time) and the organization of care may influence the accessibility to treatment. PMID:21876953

  7. 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…

  8. Doctors accessing mental-health services: an exploratory study

    PubMed Central

    Randal, Patte

    2011-01-01

    Objective To develop a more in-depth understanding of how doctors do and do not access mental healthcare from the perspectives of doctors themselves and people they have contact with through the process. Design Qualitative methodology was used with semistructured interviews transcribed and analysed using Grounded Theory. Participants were 11 doctors with experience as patients of psychiatrists, four doctor and four non-doctor personal contacts (friends, family and colleagues) and eight treating psychiatrists. Results Participants described experiencing unrealistic expectations and a harsh work environment with poor self care and denial and minimisation of signs of mental health difficulties. Doctor contacts described particular difficulty in responding effectively to doctor friends, family and colleagues in need of mental healthcare. In contrast, non-doctor personal contacts were more able to identify and speak about concerns but not necessarily to enable accessing adequate mental-health services. Conclusions Three areas with potential to address in supporting doctors' accessing of appropriate healthcare have been identified: (1) processes to enable doctors to maintain high standards of functioning with less use of minimisation and denial; (2) improving the quality and effectiveness of informal doctor-to-doctor conversations about mental-health issues among themselves; (3) role of non-doctor support people in identifying doctors' mental-health needs and enabling their access to mental healthcare. Further research in all these areas has the potential to contribute to improving doctors' access to appropriate mental healthcare and may be of value for the general population. PMID:22021726

  9. [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. PMID:12162830

  10. 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. PMID:16929487

  11. 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…

  12. 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…

  13. 77 FR 54783 - Improving Access to Mental Health Services for Veterans, Service Members, and Military Families

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-05

    ..., employees, or agents, or any other person. (Presidential Sig.) THE WHITE HOUSE, August 31, 2012. [FR Doc... Documents#0;#0; ] Executive Order 13625 of August 31, 2012 Improving Access to Mental Health Services for... deployments and intense combat conditions require optimal support for the emotional and mental health needs...

  14. Integrated Behavioral Health Services: Improving Access to Mental Health Care

    ERIC Educational Resources Information Center

    Sturm, Lynne A.; Perry, Deborah F.

    2007-01-01

    This article describes innovative service delivery models and clinical strategies that support the social-emotional development of young children and their families in the pediatric primary care setting. By understanding the trends affecting well-child care, early childhood providers will be better equipped to partner with their pediatric…

  15. Accessing maternal and child health services in Melbourne, Australia: Reflections from refugee families and service providers

    PubMed Central

    2012-01-01

    Background Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH) service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. Methods We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years). Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Results Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making phone bookings. Service users

  16. 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. PMID:26928566

  17. 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

  18. [A comprehensive and critical view of conceptual models for access to health services, 1970-2013].

    PubMed

    Arrivillaga, Marcela; Borrero, Yadira Eugenia

    2016-01-01

    The aim of this study was to critically analyze various conceptual models on access to health services described in the literature from 1970 to 2013. A systematic review was conducted on applied and theoretical research publications that explicitly conceptualized access to health services. The review included 25 articles that met the study's objectives. The analysis used a matrix containing the conceptual model's logic and its description. Access to health services was classified in five categories: (i) decent minimums, (ii) market-driven, (iii) factors and multicausality, (iv) needs-based, and (v) social justice and the right to health. The study concludes that the predominant concept of access in the literature has been the market logic of medical care services, linked to the logic of factors and multicausality. Meanwhile, no conceptual model was found for access to health services based explicitly on social justice and the right to health. PMID:27192027

  19. 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

  20. 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…

  1. Planetree health information services: public access to the health information people want.

    PubMed Central

    Cosgrove, T L

    1994-01-01

    In July 1981, the Planetree Health Resource Center opened on the San Francisco campus of California Pacific Medical Center (Pacific Presbyterian Medical Center). Planetree was founded on the belief that access to information can empower people and help them face health and medical challenges. The Health Resource Center was created to provide medical library and health information resources to the general public. Over the last twelve years, Planetree has tried to develop a consumer health library collection and information service that is responsive to the needs and interests of a diverse public. In an effort to increase accessibility to the medical literature, a consumer health library classification scheme was created for the organization of library materials. The scheme combines the specificity and sophistication of the National Library of Medicine classification scheme with the simplicity of common lay terminology. PMID:8136762

  2. 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

  3. Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda

    PubMed Central

    2014-01-01

    Introduction 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. Methods 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. Results 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. Conclusion 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. PMID:25086444

  4. The Public Health Service action plan to improve access to immunization services. The Interagency Committee to Improve Access to Immunization Services.

    PubMed Central

    1992-01-01

    The Public Health Service's Interagency Committee to Improve Access to Immunization Services (ICI) has responsibility for improving the immunization protection of the nation's children and other vulnerable populations. ICI's Action Plan to Improve Access to Immunization Services sets 14 goals with 120 action steps for improving immunization services nationwide by (a) increasing coordination among Federal health, income, housing, education, and nutrition programs; (b) reducing policy and management barriers that limit access to delivery systems, and (c) strengthening the delivery infrastructure. To accomplish the goals of the plan, there is a $72.0 million increase in funding appropriated in fiscal year 1992 specifically for this purpose. The President's Budget for fiscal year 1993 includes a $24.5 million increase for continued program implementation. The additional resources will be used to address delivery and access problems, which have been determined to be the primary factors limiting immunization for many children. PMID:1594732

  5. MPEG-21 as an access control tool for the National Health Service Care Records Service.

    PubMed

    Brox, Georg A

    2005-01-01

    Since the launch of the National Health Service (NHS) Care Records Service with plans to share patient information across England, there has been an emphasis on the need for manageable access control methods. MPEG-21 is a structured file format which includes an Intellectual Property Management and Protection (IPMP) function using XML to present all digitally stored items in the patient record. Using DICreator software, patient records consisting of written text, audio-recordings, non-X-ray digital imaging and video sequences were linked up successfully. Audio records were created using Talk-Back 2002 to standardize and optimize recording quality. The recorded reports were then linked and archived using iTunes. A key was used each time the file was displayed to secure access to confidential patient data. The building of the correct file structure could be monitored during the entire creation of the file. The results demonstrated the ability to ensure secure access of the MPEG-21 file by both health-care professionals and patients by use of different keys and a specific MPEG-21 browser. The study also showed that the enabling of IPMP will provide accurate audit trails to authenticate appropriate access to medical information. PMID:16035983

  6. 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...

  7. 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...

  8. 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...

  9. 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…

  10. Access to Rural Mental Health Services: Service Use and Out-of-Pocket Costs

    ERIC Educational Resources Information Center

    Ziller, Erika C.; Anderson, Nathaniel J.; Coburn, Andrew F.

    2010-01-01

    Purpose: To examine rural-urban differences in the use of mental health services (mental health and substance abuse office visits, and mental health prescriptions) and in the out-of-pocket costs paid for these services. Methods: The pooled 2003 and 2004 Medical Expenditure Panel Surveys were used to assess differences in mental health service use…

  11. Improving Immigrant Populations' Access to Mental Health Services in Canada: A Review of Barriers and Recommendations.

    PubMed

    Thomson, Mary Susan; Chaze, Ferzana; George, Usha; Guruge, Sepali

    2015-12-01

    This article emerges from a scoping review of over two decades of relevant literature on immigrants' access to mental health services in Canada. Key online databases were searched to explore the gaps and opportunities for improving access to mental health services using a review framework provided by Arksey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005). Immigrants and refugees came from diverse religious and cultural backgrounds and had complex mental health-related concerns that were not currently being adequately addressed by existing services. The major barriers to the utilization of mental health services included: those related to the uptake of existing health information and services; those that were related to the process of immigrant settlement; and barriers related to availability of appropriate services. A thematic analysis of the range of recommendations that emerge from these studies for improvement of research, practice and policy is provided. PMID:25742880

  12. In or out? Barriers and facilitators to refugee-background young people accessing mental health services.

    PubMed

    Colucci, Erminia; Minas, Harry; Szwarc, Josef; Guerra, Carmel; Paxton, Georgia

    2015-12-01

    Refugee young people have been identified as a group with high risk for mental health problems, due to their experience of trauma, forced migration, and stressors associated with settlement. A high prevalence of mental health problems is reported in this group, however some research suggests refugee young people have low rates of mental health service access. There is little information available on barriers and facilitators to mental service delivery for this group. Using data from 15 focus groups and five key informant interviews with a total of 115 service providers from 12 agencies in Melbourne, Australia, this paper explores barriers and facilitators to engaging young people from refugee backgrounds with mental health services. Eight key themes emerged: cultural concepts of mental health, illness, and treatment; service accessibility; trust; working with interpreters; engaging family and community; the style and approach of mental health providers; advocacy; and continuity of care. PMID:25731986

  13. 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...

  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. 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…

  17. 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

  18. Evaluating Project Connect: improving juvenile probationers' mental health and substance use service access.

    PubMed

    Wasserman, Gail A; McReynolds, Larkin S; Musabegovic, Hana; Whited, Andria L; Keating, Joseph M; Huo, Yanling

    2009-11-01

    Project Connect is a multilayered county-specific program aimed at linking juvenile probationers to needed mental health and substance use services. In four NY counties, the intervention included cooperative agreements between probation and mental health authorities, program materials to facilitate referral, in-service training for probation officers, and systematic screening for mental health needs. Charts for 583 Baseline youths were reviewed and compared with 594 youths undergoing intake under Project Connect. Compared to Baseline, under Project Connect, referred youths were 2.7 times as likely to access services, regardless of youth or county characteristics, service availability, or when the intervention took place. PMID:19582568

  19. 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

  20. Barriers to accessing generic health and social care services: a qualitative study of injecting drug users.

    PubMed

    Neale, Joanne; Tompkins, Charlotte; Sheard, Laura

    2008-03-01

    While research has clearly documented the difficulties injectors encounter in accessing specialist addiction services, there is less evidence of the problems they face when securing general health care and non-substance-misuse-specific support. This paper seeks to fill some of these knowledge gaps. Between January and May 2006, 75 current injectors were recruited and interviewed through three needle exchange programmes located in diverse geographical areas of West Yorkshire. Interview data were transcribed verbatim and analysed using Framework. Findings showed that injectors were often positive about the help they received from generic health and social care services. Nonetheless, they identified a range of barriers relating to inability to access desired assistance, the burden of appointments, travel to services, stigma and negative staff attitudes, personal ill-health, lack of material resources, and anxieties about accessing support. Although some types of barriers were more evident at some services than at others and/or affected particular subgroups of injector more than others, the impact of any barrier was contingent on a range of factors. These included the attitudes of individual professionals, the circumstances and needs of individual injectors, the local availability of suitable alternative services, and the frequency with which a service needed to be accessed. In order to better understand and potentially reduce service barriers, findings are linked to broader conceptual and theoretical debates relating to social exclusion and Foucault's analyses of power and knowledge. PMID:18290980

  1. 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

  2. Disparities in Access to Easy-to-Use Services for Children with Special Health Care Needs.

    PubMed

    Rosen-Reynoso, Myra; Porche, Michelle V; Kwan, Ngai; Bethell, Christina; Thomas, Veronica; Robertson, Julie; Hawes, Eva; Foley, Susan; Palfrey, Judith

    2016-05-01

    Objectives Families, clinicians and policymakers desire improved delivery of health and related services for children with special health care needs (CSHCN). We analyzed factors associated with ease of use in obtaining such services. We also explored what were specific difficulties or delays in receiving services. By examining data from the National Survey of Children with Special Health Care Needs (NS-CSHCN 2009-2010) and using the revised criteria for "ease of use," we were able to assess the percentage of parents who reported that their experiences seeking services for their children met those criteria. Methods We performed Chi square tests to examine associations between the independent variables and their relationship to the difficulties or delays assessed in the survey; including: eligibility, availability of services, waiting lists, cost, and access to information. We used logistic regression to determine the association of meeting the "ease of use" criteria with socio-demographic, complexity of need, and access variables. Results Overall, a third of families of CSHCN (35.3 %) encounter difficulties, delays, or frustrations in obtaining health and related services. The lack of access to health and community services in this study fell most heavily on children from racial/ethnic minority backgrounds, those in poverty, and those with complex emotional/behavioral or developmental needs and functional limitations. Conclusions for Practice CSHCN require services from a broad array of providers across multiple systems. Unfortunately, there are certain difficulties that hamper the accessibility of these systems. These findings underscore the need for both practice-level response and systems-level reform to ensure equitable distribution of health and community resources. PMID:26728898

  3. Characteristics of collaborative care in increasing access to mental health service in the Asian community.

    PubMed

    Sung, Jeehee; Mayo, Nicolle; Ko, Mei-Ju; Lasley, Chandra

    2013-09-01

    This study examined the use of thematic analysis to determine how characteristics of collaborative care facilitate accessibility to mental health services among the Asian community in the United States. This investigation explored characteristics of collaborative care in patient treatment, barriers that prevent the Asian community from utilizing care, and how collaborative settings can facilitate mental health care access in the Asian community. Mental health providers with relevant experiences in collaborative care were recruited through snowball sampling to participate in a telephone interview with the researchers. The results suggested a collectivistic culture, valuing authority, acculturation, language, and stigma as themes of Asian patients as well as key providers (mental and medical health providers), colocation, the physician's leading role, the provider's language, and collaboration among providers as themes for collaborative care. The study suggests that collaborative care's foundational characteristics can promote easier access to mental health care for the Asian community. PMID:23937434

  4. Location-allocation and accessibility models for improving the spatial planning of public health services.

    PubMed

    Polo, Gina; Acosta, C Mera; Ferreira, Fernando; Dias, Ricardo Augusto

    2015-01-01

    This study integrated accessibility and location-allocation models in geographic information systems as a proposed strategy to improve the spatial planning of public health services. To estimate the spatial accessibility, we modified the two-step floating catchment area (2SFCA) model with a different impedance function, a Gaussian weight for competition among service sites, a friction coefficient, distances along a street network based on the Dijkstra's algorithm and by performing a vectorial analysis. To check the accuracy of the strategy, we used the data from the public sterilization program for the dogs and cats of Bogot´a, Colombia. Since the proposed strategy is independent of the service, it could also be applied to any other public intervention when the capacity of the service is known. The results of the accessibility model were consistent with the sterilization program data, revealing that the western, central and northern zones are the most isolated areas under the sterilization program. Spatial accessibility improvement was sought by relocating the sterilization sites using the maximum coverage with finite demand and the p-median models. The relocation proposed by the maximum coverage model more effectively maximized the spatial accessibility to the sterilization service given the non-uniform distribution of the populations of dogs and cats throughout the city. The implementation of the proposed strategy would provide direct benefits by improving the effectiveness of different public health interventions and the use of financial and human resources. PMID:25775411

  5. Location-Allocation and Accessibility Models for Improving the Spatial Planning of Public Health Services

    PubMed Central

    Polo, Gina; Acosta, C. Mera; Ferreira, Fernando; Dias, Ricardo Augusto

    2015-01-01

    This study integrated accessibility and location-allocation models in geographic information systems as a proposed strategy to improve the spatial planning of public health services. To estimate the spatial accessibility, we modified the two-step floating catchment area (2SFCA) model with a different impedance function, a Gaussian weight for competition among service sites, a friction coefficient, distances along a street network based on the Dijkstra’s algorithm and by performing a vectorial analysis. To check the accuracy of the strategy, we used the data from the public sterilization program for the dogs and cats of Bogot´a, Colombia. Since the proposed strategy is independent of the service, it could also be applied to any other public intervention when the capacity of the service is known. The results of the accessibility model were consistent with the sterilization program data, revealing that the western, central and northern zones are the most isolated areas under the sterilization program. Spatial accessibility improvement was sought by relocating the sterilization sites using the maximum coverage with finite demand and the p-median models. The relocation proposed by the maximum coverage model more effectively maximized the spatial accessibility to the sterilization service given the non-uniform distribution of the populations of dogs and cats throughout the city. The implementation of the proposed strategy would provide direct benefits by improving the effectiveness of different public health interventions and the use of financial and human resources. PMID:25775411

  6. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Access to emergency medical and mental health services. 115.82 Section 115.82 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Medical and Mental...

  7. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Access to emergency medical and mental health services. 115.82 Section 115.82 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Medical and Mental...

  8. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Access to emergency medical and mental health services. 115.82 Section 115.82 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Medical and Mental...

  9. Health Service Access across Racial/Ethnic Groups of Children in the Child Welfare System

    ERIC Educational Resources Information Center

    Wells, Rebecca; 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.…

  10. Perceived Barriers for Accessing Health Services among Individuals with Disability in Four African Countries

    PubMed Central

    Eide, Arne H.; Mannan, Hasheem; Khogali, Mustafa; van Rooy, Gert; Swartz, Leslie; Munthali, Alister; Hem, Karl-Gerhard; MacLachlan, Malcolm; Dyrstad, Karin

    2015-01-01

    There is an increasing awareness among researchers and others that marginalized and vulnerable groups face problems in accessing health care. Access problems in particular in low-income countries may jeopardize the targets set by the United Nations through the Millennium Development Goals. Thus, identifying barriers for individuals with disability in accessing health services is a research priority. The current study aimed at identifying the magnitude of specific barriers, and to estimate the impact of disability on barriers for accessing health care in general. A population based household survey was carried out in Sudan, Namibia, Malawi, and South Africa, including a total of 9307 individuals. The sampling strategy was a two-stage cluster sampling within selected geographical areas in each country. A listing procedure to identify households with disabled members using the Washington Group six screening question was followed by administering household questionnaires in households with and without disabled members, and questionnaires for individuals with and without disability. The study shows that lack of transport, availability of services, inadequate drugs or equipment, and costs, are the four major barriers for access. The study also showed substantial variation in perceived barriers, reflecting largely socio-economic differences between the participating countries. Urbanity, socio-economic status, and severity of activity limitations are important predictors for barriers, while there is no gender difference. It is suggested that education reduces barriers to health services only to the extent that it reduces poverty. Persons with disability face additional and particular barriers to health services. Addressing these barriers requires an approach to health that stresses equity over equality. PMID:25993307

  11. A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory

    PubMed Central

    2012-01-01

    Background Immigration is not a new phenomenon but, rather, has deep roots in human history. Documents from every era detail individuals who left their homelands and struggled to reestablish their lives in other countries. The aim of this study was to explore and understand the experience of Iranian immigrants who accessed Canadian health care services. Research with immigrants is useful for learning about strategies that newcomers develop to access health care services. Methods The research question guiding this study was, “What are the processes by which Iranian immigrants learn to access health care services in Canada?” To answer the question, a constructivist grounded theory approach was applied. Initially, unstructured interviews were conducted with 17 participants (11 women and six men) who were adults (at least 18 years old) and had immigrated to Canada within the past 15 years. Eight participants took part in a second interview, and four participants took part in a third interview. Results Using a constructivist grounded theory approach, “tackling the stumbling blocks of access” emerged as the core category. The basic social process (BSP), becoming self-sufficient, was a transitional process and had five stages: becoming a stranger; feeling helpless; navigating/seeking information; employing strategies; and becoming integrated and self-sufficient. We found that “tackling the stumbling blocks of access” was the main struggle throughout this journey. Some of the immigrants were able to overcome these challenges and became proficient in accessing health care services, but others were unable to make the necessary changes and thus stayed in earlier stages/phases of transition, and sometimes returned to their country of origin. Conclusion During the course of this journey a substantive grounded theory was developed that revealed the challenges and issues confronted by this particular group of immigrants. This process explains why some Iranian

  12. Constraints and Benefits of Child Welfare Contracts with Behavioral Health Providers: Conditions that Shape Service Access.

    PubMed

    Bunger, Alicia C; Cao, Yiwen; Girth, Amanda M; Hoffman, Jill; Robertson, Hillary A

    2016-09-01

    This qualitative study examines worker perceptions of how public child welfare agencies' purchase of service contracts with private behavioral health organizations can both facilitate and constrain referral making and children's access to services. Five, 90-min focus groups were conducted with workers (n = 50) from an urban public child welfare agency in the Midwest. Using a modified grounded theory approach, findings suggest that contracts may expedite service linkages, but contract benefits are conditioned upon design and implementation. Results also suggest the critical role of front line workers in carrying out contractual relationships. Implications for research and interventions for enhancing contracting are discussed. PMID:26427998

  13. Patients’ online access to their electronic health records and linked online services: a systematic interpretative review

    PubMed Central

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-01-01

    Objectives To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Setting Primary care. Participants A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Primary and secondary outcome measures Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. Results No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Conclusions Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of

  14. Gender, sexuality and the discursive representation of access and equity in health services literature: implications for LGBT communities

    PubMed Central

    2011-01-01

    Background This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. Methods A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. Results A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. Conclusions The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions

  15. 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

  16. Outreach services to improve access to health care in South Africa: lessons from three community health worker programmes

    PubMed Central

    Nxumalo, Nonhlanhla; Goudge, Jane; Thomas, Liz

    2013-01-01

    Introduction In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW) programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO), a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care. Methods The comparative case studies, located in Eastern Cape and Gauteng, were investigated using qualitative methods. Thematic analysis was used to identify factors that constrain and enable outreach services to improve access to care. Results The local satellite (of a national NGO), successful in addressing multi-dimensional barriers to care, provided CHWs with continuous training focused on the social determinants of ill-health, regular context-related supervision, and resources such as travel and cell-phone allowances. These workers engaged with, and linked their clients to, agencies in a wide range of sectors. Relationships with participatory structures at community level stimulated coordinated responses from service providers. In contrast, an absence of these elements curtailed the ability of CHWs in the small NGO and government-initiated service to provide effective outreach services or to improve access to care. Conclusion Significant investment in resources, training, and support can enable CHWs to address barriers to care by negotiating with poorly functioning government services and community participation structures. PMID:23364101

  17. Measuring access to urban health services using Geographical Information System (GIS): a case study of health service management in Bandar Abbas, Iran

    PubMed Central

    Masoodi, Mehdi; Rahimzadeh, Mahsa

    2015-01-01

    Background: The current distribution of and access to health services along with the future health needs of the population have prompted wide application of Geographic Information Systems (GISs). During recent years, GIS has been used in public health management for planning and organization of healthcare services. This study investigates geographical accessibility of residential areas in Bandar Abbas, Iran to healthcare services. Methods: Accessibility was evaluated by using Floating Catchment Area (FCA), minimum distance methods and Response Time (RT) accessibility technique. Results: More accurate measures of distances in Bandar Abbas, illustrated that Euclidean distances were not strongly correlated with network distances. The RT accessibility technique that utilizes shortest network path and time distances, presented detailed information about all the possible positions of the patients with respect to available healthcare services based on optimum and critical response times. Conclusion: Locations of public health services in Bandar Abbas were not related to the sites of populations. The RT accessibility technique provides a reasonably sensitive and robust evaluation of accessibility. PMID:26188808

  18. Increasing Access to Health Administrative Data with ICES Data & Analytic Services.

    PubMed

    Ishiguro, Lisa; Saskin, Refik; Vermeulen, Marian J; Yates, Erika; Gunraj, Nadia; Victor, J Charles

    2016-01-01

    The Institute for Clinical Evaluative Sciences (ICES) is one of only a few organizations in Ontario permitted to access, link and analyze health administrative data for the purpose of generating evidence to inform decisions in policy and practice. Although ICES is a leading research institute, its access to the data has historically been restricted to scientists with an ICES affiliation. This requirement, designed to meet ICES' data privacy and security obligations, created barriers with respect to the widespread use of Ontario's data assets. In 2014, as part of the government's commitment to the Strategy for Patient-Oriented Research, ICES launched the Data & Analytic Services platform, which is aimed at increasing access to data and analytic services to investigators external to ICES. In making the data widely available to the broader research community, this initiative engages investigators involved in front-line care, stimulates new avenues of research and fosters collaboration that was previously challenging or unfeasible. PMID:27133600

  19. A study of HIV positive undocumented African migrants' access to health services in the UK.

    PubMed

    Whyte, James; Whyte, Maria D; Hires, Kimberly

    2015-01-01

    Newly immigrated persons, whatever their origin, tend to fall in the lower socioeconomic levels. In fact, failure of an asylum application renders one destitute in a large proportion of cases, often resulting in a profound lack of access to basic necessities. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority. The purpose of the study was to determine the basic social processes that guide HIV positive undocumented migrant's efforts to gain health services in the UK. The study used the Grounded Theory Approach. Theoretical saturation occurred after 16 participants were included in the study. The data included reflections of the prominent factors related to the establishment of a safe and productive life and the ability of individuals to remain within the UK. The data reflected heavily upon the ability of migrants to enter the medical care system during their asylum period, and on an emerging pattern of service denial after loss on immigration appeal. The findings of this study are notable in that they have demonstrated sequence of events along a timeline related to the interaction between the asylum process and access to health-related services. The results reflect that African migrants maintain a degree of formal access to health services during the period that they possess legal access to services and informal access after the failure of their asylum claim. The purpose of this paper is to examine the basic social processes that characterize efforts to gain access to health services among HIV positive undocumented African migrants to the UK. The most recent estimates indicate that there are a total of 618,000 migrants who lack legal status within the UK. Other studies have placed the number of undocumented migrants within the UK in the range of 525,000-950,000. More than 442,000 are thought to dwell in the London metropolitan area. Even in

  20. Stigma and barriers to accessing mental health services perceived by Air Force nursing personnel.

    PubMed

    Hernandez, Stephen H A; Bedrick, Edward J; Parshall, Mark B

    2014-11-01

    We investigated perceptions of stigma and barriers associated with accessing mental health services among active component U.S. Air Force officer and enlisted nursing personnel (N = 211). The Britt and Hoge et al Stigma scale and Hoge et al Barriers to Care scale were administered via an anonymous, online survey. Stigma items pertained to concerns that might affect decisions to seek mental health treatment. Most of the sample agreed with the items "Members of my unit might have less confidence in me" and "My unit leadership might treat me differently." Approximately 20% to 46% agreed with the other four stigma items. Officer nursing personnel were significantly more likely than enlisted to agree that accessing mental health services would be embarrassing, harm their career, or cause leaders to blame them for the problem (p ≤ 0.03 for each comparison). Getting time off from work for treatment and scheduling appointments were perceived as barriers by 41% and 21% of respondents, respectively. We conclude that proportions of Air Force nursing personnel reporting concerns about potential stigmatizing consequences of seeking mental health care are substantial and similar to ranges previously reported by military service members screening positive for mental health problems after deployment. PMID:25373066

  1. Demand and access to mental health services: a qualitative formative study in Nepal

    PubMed Central

    2014-01-01

    Background Nepal is experiencing a significant ‘treatment gap’ in mental health care. People with mental disorders do not always receive appropriate treatment due to a range of structural and individual issues, including stigma and poverty. The PRIME (Programme for Improving Mental Health Care) programme has developed a mental health care plan to address this issue in Nepal and four other low and middle income countries. This study aims to inform the development of this comprehensive care plan by investigating the perceptions of stakeholders at different levels of the care system in the district of Chitwan in southern Nepal: health professionals, lay workers and community members. It focuses specifically on issues of demand and access to care, and aims to identify barriers and potential solutions for reaching people with priority mental disorders. Methods This qualitative study consisted of key informant interviews (33) and focus group discussions (83 participants in 9 groups) at community and health facility levels. Data were analysed using a framework analysis approach. Results As well as pragmatic barriers at the health facility level, mental health stigma and certain cultural norms were found to reduce access and demand for services. Respondents perceived the lack of awareness about mental health problems to be a major problem underlying this, even among those with high levels of education or status. They proposed strategies to improve awareness, such as channelling education through trusted and respected community figures, and responding to the need for openness or privacy in educational programmes, depending on the issue at hand. Adapting to local perceptions of stigmatised treatments emerged as another key strategy to improve demand. Conclusions This study identifies barriers to accessing care in Nepal that reach beyond the health facility and into the social fabric of the community. Stakeholders in PRIME’s integrated care plan advocate strategic

  2. Health service utilization and access to medicines among Syrian refugee children in Jordan

    PubMed Central

    Lyles, Emily; Akhu‐Zaheya, Laila; Burton, Ann; Weiss, William

    2016-01-01

    Summary Background With over one million Syrian refugee children in the region, we undertook this study to characterize care‐seeking behaviors and health service utilization for child refugees with the aim of informing humanitarian programming for non‐camp settings in Jordan. Methods A survey of Syrian refugees living outside of camps in Jordan was conducted using a 125 × 12 cluster design with probability proportional to size sampling to obtain a representative sample. The questionnaire focused on access to health services, including a module on care seeking for children. Results Care seeking was high with 90.9% of households with a child less than 18 years seeking medical care the last time it was needed. Households most often sought care for children in the public sector (54.6%), followed by private (36.5%) and charity sectors (8.9%). Among child care seekers, 88.6% were prescribed medication during the most recent visit, 90.6% of which obtained the medication. Overall, 49.4% of households reported out‐of‐pocket expenditures for either the consultation or prescribed medications at the most recent visit (mean $US21.1 and median $US0). Conclusions Syrian refugees had good access to care for their sick children at the time of the survey; however, this has likely deteriorated since the survey because of the withdrawal of free access for refugees. The number of refugees in Jordan and relative accessibility of care has resulted in a large burden on the health system; the Jordanian government will require additional support if current levels of health access are to be maintained for Syrian refugees. © 2016 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd. PMID:26799158

  3. Patients' Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice.

    PubMed

    Mold, Freda; de Lusignan, Simon

    2015-01-01

    Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems. PMID:26690225

  4. Patients’ Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice

    PubMed Central

    Mold, Freda; de Lusignan, Simon

    2015-01-01

    Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems. PMID:26690225

  5. The Genesis, Implementation and Impact of the Better Access Mental Health Initiative Introducing Medicare-Funded Psychology Services

    ERIC Educational Resources Information Center

    Littlefield, Lyn; Giese, Jill

    2008-01-01

    The Australian Government's Better Access to Mental Health Care initiative introduced mental health reforms that included the availability of Medicare-funded psychology services. The mental health initiative has resulted in a huge uptake of these services, demonstrating the strong community demand for psychological treatment. The initiative has…

  6. Beyond Culture and Language: Access to Diabetes Preventive Health Services among Somali Women in Norway.

    PubMed

    Gele, Abdi A; Torheim, Liv Elin; Pettersen, Kjell Sverre; Kumar, Bernadette

    2015-01-01

    Despite the high prevalence of type 2 diabetes in some immigrant and refugee communities in Norway, there is very little information available on their utilization of diabetes prevention interventions, particularly for women from Somali immigrant communities. A qualitative study of 30 Somali immigrant women aged 25 years and over was carried out in the Oslo area. Unstructured interviews were used to explore women's knowledge of diabetes, their access to preventive health facilities, and factors impeding their reception of preventive health programs targeted for the prevention of type 2 diabetes. The study participants were found to have a good knowledge of diabetes. They knew that a sedentary lifestyle and unhealthy diet are among the risk factors for diabetes. Regardless of their knowledge, participants reported a sedentary lifestyle accompanied with the consumption of an unhealthy diet. This was attributed to a lack of access to tailored physical activity services and poor access to health information. Considering gender-exclusive training facilities for Somali immigrant women and others with similar needs, in addition to access to tailored health information on diet, may encourage Somali women to adopt a healthy lifestyle, and it will definitely contribute to a national strategy for the prevention of diabetes. PMID:26266267

  7. Beyond Culture and Language: Access to Diabetes Preventive Health Services among Somali Women in Norway

    PubMed Central

    Gele, Abdi A.; Torheim, Liv Elin; Pettersen, Kjell Sverre; Kumar, Bernadette

    2015-01-01

    Despite the high prevalence of type 2 diabetes in some immigrant and refugee communities in Norway, there is very little information available on their utilization of diabetes prevention interventions, particularly for women from Somali immigrant communities. A qualitative study of 30 Somali immigrant women aged 25 years and over was carried out in the Oslo area. Unstructured interviews were used to explore women's knowledge of diabetes, their access to preventive health facilities, and factors impeding their reception of preventive health programs targeted for the prevention of type 2 diabetes. The study participants were found to have a good knowledge of diabetes. They knew that a sedentary lifestyle and unhealthy diet are among the risk factors for diabetes. Regardless of their knowledge, participants reported a sedentary lifestyle accompanied with the consumption of an unhealthy diet. This was attributed to a lack of access to tailored physical activity services and poor access to health information. Considering gender-exclusive training facilities for Somali immigrant women and others with similar needs, in addition to access to tailored health information on diet, may encourage Somali women to adopt a healthy lifestyle, and it will definitely contribute to a national strategy for the prevention of diabetes. PMID:26266267

  8. Factors associated with establishment-based female sex workers accessing health care services in Shanghai.

    PubMed

    Pan, Rong; Mao, Limin; He, Na; Zhang, Jing; Chen, Kun; Liao, Cuiqin; Tang, Xian; Gong, Xiangzhen; Blaxland, Megan; de Wit, John

    2015-01-01

    Female sex workers are a priority population for HIV prevention and health promotion in China. This paper examines the patterns of and factors associated with the utilisation of HIV-related and general health services by establishment-based sex workers in Hongkou District, Shanghai. Participants were recruited through a three-stage sampling strategy and invited to self-complete a brief survey in 2012. The median age of the 400 participants included in the analyses was 33 years (range = 18-52 years old), with over three-quarters being married at the time of the survey. Participants were mostly internal migrants, more than half had lived in Shanghai for six months or longer and nearly two-thirds were working in an establishment with a total of less than five female sex workers. Routine physical examination and HIV testing were the most commonly accessed health services in the previous 12 months. Altogether, 347 women (86.8%) had actively sought, including 157 women had obtained, free health services mainly from local Community Health Service Centres (CHSCs) in the previous 12 months. The active seeking of free, largely CHSC-provided health services was associated with a longer duration of residence in Shanghai (adjusted odds ratio [AOR] = 2.55, 95% CI = 1.32-4.93; p < 0.01) and having tested for HIV in the previous 12 months (AOR = 3.68, 95% CI = 1.84-7.38; p < 0.001). Conversely, a higher annual income (AOR = 0.41, 95% CI = 0.21-0.80; p < 0.01), working in a larger establishment (AOR = 0.40, 95% CI = 0.20-0.79; p < 0.01) and knowing that HIV can be transmitted through blood transfusion with unscreened blood (AOR = 0.21, 95% CI = 0.05-0.91; p < 0.05) were associated with not actively seeking such services. Free, community-based health services are highly demanded by establishment-based female sex workers in Shanghai. Scaling-up of free and integrated health services provided by community-based health service providers in metropolitan areas in China and beyond holds

  9. PKI-based secure mobile access to electronic health services and data.

    PubMed

    Kambourakis, G; Maglogiannis, I; Rouskas, A

    2005-01-01

    Recent research works examine the potential employment of public-key cryptography schemes in e-health environments. In such systems, where a Public Key Infrastructure (PKI) is established beforehand, Attribute Certificates (ACs) and public key enabled protocols like TLS, can provide the appropriate mechanisms to effectively support authentication, authorization and confidentiality services. In other words, mutual trust and secure communications between all the stakeholders, namely physicians, patients and e-health service providers, can be successfully established and maintained. Furthermore, as the recently introduced mobile devices with access to computer-based patient record systems are expanding, the need of physicians and nurses to interact increasingly with such systems arises. Considering public key infrastructure requirements for mobile online health networks, this paper discusses the potential use of Attribute Certificates (ACs) in an anticipated trust model. Typical trust interactions among doctors, patients and e-health providers are presented, indicating that resourceful security mechanisms and trust control can be obtained and implemented. The application of attribute certificates to support medical mobile service provision along with the utilization of the de-facto TLS protocol to offer competent confidentiality and authorization services is also presented and evaluated through experimentation, using both the 802.11 WLAN and General Packet Radio Service (GPRS) networks. PMID:16340094

  10. Improving access to essential health care services: the case of Israel.

    PubMed

    van de Ven, Wynand P M M

    2016-01-01

    In a recent article in this journal Simon-Tuval, Horev and Kaplan argue that in order to improve the protection of consumers there might be a need to impose a threshold on the medical loss ratio (MLR) for voluntary health insurance (VHI) in Israel [1]. Their argument is that VHI in Israel covers several essential services that are not covered by the mandatory benefits package due to budget constraints, while there are market failures in the VHI market that justify regulation to assure consumer protection such as high accessibility to high quality coverage. In this commentary it will be argued that in addition to market failures there are also government failures. It is doubtful whether imposing a threshold on MLR is effective because of government failures. It can be even counter-productive. Therefore, alternative regulatory measures are discussed to promote the protection of the beneficiaries. If essential services covered by VHI are unaffordable for some low-income people, government can extend the current mandatory basic health insurance so that it covers all essential services. If there is a budget restriction, the amount of government funds could be increased, or the health plans could be allowed to request an additional flat rate premium, set by them and to be paid by the consumer directly to their health plan. Also, effective out-of-pocket payments could be introduced. Subsidies could be given to low-income people to compensate for their additional expenses under the mandatory health insurance. If these changes are adopted, then the government would no longer be held responsible for access to benefits outside the mandatory health insurance. Accordingly, all VHI could be sold on the normal free insurance market, just as other types of indemnity insurance. In addition, the Israeli health insurance and healthcare markets could be made more competitive by introducing procompetitive regulation. This would increase the efficiency and affordability of healthcare

  11. Fair Access to Care Services (FACS): implementation in the mental health context of the UK.

    PubMed

    Cestari, L; Munroe, M; Evans, S; Smith, A; Huxley, P

    2006-11-01

    Since April 2003, all adults requiring social care services must have an assessment to determine their eligibility, which is set within the four-level framework of Fair Access to Care Services [FACS; LAC (2002)13]. This paper examines the implementation of FACS by community mental health teams in eight sites in mental health partnership trusts, and one in a mental health and social care trust in the UK. Twenty-eight respondents (managers within trusts and social services departments) participated in in-depth qualitative interviews, which were undertaken between August 2004 and February 2005. The interviews covered: consultation with users and partner organisations; training and briefings for staff; FACS thresholds; integration of FACS and the Care Programme Approach; and the impact of implementing FACS on budgetary arrangements between health and social care. Using the framework analysis approach to analyse data, it was found that FACS implementation in mental health services has been somewhat haphazard, and has identified real differences between health and social care approaches to eligibility determination, assessment and priorities. In particular, the type and amount of consultation, training and induction into FACS was variable, and in some cases, unacceptably poor. While FACS may have reduced variability between authorities, the exercise of professional judgement in the operation of FACS and the lack of high-quality preventative services remain as potential sources of inequity within the system. The authors conclude that FACS has revealed and reinforced a growing separation rather than an integration of mental health and social care ideas and practices, at least in the participating sites. PMID:17059489

  12. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

    PubMed Central

    2010-01-01

    Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international

  13. Access to mental health services for active duty and National Guard TRICARE enrollees in Indiana.

    PubMed

    Avery, George H; Wadsworth, Shelley M MacDermid

    2011-03-01

    Mental health problems are a well-known consequence of combat exposure, and the problem of barriers to receiving mental health care for veterans is well known. The current heavy reliance on reserve component soldiers may aggravate this problem. This study tries to characterize problems with access to mental health care for activated members of the National Guard reserve component, active duty service members, and their families in the state of Indiana. Data from a telephone survey of Indiana mental health providers listed in the TRICARE provider revealed that only 25% were accepting new TRICARE patients, although regression analyses revealed that acceptance of patients was positively related to market population and negatively related to the number of deployed soldiers in the market. The primary barrier to obtain care appears to be the accuracy of the TRICARE provider list. PMID:21456350

  14. [Factors associated with geographic access to health services by TB patients in three State capitals in Northeast Brazil].

    PubMed

    Souza, Márcia São Pedro Leal; Aquino, Rosana; Pereira, Susan M; Costa, Maria da Conceição Nascimento; Barreto, Mauricio Lima; Natividade, Marcio; Ximenes, Ricardo; Souza, Wayner; Dantas, Odimariles Maria; Braga, José Ueleres

    2015-01-01

    The aim of this study was to identify factors associated with geographic access to health services by tuberculosis patients in three State capitals in Northeast Brazil. The sample consisted of new tuberculosis cases reported in 2007. The study used data from the Information System on Notifiable Diseases and the National Registry of Healthcare Organizations. Addresses of households and health services were geocoded, and difficult access was defined as a distance greater than 800 meters from the household to the health service. Crude prevalence ratios were estimated, as well as adjusted prevalence ratios using Poisson regression. After adjusting the study variables, the only variable that remained associated with difficult access was primary healthcare units in Salvador, Bahia State (PR = 0.75; 95%CI: 0.720-0.794) and in Recife, Pernambuco State (PR = 0.402; 95%CI: 0.318-0.508). The study concluded that decentralization of primary care can help improve access to health services. PMID:25715296

  15. A framework for improving access and customer service times in health care: application and analysis at the UCLA Medical Center.

    PubMed

    Duda, Catherine; Rajaram, Kumar; Barz, Christiane; Rosenthal, J Thomas

    2013-01-01

    There has been an increasing emphasis on health care efficiency and costs and on improving quality in health care settings such as hospitals or clinics. However, there has not been sufficient work on methods of improving access and customer service times in health care settings. The study develops a framework for improving access and customer service time for health care settings. In the framework, the operational concept of the bottleneck is synthesized with queuing theory to improve access and reduce customer service times without reduction in clinical quality. The framework is applied at the Ronald Reagan UCLA Medical Center to determine the drivers for access and customer service times and then provides guidelines on how to improve these drivers. Validation using simulation techniques shows significant potential for reducing customer service times and increasing access at this institution. Finally, the study provides several practice implications that could be used to improve access and customer service times without reduction in clinical quality across a range of health care settings from large hospitals to small community clinics. PMID:23903937

  16. Improving Access to Mental Health Services for Racialized Immigrants, Refugees, and Non-Status People Living with HIV/AIDS.

    PubMed

    Chen, Y Y Brandon; Li, Alan Tai; Fung, Kenneth Po; Wong, Josephine Pui

    2015-05-01

    The demographic characteristics of people living with HIV/AIDS (PHAs) in Canada are increasingly diverse. Despite literature suggesting a potentially heightened mental health burden borne by racialized immigrant, refugee, and non-status PHAs (IRN-PHAs), researchers have hitherto paid insufficient attention to whether existing services adequately address this need and how services might be improved. Employing community-based research methodology involving PHAs from five ethnoracial groups in Toronto, Ontario, this study explored IRN-PHAs' mental health service-seeking behaviors, service utilization experiences, and suggestions for service improvements. Results showed that while most IRN-PHAs were proactive in improving their mental health, their attempts to obtain support were commonly undermined by service provider mistreatment, unavailability of appropriate services, and multiple access barriers. A three-pronged approach involving IRN-PHA empowerment, anti-stigma and cultural competence promotion, and greater service integration is proposed for improving IRN-PHAs' mental health service experience. PMID:25913347

  17. Support networks and people with physical disabilities: social inclusion and access to health services.

    PubMed

    Holanda, Cristina Marques de Almeida; De Andrade, Fabienne Louise Juvêncio Paes; Bezerra, Maria Aparecida; Nascimento, João Paulo da Silva; Neves, Robson da Fonseca; Alves, Simone Bezerra; Ribeiro, Kátia Suely Queiroz Silva

    2015-01-01

    This study seeks to identify the formation of social support networks of people with physical disabilities, and how these networks can help facilitate access to health services and promote social inclusion. It is a cross-sectional study, with data collected via a form applied to physically disabled persons over eighteen years of age registered with the Family Health Teams of the municipal district of João Pessoa in the state of Paraíba. It was observed that the support networks of these individuals predominantly consist of family members (parents, siblings, children, spouses) and people outside the family (friends and neighbors). However, 50% of the interviewees declared that they could not count on any support from outside the family. It was observed that the support network contributes to access to the services and participation in social groups. However, reduced social inclusion was detected, due to locomotion difficulties, this being the main barrier to social interaction. Among those individuals who began to interact in society, the part played by social support was fundamental. PMID:25650611

  18. [The social value of teeth and access to dental health services].

    PubMed

    Fonseca, Luciara Leão Viana; Nehmy, Rosa Maria Quadros; Mota, Joaquim Antônio César

    2015-10-01

    Oral healthcare provided by the Unified Health System (SUS) faces the challenge of attending the epidemiological profile of Brazil's adult population. Qualitative research using semi-structured interviews was conducted to understand the experiences, expectations and perception of SUS users to services in Diamantina, State of Minas Gerais, and content analysis was used to assess the data. Discussion of the results was based on dialogue between the symbolic interactionism of Goffman and Bourdieu's concept of habitus. The results show that the users did not give importance to dental care during childhood and adolescence because care was unknown to them. There was no offer of treatment besides dental extraction. Today, they value teeth and suffer the embarrassment caused by rotten teeth. However, access to dental restoration via SUS is not possible. For their children, they perceive better access to information and care, but for specialized procedures there are barriers. They express resignation both in relation to the poor state of the teeth and the difficulties of access to dental care, which can be understood by the constant exclusion experienced by them in the past, shaping their actions in the present. It was concluded that oral health in SUS should incorporate the social value and the aesthetic dimension of teeth as a social right. PMID:26465855

  19. Undocumented Migrants in Canada: A scope literature review on health, access to services, and working conditions

    PubMed Central

    Carrasco, Christine; Gastaldo, Denise

    2011-01-01

    It is estimated that there are 30 to 40 million undocumented workers worldwide. Although undocumented migration has become an issue of high international relevance, it has been strikingly understudied in Canada, especially with respect to its impact on health. The purpose of this study is to explore the concept of undocumentedness in Canada through a scoping review of peer-reviewed and grey literature written in English, French, Portuguese and Spanish between 2002 and 2008. The specific aims are to: i) summarize and disseminate current academic and community-based findings on the health, service access and working conditions of undocumented migrants in Canada; ii) examine the sources and use of evidence; iii) identify significant gaps in existing knowledge; iv) set recommendations for policy and research, including considerations on transnationalism, ethics, interdisciplinary approaches, gender differences, resilience, and impact on the children of non-status parents. PMID:19657739

  20. Changing access to mental health care and social support when people living with HIV/AIDS become service providers.

    PubMed

    Li, Alan Tai-Wai; Wales, Joshua; Wong, Josephine Pui-Hing; Owino, Maureen; Perreault, Yvette; Miao, Andrew; Maseko, Precious; Guiang, Charlie

    2015-01-01

    As people living with HIV/AIDS (PHAs) achieve more stable health, many have taken on active peer support and professional roles within AIDS service organizations. Although the increased engagement has been associated with many improved health outcomes, emerging program and research evidence have identified new challenges associated with such transition. This paper reports on the results of a qualitative interpretive study that explored the effect of this role transition on PHA service providers' access to mental health support and self care. A total of 27 PHA service providers of diverse ethno-racial backgrounds took part in the study. Results show that while role transition often improves access to financial and health-care benefits, it also leads to new stress from workload demands, emotional triggers from client's narratives, feeling of burnout from over-immersion in HIV at both personal and professional levels, and diminished self care. Barriers to seeking support included: concerns regarding confidentiality; self-imposed and enacted stigma associated with accessing mental health services; and boundary issues resulting from changes in relationships with peers and other service providers. Evolving support mechanisms included: new formal and informal peer support networks amongst colleagues or other PHA service providers to address both personal and professional challenges, and having access to professional support offered through the workplace. The findings suggest the need for increased organizational recognition of HIV support work as a form of emotional labor that places complex demands on PHA service providers. Increased access to employer-provided mental health services, supportive workplace policies, and adequate job-specific training will contribute to reduced work-related stress. Community level strategies that support expansion of social networks amongst PHA service providers would reduce isolation. Systemic policies to increase access to insurance

  1. Equity of access to and utilization of reproductive health services in Thailand: national Reproductive Health Survey data, 2006 and 2009.

    PubMed

    Kongsri, Suratchada; Limwattananon, Supon; Sirilak, Supakit; Prakongsai, Phusit; Tangcharoensathien, Viroj

    2011-05-01

    This study assessed trends in equity of access to reproductive health services and service utilization in terms of coverage of family planning, antenatal care and skilled birth attendance in Thailand. Two health indicators were measured: the prevalence of low birthweight and exclusive breastfeeding. Equity was measured against the combined urban-rural areas and geographic regions, women's education level and quintiles of household assets index. The study used data from two nationally representative household surveys, the 2006 and 2009 Reproductive Health Surveys. Very high coverage of family planning (79.6%), universal antenatal care (98.9%) and skilled birth attendance (99.7%), with very small socioeconomic and geographic disparities, were observed. The public sector played a dominant role in maternity care (90.9% of all deliveries in 2009). The private sector also had a role among the higher educated, wealthier women living in urban areas. Public sector facilities, followed by drug stores, were a major supplier of contraception, which had a high use rate. High coverage and low inequity were the result of extensive investment in the health system by successive governments, in particular primary health care at district and sub-district levels, reaching universality by 2002. While maintaining these achievements, methodological improvements in measuring low birthweight and exclusive breastfeeding for future reproductive health surveys are recommended. PMID:21555089

  2. Neighbourhood Deprivation, Health Inequalities and Service Access by Adults with Intellectual Disabilities: A Cross-Sectional Study

    ERIC Educational Resources Information Center

    Cooper, S. A.; McConnachie, A.; Allan, L. M.; Melville, C.; Smiley, E.; Morrison, J.

    2011-01-01

    Background: Adults with intellectual disabilities (IDs) experience health inequalities and are more likely to live in deprived areas. The aim of this study was to determine whether the extent of deprivation of the area a person lives in affects their access to services, hence contributing to health inequalities. Method: A cross-sectional study…

  3. North Carolina physician-based preventive oral health services improve access and use among young Medicaid enrollees.

    PubMed

    Kranz, Ashley M; Lee, Jessica; Divaris, Kimon; Baker, A Diane; Vann, William

    2014-12-01

    To combat disparities in oral health and access to dental care among infants and toddlers, most state Medicaid programs now reimburse physician-based preventive oral health services such as fluoride varnish applications. We used geospatial data to examine the distribution of dental and medical Medicaid providers of pediatric oral health services throughout North Carolina to determine if these services have improved access to care for Medicaid enrollees younger than age three. We then used claims data to examine the association between distance from these practices and use of dental services for a cohort of approximately 1,000 young children. Among one hundred counties, four counties had no physician-based preventive oral health services, and nine counties had no dental practice. While children who lived farther from the nearest dental practice were less likely to make dental visits, distance from physician-based preventive oral health services did not predict utilization. For young Medicaid enrollees, oral health services provided in medical offices can improve access and increase utilization. PMID:25489032

  4. North Carolina Physician-Based Preventive Oral Health Services Improve Access And Use Among Young Medicaid Enrollees

    PubMed Central

    Kranz, Ashley; Lee, Jessica; Divaris, Kimon; Baker, Diane; Vann, William Felix

    2015-01-01

    To combat disparities in oral health and access to dental care among infants and toddlers, most state Medicaid programs now reimburse physician-based preventive oral health services, such as fluoride varnish applications. We used geospatial data to examine the distribution of dental and medical Medicaid providers of pediatric oral health services throughout North Carolina to determine if these services have improved access to care for Medicaid enrollees younger than three years old. We then used claims data to examine the association between distance from these practices and use of dental services for a cohort of approximately 1,000 young children. Among 100 counties, four counties had no physician-based preventive oral health services and nine counties had no dental practice. While children who lived further from the nearest dental practice were less likely to make dental visits, distance from physician-based preventive oral health services did not predict use. For young Medicaid enrollees, oral health services provided in medical offices can improve access and increase use. PMID:25489032

  5. Priorities and realities: addressing the rich-poor gaps in health status and service access in Indonesia

    PubMed Central

    2011-01-01

    Introduction Over the past four decades, the Indonesian health care system has greatly expanded and the health of Indonesian people has improved although the rich-poor gap in health status and service access remains an issue. The government has been trying to address these gaps and intensify efforts to improve the health of the poor following the economic crisis in 1998. Methods This paper examines trends and levels in socio-economic inequity of health and identifies critical factors constraining efforts to improve the health of the poor. Quantitative data were taken from the Indonesian Demographic Health Surveys and the National Socio-Economic Surveys, and qualitative data were obtained from interviews with individuals and groups representing relevant stakeholders. Results The health of the population has improved as indicated by child mortality decline and the increase in community access to health services. However, the continuing prevalence of malnourished children and the persisting socio-economic inequity of health suggest that efforts to improve the health of the poor have not yet been effective. Factors identified at institution and policy levels that have constrained improvements in health care access and outcomes for the poor include: the high cost of electing formal governance leaders; confused leadership roles in the health sector; lack of health inequity indicators; the generally weak capacity in the health care system, especially in planning and budgeting; and the leakage and limited coverage of programs for the poor. Conclusions Despite the government's efforts to improve the health of the poor, the rich-poor gap in health status and service access continues. Factors at institutional and policy levels are critical in contributing to the lack of efficiency and effectiveness for health programs that address the poor. PMID:22067727

  6. Advancing Migrant Access to Health Services in Europe (AMASE): Protocol for a Cross-sectional Study

    PubMed Central

    Álvarez-del Arco, Débora; Monge, Susana; Copas, Andrew J; Gennotte, Anne-Francoise; Volny-Anne, Alain; Göpel, Siri; Touloumi, Giota; Prins, Maria; Barros, Henrique; Staehelin, Cornelia; del Amo, Julia; Burns, Fiona M

    2016-01-01

    Background Migrants form a substantial proportion of the population affected by the human immunodeficiency virus (HIV) epidemic in Europe, yet HIV prevention for this population is hindered by poor understanding of access to care and of postmigration transmission dynamics. Objective We present the design and methods of the advancing Migrant Access to health Services in Europe (aMASE) study, the first European cross-cultural study focused on multiple migrant populations. It aims to identify the structural, cultural, and financial barriers to HIV prevention, diagnosis, and treatment and to determine the likely country of HIV acquisition in HIV-positive migrant populations. Methods We delivered 2 cross-sectional electronic surveys across 10 countries (Belgium, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain, Switzerland, and United Kingdom). A clinic survey aimed to recruit up to 2000 HIV-positive patients from 57 HIV clinics in 9 countries. A unique study number linked anonymized questionnaire data to clinical records data (viral loads, CD4 cell counts, viral clades, etc). This questionnaire was developed by expert panel consensus and cognitively tested, and a pilot study was carried out in 2 countries. A Web-based community survey (n=1000) reached those living with HIV but not currently accessing HIV clinics, as well as HIV-negative migrants. It was developed in close collaboration with a community advisory group (CAG) made up of representatives from community organizations in 9 of the participating countries. The CAG played a key role in data collection by promoting the survey to higher-risk migrant groups (sub-Saharan Africans, Latin Americans, men who have sex with men, and people who inject drugs). The questionnaires have considerable content overlap, allowing for comparison. Questions cover ethnicity, migration, immigration status, HIV testing and treatment, health-seeking behavior, sexual risk, and drug use. The electronic questionnaires

  7. Disparities in access to preventive health care services among insured children in a cross sectional study

    PubMed Central

    King, Christian

    2016-01-01

    Abstract Children with insurance have better access to care and health outcomes if their parents also have insurance. However, little is known about whether the type of parental insurance matters. This study attempts to determine whether the type of parental insurance affects the access to health care services of children. I used data from the 2009–2013 Medical Expenditure Panel Survey and estimated multivariate logistic regressions (N = 26,152). I estimated how family insurance coverage affects the probability that children have a usual source of care, well-child visits in the past year, unmet medical and prescription needs, less than 1 dental visit per year, and unmet dental needs. Children in families with mixed insurance (child publicly insured and parent privately insured) were less likely to have a well-child visit than children in privately insured families (odds ratio = 0.86, 95% confidence interval 0.76–0.98). When restricting the sample to publicly insured children, children with privately insured parents were less likely to have a well-child visit (odds ratio = 0.82, 95% confidence interval 0.73–0.92), less likely to have a usual source of care (odds ratio = 0.79, 95% confidence interval 0.67–0.94), and more likely to have unmet dental needs (odds ratio = 1.68, 95% confidence interval 1.10–2.58). Children in families with mixed insurance tend to fare poorly compared to children in publicly insured families. This may indicate that children in these families may be underinsured. Expanding parental eligibility for public insurance or subsidizing private insurance for children would potentially improve their access to preventive care. PMID:27428239

  8. Patients’ online access to their electronic health records and linked online services: a systematic review in primary care

    PubMed Central

    Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

    2015-01-01

    Background Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. Aim To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. Design and setting A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Method Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King’s Fund, Nuffield Health, PsycINFO, OpenGrey (1999–2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. Results A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. Conclusion While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of

  9. [The influence of the type of insurance access on health and of education on health services utilization patterns].

    PubMed

    Rodríguez, Marisol; Stoyanova, Alexandrina

    2004-05-01

    This study analyses the utilisation of health services by gender, type of insurance access and the level of education. Descriptive and logistic regression analysis of the National Health Interview Survey, 1997, confirms that women go more often to the doctor than men. Differences are greater in the case of general practitioners (versus specialists) and public doctors (versus private). However, there are hardly any differences in hospitalisations and emergency visits. Having private access has no impact on hospitalisations, emergency visits or the probability of a visit (except for women), but it increases the probability of visits to specialists (mainly among women) and to private doctors (especially among men), confirming the existence of gender differences in the impact of this variable. In fact, the utilisation patterns by men and women with only public access resemble each other more than those of men and women with only private or dual coverage. Education is to a certain extent inversely related to the probability of a medical visit, visits to a GP and hospitalisations, but directly related to the utilisation of specialists and private doctors. Here, there are also gender disparities: differences in utilisation by educational level are more prominent among men. PMID:15171865

  10. Reproductive rights denied: the Hyde Amendment and access to abortion for Native American women using Indian health service facilities.

    PubMed

    Arnold, Shaye Beverly

    2014-10-01

    Restrictions on the use of federal funds to provide abortions have limited the access to abortion services for Native American women receiving care at Indian Health Service facilities. Current data suggest that the vast majority of Indian Health Service facilities are unequipped to provide abortions under any circumstances. Native American women experience disproportionately high rates of sexual assault and unintended pregnancy. Hyde Amendment restrictions systematically infringe on the reproductive rights of Native American women and present a pressing public health policy concern. PMID:25122025

  11. Hypertension Detection, Management, Control and Associated Factors Among Residents Accessing Community Health Services In Beijing

    PubMed Central

    JIANG, Bin; LIU, Hongmei; RU, Xiaojuan; ZHANG, Hui; WU, Shengping; WANG, Wenzhi

    2014-01-01

    The aim of this study was to analyse high blood pressure detection, management, control and associated factors among residents accessing community health services (CHSs) in Beijing. We screened for HBP in 9524 individuals aged 50 years or older who accessed care in four Beijing CHSs. Among the 9397 residents with questionnaire responses that qualified them for inclusion in the study, 5029 patients with HBP were identified, 1510 (i.e., 30% of the HBP patient group) of whom were newly identified cases. The rate of hypertension detection was 53.5%. Among the 5029 HBP patients, the rates of awareness, treatment and control of hypertension were 70.0%, 62.1% and 29.6%, respectively. In general, the rate of hypertension control was higher when the rates of hypertension awareness and treatment were higher in subgroups stratified by different sociodemographic and risk factors, except for the overweight and obesity subgroups. In conclusion, suboptimal HBP awareness, treatment, and control are still major problems confronting CHSs in Beijing. Control of hypertension in the population may be improved by increasing awareness and improving the treatment of hypertension in CHSs. PMID:24784167

  12. 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. PMID:25102218

  13. Adolescent Substance Abuse and Mental Health: Problem Co-Occurrence and Access to Services

    ERIC Educational Resources Information Center

    Winstanley, Erin L.; Steinwachs, Donald M.; Stitzer, Maxine L.; Fishman, Marc J.

    2012-01-01

    The purpose of this study is to identify factors associated with adolescent alcohol or drug (AOD) abuse/dependence, mental health and co-occurring problems, as well as factors associated with access to treatment. This is a secondary analysis of data from the National Survey on Drug Use and Health (NSDUH) 2000. The 12-month prevalence rate of…

  14. Overcoming access barriers to health services through membership-based microfinance organizations: a review of evidence from South Asia

    PubMed Central

    Saha, Somen; Annear, Peter Leslie

    2015-01-01

    It is a challenge for the poor to overcome the barriers to accessing health services. Membership-based microfinance with associated health programmes can improve health outcomes for the poor. This study reviewed the evidence published between 1993 and 2013 on the role of membership-based microfinance with associated health programmes in improving health outcomes for the poor in South Asia. A total of 661 papers were identified and 26 selected for inclusion, based on the relevance and rigour of the research methods. Of these 26, five were evidence reviews. Of the remaining 21 papers, 12 were from India, seven from Bangladesh, and one each from Sri Lanka and Indonesia. Three papers addressed more than one theme. Five key themes emerged from the review: (i) the impact of microfinance programmes on the social and economic situation of the poor; (ii) the impact of microfinance programmes on community health; (iii) the impact of integrated microfinance health programmes on raising client awareness; (iv) the impact of integrated microfinance health programmes on financing health care; and (v) the impact of integrated microfinance health programmes on affordable health-care products and services. The review provides new evidence on the pathways through which microfinance helps to improve population health and value for money for such programmes. Among countries with large populations in the informal sector, there is a strong case for policy-makers to support these groups in providing access to life-saving health care among the poor. PMID:25685728

  15. Living conditions and access to health services by Bolivian immigrants in the city of São Paulo, Brazil.

    PubMed

    Silveira, Cássio; Carneiro Junior, Nivaldo; Ribeiro, Manoel Carlos Sampaio de Almeida; Barata, Rita de Cássia Barradas

    2013-10-01

    Bolivian immigrants in Brazil experience serious social problems: precarious work conditions, lack of documents and insufficient access to health services. The study aimed to investigate inequalities in living conditions and access to health services among Bolivian immigrants living in the central area of São Paulo, Brazil, using a cross-sectional design and semi-structured interviews with 183 adults. According to the data, the immigrants tend to remain in Brazil, thus resulting in an aging process in the group. Per capita income increases the longer the immigrants stay in the country. The majority have secondary schooling. Work status does not vary according to time since arrival in Brazil. The immigrants work and live in garment sweatshops and speak their original languages. Social networks are based on ties with family and friends. Access to health services shows increasing inclusion in primary care. The authors conclude that the immigrants' social exclusion is decreasing due to greater access to documentation, work (although precarious), and the supply of health services from the public primary care system. PMID:24127096

  16. Access the Unified Health System actions and services from the perspective of judicialization1

    PubMed Central

    Ramos, Raquel de Souza; Gomes, Antonio Marcos Tosoli; de Oliveira, Denize Cristina; Marques, Sergio Corrêa; Spindola, Thelma; Nogueira, Virginia Paiva Figueiredo

    2016-01-01

    Objective: the judicialization of health is incorporated into the daily work of health institutions in Brazil through the court orders for access. In this study, the objective was to describe the contents of the social representations of access, through judicialization, for the health professionals. Method: qualitative study based on Social Representations Theory, involving 40 professionals, at a teaching hospital and at the center for the regulation of beds and procedures in Rio de Janeiro. Forty semistructured interviews were held, to which the thematic-categorical content analysis technique was applied. Results: the health professionals' attitude towards the reality the judicialization imposes is negative, but they acknowledge this resource as necessary in view of the public health crisis. Judicialization is considered a strategy to exercise citizenship that superimposes individual on collective law, increases social inequalities in access and compromises the efficacy of health policies. Conclusion: considering social representation as a determinant of practices, the representations that emerged can contribute to the change of the professionals' practices. Improvements in user care should be promoted, characterized as one of the main challenges to advance in universal access to health. PMID:27143542

  17. Health systems and access to antiretroviral drugs for HIV in Southern Africa: service delivery and human resources challenges.

    PubMed

    Schneider, Helen; Blaauw, Duane; Gilson, Lucy; Chabikuli, Nzapfurundi; Goudge, Jane

    2006-05-01

    Without strengthened health systems, significant access to antiretroviral (ARV) therapy in many developing countries is unlikely to be achieved. This paper reflects on systemic challenges to scaling up ARV access in countries with both massive epidemics and weak health systems. It draws on the authors' experience in southern Africa and the World Health Organization's framework on health system performance. Whilst acknowledging the still significant gap in financing, the paper focuses on the challenges of reorienting service delivery towards chronic disease care and the human resource crisis in health systems. Inadequate supply, poor distribution, low remuneration and accelerated migration of skilled health workers are increasingly regarded as key systems constraints to scaling up of HIV treatment. Problems, however, go beyond the issue of numbers to include productivity and cultures of service delivery. As more countries receive funds for antiretroviral access programmes, strong national stewardship of these programmes becomes increasingly necessary. The paper proposes a set of short- and long-term stewardship tasks, which include resisting the verticalisation of HIV treatment, the evaluation of community health workers and their potential role in HIV treatment access, international action on the brain drain, and greater investment in national human resource functions of planning, production, remuneration and management. PMID:16713875

  18. The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa

    PubMed Central

    Visagie, Surona; Schneider, Marguerite

    2015-01-01

    Background Health care access is complex and multi-faceted and, as a basic right, equitable access and services should be available to all user groups. Objectives The aim of this article is to explore how service delivery impacts on access to healthcare for vulnerable groups in an urban primary health care setting in South Africa. Methods A descriptive qualitative study design was used. Data were collected through semi-structured interviews with purposively sampled participants and analysed through thematic content analysis. Results Service delivery factors are presented against five dimensions of access according to the ACCESS Framework. From a supplier perspective, the organisation of care in the study setting resulted in available, accessible, affordable and adequate services as measured against the District Health System policies and guidelines. However, service providers experienced significant barriers in provision of services, which impacted on the quality of care, resulting in poor client and provider satisfaction and ultimately compromising acceptability of service delivery. Although users found services to be accessible, the organisation of services presented them with challenges in the domains of availability, affordability and adequacy, resulting in unmet needs, low levels of satisfaction and loss of trust. These challenges fuelled perceptions of unacceptable services. Conclusion Well developed systems and organisation of services can create accessible, affordable and available primary healthcare services, but do not automatically translate into adequate and acceptable services. Focussing attention on how services are delivered might restore the balance between supply (services) and demand (user needs) and promote universal and equitable access. PMID:26245611

  19. Social Capital, Acculturation, Mental Health, and Perceived Access to Services among Mexican American Women

    ERIC Educational Resources Information Center

    Valencia-Garcia, Dellanira; Simoni, Jane M.; Alegria, Margarita; Takeuchi, David T.

    2012-01-01

    Objective: We examined whether individual-level social capital--the intangible resources in a community available through membership in social networks or other social structures and perceived trust in the community--was associated with acculturation, depression and anxiety symptoms, and perceived access to services among women of Mexican…

  20. The Social Implications of Health Care Reform: Reducing Access Barriers to Health Care Services for Uninsured Hispanic and Latino Americans in the United States

    ERIC Educational Resources Information Center

    Kaplan, Mitchell A.; Inguanzo, Marian M.

    2011-01-01

    The U.S. health care system is currently facing one of its most significant social challenges in decades in terms of its ability to provide access to primary care services to the millions of Americans who have lost their health insurance coverage in the recent economic recession. National statistics compiled by the U.S. Census Bureau for 2009…

  1. Health services access and use among older adults in North Carolina: urban vs rural residents.

    PubMed Central

    Blazer, D G; Landerman, L R; Fillenbaum, G; Horner, R

    1995-01-01

    OBJECTIVES. This study compared health service use and satisfaction with health care among older adults living in urban vs rural counties in North Carolina. METHODS. A stratified random sample of 4162 residents of one urban and four rural counties of North Carolina was surveyed to determine urban/rural variation in inpatient and outpatient health service use, continuity of care and satisfaction with care, and barriers (transportation, cost) to care. RESULTS. Inpatient and outpatient service use did not vary by residence in controlled analyses. Continuity of care was more frequent in rural counties. Transportation was not perceived as a barrier to health care more frequently in rural than in urban counties, but cost was a greater barrier to care among rural elderly people. CONCLUSIONS. In this sample, older persons living in rural counties within reasonable driving distance of urban counties with major medical centers used health services as frequently and were as satisfied with their health care as persons in urban counties. Cost of care, however, was a significant and persistent barrier among rural elderly people, despite Medicare coverage. PMID:7573622

  2. Availability and Accessibility of Student-Specific Weight Loss Programs and Other Risk Prevention Health Services on College Campuses

    PubMed Central

    Hayes, Sharon; Napolitano, Melissa; Hufnagel, Katrina

    2016-01-01

    Background More than one third of college students who are overweight or obese are in need of weight loss programs tailored to college students. However, the availability and accessibility of these programs is unknown. Objective The aim of this study is to examine the availability and ease of access to weight loss programs for students at 10 universities with the largest undergraduate enrollment. Methods The 10 public universities with the largest student bodies with a mean (SD) undergraduate enrollment of 41,122 (7657) students were examined. The websites of the universities were assessed to determine the availability of weight loss programs. Services for high-risk health needs common to university campuses (ie, alcohol and other drugs, victim services, sexual health, and eating disorders) were searched. Results Of the universities searched, 3 (30%, 3/10) offered weight loss programming, however, none met the predetermined criteria. Comparatively, all schools (100%, 10/10) offered no-cost and continual enrollment programming for the other high-risk health needs. Conclusions There are limited weight loss services available to undergraduate students compared with other university services. Collaboration between existing college health service providers is suggested for the delivery of appropriate programming for overweight and obese undergraduates wanting to lose weight. PMID:27278261

  3. Access to and use of sexual health care services among young Canadians with and without a history of sexual coercion

    PubMed Central

    O’Sullivan, Lucia F.; Sandra Byers, E.; Brotto, Lori A.; Majerovich, Jo Ann

    2015-01-01

    Objective To determine access to and use of sexual health care services among adolescents and young adults with and without a history of sexual coercion, and to examine whether a history of sexual coercion was a barrier to using sexual health care services. Design Online survey. Setting Canada. Participants A total of 405 adolescents and young adults aged 16 to 21. Main outcome measures Participants’ sexual histories, sexual coercion histories, current psychological functioning, and perceptions and use of health care services. Results A history of sexual coercion was reported by 29.6% of participants; more female participants reported a history of sexual coercion than male participants did, and female participants reported more related distress than male participants did. Those with a history of sexual coercion reported more sexual health–related visits than those without a history of sexual coercion did. Among participants with and without sexual coercion histories, there were no differences in difficulty accessing care, perceived quality of care, or rates of unmet health needs. Among those who reported a history of sexual coercion, the odds of having a sexual health–related visit increased for those who had had a routine checkup in the previous year (odds ratio = 8.29) and those who believed it was not difficult to access care (odds ratio = 1.74). Conclusion Having a history of sexual coercion was not a barrier to the use of health care services among adolescents and young adults. In fact, rates of health care service use were higher among those with a history of sexual coercion than those without such a history. PMID:26759846

  4. The social determinants of health and health service access: an in depth study in four poor communities in Phnom Penh Cambodia

    PubMed Central

    2012-01-01

    Background Increasing urbanization and population density, and persisting inequities in health outcomes across socioeconomic groupings have raised concerns internationally regarding the health of the urban poor. These concerns are also evident in Cambodia, which prompted the design of a study to identify and describe the main barriers to access to health services by the poor in the capital city, Phnom Penh. Sources and Methods Main sources of data were through a household survey, followed by in-depth qualitative interviews with mothers, local authorities and health centre workers in four very poor communities in Phnom Penh. Main findings Despite low incomes and education levels, the study communities have moderate levels of access to services for curative and preventive care. However, qualitative findings demonstrate that households contextualize poor health and health access in terms of their daily living conditions, particularly in relation to environmental conditions and social insecurity. The interactions of low education, poor living conditions and high food costs in the context of low and irregular incomes reinforce a pattern of “living from moment to moment” and results in a cycle of disadvantage and ill health in these communities. There were three main factors that put poor communities at a health disadvantage; these are the everyday living conditions of communities, social and economic inequality and the extent to which a society assesses and acts on inequities in their health care access. Conclusions In order to improve access to health and health services for the urban poor, expansion of public health functions and capacities will be required, including building partnerships between health providers, municipal authorities and civil society. PMID:22900888

  5. Unregulated access to health-care services is associated with overutilization—lessons from Austria

    PubMed Central

    Maier, Manfred

    2015-01-01

    The Austrian health-care system is characterized by free provider choice and uncontrolled access to all levels of care. Using primary data, the ECOHCARE study shows that hospitalization rates for the secondary and tertiary care levels in Austria are both 4.4 times higher than those reported from the USA using a similar methodology. At the same time, essential functions of the primary care sector are weak. We propose that regulating access to secondary and tertiary care and restricting free provider choice to the primary care level would both reverse over utilization and strengthen the primary care sector. PMID:25417940

  6. Community, service, and policy strategies to improve health care access in the changing urban environment.

    PubMed

    Andrulis, D P

    2000-06-01

    Urban communities continue to face formidable historic challenges to improving public health. However, reinvestment initiatives, changing demographics, and growth in urban areas are creating changes that offer new opportunities for improving health while requiring that health systems be adapted to residents' health needs. This commentary suggests that health care improvement in metropolitan areas will require setting local, state, and national agendas around 3 priorities. First, health care must reorient around powerful population dynamics, in particular, cultural diversity, growing numbers of elderly, those in welfare-workplace transition, and those unable to negotiate an increasingly complex health system. Second, communities and governments must assess the consequences of health professional shortages, safety net provider closures and conversions, and new marketplace pressures in terms of their effects on access to care for vulnerable urban populations; they must also weigh the potential value of emerging models for improving those populations' care. Finally, governments at all levels should use their influence through accreditation, standards, tobacco settlements, and other financing streams to educate and guide urban providers in directions that respond to urban communities' health care needs. PMID:10846501

  7. Poverty, food security and universal access to sexual and reproductive health services: a call for cross-movement advocacy against neoliberal globalisation.

    PubMed

    Sundari Ravindran, T K

    2014-05-01

    Universal access to sexual and reproductive health services is one of the goals of the International Conference on Population and Development of 1994. The Millennium Development Goals were intended above all to end poverty. Universal access to health and health services are among the goals being considered for the post-2015 agenda, replacing or augmenting the MDGs. Yet we are not only far from reaching any of these goals but also appear to have lost our way somewhere along the line. Poverty and lack of food security have, through their multiple linkages to health and access to health care, deterred progress towards universal access to health services, including for sexual and reproductive health needs. A more insidious influence is neoliberal globalisation. This paper describes neoliberal globalisation and the economic policies it has engendered, the ways in which it influences poverty and food security, and the often unequal impact it has had on women as compared to men. It explores the effects of neoliberal economic policies on health, health systems, and universal access to health care services, and the implications for access to sexual and reproductive health. To be an advocate for universal access to health and health care is to become an advocate against neoliberal globalisation. PMID:24908453

  8. Ethnic minority, young onset, rare dementia type, depression: A case study of a Muslim male accessing UK dementia health and social care services.

    PubMed

    Regan, Jemma L

    2016-07-01

    A case study comprised of formal interviews, formal observations and informal discussions investigated the motivations and experiences accessing dementia care health and social care services for a Muslim, Pakistani male with dementia. Motivations derived from 'desperation' and an inability to access support from family or religious community. Experiences of accessing services were mostly negative. Dementia services were ill-informed about how to support persons with young onset dementia, with pre-existing mental health conditions, from an ethnic minority. Education and training to remove barriers to all dementia care services is required for persons with dementia, their families and within dementia services and religious communities. PMID:24858552

  9. [Health status and access to health services by the population of L'Aquila (Abruzzo Region, Italy) six years after the earthquake].

    PubMed

    Altobelli, Emma; Vittorini, Pierpaolo; Leuter, Cinzia; Bianchini, Valeria; Angelone, Anna Maria; Aloisio, Federica; Cofini, Vincenza; Zazzara, Francesca; Di Orio, Ferdinando

    2016-01-01

    Natural disasters, such as the earthquake that occurred in the province of L'Aquila in central Italy, in 2009, generally increase the demand for healthcare. A survey was conducted to assess perception of health status an d use of health services in a sample of L'Aquila's resident population, five years after the event, and in a comparison population consisting of a sample of the resident population of Avezzano, a town in the same region, not affected by the earthquake. No differences were found in perception of health status between the two populations. Both groups reported difficulties in accessing specialized healthcare and rehabilitation services. PMID:27077558

  10. Prevention of Health Problems among Gay and Lesbian Youth. Making Health and Human Services Accessible and Effective for Gay and Lesbian Youth.

    ERIC Educational Resources Information Center

    Massachusetts Governor's Commission on Gay and Lesbian Youth, Boston.

    This third report of the Massachusetts Governor's Commission on Gay and Lesbian Youth deals with problems faced by gay and lesbian youth as they attempt to access health and human services. To gather information, the Commission held five hearings across Massachusetts in the autumn of 1992. This report focuses on the testimony of gay and lesbian…

  11. Experiences of French Speaking Immigrants and Non-immigrants Accessing Health Care Services in a Large Canadian City

    PubMed Central

    Ngwakongnwi, Emmanuel; Hemmelgarn, Brenda R.; Musto, Richard; Quan, Hude; King-Shier, Kathryn M.

    2012-01-01

    French speakers residing in predominantly English-speaking communities have been linked to difficulties accessing health care. This study examined health care access experiences of immigrants and non-immigrants who self-identify as Francophone or French speakers in a mainly English speaking province of Canada. We used semi-structured interviews to gather opinions of recent users of physician and hospital services (N = 26). Language barriers and difficulties finding family doctors were experienced by both French speaking immigrants and non-immigrants alike. This was exacerbated by a general preference for health services in French and less interest in using language interpreters during a medical consultation. Some participants experienced emotional distress, were discontent with care received, often delayed seeking care due to language barriers. Recent immigrants identified lack of insurance coverage for drugs, transportation difficulties and limited knowledge of the healthcare system as major detractors to achieving health. This study provided the groundwork for future research on health issues of official language minorities in Canada. PMID:23202772

  12. eTriage--a novel, web-based triage and booking service: enabling timely access to sexual health clinics.

    PubMed

    Jones, R; Menon-Johansson, A; Waters, A M; Sullivan, A K

    2010-01-01

    In recent years, the sexual health of the nation has risen in profile. We face increasing demands and targets, in particular the 48-hour waiting time directive, and as a result clinic access has become a priority. eTriage is a novel, secure, web-based service designed specifically to increase access to our clinics. It has proved a popular booking method, providing access to 10% of all appointments across the Directorate within six months of introduction. KC60 analyses revealed that the majority of users (58%) underwent asymptomatic screening with the remainder having some degree of pathology. There was a greater percentage prevalence of human papilloma virus, chlamydia, non-specific urethritis, gonorrhoea, herpes and trichomonas in the eTriage population when compared with the general clinic population. A notes review illustrated a high degree of concordance between data entered on eTriage registration and clinical review (97%). A patient survey revealed high levels of patient satisfaction with the service. As an adjunct to our existing booking services, eTriage has served to increase patient choice and has proved itself to be a safe, efficient and effective means of improving patient access. PMID:19884355

  13. Trade in health services.

    PubMed Central

    Chanda, Rupa

    2002-01-01

    In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services. PMID:11953795

  14. Factors that influence the preventive care offered to adolescents accessing Public Oral Health Services, NSW, Australia

    PubMed Central

    Masoe, Angela V; Blinkhorn, Anthony S; Taylor, Jane; Blinkhorn, Fiona A

    2015-01-01

    Background Many adolescents are at risk of dental caries and periodontal disease, which may be controlled through health education and clinical preventive interventions provided by oral health and dental therapists (therapists). Senior clinicians (SCs) can influence the focus of dental care in the New South Wales (NSW) Public Oral Health Services as their role is to provide clinical support and advice to therapists, advocate for their communities, and inform Local Health District (LHD) managers of areas for clinical quality improvement. The objective of this study was to record facilitating factors and strategies that are used by SCs to encourage therapists to provide preventive care and advice to adolescent patients. Methods In-depth, semistructured interviews were undertaken with 16 SCs from all of the 15 NSW LHDs (nine rural and six metropolitan). A framework matrix was used to systematically code data and enable key themes to be identified for analysis. Results All SCs from the 15 NSW Health LHDs participated in the study. Factors influencing SCs’ ability to integrate preventive care into clinical practice were: 1) clinical leadership and administrative support, 2) professional support network, 3) clinical and educational resources, 4) the clinician’s patient management aptitude, and 5) clinical governance processes. Clinical quality improvement and continuing professional development strategies equipped clinicians to manage and enhance adolescents’ confidence toward self-care. Conclusion This study shows that SCs have a clear understanding of strategies to enhance the therapist’s offer of scientific-based preventive care to adolescents. The problem they face is that currently, success is measured in terms of relief of pain activities, restorations placed, and extraction of teeth, which is an outdated concept. However, to improve clinical models of care will require the overarching administrative authority, NSW Health, to accept that the scientific

  15. Accelerators/decelerators of achieving universal access to sexual and reproductive health services: a case study of Iranian health system

    PubMed Central

    2013-01-01

    Background At the 1994 International Conference on Population and Development (ICPD), held in Cairo, the global community agreed to the goal of achieving universal access to sexual and reproductive health (SRH) and rights by 2015. This research explores the accelerators and decelerators of achieving universal access to the sexual and reproductive health targets and accordingly makes some suggestions. Method We have critically reviewed the latest national reports and extracted the background data on each SRH indicator. The key stakeholders, both national and international, were visited and interviewed at two sites. A total of 55 in-depth interviews were conducted with religious leaders, policy-makers, senior managers, senior academics, and health care managers. Six focus-group discussions were also held among health care providers. The study was qualitative in nature. Results Obstacles on the road to achieving universal access to SRH can be viewed from two perspectives. One gap exists between current achievements and the targets. The other gap arises due to age, marital status, and residency status. The most recently observed trends in the indicators of the universal access to SRH shows that the achievements in the “unmet need for family planning” have been poor. Unmet need for family planning could directly be translated to unwanted pregnancies and unwanted childbirths; the former calls for sexual education to underserved people, including adolescents; and the latter calls for access to safe abortion. Local religious leaders have not actively attended international goal-setting programs. Therefore, they usually do not presume a positive attitude towards these goals. Such negative attitudes seem to be the most important factors hindering the progress towards universal access to SRH. Lack of international donors to fund for SRH programs is also another barrier. In national levels both state and the society are interactively playing their roles. We have used a

  16. Making sexual health more accessible.

    PubMed

    Hearton, Lynn

    2009-01-01

    Sexual health is the capacity and freedom to enjoy and express sexuality without fear of exploitation, oppression, physical or emotional harm. Sexual health needs are influenced by many factors including age, lifestyle, motivation, perception, culture and beliefs. Service providers need to understand the complexity of these influences to enable people to make informed choices. Assumptions about individuals and attempting to simplify their needs leads to services being delivered in a way which limits access and choice. The National Strategy for Sexual Health and HIV was launched in 2001 to bring about a new, consumer-oriented approach to sexual health services. The work of the UK sexual health charity fpa in providing accessible information is described. PMID:20120881

  17. Mental Health Need and Access to Mental Health Services by Youths Involved with Child Welfare: A National Survey.

    ERIC Educational Resources Information Center

    Burns, Barbara J.; Phillips, Susan D.; Wagner, H. Ryan; Barth, Richard P.; Kolko, David J.; Campbell, Yvonne; Landsverk, John

    2004-01-01

    Objective: This study assessed the relationship between the need for and use of mental health services among a nationally representative sample of children who were investigated by child welfare agencies after reported maltreatment. Method: Data were collected at study entry into the National Survey of Child and Adolescent Well-Being and were…

  18. Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health

    PubMed Central

    2013-01-01

    Background The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs. This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. Methods We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. Results We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. Conclusions The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also

  19. A nutrition strategy to reduce the burden of diet related disease: access to dietician services must complement population health approaches.

    PubMed

    Segal, Leonie; Opie, Rachelle S

    2015-01-01

    Poor diet quality is implicated in almost every disease and health issue. And yet, in most advanced market economies diet quality is poor, with a minority meeting guidelines for healthy eating. Poor diet is thus responsible for substantial disease burden. Societies have at their disposal a range of strategies to influence diet behaviors. These can be classified into: (i) population level socio-educational approaches to enhance diet knowledge; (ii) pricing incentives (subsidies on healthy foods, punitive taxes on unhealthy foods); (iii) regulations to modify the food environment, and (iv) the provision of clinical dietetic services. There is little evidence that societies are active in implementing the available strategies. Advertising of "junk foods" is largely unchecked, contrasting with strict controls on advertising tobacco products, which also attract punitive taxes. Access to dieticians is restricted in most countries, even in the context of universal health care. In Australia in 2011 there were just 2,969 practicing dieticians/nutritionists or 1.3 clinicians per 10,000 persons, compared with 5.8 physiotherapists per 10,000 persons, 14.8 general practitioners (family physicians) per 10,000 persons or 75 nurses per 10,000 persons. It is time to implement comprehensive national nutrition strategies capable of effecting change. Such strategies need to be multi-component, incorporating both public health approaches and expanded publicly funded dietetic services. Access to individualized dietetic services is needed by those at risk, or with current chronic conditions, given the complexity of the diet message, the need for professional support for behavior change and to reflect individual circumstances. The adoption of a comprehensive nutrition strategy offers the promise of substantial improvement in diet quality, better health and wellbeing and lower health care costs. PMID:26321951

  20. A nutrition strategy to reduce the burden of diet related disease: access to dietician services must complement population health approaches

    PubMed Central

    Segal, Leonie; Opie, Rachelle S.

    2015-01-01

    Poor diet quality is implicated in almost every disease and health issue. And yet, in most advanced market economies diet quality is poor, with a minority meeting guidelines for healthy eating. Poor diet is thus responsible for substantial disease burden. Societies have at their disposal a range of strategies to influence diet behaviors. These can be classified into: (i) population level socio-educational approaches to enhance diet knowledge; (ii) pricing incentives (subsidies on healthy foods, punitive taxes on unhealthy foods); (iii) regulations to modify the food environment, and (iv) the provision of clinical dietetic services. There is little evidence that societies are active in implementing the available strategies. Advertising of “junk foods” is largely unchecked, contrasting with strict controls on advertising tobacco products, which also attract punitive taxes. Access to dieticians is restricted in most countries, even in the context of universal health care. In Australia in 2011 there were just 2,969 practicing dieticians/nutritionists or 1.3 clinicians per 10,000 persons, compared with 5.8 physiotherapists per 10,000 persons, 14.8 general practitioners (family physicians) per 10,000 persons or 75 nurses per 10,000 persons. It is time to implement comprehensive national nutrition strategies capable of effecting change. Such strategies need to be multi-component, incorporating both public health approaches and expanded publicly funded dietetic services. Access to individualized dietetic services is needed by those at risk, or with current chronic conditions, given the complexity of the diet message, the need for professional support for behavior change and to reflect individual circumstances. The adoption of a comprehensive nutrition strategy offers the promise of substantial improvement in diet quality, better health and wellbeing and lower health care costs. PMID:26321951

  1. Does the company's economic performance affect access to occupational health services?

    PubMed Central

    Kankaanpää, Eila; Suhonen, Aki; Valtonen, Hannu

    2009-01-01

    Background In Finland like in many other countries, employers are legally obliged to organize occupational health services (OHS) for their employees. Because employers bear the costs of OHS it could be that in spite of the legal requirement OHS expenditure is more determined by economic performance of the company than by law. Therefore, we explored whether economic performance was associated with the companies' expenditure on occupational health services. Methods We used a prospective design to predict expenditure on OHS in 2001 by a company's economic performance in 1999. Data were provided by Statistics Finland and expressed by key indicators for profitability, solidity and liquidity and by the Social Insurance Institution as employers' reimbursement applications for OHS costs. The data could be linked at the company level. Regression analysis was used to study associations adjusted for various confounders. Results Nineteen percent of the companies (N = 6 155) did not apply for reimbursement of OHS costs in 2001. The profitability of the company represented by operating margin in 1999 and adjusted for type of industry was not significantly related to the company's probability to apply for reimbursement of the costs in 2001 (OR = 1.00, 95%CI: 0.99 to 1.01). Profitability measured as operating profit in 1999 and adjusted for type of industry was not significantly related to costs for curative medical services (Beta -0.001, 95%CI: -0.00 to 0.11) nor to OHS cost of prevention in 2001 (Beta -0.001, 95%CI: -0.00 to 0.00). Conclusion We did not find a relation between the company's economic performance and expenditure on OHS in Finland. We suppose that this is due to legislation obliging employers to provide OHS and the reimbursement system both being strong incentives for employers. PMID:19725952

  2. Access to health care services as a justiciable socio-economic right under the South African constitution.

    PubMed

    Ngwena, Charles

    2003-01-01

    This commentary describes and analyses the decision of the Constitutional Court of South Africa in Minister of Health and Others v Treatment Action Campaign and Others where the South African government was found to have violated the right of access to health care under the Constitution. Section 27(1) guarantees everyone the right of access to health care services. Section 27(2) imposes on the state a duty to take reasonable measures within its available resources to achieve the progressive realisation of this right. To the extent that government was unreasonably delaying access to patently affordable life-saving therapy for the prevention of mother-to-child transmission of HIV to a class of persons that was largely vulnerable and indigent, it is submitted that the case was correctly decided. However, there is little doubt that the decision, and in particular the prescriptive nature of the remedy granted by the Court and its budgetary implications, do no sit easily with a traditional notion of separation of powers between the judiciary on the one hand, and the executive and Parliament on the other. At the same time, it must be accepted that the remedy and its budgetary implications are an inevitable consequence of the inclusion of justiciable socio-economic rights in the Bill of Rights. The principles that were applied by the Court in determining the case were largely drawn from jurisprudence developed by organs under treaty bodies, and in particular the Committee on Economic, Social and Cultural Rights. PMID:14983892

  3. The Starting Early Starting Smart Integrated Services Model: Improving Access to Behavioral Health Services in the Pediatric Health Care Setting for At-Risk Families with Young Children

    ERIC Educational Resources Information Center

    Morrow, Connie E.; Mansoor, Elana; Hanson, K. Lori; Vogel, April L.; Rose-Jacobs, Ruth; Genatossio, Carolyn Seval; Windham, Amy; Bandstra, Emmalee S.

    2010-01-01

    We evaluated the Starting Early Starting Smart (SESS) national initiative to integrate behavioral health services (parenting, mental health, and drug treatment) into the pediatric health care setting for families with young children. Data are presented from five pediatric care (PC) sites, drawing from families at risk due to demographic and…

  4. Employers' role in helping Latino workers obtain access to health care services: results of a community-based pilot demonstration project.

    PubMed

    Dembe, Allard E; Biehl, Jeffrey M; Smith, Alicia D; Garcia de Gutierrez, Teresa

    2013-06-01

    A coalition of employers in the hotel and restaurant industries collaborated with community-based organizations to undertake a unique demonstration project, called the Employed Latino Health Initiative, aimed at improving access to basic health care services for low-wage Latino workers in Columbus, Ohio. With grant funding from the Robert Wood Johnson Foundation, the project developed and tested protocols allowing Latino workers from participating companies to obtain basic health care screenings, referrals to medical providers, health education training, and the services of a qualified community health navigator. Data from the pilot project indicated high screening participation rates, extensive referrals to providers for follow-up care, and a substantial need for facilitation services by community health navigators. The project provides a model for how employers can potentially promote their own interests in boosting work productivity through facilitating expanded access to basic medical services among vulnerable workers, despite the absence of conventional health insurance coverage. PMID:22610691

  5. Slums’ Access to and Coverage of Primary Health Care Services: A Cross-Sectional Study in Shiraz, a Metropolis in Southern Iran

    PubMed Central

    Joulaei, Hassan; Bhuiyan, Azad R; Sayadi, Mehrab; Morady, Fariba; Afsar Kazerooni, Parvin

    2014-01-01

    Background: The United Nations has predicted that the population of slum dwellers will have grown from one billion people worldwide to 2 billion by 2030. This trend is also predictable in Iran. In the Iranian metropolis of Shiraz, more than 10% of the residents live in slum areas. There are several problems regarding the delivery of social services in these areas. The aim of this study was to evaluate slums dwellers’ access to and coverage of health care. Methods: This cross-sectional face-to-face study included 380 household of slum dwellers via stratified random sampling. Demographics, accessibility of health services, coverage of health care, and route of receiving health services were recorded through interviews. Results: Approximately, 21.6% of the households had no physical access to health centers. The coverage rate of family planning programs for safe methods was 51.4% (95% CI: 48.86-53.9%). Vaccination coverage among children under 5 years old was 98% (95% CI: 97-99%). Furthermore, 34% of pregnant women had not received standard health care due to a lack of access to health centers. Conclusion: Limited access to health services along with inadequate knowledge of slum residents about health care facilities was the main barrier to the utilization of the health care in the slums. PMID:24753641

  6. The effect of Self-Help Groups on access to maternal health services: evidence from rural India

    PubMed Central

    2013-01-01

    Introduction The main challenge for achieving universal health coverage in India is ensuring effective coverage of poor and vulnerable communities in the face of high levels of income and gender inequity in access to health care. Drawing on the social capital generated through women’s participation in community organizations like SHGs can influence health outcomes. To date, evidence about the impact of SHGs on health outcomes has been derived from pilot-level interventions, some using randomised controlled trials and other rigorous methods. While the evidence from these studies is convincing, our study is the first to analyse the impact of SHGs at national level. Methods We analyzed the entire dataset from the third national District Level Household Survey from 601 districts in India to assess the impact of the presence of SHGs on maternal health service uptake. The primary predictor variable was presence of a SHG in the village. The outcome variables were: institutional delivery; feeding new-borns colostrum; knowledge about family planning methods; and ever used family planning. We controlled for respondent education, wealth, heard or seen health messages, availability of health facilities and the existence of a village health and sanitation committee. Results Stepwise logistic regression shows respondents from villages with a SHG were 19 per cent (OR: 1.19, CI: 1.13-1.24) more likely to have delivered in an institution, 8 per cent (OR: 1.08, CI: 1.05-1.14) more likely to have fed newborns colostrum, have knowledge (OR: 1.48, CI 1.39 – 1.57) and utilized (OR: 1.19, CI 1.11 – 1.27) family planning products and services. These results are significant after controlling for individual and village-level heterogeneities and are consistent with existing literature that the social capital generated through women’s participation in SHGs influences health outcome. Conclusion The study concludes that the presence of SHGs in a village is associated with higher

  7. Effect of the Implementation of the Family Physician Program 2015 on Fair Accessibility for People to Health Care Services in the Sistan Region.

    PubMed

    Sarani, Mohammad; Arbabisarjou, Azizollah; Saravani, Soleyman; Miri, Ali; Shahrakivahed, Aziz

    2016-01-01

    Equitable access to primary health care is an indispensable right and a basic need of all human beings. Currently, the development of any society is judged based on the level of public access to primary health care services. This comparative study attempted to examine the fairness accessibility of people in Sistan to health care services through Family Physician Program 2015.This was a descriptive, analytical research focusing on the level of equitable public access to primary health care in Sistan. Samples were taken from all the service-providing centers. Data were collected through HNIS software, network management center to analyze the gathered data. The results showed that prior to the implementation of the family doctor plan (before 2005), there was a doctor for every 9545 people, a midwife for every 10,000 people and one paramedic for 1,111 people. After beginning the family doctor plan, the figures showed that there was one doctor or MD for every 3387 people and one midwife for every 2916 people, and one health worker for every 549 rural residents. The implementation of the family physician program was an opportunity for the health system in Sistan region, where the appropriate resources management and equitable distribution of health care services throughout the region could facilitate accessibility to identical services. PMID:27357871

  8. 42 CFR 422.112 - Access to services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Access to services. 422.112 Section 422.112 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Benefits and Beneficiary Protections § 422.112 Access to services. (a) Rules for...

  9. Accessing Sexual and Reproductive Health Information and Services: A Mixed Methods Study of Young Women's Needs and Experiences in Soweto, South Africa.

    PubMed

    Lince-Deroche, Naomi; Hargey, Adila; Holt, Kelsey; Shochet, Tara

    2015-03-01

    Young women and girls in South Africa are at high risk of unintended pregnancy and HIV. Previous studies have reported barriers to contraceptive and other sexual and reproductive health (SRH) services among young women in this context. We aimed to assess young women's SRH knowledge and experiences and to determine how they get SRH information and services in Soweto, South Africa using quantitative and qualitative methods. Young women, aged 18-24, recruited from primary health clinics and a shopping mall, reported that they have access to SRH information and know where to obtain services. However there are challenges to accessing and utilizing information and services including providers' unsupportive attitudes, uneven power dynamics in relationships and communication issues with parents and community members. There is a need to assist young women in understanding the significance of SRH information. They need access to age-appropriate, youth-friendly services in order to have healthy sexual experiences. PMID:26103697

  10. MEDICAID: Stronger Efforts Needed To Ensure Children's Access to Health Screening Services. Report to Congressional Requesters.

    ERIC Educational Resources Information Center

    Allen, Kathryn G.

    In response to Committee requests from the U.S. House of Representatives, the Government Accounting Office examined the extent to which children in Medicaid are receiving Early and Periodic Screening Diagnostic and Treatment (EPSDT) services. State efforts to improve service delivery and federal government efforts to ensure that state Medicaid…

  11. The Outcomes of an Intervention Study to Reduce the Barriers Experienced by People with Intellectual Disabilities Accessing Primary Health Care Services

    ERIC Educational Resources Information Center

    Melville, C. A.; Cooper, S.-A.; Morrison, J.; Finlayson, J.; Allan, L.; Robinson, N.; Burns, E.; Martin, G.

    2006-01-01

    Background: People with intellectual disabilities (IDs) experience significant health inequalities compared with the general population. The barriers people with IDs experience in accessing services contribute to these health inequalities. Professionals' significant unmet training needs are an important barrier to people with IDs accessing…

  12. Rural health care: redefining access.

    PubMed

    Collins, Chris

    2015-01-01

    The population and demographics of rural America are shifting once again. As our nation's unprecedented health care reform unfolds, it is becoming clear that rural communities have unique strengths, and capitalizing on these strengths can position them well for this health care transformation. Equally important are the distinct challenges that--with careful planning, attention, and resources--can be transformed into opportunities to thrive in the new health care environment. The North Carolina Institute of Medicine's Task Force on Rural Health recently published a report that highlights the strengths and challenges of rural communities [1]. In order to fully leverage these opportunities, we must continue to acknowledge the fundamental importance of access to basic health care, while also broadening our discussion to collectively tackle the additional components necessary to create healthy, thriving rural communities. As we reexamine the needs of rural communities, we should broaden our discussions to include an expansion of the types of access that are necessary for strengthening rural health. Collaboration, successful recruitment and retention, availability of specialty services, quality care, and cost effectiveness are some of the issues that must come into discussions about access to services. With this in mind, this issue of the NCMJ explores opportunities to strengthen the health of North Carolina's rural communities. PMID:25621473

  13. 45 CFR 152.22 - Access to services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING CONDITION INSURANCE PLAN PROGRAM Benefits § 152.22 Access to services. (a) General rule. A PCIP may specify... reasonably available and accessible to its enrollees. (b) Emergency services. In the case of...

  14. Parent Partnerships Project for Children's Mental Health "Access to Services." PHP-c88

    ERIC Educational Resources Information Center

    PACER Center, 2004

    2004-01-01

    In the fall of 2003, PACER Center's Parent Partnership Project for Children's Mental Health conducted a survey to better understand what parents and families need from the children's mental health system in Minnesota. The research team developed a survey questionnaire, a telephone interview, and a focus group session directed at learning what was…

  15. Apollo: Giving application developers a single point of access to public health models using structured vocabularies and Web services

    PubMed Central

    Wagner, Michael M.; Levander, John D.; Brown, Shawn; Hogan, William R.; Millett, Nicholas; Hanna, Josh

    2013-01-01

    This paper describes the Apollo Web Services and Apollo-SV, its related ontology. The Apollo Web Services give an end-user application a single point of access to multiple epidemic simulators. An end user can specify an analytic problem—which we define as a configuration and a query of results—exactly once and submit it to multiple epidemic simulators. The end user represents the analytic problem using a standard syntax and vocabulary, not the native languages of the simulators. We have demonstrated the feasibility of this design by implementing a set of Apollo services that provide access to two epidemic simulators and two visualizer services. PMID:24551417

  16. Health Behaviors, Service Utilization, and Access to Care among Older Mothers of Color Who Have Children with Developmental Disabilities

    ERIC Educational Resources Information Center

    Magana, Sandy; Smith, Matthew J.

    2008-01-01

    This study examined health behaviors, utilization, and access to care among older Latina and Black American mothers who co-reside with a child with developmental disabilities. Using data from the National Health Interview Survey National Center for Health Statistics (2005a), we compared Latina and Black American caregivers to similar women who did…

  17. South Asian Families' Access to Special Education and Mental Health Services: Obstacles and Strategies

    ERIC Educational Resources Information Center

    Pathappilil, Jessy; Bhatt, Hiral; Kabler, Brenda

    2013-01-01

    Immigration trends in recent years reveal that the number of students from culturally and linguistically diverse backgrounds is continuing to rise. As the proportion of culturally and linguistically diverse students in the total school population expands, the need for culturally responsive school psychology services will be increasingly magnified…

  18. Opportunities and Barriers to Rural, Remote and First Nation Health Services Research in Canada: Comparing Access to Administrative Claims Data in Manitoba and British Columbia.

    PubMed

    Lavoie, Josée G; Wong, Sabrina; Katz, Alan; Sinclair, Stephanie

    2016-08-01

    Access to geographically disaggregated data is essential for the pursuit of meaningful rural, remote and First Nation health services research. This paper explores the opportunities and challenges associated with undertaking administrative claims data research in the context of two different models of administrative data management: the Manitoba and British Columbia models. We argue that two conditions must be in place to support rural, remote and First Nation health services research: (1) pathways to data access that reconcile the need to protect privacy with the imperative to conduct analyses on disaggregated data; and (2) a trust-based relationship with data providers. PMID:27585026

  19. Children's Health, Access to Services and Quality of Care. Revised Executive Summary.

    ERIC Educational Resources Information Center

    Dutton, Diana B.

    This research investigated factors affecting children's health, based on empirical analyses of data from Washington, D.C. and national data. By most measures, poor children experience disproportionate morbidity and mortality. Yet certain ear and vision problems exhibit a U-shaped relation to family income in both national statistics and the…

  20. Strategies to Improve Minority Access to Public Mental Health Services in California: Description and Preliminary Evaluation

    ERIC Educational Resources Information Center

    Snowden, Lonnie; Masland, Mary; Ma, Yifei; Ciemens, Elizabeth

    2006-01-01

    The present study documented and evaluated steps taken by public mental health administrators to recruit members of underrepresented ethnic minority populations into treatment. By surveying county-level ethnic program specialists in the decentralized California state system, the study identified strategies considered effective for reaching African…

  1. Public health service options for affordable and accessible noncommunicable disease and related chronic disease prevention and management

    PubMed Central

    Brownie, Sharon; Hills, Andrew P; Rossiter, Rachel

    2014-01-01

    Globally, nations are confronted with the challenge of providing affordable health services to populations with increasing levels of noncommunicable and chronic disease. Paradoxically, many nations can both celebrate increases in life expectancy and bemoan parallel increases in chronic disease prevalence. Simply put, despite living longer, not all of that time is spent in good health. Combined with factors such as rising levels of obesity and related noncommunicable disease, the demand for health services is requiring nations to consider new models of affordable health care. Given the level of disease burden, all staff, not just doctors, need to be part of the solution and encouraged to innovate and deliver better and more affordable health care, particularly preventative primary health care services. This paper draws attention to a range of exemplars to encourage and stimulate readers to think beyond traditional models of primary health service delivery. Examples include nurse-led, allied health-led, and student-led clinics; student-assisted services; and community empowerment models. These are reported for the interest of policy makers and health service managers involved in preventative and primary health service redesign initiatives. PMID:25473294

  2. Improving health in the Arctic region through safe and affordable access to household running water and sewer services: an Arctic Council initiative.

    PubMed

    Hennessy, Thomas W; Bressler, Jonathan M

    2016-01-01

    Important health disparities have been documented among the peoples of the Arctic and subarctic, including those related to limited access to in-home improved drinking water and sanitation services. Although improving water, sanitation and hygiene (WASH) has been a focus of the United Nations for decades, the Arctic region has received little attention in this regard. A growing body of evidence highlights inequalities across the region for the availability of in-home drinking WASH services and for health indicators associated with these services. In this review, we highlight relevant data and describe an initiative through the Arctic Council's Sustainable Development Working Group to characterize the extent of WASH services in Arctic nations, the related health indicators and climate-related vulnerabilities to WASH services. With this as a baseline, efforts to build collaborations across the Arctic will be undertaken to promote innovations that can extend the benefits of water and sanitation services to all residents. PMID:27132632

  3. Improving health in the Arctic region through safe and affordable access to household running water and sewer services: an Arctic Council initiative

    PubMed Central

    Hennessy, Thomas W.; Bressler, Jonathan M.

    2016-01-01

    Important health disparities have been documented among the peoples of the Arctic and subarctic, including those related to limited access to in-home improved drinking water and sanitation services. Although improving water, sanitation and hygiene (WASH) has been a focus of the United Nations for decades, the Arctic region has received little attention in this regard. A growing body of evidence highlights inequalities across the region for the availability of in-home drinking WASH services and for health indicators associated with these services. In this review, we highlight relevant data and describe an initiative through the Arctic Council's Sustainable Development Working Group to characterize the extent of WASH services in Arctic nations, the related health indicators and climate-related vulnerabilities to WASH services. With this as a baseline, efforts to build collaborations across the Arctic will be undertaken to promote innovations that can extend the benefits of water and sanitation services to all residents. PMID:27132632

  4. Access to health care

    PubMed Central

    Fortin, Martin; Maltais, Danielle; Hudon, Catherine; Lapointe, Lise; Ntetu, Antoine Lutumba

    2005-01-01

    OBJECTIVE To explore access to health care for patients presenting with multiple chronic conditions and to identify barriers and factors conducive to access. DESIGN Qualitative study with focus groups. SETTING Family practice unit in Chicoutimi (Saguenay), Que. PARTICIPANTS Twenty-five male and female adult patients with at least four chronic conditions but no cognitive disorders or decompensating conditions. METHODS For this pilot study, only three focus group discussions were held. MAIN FINDINGS The main barriers to accessing follow-up appointments included long waits on the telephone, automated telephone-answering systems, and needing to attend at specific times to obtain appointments. The main barriers to specialized care were long waiting times and the need to get prescriptions and referrals from family physicians. Factors reported conducive to access included systematic callbacks and the personal involvement of family physicians. Good communication between family physicians and specialists was also perceived to be an important factor in access. CONCLUSION Systematic callbacks, family physicians’ personal efforts to obtain follow-up visits, and better physician-specialist communication were all suggested as ways to improve access to care for patients with multiple chronic conditions. PMID:16926944

  5. Correlates of Strengthening Lessons from HIV/AIDS Treatment and Care Services in Ethiopia Perceived Access and Implications for Health System

    PubMed Central

    Ncama, Busisiwe Purity

    2016-01-01

    Background Access to healthcare is an important public health concept and has been traditionally measured by using population level parameters, such as availability, distribution and proximity of the health facilities in relation to the population. However, client based factors such as their expectations, experiences and perceptions which impact their evaluations of health care access were not well studied and integrated into health policy frameworks and implementation programs. Objective This study aimed to investigate factors associated with perceived access to HIV/AIDS Treatment and care services in Wolaita Zone, Ethiopia. Methods A cross-sectional survey was conducted on 492 people living with HIV, with 411 using ART and 81 using pre-ART services accessed at six public sector health facilities from November 2014 to March 2015. Data were analyzed using the ologit function of STATA. The variables explored consisted of socio-demographic and health characteristics, type of health facility, type of care, distance, waiting time, healthcare responsiveness, transportation convenience, satisfaction with service, quality of care, financial fairness, out of pocket expenses and HIV disclosure. Results Of the 492 participants, 294 (59.8%) were females and 198 (40.2%) were males, with a mean age of 38.8 years. 23.0% and 12.2% believed they had ‘good’ or ‘very good’ access respectively, and 64.8% indicated lower ratings. In the multivariate analysis, distance from the health facility, type of care, HIV clinical stage, out of pocket expenses, employment status, type of care, HIV disclosure and perceived transportation score were not associated with the perceived access (PA). With a unit increment in satisfaction, perceived quality of care, health system responsiveness, transportation convenience and perceived financial fairness scores, the odds of providing higher rating of PA increased by 29.0% (p<0.001), 6.0%(p<0.01), 100.0% (p<0.001), 9.0% (p<0.05) and 6.0% (p<0

  6. [Reflections on the conceptualization and measurement of access to health services in Argentina: The case of the National Survey of Risk Factors 2009].

    PubMed

    Ballesteros, Matías Salvador; Freidin, Betina

    2015-12-01

    In this article we reflect on the complexity surrounding the conceptualization and measurement of access to health services. We present the theoretical models habitually used to approach the issue and different ways of operationalizing these models, taking into account the implications for the analysis of the data and the information obtained. As an example of this complexity, we analyze the National Survey of Risk Factors [Encuesta Nacional de Factores de Riesgo] conducted in Argentina in 2009. We show that the survey provides important information for understanding inequalities in access to health services. However, the way in which the barriers to access to the health system are measured may underreport the problem by only capturing extreme situations. PMID:26676595

  7. Health Care System Accessibility

    PubMed Central

    Steinberg, Annie G; Barnett, Steven; Meador, Helen E; Wiggins, Erin A; Zazove, Philip

    2006-01-01

    BACKGROUND People who are deaf use health care services differently than the general population; little research has been carried out to understand the reasons. OBJECTIVE To better understand the health care experiences of deaf people who communicate in American Sign Language. DESIGN Qualitative analyses of focus group discussions in 3 U.S. cities. PARTICIPANTS Ninety-one deaf adults who communicate primarily in American Sign Language. MEASUREMENTS We collected information about health care communication and perceptions of clinicians' attitudes. We elicited stories of both positive and negative encounters, as well as recommendations for improving health care. RESULTS Communication difficulties were ubiquitous. Fear, mistrust, and frustration were prominent in participants' descriptions of health care encounters. Positive experiences were characterized by the presence of medically experienced certified interpreters, health care practitioners with sign language skills, and practitioners who made an effort to improve communication. Many participants acknowledged limited knowledge of their legal rights and did not advocate for themselves. Some participants believed that health care practitioners should learn more about sociocultural aspects of deafness. CONCLUSIONS Deaf people report difficulties using health care services. Physicians can facilitate change to improve this. Future research should explore the perspective of clinicians when working with deaf people, ways to improve communication, and the impact of programs that teach deaf people self-advocacy skills and about their legal rights. PMID:16499543

  8. Leadership/citizen participation: perceived impact of advocacy activities by people with physical disabilities on access to health care, attendant care and social services.

    PubMed

    Jurkowski, Elaine; Jovanovic, Borko; Rowitz, Louis

    2002-01-01

    Increasingly, the climate of shrinking health care resources will impact access to health care for the people most vulnerable-those with disabilities. This study looked at the perceived impact of leadership and participation by people with physical disabilities and at their ability to gain increased access to health care, attendant care and social services. Respondents were randomly selected from Canada and the United States, from a pool of participants with physical disabilities serving in leadership roles within disability organizations in either country. Responses from a mail-out survey questionnaire were tabulated using logistic regression procedures to identify the perceived impact of advocacy activity on improved access to health care, attendant care and social ser- vices. Findings suggest that those who participated in advocacy activities were significantly more likely to feel that their action improved access to health care resources, attendant care resources and social services. Advocates also perceived the impact of access for their family, local organizations, and at a regional/national level. This study highlights the value of consumer/citizen participation, and the vital role this action can play in collaboration with social work professionals for system changes, health resource planning and policy development. PMID:12206464

  9. 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. PMID:18955546

  10. Improving Maternal Health in Pakistan: Toward a Deeper Understanding of the Social Determinants of Poor Women’s Access to Maternal Health Services

    PubMed Central

    Salway, Sarah; Bhatti, Afshan; Shanner, Laura; Zaman, Shakila; Laing, Lory; Ellison, George T. H.

    2014-01-01

    Evidence suggests national- and community-level interventions are not reaching women living at the economic and social margins of society in Pakistan. We conducted a 10-month qualitative study (May 2010–February 2011) in a village in Punjab, Pakistan. Data were collected using 94 in-depth interviews, 11 focus group discussions, 134 observational sessions, and 5 maternal death case studies. Despite awareness of birth complications and treatment options, poverty and dependence on richer, higher-caste people for cash transfers or loans prevented women from accessing required care. There is a need to end the invisibility of low-caste groups in Pakistani health care policy. Technical improvements in maternal health care services should be supported to counter social and economic marginalization so progress can be made toward Millennium Development Goal 5 in Pakistan. PMID:24354817

  11. Accessing health services through the back door: a qualitative interview study investigating reasons why people participate in health research in Canada

    PubMed Central

    2013-01-01

    Background Although there is extensive information about why people participate in clinical trials, studies are largely based on quantitative evidence and typically focus on single conditions. Over the last decade investigations into why people volunteer for health research have become increasingly prominent across diverse research settings, offering variable based explanations of participation patterns driven primarily by recruitment concerns. Therapeutic misconception and altruism have emerged as predominant themes in this literature on motivations to participate in health research. This paper contributes to more recent qualitative approaches to understanding how and why people come to participate in various types of health research. We focus on the experience of participating and the meanings research participation has for people within the context of their lives and their health and illness biographies. Methods This is a qualitative exploratory study informed by grounded theory strategies. Thirty-nine participants recruited in British Columbia and Manitoba, Canada, who had taken part in a diverse range of health research studies participated in semi-structured interviews. Participants described their experiences of health research participation including motivations for volunteering. Interviews were recorded, transcribed, and analyzed using constant comparisons. Coding and data management was supported by Nvivo-7. Results A predominant theme to emerge was 'participation in health research to access health services.’ Participants described research as ways of accessing: (1) Medications that offered (hope of) relief; (2) better care; (3) technologies for monitoring health or illness. Participants perceived standard medical care to be a “trial and error” process akin to research, which further blurred the boundaries between research and treatment. Conclusions Our findings have implications for recruitment, informed consent, and the dichotomizing of medical/health

  12. Asymptomatic Mycoplasma genitalium infection amongst marginalised young people accessing a youth health service in Melbourne.

    PubMed

    Henning, Dorothy; Eade, Donna; Langstone, Alison; Bean-Hodges, Alison; Marceglia, Alexandra; Azzopardi, Peter

    2014-03-01

    We conducted a study to establish the prevalence of Mycoplasma genitalium amongst asymptomatic young people experiencing homelessness in the context of comprehensive health care delivery. All asymptomatic young people at risk of sexually transmitted infections were offered urinary polymerase chain reaction testing for M. genitalium whilst being tested for Chlamydia trachomatis and Neisseria gonorrhoeae over a four-month period in 2012. Those who tested positive were notified of the infection and offered treatment. Sixty asymptomatic young people (36 female and 24 male) were tested for M. genitalium, identifying eight cases (13%) (six female and two male). Ten young people (17%) tested positive for C. trachomatis, three (5%) of whom were positive for both M. genitalium and C. trachomatis. There were no cases of N. gonorrhoeae. Of the eight cases of M. genitalium, seven were contactable and five were treated at our clinic with azithromycin 1 g stat. Two of the five returned after a month for a test of cure, identifying one resistant infection. Further data on the epidemiology of M. genitalium are required before testing recommendations can be made; however, consideration should be given to testing for M. genitalium in settings where other sexually transmitted infections are prevalent. PMID:24026408

  13. Access to Services, Quality of Care, and Family Impact for Children with Autism, Other Developmental Disabilities, and Other Mental Health Conditions

    ERIC Educational Resources Information Center

    Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha; St Peter, Claire

    2014-01-01

    This cross-sectional study examined perceived access to services, quality of care, and family impact reported by caregivers of children aged 3-17 years with autism spectrum disorders, as compared to caregivers of children with other developmental disabilities and other mental health conditions. The 2009-2010 National Survey of Children with…

  14. [Occupational physicians' system in the United kingdom and fit note to promote access to occupational health services].

    PubMed

    Kubo, Tatsuhiko; Fujino, Yoshihisa; Muramatsu, Keiji; Matsuda, Shinya

    2013-12-01

    The Statement of Fitness for Work (Fit Note) policy was started in the UK in 2010 in order to promote return to work after sickness absence. Fit Note is issued by General Practitioners (GP). We conducted an interview survey of 2 occupational physicians working in the UK to ascertain the impact of the introduction of Fit Note on occupational health in the UK. They regard the low coverage of occupational health services in the UK, especially among small companies and self-employed workers, as a serious issue. Fit Note was regarded as a tool to induce GPs to participate in occupational health services, and it is expected that they will be new partners in occupational health. The English occupational physicians evaluated the Fit Note system highly, and believe that the increasing participation of GPs in occupational health services will be a steady advancement in occupational health in the UK. PMID:24334697

  15. Access to and use of sexual and reproductive health services provided by midwives among rural immigrant women in Spain: midwives’ perspectives

    PubMed Central

    Otero-Garcia, Laura; Goicolea, Isabel; Gea-Sánchez, Montserrat; Sanz-Barbero, Belen

    2013-01-01

    Background There is insufficient information regarding access and participation of immigrant women in Spain in sexual and reproductive health programs. Recent studies show their lower participation rate in gynecological cancer screening programs; however, little is known about the participation in other sexual and reproductive health programs by immigrant women living in rural areas with high population dispersion. Objectives The objective of this study is to explore the perceptions of midwives who provide these services regarding immigrant women's access and participation in sexual and reproductive health programs offered in a rural area. Design A qualitative study was performed, within a larger ethnographic study about rural primary care, with data collection based on in-depth interviews and field notes. Participants were the midwives in primary care serving 13 rural basic health zones (BHZ) of Segovia, a region of Spain with high population dispersion. An interview script was designed to collect information about midwives’ perceptions on immigrant women's access to and use of the healthcare services that they provide. Interviews were recorded and transcribed with participant informed consent. Data were analyzed based on the qualitative content analysis approach and triangulation of results with fieldwork notes. Results Midwives perceive that immigrants in general, and immigrant women in particular, underuse family planning services. This underutilization is associated with cultural differences and gender inequality. They also believe that the number of voluntary pregnancy interruptions among immigrant women is elevated and identify childbearing and childrearing-related tasks and the language barrier as obstacles to immigrant women accessing the available prenatal and postnatal healthcare services. Conclusions Immigrant women's underutilization of midwifery services may be linked to the greater number of unintended pregnancies, pregnancy terminations, and the

  16. HealthyME HealthyU(©2010UCPGB): a collaborative project to enhance access to health information and services for individuals with disabilities.

    PubMed

    Geiger, Brian F; O'Neal, Marcia R; Firsing, Stephen L; Smith, Kay Hogan; Chandan, Priya; Schmidt, Anne; Jackson, Jeri B

    2010-01-01

    In response to the limited information about health information and training needs among persons with disabilities, a collaborative group of Alabama researchers, educators, and clinicians was formed to implement a statewide needs assessment with support provided by the Alabama Council for Developmental Disabilities and the National Network of Libraries of Medicine. Educational and assessment activities were guided by the Systems Model of Clinical Preventive Care and Health Information National Trends Survey (HINTS) methodology. Four constructs from the 2007 HINTS Annotated Version were identified as relevant to the concepts of local interest. Results of printed and online surveys administered to 251 family and other caregivers, 87 individuals with disabilities, 110 clinical service providers, and 570 health professions students revealed outstanding health communication needs to improve access to reliable consumer information and clinical services. HealthyME HealthyU(©2010UCPGB) developed new educational materials that address issues identified from the needs assessment, specifically (a) accessibility of health care facilities; (b) patient-provider communication; (c) personal health management by consumers and families/caregivers; and (d) sources of trustworthy electronic health information. Six brief digital video training modules were developed for consumers, families, and professionals featuring as speakers health care providers, health professions students, and individuals with cognitive disabilities. Following field testing, video modules were revised and then widely distributed to consumers, family caregivers, and service providers. Preliminary evaluation indicates content is relevant and comprehensible to individuals with disabilities. PMID:21154083

  17. Access to and Use of Health Care Services Among Latinos in East Los Angeles and Boyle Heights.

    PubMed

    Alcalá, Héctor E; Albert, Stephanie L; Trabanino, Shawn K; Garcia, Rosa-Elena; Glik, Deborah C; Prelip, Michael L; Ortega, Alexander N

    2016-01-01

    This study examined differences in access, utilization, and barriers to health care by nativity, language spoken at home, and insurance status in East Los Angeles and Boyle Heights, California. Data from household interviews of neighborhood residents conducted as part of a corner store intervention project were used. Binary and multinomial logistic regression models were fitted. Results showed that uninsured and foreign-born individuals were differentially affected by lack of access to and utilization of health care. While the Affordable Care Act may ameliorate some disparities, the impact will be limited because of the exclusion of key groups, like the undocumented, from benefits. PMID:26605956

  18. Creating a Front Porch in Systems of Care: Improving Access to Behavioral Health Services for Diverse Children and Families

    ERIC Educational Resources Information Center

    Callejas, Linda M.; Hernandez, Mario; Nesman, Teresa; Mowery, Debra

    2010-01-01

    Despite recognition of the central role that service accessibility (and availability) should assume within a system of care, the definition proposed in the feature article of this special issue does not identify specific factors that systems of care must take into account in order to serve diverse children with serious emotional disturbance and…

  19. [Experiences of undocumented Mexican migrant women when accessing sexual and reproductive health services in California, USA: a case study].

    PubMed

    Deeb-Sossa, Natalia; Díaz Olavarrieta, Claudia; Juárez-Ramírez, Clara; García, Sandra G; Villalobos, Aremis

    2013-05-01

    This study focuses on the experience of Mexican women migrants in California, USA, with the use of formal health services for sexual and reproductive health issues. The authors used a qualitative interpretative approach with life histories, interviewing eight female users of healthcare services in California and seven key informants in Mexico and California. There were three main types of barriers to healthcare: immigration status, language, and gender. Participants reported long waiting times, discriminatory attitudes, and high cost of services. A combination of formal and informal healthcare services was common. The assessment of quality of care was closely related to undocumented immigration status. Social support networks are crucial to help solve healthcare issues. Quality of care should take intercultural health issues into account. PMID:23703003

  20. Do the Medicaid and Medicare programs compete for access to health care services? A longitudinal analysis of physician fees, 1998-2004.

    PubMed

    Howard, Larry L

    2014-09-01

    As the demand for publicly funded health care continues to rise in the U.S., there is increasing pressure on state governments to ensure patient access through adjustments in provider compensation policies. This paper longitudinally examines the fees that states paid physicians for services covered by the Medicaid program over the period 1998-2004. Controlling for an extensive set of economic and health care industry characteristics, the elasticity of states' Medicaid fees, with respect to Medicare fees, is estimated to be in the range of 0.2-0.7 depending on the type of physician service examined. The findings indicate a significant degree of price competition between the Medicaid and Medicare programs for physician services that is more pronounced for cardiology and critical care, but not hospital care. The results also suggest several policy levers that work to either increase patient access or reduce total program costs through changes in fees. PMID:24682916

  1. Youth reproductive health services in Bulawayo, Zimbabwe.

    PubMed

    Mashamba, Alethea; Robson, Elsbeth

    2002-12-01

    This study examines young people's access to reproductive healthcare services via an urban youth advisory centre in Bulawayo, Zimbabwe. The aim is to explain why teenagers do not always use existing health services. Data from exit questionnaires with users and focus groups with non-users are analysed to evaluate service accessibility. Analysis suggests that even where clinics are spatially accessible, barriers to access include temporal factors, lack of factual knowledge and stigmatisation. The paper concludes that spatial accessibility is not the only factor necessary to ensure equal access to health services. Recommendations are made towards tackling young people's unmet needs for reproductive healthcare services. PMID:12399216

  2. Database Access Integration Services (DAIS)

    SciTech Connect

    Mitchell, P. . Sensor and System Development Center); Nordell, D. )

    1992-12-01

    The Database Access Integration Services (DAIS) is a collection of services that facilitate access to data among diverse data systems in an electric utility communications network. DAIS provides access to data in distributed, heterogeneous data systems that include relational database management systems, other database management systems, control systems, file systems, and application systems. It also provides a common method for describing data, common data access operations and essential support services including a data dictionary, a data directory and distributed data access management capabilities. The DAIS project has developed specifications intended for vendor and third-party implementation. The software developed is only to implement a data access integration demonstration. These specifications can serve as a basis for influencing industry standards development. One important consequence of this strategy is that most actual software development will be performed by vendors, not utilities. DAIS is a tool to support data access. It is policy neutral regarding issues such as local or central administration of data or standardization of information model contents (e.g., EPRI Plant Information Network). As a tool, it can be used to help realize such policies. The DAIS does not provide data storage facilities, schema integration, distributed query processing, distributed applications or cooperative processing. Rather, DAIS is complementary to these functions and can be used with other software that does provide these functions. This project documented the requirements for the DAIS. These requirements are the basis for design of the DAIS specifications. The key requirements for a DAIS are: Uniform access to heterogeneous utility data systems, remote update; coexistence with local data systems; local autonomy ; Security and access restriction enforcement; OSI compatibility; open architecture and extensibility; and operating platform independence.

  3. Changes in Access to Health Services of the Immigrant and Native-Born Population in Spain in the Context of Economic Crisis †

    PubMed Central

    Garcia-Subirats, Irene; Vargas, Ingrid; Sanz-Barbero, Belén; Malmusi, Davide; Ronda, Elena; Ballesta, Mónica; Vázquez, María Luisa

    2014-01-01

    Aim: To analyze changes in access to health care and its determinants in the immigrant and native-born populations in Spain, before and during the economic crisis. Methods: Comparative analysis of two iterations of the Spanish National Health Survey (2006 and 2012). Outcome variables were: unmet need and use of different healthcare levels; explanatory variables: need, predisposing and enabling factors. Multivariate models were performed (1) to compare outcome variables in each group between years, (2) to compare outcome variables between both groups within each year, and (3) to determine the factors associated with health service use for each group and year. Results: unmet healthcare needs decreased in 2012 compared to 2006; the use of health services remained constant, with some changes worth highlighting, such as the decline in general practitioner visits among autochthons and a narrowed gap in specialist visits between the two populations. The factors associated with health service use in 2006 remained constant in 2012. Conclusion: Access to healthcare did not worsen, possibly due to the fact that, until 2012, the national health system may have cushioned the deterioration of social determinants as a consequence of the financial crisis. Further studies are necessary to evaluate the effects of health policy responses to the crisis after 2012. PMID:25272078

  4. Challenges in access to health services and its impact on quality of life: a randomised population-based survey within Turkish speaking immigrants in London

    PubMed Central

    2012-01-01

    Background and aim There are a significant number of Turkish speaking immigrants living in London. Their special health issues including women's health, mental health, and alcohol and smoking habits has been assessed. The aim of this study was to explore the ongoing challenges in access to health care services and its impact on Quality of Life of immigrants. Material and methods This cross-sectional population-based study was conducted between March and August 2010 with Turkish immigrants (n = 416) living in London. Of these, 308 (74%) were Turkish and 108 (26%) were Turkish Cypriots. All healthy or unhealthy adults of 17-65 years of age were enrolled. A structured questionnaire with 44 items in five subcategories and 26-items WHOQOL BREF were used. Results Mean duration of stay for Turkish Cypriots (26.9 ± 13.9 years) was significantly longer than Turkish immigrants (13.3 ± 7.5) (p < 0.001). Turkish immigrants (n = 108, 36.5%) need interpretation more often when using health services than Turkish Cypriots (n = 16, 15%) (p < 0.001). Multivariate analyses suggested significant effects of older age, non-homeownership, low socioeconomic class, poor access to health services, being ill, poor community integration and being obese on physical well-being and also significant effects of low income and poor community integration on perceived overall Quality of Life (WHOQOL) of the participants. Conclusions The results of this study demonstrate how the health and well-being of members of the Turkish speaking community living in London are affected by social aspects of their lives. Providing culturally competent care and interpretation services and advocacy may improve the accessibility of the health care. PMID:22280521

  5. The case for developing publicly-accessible datasets for health services research in the Middle East and North Africa (MENA) region

    PubMed Central

    Saleh, Shadi S; Alameddine, Mohamad S; El-Jardali, Fadi

    2009-01-01

    Background The existence of publicly-accessible datasets comprised a significant opportunity for health services research to evolve into a science that supports health policy making and evaluation, proper inter- and intra-organizational decisions and optimal clinical interventions. This paper investigated the role of publicly-accessible datasets in the enhancement of health care systems in the developed world and highlighted the importance of their wide existence and use in the Middle East and North Africa (MENA) region. Discussion A search was conducted to explore the availability of publicly-accessible datasets in the MENA region. Although datasets were found in most countries in the region, those were limited in terms of their relevance, quality and public-accessibility. With rare exceptions, publicly-accessible datasets - as present in the developed world - were absent. Based on this, we proposed a gradual approach and a set of recommendations to promote the development and use of publicly-accessible datasets in the region. These recommendations target potential actions by governments, researchers, policy makers and international organizations. Summary We argue that the limited number of publicly-accessible datasets in the MENA region represents a lost opportunity for the evidence-based advancement of health systems in the region. The availability and use of publicly-accessible datasets would encourage policy makers in this region to base their decisions on solid representative data and not on estimates or small-scale studies; researchers would be able to exercise their expertise in a meaningful manner to both, policy makers and the public. The population of the MENA countries would exercise the right to benefit from locally- or regionally-based studies, versus imported and in 'best cases' customized ones. Furthermore, on a macro scale, the availability of regionally comparable publicly-accessible datasets would allow for the exploration of regional variations

  6. Access to services, quality of care, and family impact for children with autism, other developmental disabilities, and other mental health conditions

    PubMed Central

    Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha; St Peter, Claire

    2016-01-01

    This cross-sectional study examined perceived access to services, quality of care, and family impact reported by caregivers of children aged 3–17 years with autism spectrum disorders, as compared to caregivers of children with other developmental disabilities and other mental health conditions. The 2009–2010 National Survey of Children with Special Health Care Needs was utilized to examine the association between child’s special needs condition and three outcomes (N = 18,136): access to services (difficulty using services, difficulty getting referrals, lack of source of care, and inadequate insurance coverage), quality of care (lack of care coordination, lack of shared decision making, and no routine screening), and family impact (financial, employment, and time-related burden). Multivariate logistic regressions were performed to compare caregivers of children with autism spectrum disorders to caregivers of children with developmental disabilities (cerebral palsy, Down syndrome, developmental delay, or intellectual disability), mental health conditions (attention deficit hyperactivity disorder, anxiety, behavioral/conduct problems, or depression), or both developmental disabilities and mental health conditions. Caregivers of children with autism spectrum disorders were significantly more likely to report difficulty using services, lack of source of care, inadequate insurance coverage, lack of shared decision making and care coordination, and adverse family impact as compared to caregivers of children with developmental disabilities, mental health conditions, or both. PMID:24353274

  7. Estimating Health Services Requirements

    NASA Technical Reports Server (NTRS)

    Alexander, H. M.

    1985-01-01

    In computer program NOROCA populations statistics from National Center for Health Statistics used with computational procedure to estimate health service utilization rates, physician demands (by specialty) and hospital bed demands (by type of service). Computational procedure applicable to health service area of any size and even used to estimate statewide demands for health services.

  8. Public health care provisions: access and equity.

    PubMed

    Bin Juni, M H

    1996-09-01

    Within the current exercise of reforming the health care system, underlying all issues, is the reassessment of the role of government. It is a government's responsibility and concern that the health sector be accessible and equitable to the population, and more important that the health sector be more efficient and affordable. Many governments in the world attempt to provide universal health care services to their population through public health care provisions. This paper reviews and analyses the experience of the Malaysian health system, focusing on the performance of the system in relation to access and equity. The performance of the Malaysian health system has been impressive. At minimum cost it has achieved virtually accessible and equitable health care to the entire population. This is evident by analysing almost all the commonly used indicators. These clearly show that when matched to comparable countries, health outcome is even better than predicted value. PMID:8870140

  9. MEDNET: Telemedicine via Satellite Combining Improved Access to Health-Care Services with Enhanced Social Cohesion in Rural Peru

    NASA Astrophysics Data System (ADS)

    Panopoulos, Dimitrios; Sachpazidis, Ilias; Rizou, Despoina; Menary, Wayne; Cardenas, Jose; Psarras, John

    Peru, officially classified as a middle-income country, has benefited from sustained economic growth in recent years. However, the benefits have not been seen by the vast majority of the population, particularly Peru's rural population. Virtually all of the nation's rural health-care centres are cut off from the rest of the country, so access to care for most people is not only difficult but also costly. MEDNET attempts to redress this issue by developing a medical health network with the help of the collaboration medical application based on TeleConsult & @HOME medical database for vital signs. The expected benefits include improved support for medics in the field, reduction of patient referrals, reduction in number of emergency interventions and improved times for medical diagnosis. An important caveat is the emphasis on exploiting the proposed infrastructure for education and social enterprise initiatives. The project has the full support of regional political and health authorities and, importantly, full local community support.

  10. Incremental cost of increasing access to maternal health care services: perspectives from a demand and supply side intervention in Eastern Uganda

    PubMed Central

    2014-01-01

    Introduction High maternal and infant mortality continue to be major challenges to the attainment of the Millennium Development Goals for many low and middle-income countries. There is now evidence that voucher initiatives can increase access to maternal health services. However, a dearth of knowledge exists on the cost implications of voucher schemes. This paper estimates the incremental costs of a demand and supply side intervention aimed at increasing access to maternal health care services. Methods This costing study was part of a quasi-experimental voucher study conducted in two districts in Eastern Uganda to explore the impact of demand and supply - side incentives on increasing access to maternal health services. The provider’s perspective was used and the ingredients approach to costing was employed. Costs were based on market prices as recorded in program records. Total, unit, and incremental costs were calculated. Results The estimated total financial cost of the intervention for the one year of implementation was US$525,472 (US$1 = 2200UgShs). The major cost drivers included costs for transport vouchers (35.3%), health system strengthening (29.2%) and vouchers for maternal health services (18.2%). The average cost of transport per woman to and from the health facility was US$4.6. The total incremental costs incurred on deliveries (excluding caesarean section) was US$317,157 and US$107,890 for post natal care (PNC). The incremental costs per additional delivery and PNC attendance were US$23.9 and US$7.6 respectively. Conclusion Subsidizing maternal health care costs through demand and supply – side initiatives may not require significant amounts of resources contrary to what would be expected. With Uganda’s Gross Domestic Product (GDP) per capita of US$55` (2012), the incremental cost per additional delivery (US$23.9) represents about 5% of GDP per capita to save a mother and probably her new born. For many low income countries, this may not be

  11. Exploring the Influence of Income and Geography on Access to Services for Older Adults in British Columbia: A Multivariate Analysis Using the Canadian Community Health Survey (Cycle 3.1)

    ERIC Educational Resources Information Center

    Allan, Diane E.; Funk, Laura M.; Reid, R. Colin; Cloutier-Fisher, Denise

    2011-01-01

    Existing research on the health care utilization patterns of older Canadians suggests that income does not usually restrict an individual's access to care. However, the role that income plays in influencing access to health services by older adults living in rural areas is relatively unknown. This article examines the relationship between income…

  12. [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. PMID:22569702

  13. Mobile Health (mHealth) Services and Online Health Educators

    PubMed Central

    Anshari, Muhammad; Almunawar, Mohammad Nabil

    2016-01-01

    Mobile technology enables health-care organizations to extend health-care services by providing a suitable environment to achieve mobile health (mHealth) goals, making some health-care services accessible anywhere and anytime. Introducing mHealth could change the business processes in delivering services to patients. mHealth could empower patients as it becomes necessary for them to become involved in the health-care processes related to them. This includes the ability for patients to manage their personal information and interact with health-care staff as well as among patients themselves. The study proposes a new position to supervise mHealth services: the online health educator (OHE). The OHE should be occupied by special health-care staffs who are trained in managing online services. A survey was conducted in Brunei and Indonesia to discover the roles of OHE in managing mHealth services, followed by a focus group discussion with participants who interacted with OHE in a real online health scenario. Data analysis showed that OHE could improve patients’ confidence and satisfaction in health-care services. PMID:27257387

  14. Men Who Have Sex With Men in Kisumu, Kenya: Comfort in Accessing Health Services and Willingness to Participate in HIV Prevention Studies

    PubMed Central

    OKALL, DANCUN O.; ONDENGE, KEN; NYAMBURA, MONICAH; OTIENO, FREDRICK O.; HARDNETT, FELICIA; TURNER, KYLE; MILLS, LISA A.; MASINYA, KENNEDY; CHEN, ROBERT T.; GUST, DEBORAH A.

    2016-01-01

    Men who have sex with men (MSM) are a crucial and marginalized at risk population for HIV in Africa but are poorly studied. Like other areas of Africa, homosexuality is illegal in Kenya. We assessed MSM comfort in accessing health services and willingness to participate in HIV prevention research in Kisumu, Kenya—an area of high HIV prevalence. We conducted a two-phase formative study with individual interviews (n = 15) and a structured survey (n = 51). Peer contact or snowball method (n = 43, 84.3%) was the primary recruitment strategy used to locate MSM. Exact logistic regression models were used for survey data analysis. Over 60% (32/51) of survey participants were not very comfortable seeking health services from a public hospital. Almost all MSM (49/51; 96.1%) reported willingness to be contacted to participate in future HIV research studies. Efforts to provide facilities that offer safe and confidential health services and health education for MSM is required. Continued community engagement with the MSM population in Kenya is needed to guide best practices for involving them in HIV prevention research. PMID:25089554

  15. American Psychiatric Association: Position Statement on Firearm Access, Acts of Violence and the Relationship to Mental Illness and Mental Health Services.

    PubMed

    Pinals, Debra A; Appelbaum, Paul S; Bonnie, Richard; Fisher, Carl E; Gold, Liza H; Lee, Li-Wen

    2015-06-01

    The American Psychiatric Association, ("APA"), with more than 36,000 members at present, is the Nation's leading organization of physicians who specialize in psychiatry. APA provides for education and advocacy and develops policy through Position Statements. It promotes enhanced knowledge of particular topics relevant to psychiatric practice and patient care through Resource Documents. Since 1993, the APA has developed various positions and resource materials related to firearms and mental illness, incorporating evolving themes as new issues emerge. This paper reflects the APA's 2014 Position Statement on Firearm Access, Acts of Violence and the Relationship to Mental Illness and Mental Health Services. PMID:26095100

  16. Streamlining Data Access Services and Data Analysis Services Integration

    NASA Astrophysics Data System (ADS)

    Del Rio, N.; Pennington, D. D.; Pinheiro da Silva, P.; Benedict, K. K.

    2012-12-01

    There are few data analysis services capable of understanding and consuming data coming from multiple data access services. This lack of interoperability between data access services and data analysis services is indeed a major roadblock for science because it prevents the reuse and repurposing of both data and analytical software to support new scientific discoveries. In this presentation, we discuss this problem in light of the Earth, Life, and Semantic Web (ELSEWEB) project funded through NASA's ACCESS Program. The project uses the University of Kansas' Lifemapper system as its analytical Web Service platform, which models potential future species distributions under scenarios of climate change. In an effort to broaden the range of scenarios to include land cover/land use change, ELSEWEB aims to streamline the flow of highly heterogeneous geographic, social, and geological data hosted at UNM's Earth Data Analysis Center (EDAC) through a collection of OGC Web Coverage Services into Lifemapper. In turn, this integration will enable new modeling of complex factors associated with biotic change such as health and infectious disease, that depend not only on climate change and species distributions, but also on other human/environmental interactions. In this presentation we discuss the integration of Lifemapper and EDAC data and model services, provided by a third party semantic system, known as VisKo, that (1) translates Lifemapper data requirements to EDAC service invocations and (2) pipes the data output from EDAC into Lifemapper. VisKo is supported by a knowledge base of web service descriptions that contains information about interface requirements as well as invocation details, including service parameters. VisKo ontologies are designed to capture the knowledge required by the system to orchestrate and execute service pipelines that perform scientist's required computation. The ELSEWEB project also aims to expand VisKo's original goal of building visualization

  17. College Health: Health Services and Common Health Problems

    MedlinePlus

    ... Conditions Nutrition & Fitness Emotional Health College Health: Health Services and Common Health Problems Posted under Health Guides . ... March 2015. +Related Content What are student health services? The student health services (sometimes called the student ...

  18. Selected Health Service Occupations.

    ERIC Educational Resources Information Center

    Coleman, Arthur D.

    Prepared by an occupational analyst of the Utah Department of Employment Security, this manual provides job guides for 39 health service occupations concerned mainly with doctors, nurses, and related hospital-medical-health consultants and services. Classified according to "The Dictionary of Occupational Titles," each occupational description…

  19. Medical Student Mental Health Services

    PubMed Central

    Roman, Brenda

    2009-01-01

    Medical school is a stressful and challenging time in the academic career of physicians. Because of the psychological pressure inherent to this process, all medical schools should have easily accessible medical student mental health services. Some schools of medicine provide these services through departments of psychiatry or other associated training programs. Since this stressful lifestyle often continues through residency training and life as a physician, this is a critical period in which to develop and utilize functional and effective coping strategies. When psychiatrists provide the mental health treatment to medical students, it is important to consider transference and countertransference issues, over intellectualization, and instances of strong idealization and identification. PMID:19724734

  20. 42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan...

  1. 42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan...

  2. 42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan...

  3. 42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Access to services under an MA private fee-for... Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must demonstrate to...

  4. The effect of metropolitan-area mortgage delinquency on health behaviors, access to health services, and self-rated health in the United States, 2003-2010.

    PubMed

    Charters, Thomas J; Harper, Sam; Strumpf, Erin C; Subramanian, S V; Arcaya, Mariana; Nandi, Arijit

    2016-07-01

    The recent housing crisis offers the opportunity to understand the effects of unique indicators of macroeconomic conditions on health. We linked data on the proportion of mortgage borrowers per US metropolitan-area who were at least 90 days delinquent on their payments with individual-level outcomes from a representative sample of 1,021,341 adults surveyed through the Behavioral Risk Factor Surveillance System (BRFSS) between 2003 and 2010. We estimated the effects of metropolitan-area mortgage delinquency on individual health behaviors, medical coverage, and health status, as well as whether effects varied by race/ethnicity. Results showed that increases in the metropolitan-area delinquency rate resulted in decreases in heavy alcohol consumption and increases in exercise and health insurance coverage. However, the delinquency rate was also associated with increases in smoking and obesity in some population groups, suggesting the housing crisis may have induced stress-related behavioral change. Overall, the effects of metropolitan-area mortgage delinquency on population health were relatively modest. PMID:27261531

  5. Data access service of China-VO

    NASA Astrophysics Data System (ADS)

    Sang, Jian; Zhao, Yong-Heng; Cui, Chen-Zhou

    2004-09-01

    With the development of technologies and the implementation of large quantity of astronomical observation projects, astronomy faces data avalanche and has entered an information era. A basic aim of the Virtual Observatory is to provide uniform access to highly distributed, complicated, huge astronomical datasets, and to realize federation of global astronomical data resources, so that astronomers can obtain required data efficiently and conveniently for their research. China Virtual Observatory (China-VO) project designs and implements astronomical data access services based on Grid technology, and provides uniform interface to Grid client application. In this paper, we introduce the data access service toolkit development using Globus Toolkit, the Grid services encapsulation of catalogs according to the latest astronomical data standards recommended by International Virtual Observatory Alliance, the implements of catalog Cone Search access service. Furthermore, we also introduce how to construct other Grid services using above data access services.

  6. Access to Mainstream Health Services: A Case Study of the Difficulties Faced by a Child with Learning Disabilities

    ERIC Educational Resources Information Center

    Brown, Freddy Jackson; Cooper, Kate; Diebel, Tara

    2013-01-01

    People with learning disabilities have higher levels of health needs compared with the general population (Nocon, 2006, Background evidence for the DRC's formal investigation into health inequalities experienced by people with learning disabilities or mental health problems. London and Manchester, Disability Rights Commission). Research has shown…

  7. Group health cooperative's transformation toward patient-centered access.

    PubMed

    Ralston, James D; Martin, Diane P; Anderson, Melissa L; Fishman, Paul A; Conrad, Douglas A; Larson, Eric B; Grembowski, David

    2009-12-01

    The Institute of Medicine suggests redesigning health care to ensure safe, effective, timely, efficient, equitable, and patient-centered care. The concept of patient-centered access supports these goals. Group Health, a mixed-model health care system, attempted to improve patients' access to care through the following changes: (a) offering a patient Web site with patient access to patient-physician secure e-mail, electronic medical records, and health promotion information; (b) offering advanced access to primary physicians; (c) redesigning primary care services to enhance care efficiency; (d) offering direct access to physician specialists; and (e) aligning primary physician compensation through incentives for patient satisfaction, productivity, and secure messaging with patients. In the 2 years following the redesign, patients reported higher satisfaction with certain aspects of access to care, providers reported improvements in the quality of service given to patients, and enrollment in Group Health stayed aligned with statewide trends in health care coverage. PMID:19549993

  8. Depression and post-traumatic stress disorder among Haitian immigrant students: implications for access to mental health services and educational programming

    PubMed Central

    2009-01-01

    Background Previous studies of Haitian immigrant and refugee youth have emphasized "externalizing" behaviors, such as substance use, high risk sexual behavior, and delinquency, with very little information available on "internalizing" symptoms, such as depression and anxiety. Analyzing stressors and "internalizing" symptoms offers a more balanced picture of the type of social and mental health services that may be needed for this population. The present study aims to: 1) estimate the prevalence of depression and post-traumatic stress disorder (PTSD) among Haitian immigrant students; and 2) examine factors associated with depression and PTSD to identify potential areas of intervention that may enhance psychosocial health outcomes among immigrant youth from Haiti in the U.S. Methods A stratified random sample of Haitian immigrant students enrolled in Boston public high schools was selected for participation; 84% agreed to be interviewed with a standardized questionnaire. Diagnosis of depression and PTSD was ascertained using the best estimate diagnosis method. Results The prevalence estimates of depression and PTSD were 14.0% and 11.6%; 7.9% suffered from comorbid PTSD and depression. Multivariate logistic regression demonstrated factors most strongly associated with depression (history of father's death, self-report of schoolwork not going well, not spending time with friends) and PTSD (concern for physical safety, having many arguments with parents, history of physical abuse, and lack of safety of neighborhood). Conclusions A significant level of depression and PTSD was observed. Stressors subsequent to immigration, such as living in an unsafe neighborhood and concern for physical safety, were associated with an increased risk of PTSD and should be considered when developing programs to assist this population. Reducing exposure to these stressors and enhancing access to social support and appropriate school-based and mental health services may improve educational

  9. Abortion health services in Canada

    PubMed Central

    Norman, Wendy V.; Guilbert, Edith R.; Okpaleke, Christopher; Hayden, Althea S.; Steven Lichtenberg, E.; Paul, Maureen; White, Katharine O’Connell; Jones, Heidi E.

    2016-01-01

    Abstract Objective To determine the location of Canadian abortion services relative to where reproductive-age women reside, and the characteristics of abortion facilities and providers. Design An international survey was adapted for Canadian relevance. Public sources and professional networks were used to identify facilities. The bilingual survey was distributed by mail and e-mail from July to November 2013. Setting Canada. Participants A total of 94 abortion facilities were identified. Main outcome measures The number and location of services were compared with the distribution of reproductive-age women by location of residence. Results We identified 94 Canadian facilities providing abortion in 2012, with 48.9% in Quebec. The response rate was 83.0% (78 of 94). Facilities in every jurisdiction with services responded. In Quebec and British Columbia abortion services are nearly equally present in large urban centres and rural locations throughout the provinces; in other Canadian provinces services are chiefly located in large urban areas. No abortion services were identified in Prince Edward Island. Respondents reported provision of 75 650 abortions in 2012 (including 4.0% by medical abortion). Canadian facilities reported minimal or no harassment, in stark contrast to American facilities that responded to the same survey. Conclusion Access to abortion services varies by region across Canada. Services are not equitably distributed in relation to the regions where reproductive-age women reside. British Columbia and Quebec have demonstrated effective strategies to address disparities. Health policy and service improvements have the potential to address current abortion access inequity in Canada. These measures include improved access to mifepristone for medical abortion; provincial policies to support abortion services; routine abortion training within family medicine residency programs; and increasing the scope of practice for nurses and midwives to include abortion

  10. ‘Are We Not Human?’ Stories of Stigma, Disability and HIV from Lusaka, Zambia and Their Implications for Access to Health Services

    PubMed Central

    Parsons, Janet A.; Bond, Virginia A.; Nixon, Stephanie A.

    2015-01-01

    Background The advent of anti-retroviral therapy (ART) in Southern Africa holds the promise of shifting the experience of HIV toward that of a manageable chronic condition. However, this potential can only be realized when persons living with HIV are able to access services without barriers, which can include stigma. Our qualitative study explored experiences of persons living with disabilities (PWD) in Lusaka, Zambia who became HIV-positive (PWD/HIV+). Methods and Findings We conducted interviews with 32 participants (21 PWD/HIV+ and 11 key informants working in the fields of HIV and/or disability). Inductive thematic analysis of interview transcripts was informed by narrative theory. Participants’ accounts highlighted the central role of stigma experienced by PWD/HIV+, with stigmatizing attitudes closely linked to prevailing societal assumptions that PWD are asexual. Seeking diagnostic and treatment services for HIV was perceived as evidence of PWD being sexually active. Participants recounted that for PWD/HIV+, stigma was enacted in a variety of settings, including the queue for health services, their interactions with healthcare providers, and within their communities. Stigmatizing accounts told about PWD/HIV+ were described as having important consequences. Not only did participants recount stories of internalized stigma (with its damaging effects on self-perception), but also that negative experiences resulted in some PWD preferring to “die quietly at home” rather than being subjected to the stigmatizing gaze of others when attempting to access life-preserving ART. Participants recounted how experiences of stigma also affected their willingness to continue ART, their willingness to disclose their HIV status to others, as well as their social relations. However, participants also offered counter-stories, actively resisting stigmatizing accounts and portraying themselves as resilient and resourceful social actors. Conclusions The study highlights a

  11. 3 CFR 13625 - Executive Order 13625 of August 31, 2012. Improving Access to Mental Health Services for Veterans...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... health conditions, and Traumatic Brain Injury (TBI) has hampered progress in prevention, diagnosis, and... Science and Technology Policy; (vi) the Office of National Drug Control Policy; and (vii) such...

  12. The Impact of the "Village" Model on Health, Well-Being, Service Access, and Social Engagement of Older Adults

    ERIC Educational Resources Information Center

    Graham, Carrie L.; Scharlach, Andrew E.; Price Wolf, Jennifer

    2014-01-01

    Background: Villages represent an emerging consumer-driven social support model that aims to enhance the social engagement, independence, and well-being of community-dwelling seniors through a combination of social activities, volunteer opportunities, service referral, and direct assistance. This study aimed to assess the perceived impact of…

  13. [Smart cards in health services].

    PubMed

    Rienhoff, O

    2001-10-01

    Since the early 1980-ties it has been tried to utilise smart cards in health care. All industrialised countries participated in those efforts. The most sustainable analyses took place in Europe--specifically in the United Kingdom, France, and Germany. The first systems installed (the service access cards in F and G, the Health Professional Card in F) are already conceptionally outdated today. The senior understanding of the great importance of smart cards for security of electronic communication in health care does contrast to a hesitating behaviour of the key players in health care and health politics in Germany. There are clear hints that this may relate to the low informatics knowledge of current senior management. PMID:11688229

  14. 42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Access to services under an MA private fee-for-service plan. 422.114 Section 422.114 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits...

  15. [Mental health services in Australia].

    PubMed

    Kisely, Steve; Lesage, Alain

    2014-01-01

    Canada is 1.5 times the size of Australia. Australia's population of 20 million is located principally on the east coast. Like Canada, the Australia has a federal system of Government with 5 States and two territories. Each State and territory has its own legislation on mental health. The federal (Commonwealth) Government is responsible for health care planning. In addition, the federal Government subsidizes an insurance program (Medicare) that covers visits to specialists and family physicians, while provincial governments are involved in the provision of hospital care and community mental health services. The Commonwealth government also subsidises the cost of medication through the Pharmaceutical Benefits Scheme. These funds are supplemented by private health insurance. Mental health costs account for 6.5 per cent of all health care costs. Primary care treats the majority of common psychological disorders such as anxiety or depression, while specialist mental health services concentrate on those with severe mental illness. There have been 4 national mental health plans since 1992 with the long term aims of promoting mental health, increasing the quality and responsiveness of services, and creating a consistent approach to mental health service system reform among Australian states and territories. These systematic cycles of planning have first allowed a shift from psychiatric hospitals to community services, from reliance on psychiatric hospitals as pivotal to psychiatric care system. Community care budgets have increased, but overall have decreased with money not following patients; but recent deployment of federally funded through Medicare access to psychotherapy by psychologists for common mental disorders in primary care have increased overall budget. Concerns remain that shift to youth first onset psychosis clinics may come from older long-term psychotic patients, a form of discrimination whilst evidence amount of excess mortality by cardio

  16. Consumer Health: Products and Services.

    ERIC Educational Resources Information Center

    Haag, Jessie Helen

    This book presents a general overview of consumer health, its products and services. Consumer health is defined as those topics dealing with a wise selection of health products and services, agencies concerned with the control of these products and services, evaluation of quackery and health misconceptions, health careers, and health insurance.…

  17. StreetHealth - improving access to primary care.

    PubMed

    Hookey, Susan J

    2012-01-01

    Homeless, marginalised and other disadvantaged groups may be reluctant to access mainstream health services. StreetHealth, a mobile street-based after hours primary healthcare service, was developed to address the primary health care needs of disadvantaged groups in the western Melbourne region of Victoria. This article describes StreetHealth and reflects on strategies to improve access to primary care services in this population. Mainstream general practices may like to consider and adapt some of these strategies to better meet the needs of similar patients in their community. PMID:22276289

  18. 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

  19. [Vulnerability and National Health Service].

    PubMed

    Lima, Cristina

    2006-01-01

    Safegarding health has been an objective of every learned civilization, ancient and modern. In modern times, at least in the western world, the increase in longevity associated with social isolation has created further vu1nerability for the older individua1. Today, healthcare is a social burden of extremely high cost. Among us this service is provided by the National Health Service in accordance to the Constituição da República Portuguesa (Constitution of the Portuguese Republic). Despite the constitutional guarantees of equa1ity in health there are obvious discrepancies in access to health care and the conditions that promote health such as education and wealth. In a poor country, even with limited resources, inequa1ity can be minimized via policies and practical measures founded in equa1ity and social responsibility, not only the principles of economic efficiency. Only in this way can we guarantee equa1 access to health and the distribution of available resources in accordance to health care necessities. Yet, the investment in high technology among us seems out of fase with the investment in the area concerning functional recovery from high morta1ity illness, such as stroke. In Portugal the problem is extremely bad. Life expectancy has been extended but qua1ity of life is still very low. Victims of the social order, the elderly live alone without family who can care for them; on the other hand, the lack of investment in recovery and social integration of individua1s with disabling scars, Turns the ends of their life's into a nightmare for themselves and their kin. It follows stating the necessity to analyse and define the criteria to be used when allocating resources in order to guarantee equality in health and relief from suffering and also to stop discrimination of vu1nerable populations in access to healthcare. Whatever the criteria, it must be pre-defined and its principles widely discussed, reiterating, only that longevity cannot be an acceptable criteria

  20. Transparent data service with multiple wireless access

    NASA Technical Reports Server (NTRS)

    Dean, Richard A.; Levesque, Allen H.

    1993-01-01

    The rapid introduction of digital wireless networks is an important part of the emerging digital communications scene. The introduction of Digital Cellular, LEO and GEO Satellites, and Personal Communications Services poses both a challenge and an opportunity for the data user. On the one hand wireless access will introduce significant new portable data services such as personal notebooks, paging, E-mail, and fax that will put the information age in the user's pocket. On the other hand the challenge of creating a seamless and transparent environment for the user in multiple access environments and across multiple network connections is formidable. A summary of the issues associated with developing techniques and standards that can support transparent and seamless data services is presented. The introduction of data services into the radio world represents a unique mix of RF channel problems, data protocol issues, and network issues. These problems require that experts from each of these disciplines fuse the individual technologies to support these services.

  1. Interoperable Data Access Services for NOAA IOOS

    NASA Astrophysics Data System (ADS)

    de La Beaujardiere, J.

    2008-12-01

    The Integrated Ocean Observing System (IOOS) is intended to enhance our ability to collect, deliver, and use ocean information. The goal is to support research and decision-making by providing data on our open oceans, coastal waters, and Great Lakes in the formats, rates, and scales required by scientists, managers, businesses, governments, and the public. The US National Oceanic and Atmospheric Administration (NOAA) is the lead agency for IOOS. NOAA's IOOS office supports the development of regional coastal observing capability and promotes data management efforts to increase data accessibility. Geospatial web services have been established at NOAA data providers including the National Data Buoy Center (NDBC), the Center for Operational Oceanographic Products and Services (CO-OPS), and CoastWatch, and at regional data provider sites. Services established include Open-source Project for a Network Data Access Protocol (OpenDAP), Open Geospatial Consortium (OGC) Sensor Observation Service (SOS), and OGC Web Coverage Service (WCS). These services provide integrated access to data holdings that have been aggregated at each center from multiple sources. We wish to collaborate with other groups to improve our service offerings to maximize interoperability and enhance cross-provider data integration, and to share common service components such as registries, catalogs, data conversion, and gateways. This paper will discuss the current status of NOAA's IOOS efforts and possible next steps.

  2. Birth of a health service.

    PubMed

    Anderson, G

    On April 18th, independent Zimbabwe celebrated its 3rd birthday. In 1980, within days after taking power, Robert Mugabe's government announced that health care was to be free to everyone earning less then Z150 (60 British pounds) a month--the vast majority of the population. Although the free services are a good public relations policy, more important was the decision to expand the health services at grassroots level and to shift emphasis from an urban based curative system to rural based preventive care. Zimbabwe desperately needs doctors. According to the World Health Organization (WHO), the country has some 1400 registered doctors, roughly 1 for every 6000 people. Yet, of the 1400, under 300 work in the government health services and many of those are based in Harare, the capital. Of Zimbabwe's 28 district hospitals, only 14 have a full-time doctor. In some rural areas, there is 1 doctor/100,000 or more people. The nature of the country's health problems, coupled with the government's severe shortage of cash, shows why nursing is so crucial to Zimbabwe's development. If the rural communities, which make up 85% of the population, were to have easy access to a qualified nurse, or even a nursing assistant, the quality of life would double. The only thing that is more important is a clean water supply. Possibly the most important role for nurses in Zimbabwe is that of education. Nurses can spread awareness of basic hygiene, raise the skill of local people in dealing with minor health problems independently, carry out immunization programs, offer contraceptive advice, give guidance on breastfeeding and infant nutrition, and work with practitioners of traditional African medicines to make sure they possess basic scientific knowledge. Rebuilding after the war was not a major problem for the Mugabe health ministry, for in many areas there was simply nothing to rebuild. There were never any health services. A far greater problem has been the top heavy structure of the

  3. 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

  4. 45 CFR 147.130 - Coverage of preventive health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Coverage of preventive health services. 147.130 Section 147.130 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE REFORM REQUIREMENTS FOR THE GROUP AND INDIVIDUAL HEALTH INSURANCE MARKETS § 147.130 Coverage of preventive...

  5. 45 CFR 147.130 - Coverage of preventive health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Coverage of preventive health services. 147.130 Section 147.130 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE REFORM REQUIREMENTS FOR THE GROUP AND INDIVIDUAL HEALTH INSURANCE...

  6. Health Occupations Education. Health Services Careers.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    Twenty-four units on health service careers are presented in this teacher's guide. The units are organized into four sections as follow: Section A--Orientation (health careers, career success, Health Occupations Students of America); Section B--Health and First Aid (personal health, community health, and first aid); Section C--Body Structure and…

  7. Health services in Indonesia.

    PubMed

    Kosen, S; Gunawan, S

    In Indonesia, rapid economic development has led to a reduction in poverty among the 195 million inhabitants. While population increased more than 50% from 1971 to 1990, the annual growth rate, crude birth rate, and total fertility rates have declined rapidly. Life expectancy has increased from 45.7 years in 1971 to 62.7 in 1994 as crude death rates and infant and child mortality rates have declined. Causes of death have shifted from infectious to chronic diseases, but in 1992 major causes of death in children under 5 years old were preventable, and the maternal mortality rate was 425/100,000. Policies which guide the development of health care call for improvements in quality of life, adherence to humanitarian principles, use of scientifically approved traditional medicine, and provision of public health through a three-tiered system. Health care is financed by the government and the community, and managed care has been encouraged. Foreign aid has bolstered development in the health sector. Adequate sanitation has been achieved for 35% of the population, and 65% of urban and 35% of rural residents have reasonable access to clean water. Improvements in health indicators include 55% contraceptive prevalence, reduction in prevalence of anemia during pregnancy, 55.8% of pregnant women receiving prenatal care, a decrease in protein-energy malnutrition among children under five, and high vaccination coverage. Remaining public health problems include malaria, tuberculosis, dengue hemorrhagic fever, an increase in HIV/AIDS, iodine-deficiency, an increasing number of traffic fatalities, and an increasing number of smokers. New health policies have been instituted to meet these challenges as Indonesia's need for a productive and competitive labor force increases. PMID:8985447

  8. 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

  9. 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…

  10. 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. PMID:18560100

  11. Leveraging Resources to Create Comprehensive Access Services

    ERIC Educational Resources Information Center

    Boisvert, Pamela K.

    2007-01-01

    The Colleges of Worcester Consortium has created a broad array of statewide, higher education access services over several decades by leveraging federal, state, local, and foundation resources. The consortium comprises thirteen diverse colleges and universities in central Massachusetts and is a nonprofit regional association of these institutions:…

  12. Moving beyond the Amalgam: Restructuring Access Services

    ERIC Educational Resources Information Center

    Austin, Brice

    2010-01-01

    At least since the early 1990s, academic libraries have been merging Circulation and various other related functions into a single department typically labeled "Access Services." In many cases, however, that merger has proven to be administrative rather than functional, with minimal integration of common workflows. This article describes a…

  13. Access to Service: Rural and Remote Communities.

    ERIC Educational Resources Information Center

    Knight, Robert

    This paper discusses public library services to remote communities in Australia, focusing on New South Wales (NSW). The first section presents background on the public library network in NSW, including statistics, descriptors/characteristics of public libraries, and funding to establish public Internet access. The second section addresses regional…

  14. Barriers to Accessing Services for Young Children

    ERIC Educational Resources Information Center

    Williams, Marian E.; Perrigo, Judith L.; Banda, Tanya Y.; Matic, Tamara; Goldfarb, Fran D.

    2013-01-01

    This study investigates barriers to accessing services for children under age 3 presenting with language delays and behavioral difficulties, including language barriers for Spanish-speaking families. Using a telephone script, researchers called 30 agencies in Los Angeles County, including regional centers (the state network of Part C agencies for…

  15. Assessment and Evaluation Methods for Access Services

    ERIC Educational Resources Information Center

    Long, Dallas

    2014-01-01

    This article serves as a primer for assessment and evaluation design by describing the range of methods commonly employed in library settings. Quantitative methods, such as counting and benchmarking measures, are useful for investigating the internal operations of an access services department in order to identify workflow inefficiencies or…

  16. 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

  17. Equity in development and access to health services in the Wild Coast of South Africa: the community view through four linked cross-sectional studies between 1997 and 2007

    PubMed Central

    2011-01-01

    Background After election in 1994, the South African government implemented national and regional programmes, such as the Wild Coast Spatial Development Initiative (SDI), to provoke economic growth and to decrease inequities. CIET measured development in the Wild Coast region across four linked cross-sectional surveys (1997-2007). The 2007 survey was an opportunity to look at inequities since the original 1997 baseline, and how such inequities affect access to health care. Methods The 2000, 2004 and 2007 follow-up surveys revisited the communities of the 1997 baseline. Household-level multivariate analysis looked at development indicators and access to health in the context of inequities such as household crowding, access to protected sources of water, house roof construction, main food item purchased, and perception of community empowerment. Individual multivariate models accounted for age, sex, education and income earning opportunities. Results Overall access to protected sources of water increased since the baseline (from 20% in 1997 to 50% in 2007), yet households made of mud and grass, and households who bought basics as their main food item were still less likely to have protected sources of water. The most vulnerable, such as those with less education and less water and food security, were also less likely to have worked for wages leaving them with little chance of improving their standard of living (less education OR 0.59, 95%CI 0.37-0.94; less water security OR 0.67, 95%CI 0.48-0.93; less food security OR 0.43, 95%CI 0.29-0.64). People with less income were more likely to visit government services (among men OR 0.28, 95%CI 0.13-0.59; among women OR 0.33, 95%CI 0.20-0.54), reporting decision factors of cost and distance; users of private clinics sought out better service and medication. Lower food security and poorer house construction was also associated with women visiting government rather than private health services. Women with some formal education

  18. 47 CFR 54.807 - Interstate access universal service support.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Interstate access universal service support. 54... SERVICES (CONTINUED) UNIVERSAL SERVICE Interstate Access Universal Service Support Mechanism § 54.807 Interstate access universal service support. (a) Each Eligible Telecommunications Carrier (ETC) that...

  19. 47 CFR 54.807 - Interstate access universal service support.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Interstate access universal service support. 54... SERVICES (CONTINUED) UNIVERSAL SERVICE Interstate Access Universal Service Support Mechanism § 54.807 Interstate access universal service support. (a) Each Eligible Telecommunications Carrier (ETC) that...

  20. 47 CFR 54.807 - Interstate access universal service support.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Interstate access universal service support. 54.807 Section 54.807 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Interstate Access Universal Service Support Mechanism § 54.807 Interstate access universal service support....

  1. 47 CFR 54.807 - Interstate access universal service support.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Interstate access universal service support. 54... SERVICES (CONTINUED) UNIVERSAL SERVICE Interstate Access Universal Service Support Mechanism § 54.807 Interstate access universal service support. (a) Each Eligible Telecommunications Carrier (ETC) that...

  2. 47 CFR 54.807 - Interstate access universal service support.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Interstate access universal service support. 54... SERVICES (CONTINUED) UNIVERSAL SERVICE Interstate Access Universal Service Support Mechanism § 54.807 Interstate access universal service support. (a) Each Eligible Telecommunications Carrier (ETC) that...

  3. Unifying access to services: ESO's user portal

    NASA Astrophysics Data System (ADS)

    Chavan, A. M.; Tacconi-Garman, L. E.; Peron, M.; Sogni, F.; Canavan, T.; Nass, P.

    2006-06-01

    The European Southern Observatory (ESO) is in the process of creating a central access point for all services offered to its user community via the Web. That gateway, called the User Portal, will provide registered users with a personalized set of service access points, the actual set depending on each user's privileges. Correspondence between users and ESO will take place by way of "profiles", that is, contact information. Each user may have several active profiles, so that an investigator may choose, for instance, whether their data should be delivered to their own address or to a collaborator. To application developers, the portal will offer authentication and authorization services, either via database queries or an LDAP server. The User Portal is being developed as a Web application using Java-based technology, including servlets and JSPs.

  4. 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,…

  5. Promoting Access Through Integrated Mental Health Care Education.

    PubMed

    Kverno, Karan

    2016-01-01

    Mental disorders are the leading cause of non-communicable disability worldwide. Insufficient numbers of psychiatrically trained providers and geographic inequities impair access. To close this treatment gap, the World Health Organization (WHO) has called for the integration of mental health services with primary care. A new innovative online program is presented that increases access to mental health education for primary care nurse practitioners in designated mental health professional shortage areas. To create successful and sustainable change, an overlapping three-phase strategy is being implemented. Phase I is recruiting and educating primary care nurse practitioners to become competent and certified psychiatric mental health nurse practitioners. Phase II is developing partnerships with state and local agencies to identify and support the psychiatric mental health nurse practitioner education and clinical training. Phase III is sustaining integrated mental health care services through the development of nurse leaders who will participate in interdisciplinary coalitions and educate future students. PMID:27347257

  6. Promoting Access Through Integrated Mental Health Care Education

    PubMed Central

    Kverno, Karan

    2016-01-01

    Mental disorders are the leading cause of non-communicable disability worldwide. Insufficient numbers of psychiatrically trained providers and geographic inequities impair access. To close this treatment gap, the World Health Organization (WHO) has called for the integration of mental health services with primary care. A new innovative online program is presented that increases access to mental health education for primary care nurse practitioners in designated mental health professional shortage areas. To create successful and sustainable change, an overlapping three-phase strategy is being implemented. Phase I is recruiting and educating primary care nurse practitioners to become competent and certified psychiatric mental health nurse practitioners. Phase II is developing partnerships with state and local agencies to identify and support the psychiatric mental health nurse practitioner education and clinical training. Phase III is sustaining integrated mental health care services through the development of nurse leaders who will participate in interdisciplinary coalitions and educate future students. PMID:27347257

  7. Improving service accessibility in service-oriented HIS.

    PubMed

    Babamir, Seyed Morteza; Arabfard, Masoud

    2012-12-01

    Nowadays, new trend in design and implementation of Hospital Information System (HIS) is towards using Web-based Service-Oriented Architecture (SOA). However, the standard SOA includes an insensitive service store through which the accessibility of some hospital services becomes difficult when their specification or network address are changed or missed. This paper discusses problems of insensitive service store and then presents a model where a sensitive service store is used to mitigate the problems. To show the efficiency of the proposed model, HIS of the Shahid Beheshti Hospital of Kashan including information systems of Admission, Outpatient, Ward, Pharmacy, Medical Document, Discharge and Insurance was designed and implemented with sensitive service store and its performance was considered. PMID:22898904

  8. Office for prevention and health services assessment

    NASA Astrophysics Data System (ADS)

    Wright, James A.

    1994-12-01

    The Air Force Surgeon General has established the Office for Prevention and Health Care ASsessment (OPHSA) to become the center of excellence for preventive services and health care assessment in the U.S. Air Force and the Department of Defense. OPHSA using the principles of total quality management and integrated teams will evaluate, compare, and modify preventive services delivery guidelines to preserve the fighting force by preventing illness and injuries in military populations. OPHSA will evaluate and formulate health care delivery guidelines to improve health care access and delivery to military patient populations. OPHSA will develop data to determine the health status and health needs to beneficiary populations so medical managers can deliver medical care in the most cost effective manner. OPHSA is located at Brooks Air Force Base in San Antonio, Texas. OPHSA will have thirty seven active duty military, civil service, and contract employees and should be fully functional by the end of 1995.

  9. Measuring health care access and quality to improve health in populations.

    PubMed

    Kottke, Thomas E; Isham, George J

    2010-07-01

    Poor health status, rapidly escalating health care costs, and seemingly little association between investments in health care and health outcomes have prompted a call for a "pay-for-performance" system to improve population health. We suggest that both health plans and clinical service providers measure and report the rates of 5 behaviors: 1) smoking, 2) physical activity, 3) excessive drinking, 4) nutrition, and 5) condom use by sexually active youth. Because preventive services can improve population health, we suggest that health plans and clinical service providers report delivery rates of preventive services. We also suggest that an independent organization report 8 county-level indicators of health care performance: 1) health care expenditures, 2) insurance coverage, 3) rates of unmet medical, dental, and prescription drug needs, 4) preventive services delivery rates, 5) childhood vaccination rates, 6) rates of preventable hospitalizations, 7) an index of affordability, and 8) disparities in access to health care associated with race and income. To support healthy behaviors, access to work site wellness and health promotion programs should be measured. To promote coordinated care, an indicator should be developed for whether a clinical service provider is a member of an accountable care organization. To encourage clinical service providers and health plans to address the social determinants of health, organizational participation in community-benefit initiatives that address the leading social determinants of health should be assessed. PMID:20550831

  10. [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. PMID:22642049

  11. Disparities in access to reproductive health options for female adolescents.

    PubMed

    Ely, Gretchen E; Dulmus, Catherine N

    2010-05-01

    Fifty percent of female adolescents in the United States have intercourse by age 17, yet they do not have the autonomy under the law to access reproductive healthcare services that can address and prevent the negative consequences often associated with adolescent involvement in sexual activity. This article discusses disparities in access to reproductive health services for adolescents in three areas: abortion, over-the-counter emergency contraception, and the provision of the human papillomavirus vaccine. Suggestions for advocacy efforts necessary to eliminate such health disparities are also presented in an effort to elevate female adolescents to a status where they have the same access to health services that are available to adult women. PMID:20446180

  12. Health services in urban India.

    PubMed

    Mittal, S K; Ramji, S

    1989-01-01

    At the time of independence 340 million lived in urban areas in India, and currently 200 million of an estimated population of 800 million live in 3000 cities and towns with inhabitants over 10.000. There are 90.000 government-employed doctors in urban areas: 1 doctor per 2200 residents. Another 180.000 are practicing in such areas providing a ratio of 1 doctor for every 800 urban people. In Delhi in 1986 there were 63 allopathic hospitals with 15.000 beds and 561 dispensaries. Government employees receive preferential treatment, while the public waits long hours. In frustration the poor often turn to private practitioners even if their qualifications are dubious. Despite 35 years of socialistic planning, only 10-15% of children living in a Delhi colony received adequate vaccination. To rectify this inequality a system is recommended guaranteeing public access to dispensaries on the same fee-basis as that accorded to government employees. A health card could prevent misuse, and it would ensure optimal utilization of existing health facilities. Future development of 50-100 bed hospitals within 2-3 km of clients' homes and the attachment of 5-10 of them to a large hospital or medical school is proposed. A central health board could oversee and coordinate area-based health services. PMID:2638675

  13. 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.…

  14. Mental health services in the Solomon Islands.

    PubMed

    Orotaloa, Paul; Blignault, Ilse

    2012-06-01

    The Solomon Islands comprise an archipelago of nearly 1,000 islands and coral atolls and have an estimated population of 549,574 people. Formal mental health services date back to 1950 when an asylum was established. Since then the process of mental health service development has been largely one of incremental change, with a major boost to community services in the last two decades. During the 1990s a mental health outpatient clinic was established in Honiara, together with attempts to recruit nursing staff as psychiatric coordinators in the provinces. In 1996, the Ministry commenced sending registered nurses for psychiatric training in Papua New Guinea. By 2010, there were 13 psychiatric nurses and one psychiatrist, with a second psychiatrist in training. A National Mental Health Policy was drafted in 2009 but is yet to be endorsed by Cabinet. A significant portion of the population still turns to traditional healers or church leaders for purposes of healing, seeking help from Western medicine only after all other alternatives in the community have been exhausted. There is still a long way to go before mental health services are available, affordable and accessible to the whole population, including people living in geographically remote areas. Realization of this vision requires increased resourcing for mental health services; improved communication and collaboration between the centrally-based, national mental health services and the provincial health services; and closer, ongoing relationships between all stakeholders and partners, both locally and internationally. PMID:26767360

  15. Knowledge and perception of Prevention of Mother to Child services amongst pregnant women accessing antenatal clinic in a Primary Health Care centre in Nigeria

    PubMed Central

    Omidokun, Adedoyin D.; Ige, Olusimbo K.

    2012-01-01

    Abstract Background Few studies have assessed pregnant women's perceptions regarding prevention of mother to child of HIV and the available services at the primary health care level in Nigeria. Objective Assessment of knowledge and perception of antenatal clinic (ANC) attendees regarding Prevention of Mother to Child Transmission (PMTCT) of HIV at primary health care facilities in south-west Nigeria. Method A cross-sectional survey was conducted amongst 400 antenatal attendees in a Primary Health Care centre in Ibadan, Nigeria. Results Known methods of PMTCT were: use of anti-retroviral treatment (ART) during pregnancy (75.0%), ART at birth (65.8%) and not breastfeeding (61.8%). Previous HIV Counselling and Testing (HCT) was reported by 71%, significantly higher proportions of those who were married, in the third trimester of pregnancy or engaged in professional and/or skilled occupations had been tested. Regarding the HCT services provided, 92.2% understood the HIV-related health education provided, 89.7.2% reported that the timing was appropriate, 92.6% assessed the nurses’ approach as acceptable but 34.0% felt the test was forced upon them. Majority (79.6%) were aware of non-breastfeeding options of infant feeding, but only 3.5% were aware of exclusive breastfeeding for a stipulated period as an infant feeding option. Nevertheless, the majority of the women found the non-breast feeding option culturally unacceptable. Conclusion Women in this survey were knowledgeable about the methods of PMTCT, but had negative perceptions regarding certain aspects of the HCT services and the recommended non-breastfeeding infant feeding option. Health workers should provide client friendly services and infant feeding counselling that is based on current WHO recommendations and culturally acceptable.

  16. Barriers to mental health services utilization in the Niger Delta region of Nigeria: service users’ perspectives

    PubMed Central

    Jack-Ide, Izibeloko Omi; Uys, Leana

    2013-01-01

    Introduction There is only one neuro-psychiatric hospital for over four million people in the Niger Delta region of Nigeria. Low-income groups in urban and rural areas who access care through public mental health clinics are at greater risk of not accessing the needed mental health care. This study aimed to explored barriers that prevent people from utilizing mental health services, and to identifies key factors to increase access and improved service delivery. Methods A qualitative study was conducted among 20 service users attending the outpatient clinic of Rumuigbo neuropsychiatric hospital. Ten participants were caregivers and 10 were clients, both having accessed services for at least one year. Results The mean age was 37.7 years, 60% were males, 40% were unemployed and only 15% had a regular monthly income, while 65% live in rural areas. Barriers observed in mental health services use were physical, financial and cultural. These include absence of service in rural communities, poor knowledge of mental health services, stigma, transportation problems, waiting time at the facility and cost of service. Conclusion Stigma remains a strong barrier to accessing mental health services, and extensive efforts need to be made to overcome ignorance and discrimination. Mental health services need to be provided throughout the health care system to enable people to access them locally and affordably, preventing the need to travel and promoting service uptake and treatment continuation. PMID:23785564

  17. 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

  18. Coordination between Child Welfare Agencies and Mental Health Service Providers, Children's Service Use, and Outcomes

    ERIC Educational Resources Information Center

    Bai, Yu; Wells, Rebecca; Hillemeier, Marianne M.

    2009-01-01

    Objective: Interorganizational relationships (IORs) between child welfare agencies and mental health service providers may facilitate mental health treatment access for vulnerable children. This study investigates whether IORs are associated with greater use of mental health services and improvement in mental health status for children served by…

  19. Developing a strategic marketing plan for physical and occupational therapy services: a collaborative project between a critical access hospital and a graduate program in health care management.

    PubMed

    Kash, Bita A; Deshmukh, A A

    2013-01-01

    The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program. PMID:23924224

  20. 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…

  1. 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. PMID:26547091

  2. Richmond Wellbeing Service Access Strategy for Older Adults

    PubMed Central

    Gowling, Sarah; Persson, Jennie; Holt, Genevieve; Ashbourne, Sue; Bloomfield, James; Shortland, Hannah; Bate, Clare

    2016-01-01

    IAPT (Improving Access to Psychological Therapies) is a national programme aimed at increasing availability of evidence based psychological therapies in the NHS. IAPT is primarily for people who have mild to moderate, common mental health difficulties such as depression, anxiety, phobias and post traumatic stress disorder (PTSD). The programme seeks to use the least intrusive method of care possible to treat people at the time when it will be of most help to them. Individuals are able to self-refer into most IAPT services or alternatively can request to be referred by their GP or other services in the community. Richmond Wellbeing Service (RWS) is one such IAPT Service and this research is based on our work to promote accessibility of the service to one of the harder to reach population groups - older adults. We know that IAPT services could have a positive impact on older adults as it is believed on average, 25% of over 65 year olds face common mental health problems. However, only a third of these people discuss this with their GP and so are less likely to be referred to an IAPT Service. In relation to the above, this project was designed to look at increasing access for older adults into Richmond Wellbeing Service (RWS) specifically to improve access to the RWS by older adults by 100. The overall goal was to increase older adult (65+) referral rates by 20% over a year, in raw number this would translate to an increase of 100 over a year period, and in percentage terms an average of 8% of total referrals. Results yielded an increase of 39 referrals between baseline and test period. The majority of this increase had occurred in the final five months of the projects duration(31). Interestingly the number of older adults in the older age band (85+) almost doubled within this period (from 12 to 21). In total, in percentage terms this translates to an an increase of OA referrals from 6% up to 6.7%, as above we are aiming for 8% or an additional increase of 61 patients

  3. Richmond Wellbeing Service Access Strategy for Older Adults.

    PubMed

    Gowling, Sarah; Persson, Jennie; Holt, Genevieve; Ashbourne, Sue; Bloomfield, James; Shortland, Hannah; Bate, Clare

    2016-01-01

    IAPT (Improving Access to Psychological Therapies) is a national programme aimed at increasing availability of evidence based psychological therapies in the NHS. IAPT is primarily for people who have mild to moderate, common mental health difficulties such as depression, anxiety, phobias and post traumatic stress disorder (PTSD). The programme seeks to use the least intrusive method of care possible to treat people at the time when it will be of most help to them. Individuals are able to self-refer into most IAPT services or alternatively can request to be referred by their GP or other services in the community. Richmond Wellbeing Service (RWS) is one such IAPT Service and this research is based on our work to promote accessibility of the service to one of the harder to reach population groups - older adults. We know that IAPT services could have a positive impact on older adults as it is believed on average, 25% of over 65 year olds face common mental health problems. However, only a third of these people discuss this with their GP and so are less likely to be referred to an IAPT Service. In relation to the above, this project was designed to look at increasing access for older adults into Richmond Wellbeing Service (RWS) specifically to improve access to the RWS by older adults by 100. The overall goal was to increase older adult (65+) referral rates by 20% over a year, in raw number this would translate to an increase of 100 over a year period, and in percentage terms an average of 8% of total referrals. Results yielded an increase of 39 referrals between baseline and test period. The majority of this increase had occurred in the final five months of the projects duration(31). Interestingly the number of older adults in the older age band (85+) almost doubled within this period (from 12 to 21). In total, in percentage terms this translates to an an increase of OA referrals from 6% up to 6.7%, as above we are aiming for 8% or an additional increase of 61 patients

  4. 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

  5. A Scoping Review of Immigrant Experience of Health Care Access Barriers in Canada.

    PubMed

    Kalich, Angela; Heinemann, Lyn; Ghahari, Setareh

    2016-06-01

    Canadian population-based surveys report comparable access to health care services between immigrant and non-immigrant populations, yet other research reports immigrant-specific access barriers. A scoping review was conducted to explore research regarding Canadian immigrants' unique experiences in accessing health care, and was guided by the research question: "What is currently known about the barriers that adult immigrants face when accessing Canadian health care services?" The findings of this study suggest that there are unmet health care access needs specific to immigrants to Canada. In reviewing research of immigrants' health care experiences, the most common access barriers were found to be language barriers, barriers to information, and cultural differences. These findings, in addition to low cultural competency reported by interviewed health care workers in the reviewed articles, indicate inequities in access to Canadian health care services for immigrant populations. Suggestions for future research and programming are discussed. PMID:26093784

  6. 39 CFR 3055.91 - Consumer access to postal services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Consumer access to postal services. 3055.91 Section 3055.91 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL SERVICE PERFORMANCE AND CUSTOMER SATISFACTION REPORTING Reporting of Customer Satisfaction § 3055.91 Consumer access to postal services. (a)...

  7. 39 CFR 3055.91 - Consumer access to postal services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false Consumer access to postal services. 3055.91 Section 3055.91 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL SERVICE PERFORMANCE AND CUSTOMER SATISFACTION REPORTING Reporting of Customer Satisfaction § 3055.91 Consumer access to postal services. (a)...

  8. 39 CFR 3055.91 - Consumer access to postal services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 false Consumer access to postal services. 3055.91 Section 3055.91 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL SERVICE PERFORMANCE AND CUSTOMER SATISFACTION REPORTING Reporting of Customer Satisfaction § 3055.91 Consumer access to postal services. (a)...

  9. 39 CFR 3055.91 - Consumer access to postal services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Consumer access to postal services. 3055.91 Section 3055.91 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL SERVICE PERFORMANCE AND CUSTOMER SATISFACTION REPORTING Reporting of Customer Satisfaction § 3055.91 Consumer access to postal services. (a)...

  10. National School Health Service Program. Special Report. Number 1, 1985.

    ERIC Educational Resources Information Center

    Robert Wood Johnson Foundation, New Brunswick, NJ.

    A five-year School Health Service demonstration program, sponsored by The Robert Wood Johnson Foundation, tested whether School Nurse Practitioners (SNP's) supported by community physicians could improve children's access to health care by expanding the health services in schools. The program was conducted in 18 school districts in medically…

  11. 47 CFR 54.621 - Access to advanced telecommunications and information services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Access to advanced telecommunications and information services. 54.621 Section 54.621 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care...

  12. 47 CFR 54.621 - Access to advanced telecommunications and information services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Access to advanced telecommunications and information services. 54.621 Section 54.621 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care...

  13. Health care's service fanatics.

    PubMed

    Merlino, James I; Raman, Ananth

    2013-05-01

    The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life. PMID:23898737

  14. Access Services Education in Library and Information Science Programs

    ERIC Educational Resources Information Center

    McCaslin, David

    2009-01-01

    This article defines the elements of Access Services, explains the importance of those aspects in the library, and proposes a course centered on Access Services for library schools. The areas of circulation, interlibrary loan, course reserves, collection maintenance, and public relations are core components of Access Services. Each of those…

  15. Mental Health Services in School-Based Health Centers: Systematic Review

    ERIC Educational Resources Information Center

    Bains, Ranbir Mangat; Diallo, Ana F.

    2016-01-01

    Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…

  16. [Coverage of health services].

    PubMed

    Martínez-Narváez, G

    1992-01-01

    In this paper the concepts and criteria related to health coverage are discussed in the context of the organization of national health systems. The main international agreements based on WHO/PAHO proposals are also described. The relationship between primary health care and health coverage is analyzed and the evolution of the programs for the extension of health coverage in Mexico are discussed, with emphasis on the problems of overlap and definition of the universe in the several institutions of the health sector. Finally, the author reviews the problems to measure coverage in order to guarantee social and operative efficiency of the Mexican health system. PMID:1411776

  17. 47 CFR 54.621 - Access to advanced telecommunications and information services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... information services. 54.621 Section 54.621 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED... § 54.621 Access to advanced telecommunications and information services. (a) Twenty-five percent of the monthly cost of eligible Internet access shall be eligible for universal support. Health care...

  18. Recent Developments in Alcohol Services Research on Access to Care

    PubMed Central

    Schmidt, Laura A.

    2016-01-01

    In the United States, only about 10 percent of people with an alcohol or drug use disorder receive care for the condition, pointing to a large treatment gap. Several personal characteristics influence whether a person will receive treatment; additionally, many people with an alcohol use disorder do not perceive the need for treatment. The extent of the treatment gap differs somewhat across different population subgroups, such as those based on gender, age, or race and ethnicity. Recent health care reforms, such as implementation of the Patient Protection and Affordable Care Act of 2010, likely will improve access to substance abuse treatment. In addition, new treatment approaches, service delivery systems, and payment innovations may facilitate access to substance abuse services. Nevertheless, efforts to bridge the treatment gap will continue to be needed to ensure that all people who need alcohol and drug abuse treatment can actually receive it. PMID:27159809

  19. Recent Developments in Alcohol Services Research on Access to Care.

    PubMed

    Schmidt, Laura A

    2016-01-01

    In the United States, only about 10 percent of people with an alcohol or drug use disorder receive care for the condition, pointing to a large treatment gap. Several personal characteristics influence whether a person will receive treatment; additionally, many people with an alcohol use disorder do not perceive the need for treatment. The extent of the treatment gap differs somewhat across different population subgroups, such as those based on gender, age, or race and ethnicity. Recent health care reforms, such as implementation of the Patient Protection and Affordable Care Act of 2010, likely will improve access to substance abuse treatment. In addition, new treatment approaches, service delivery systems, and payment innovations may facilitate access to substance abuse services. Nevertheless, efforts to bridge the treatment gap will continue to be needed to ensure that all people who need alcohol and drug abuse treatment can actually receive it. PMID:27159809

  20. Health services under the General Agreement on Trade in Services.

    PubMed Central

    Adlung, R.; Carzaniga, A.

    2001-01-01

    The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). It is possible that Members of the World Trade Organization have been discouraged from undertaking access commitments by the novelty of the Agreement, coordination problems between relevant agencies, widespread inexperience in concepts of services trade, a traditionally strong degree of government involvement in the health sector, and concerns about basic quality and social objectives. However, more than five years have passed since GATS entered into force, allowing hesitant administrations to familiarize themselves with its main elements and its operation in practice. The present paper is intended to contribute to this process. It provides an overview of the basic structure of GATS and of the patterns of current commitments in health services and of limitations frequently used in this context. The concluding section discusses possibilities of pursuing basic policy objectives in a more open environment and indicates issues that may have to be dealt with in current negotiations on services. PMID:11357215

  1. Green Infrastructure, Ecosystem Services, and Human Health

    PubMed Central

    Coutts, Christopher; Hahn, Micah

    2015-01-01

    Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture—in the form of a primer—of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being. PMID:26295249

  2. Green Infrastructure, Ecosystem Services, and Human Health.

    PubMed

    Coutts, Christopher; Hahn, Micah

    2015-08-01

    Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture-in the form of a primer-of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being. PMID:26295249

  3. School Health Services.

    ERIC Educational Resources Information Center

    Wilson, Charles C., Ed.

    A comprehensive guide for health procedures in small and large school systems, this volume emphasizes the need for coordination of school efforts with those of parents, departments of health, private practitioners of medicine and dentistry, and community health agencies. Particular attention is given to the role of the teacher in school health…

  4. Guidelines for School Health Services.

    ERIC Educational Resources Information Center

    Dougherty, Sarah; And Others

    This publication was designed to assist chief school administrators, school nurses, school physicians, staff, and other school health personnel in developing, implementing, and evaluating sound school health programs for New Jersey public school students. Section I delineates responsibility for school health services, discussing the role of…

  5. Health services reforms in revolutionary Nicaragua.

    PubMed Central

    Garfield, R M; Taboada, E

    1984-01-01

    Before the Nicaraguan revolution of 1979, access to health services was largely limited to the affluent sectors of the urban population and the minority of workers with social security coverage. Repeated attempts at reform by organized medicine were ineffective. Since the revolution, a tremendous expansion in health services has occurred. The national health system receives approximately one-third of its funds from the social security system. Steadily increasing equity in access is a result of the promotion of primary care, health campaigns involving up to 10 per cent of the general population as volunteers, the use of paramedical aides, and foreign assistance. Private practice nevertheless remains strong. In the coming years, several complex issues must be examined, including: a balance in the number of nurses and doctors trained, the role of private practice, and the relationship of the Ministry of Health to the social security system. Further progress in health reforms may be delayed by the defensive war which Nicaragua is fighting on its northern and southern borders. Despite emergent health problems in the war zones, most of the innovative aspects of the health system remain intact as of this writing. PMID:6476169

  6. 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

  7. Sustaining an Aboriginal mental health service partnership.

    PubMed

    Fuller, Jeffrey D; Martinez, Lee; Muyambi, Kuda; Verran, Kathy; Ryan, Bronwyn; Klee, Ruth

    2005-11-21

    The Regional Aboriginal Integrated Social and Emotional (RAISE) Wellbeing program commenced in February 2003 as an Aboriginal mental health service partnership between one Aboriginal Health Service and three mainstream services: a community mental health team, a hospital mental health liaison, and an "outback" community counselling service. A case study method was used to describe the drivers (incentives for program development), linkage processes (structures and activities through which the partnership operated), and sustainability of the program. Program drivers were longstanding problems with Aboriginal peoples' access to mental health care, policy direction favouring shared service responsibility, and a relatively small amount of new funding for mental health that allowed the program to commence. Linkage processes were the important personal relationships between key individuals. Developing the program as a part of routine practice within and across the partner organisations is now needed through formal agreements, common care-management tools, and training. The program's sustainability will depend on this development occurring, as well as better collection and use of data to communicate the value of the program and support calls for adequate recurrent funds. The development of care-management tools, training and data systems will require a longer period of start-up funding as well as some external expertise. PMID:16296956

  8. Predictors of Health Service Barriers for Older Chinese Immigrants in Canada

    ERIC Educational Resources Information Center

    Lai, Daniel W. L.; Chau, Shirley B. Y.

    2007-01-01

    Elderly people from ethnic minority groups often experience different barriers in accessing health services. Earlier studies on access usually focused on types and frequency but failed to address the predictors of service barriers. This study examined access barriers to health services faced by older Chinese immigrants in Canada. Factor analysis…

  9. NASA Alternate Access to Station Service Concept

    NASA Astrophysics Data System (ADS)

    Bailey, M. D.; Crumbly, C.

    2002-01-01

    The evolving nature of the NASA space enterprise compels the agency to develop new and innovative space systems concepts. NASA, working with increasingly strained budgets and a declining manpower base, is attempting to transform from operational activities to procurement of commercial services. NASA's current generation reusable launch vehicle, the Shuttle, is in transition from a government owned and operated entity to a commercial venture to reduce the civil servant necessities for that program. NASA foresees its second generation launch vehicles being designed and operated by industry for commercial and government services. The "service" concept is a pioneering effort by NASA. The purpose the "service" is not only to reduce the civil servant overhead but will free up government resources for further research and enable industry to develop a space business case so that industry can sustain itself beyond government programs. In addition, NASA desires a decreased responsibility thereby decreasing liability. The Second Generation Reusable Launch Vehicle (RLV) program is implementing NASA's Space Launch Initiative (SLI) to enable industry to develop the launch vehicles of the future. The Alternate Access to Station (AAS) project office within this program is chartered with enabling industry to demonstrate an alternate access capability for the International Space Station (ISS). The project will not accomplish this by traditional government procurement methods, not by integrating the space system within the project office, or by providing the only source of business for the new capability. The project funds will ultimately be used to purchase a service to take re-supply cargo to the ISS, much the same as any business might purchase a service from FedEx to deliver a package to its customer. In the near term, the project will fund risk mitigation efforts for enabling technologies. AAS is in some ways a precursor to the 2nd Generation RLV. By accomplishing ISS resupply

  10. NASA Alternate Access to Station Service Concept

    NASA Technical Reports Server (NTRS)

    Bailey, Michelle D.; Crumbly, Chris

    2001-01-01

    The evolving nature of the NASA space enterprise compels the agency to develop new and innovative space systems concepts. NASA, working with increasingly strained budgets and a declining manpower base, is attempting to transform from operational activities to procurement of commercial services. NASA's current generation reusable launch vehicle, the Shuttle, is in transition from a government owned and operated entity to a commercial venture to reduce the civil servant necessities for that program. NASA foresees its second generation launch vehicles being designed and operated by industry for commercial and government services. The "service" concept is a pioneering effort by NASA. The purpose the "service" is not only to reduce the civil servant overhead but will free up government resources for further research - and enable industry to develop a space business case so that industry can sustain itself beyond government programs. In addition, NASA desires a decreased responsibility thereby decreasing liability. The Second Generation Reusable Launch Vehicle (RLV) program is implementing NASA's Space Launch Initiative (SLI) to enable industry to develop the launch vehicles of the future. The Alternate Access to Station (AAS) project office within this program is chartered with enabling industry to demonstrate an alternate access capability for the International Space Station (ISS). The project will not accomplish this by traditional government procurement methods, not by integrating the space system within the project office, or by providing the only source of business for the new capability. The project funds will ultimately be used to purchase a service to take re-supply cargo to the ISS, much the same as any business might purchase a service from FedEx to deliver a package to its customer. In the near term, the project will fund risk mitigation efforts for enabling technologies. AAS is in some ways a precursor to the 2nd Generation RLV. By accomplishing ISS resupply

  11. Strategic service quality management for health care.

    PubMed

    Anderson, E A; Zwelling, L A

    1996-01-01

    Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes. PMID:8763215

  12. Public Health Services for Foreign Workers in Malaysia.

    PubMed

    Noh, Normah Awang; Wahab, Haris Abd; Bakar Ah, Siti Hajar Abu; Islam, M Rezaul

    2016-01-01

    The objective of this study was to know the status of the foreign workers' access to public health services in Malaysia based on their utilization pattern. The utilization pattern covered a number of areas, such as frequency of using health services, status of using health services, choice and types of health institutions, and cost of health treatment. The study was conducted on six government hospitals in the Klang Valley area in Kuala Lumpur, Malaysia. Data were collected from 600 foreign patients working in the country, using an interview method with a structured questionnaire. The results showed that the foreign workers' access to public health services was very low. The findings would be an important guideline to formulate an effective health service policy for the foreign workers in Malaysia. PMID:27177326

  13. 47 CFR 69.3 - Filing of access service tariffs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....3, see the List of CFR Sections Affected, which appears in the Finding Aids section of the printed... 47 Telecommunication 3 2010-10-01 2010-10-01 false Filing of access service tariffs. 69.3 Section... (CONTINUED) ACCESS CHARGES General § 69.3 Filing of access service tariffs. (a) Except as provided...

  14. Health Services and Collective Bargaining

    ERIC Educational Resources Information Center

    Torrence, William D.

    1974-01-01

    A rationale is suggested for designing and developing education and training programs in labor relations for hospital managements. Also, federal work stoppage data are identified as they relate to medical and other health services. (AG)

  15. Services Shared by Health Care Organizations: An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Hospital Research and Educational Trust, Chicago, IL.

    This bibliography is designed to assist planners in the field of institutional health and health support services in gaining access to knowledge that will enhance their efforts to achieve new or expanded arrangements of service sharing. Entries are cross-referenced to as many categories as the material warrants. Case studies that are not annotated…

  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. 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…

  18. Characteristics of Telemental Health Service Use by American Indian Veterans

    PubMed Central

    Shore, Jay H.; Brooks, Elizabeth; Anderson, Heather; Bair, Byron; Dailey, Nancy; Kaufmann, L. Jeanne; Manson, Spero

    2016-01-01

    Objective This study examined use by American Indian and Alaska Native veterans of services provided by specialty telemental health clinics focused on posttraumatic stress disorder. These clinics offer services via videoconferencing to address challenges faced by rural veterans in accessing care. Methods A retrospective chart and electronic medical record review was conducted for 85 male veteranswho used services at two rural telemental health clinics in 2006 and 2007. Service use and other characteristics were documented before and after their initial telemental health intake. Results After intake, patients use of any health services (both general medical and mental health services) significantly increased (p<.01), as did the proportion receiving appropriate psychotropic medication (p<.01). Conclusions This first examination of service use by American Indian and Alaska Native veterans at specialty telemental health clinics will help inform research and clinical strategies for improving telemental health for this and other rural populations. PMID:22302338

  19. 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

  20. The Future of Access Services: Should There Be One?

    ERIC Educational Resources Information Center

    Hersey, Denise P.

    2004-01-01

    The creation of "Access Services" departments in academic libraries did not translate into the creation or offering of new services for patrons. Instead, it was typically just the combination of three already existing departments. Recent changes and trends in Access Services, including new NCIP and ISO standards, an increase in the use of…

  1. 47 CFR 36.213 - Network access services revenues.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Network access services revenues. 36.213 Section 36.213 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Income Accounts Operating Revenues § 36.213 Network access services revenues. (a) End User...

  2. 47 CFR 36.213 - Network access services revenues.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Network access services revenues. 36.213 Section 36.213 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Income Accounts Operating Revenues § 36.213 Network access services revenues. (a) End User...

  3. 47 CFR 36.213 - Network access services revenues.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Network access services revenues. 36.213 Section 36.213 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Income Accounts Operating Revenues § 36.213 Network access services revenues. (a) End User...

  4. 47 CFR 36.213 - Network access services revenues.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Network access services revenues. 36.213 Section 36.213 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Income Accounts Operating Revenues § 36.213 Network access services revenues. (a) End User...

  5. 47 CFR 36.213 - Network access services revenues.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Network access services revenues. 36.213 Section 36.213 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Income Accounts Operating Revenues § 36.213 Network access services revenues. (a) End User...

  6. Electronic Health Services

    PubMed Central

    Khalil, Mounir M; Jones, Ray

    2007-01-01

    Information and communication technologies have made dramatic changes in our lives. Healthcare communities also made use of these technologies. Using computerized medical knowledge, electronic patients’ information and telecommunications a lot of applications are now established throughout the world. These include better ways of information management, remote education, telemedicine and public services. Yet, a lot of people don't know about these technologies and their applications. Understanding the concepts and ideologies behind these terms, knowing how they will be implemented, what is it like to use them and what benefit will be gained, are basic knowledge steps approaching these technologies. Difficulties using these services, especially in developing countries should not be neglected or underestimated. PMID:21503245

  7. Direct access to potential research participants for a cohort study using a confidentiality waiver included in UK National Health Service legal statutes

    PubMed Central

    Taylor, Rachel M; Fern, Lorna A; Aslam, Natasha; Whelan, Jeremy S

    2016-01-01

    Objectives To describe our experience of using a confidentiality waiver (Section 251) in the National Health Service (NHS) Act to identify and recruit potential research participants to a cohort study and consider its use in a wider research context. Design Methodological discussion. Setting NHS Trusts in England. Methods We established a research recruitment process with quality health (QH), administrators of the National Cancer Patient Experience Survey, after an amendment to a Section 251 approval (reference number ECC-8-05d-2011). NHS Trusts agreeing to implement the process were requested to send the details of 16–24-year-olds, identified by a relevant ICD-10 code indicating a cancer diagnosis within a specified time period to QH. QH sent study information and a consent-to-be-contacted form which allowed QH to send details to BRIGHTLIGHT, for BRIGHTLIGHT to contact the treating team confirming eligibility and for an interviewer from Ipsos MORI to contact them. Written consent was to be obtained at interview. Results The method was implemented in 98 trusts; 75 supplied patient details. QH sent information to 441 young people, of whom 64 (15%) responded. Of these, 23 had already consented to participate. Adverse events were reported by 6 (1%) invitees: 4 were distressed because they did not have cancer, their details being submitted to QH due to incorrect hospital coding, and 1 young person was distressed about their diagnosis and requested no further contact and 1 young person found out they had cancer from the invitation. Conclusions Application of Section 251 of the NHS Act (2006) to directly approach participants can facilitate recruitment to research projects where routinely collected NHS data are available to select eligible patients. The benefits of this method are that it requires fewer resources to recruit across multiple sites, and is quicker. Further information on the impact on bias and adverse event profile are required. PMID:27481623

  8. 34 CFR 303.16 - Health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Health services. 303.16 Section 303.16 Education... DISABILITIES General Definitions Used in This Part § 303.16 Health services. (a) Health services mean services..., the changing of dressings or colostomy collection bags, and other health services; and...

  9. 34 CFR 303.16 - Health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Health services. 303.16 Section 303.16 Education... DISABILITIES General Definitions Used in This Part § 303.16 Health services. (a) Health services mean services..., the changing of dressings or colostomy collection bags, and other health services; and...

  10. 34 CFR 303.16 - Health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Health services. 303.16 Section 303.16 Education... DISABILITIES General Definitions Used in This Part § 303.16 Health services. (a) Health services mean services..., the changing of dressings or colostomy collection bags, and other health services; and...

  11. Latino adults' access to mental health care: a review of epidemiological studies.

    PubMed

    Cabassa, Leopoldo J; Zayas, Luis H; Hansen, Marissa C

    2006-05-01

    Since the early 1980s, epidemiological studies using state-of-the-art methodologies have documented the unmet mental health needs of Latinos adults in the U.S. and Puerto Rico. This paper reviews 16 articles based on seven epidemiological studies, examines studies methodologies, and summarizes findings about how Latino adults access mental health services. Studies consistently report that, compared to non-Latino Whites, Latinos underutilize mental health services, are less likely to receive guideline congruent care, and rely more often on primary care for services. Structural, economic, psychiatric, and cultural factors influence Latinos' service access. In spite of the valuable information these studies provide, methodological limitations (e.g., reliance on cross-sectional designs, scarcity of mixed Latino group samples) constrict knowledge about Latinos access to mental health services. Areas for future research and development needed to improve Latinos' access and quality of mental health care are discussed. PMID:16598658

  12. The impact of health insurance on health services utilization and health outcomes in Vietnam.

    PubMed

    Guindon, G Emmanuel

    2014-10-01

    In recent years, a number of low- and middle-income country governments have introduced health insurance schemes. Yet not a great deal is known about the impact of such policy shifts. Vietnam's recent health insurance experience including a health insurance scheme for the poor in 2003 and a compulsory scheme that provides health insurance to all children under six years of age combined with Vietnam's commitment to universal coverage calls for research that examines the impact of health insurance. Taking advantage of Vietnam's unique policy environment, data from the 2002, 2004 and 2006 waves of the Vietnam Household Living Standard Survey and single-difference and difference-in-differences approaches are used to assess whether access to health insurance--for the poor, for children and for students--impacts on health services utilization and health outcomes in Vietnam. For the poor and for students, results suggest health insurance increased the use of inpatient services but not of outpatient services or health outcomes. For young children, results suggest health insurance increased the use of outpatient services (including the use of preventive health services such as vaccination and check-up) but not of inpatient services. PMID:24661805

  13. 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

  14. Heart Health May Hinge on Easy Access to Fresh Food

    MedlinePlus

    ... of Health, the U.S. Department of Health and Human Services, or federal policy. More Health News on: Health Disparities Heart Diseases--Prevention Nutrition Recent Health News Related MedlinePlus Health Topics Health ...

  15. Practical Strategies for Making Online Library Services and Instruction Accessible to All Patrons

    ERIC Educational Resources Information Center

    Wray, Christina C.

    2013-01-01

    Providing accessible library services and instruction to distance users with disabilities can seem daunting. This article, which grew out of a webinar presented by the author to the Health Science Special Interest Group of ACRL, provides practical strategies to help content creators utilize built-in accessibility features and provides a resources…

  16. Health Services and Rural America.

    ERIC Educational Resources Information Center

    Rural Housing Alliance, Washington, DC.

    Rural people lose more days of school and work due to illness than do urban people; have higher infant mortality rates, and have more work-related injuries, all of which are aggravated by lack of access to or even the absence of medical services. Lack of doctors is the most glaring problem (in 1973 there were 138 U.S. counties which had no…

  17. Federal health services grants, 1985.

    PubMed

    Zwick, D I

    1986-01-01

    Federal health services grants amounted to about $1.8 billion in fiscal year 1985. The total amount was about $100 million less, about 6 percent, than in 1980. Reductions in the health planning program accounted for most of the decline in absolute dollars. The four formula grants to State agencies amounted to about $1.0 billion in 1985, about 60 percent of the total. The largest formula grants were for maternal and child health services and for alcohol, drug abuse, and mental health services. Project grants to selected State and local agencies amounted to about $.8 billion. There was 12 such grants in 1985 (compared with 34 in 1980). The largest, for community health services, equaled almost half the total. In real, inflation-adjusted dollars, the decline in Federal funds for these programs exceeded a third during the 5-year period. The overall dollar total in real terms in 1985 approximated the 1970 level. The ratio of formula grants to project grants in 1985 was similar to that in 1965. Studies of the impact of changes in Federal grants have found that while the development of health programs has been seriously constrained in most cases, their nature has not been substantially altered. In some cases broader program approaches and allocations have been favored. Established modes of operations and administration have generally been strengthened. Some efficiencies but few savings in administration have been identified. Replacement of reduced Federal funding by the States has been modest but has increased over time, especially for direct service activities. These changes reflect the important influence of professionalism in the health fields and the varying strengths of political interest and influence among program supporters. The long-term impact on program innovation is not yet clear. PMID:3094081

  18. Access to Tuberculosis Services for Individuals with Disability in Rural Malawi, a Qualitative Study

    PubMed Central

    Grut, Lisbet; Sanudi, Lifah; Braathen, Stine Hellum; Jürgens, Thomas; Eide, Arne H.

    2015-01-01

    Tuberculosis occurs in all populations, but with higher prevalence in poor contexts. Vulnerable groups, including individuals with disability, run a particular risk due to poorer access to information and health services. Studying access to tuberculosis services for vulnerable groups in poor contexts may provide useful insight into the quality of such services in low-income contexts. This article aims to present a contextual understanding of access to tuberculosis services for people with disabilities in one district in southern Malawi. A qualitative method with semi-structured interviews and site observations was applied. In all, 89 participants were interviewed: 47 persons with disability, 11 parents/guardians of youths with disability, and the remaining 31 comprising eight health workers, four community rehabilitation assistants and volunteers, and 19 leaders in the community.Our main findings are that lack of information and knowledge, and considerable confusion related to tuberculosis, its cause and how to protect oneself, are major barrier to accessing services. Disease awareness and personal risk perception are key factors in this regard. Further findings concerns the pathways to tuberculosis related health services, in particular having a test and completing the treatment. The combination of lack of knowledge and barriers in accessing tests implies substantial availability and access problems.It is of importance to understand the combined impact of individual, social, contextual, and systems barriers to fully address the complexity of accessing tuberculosis services for vulnerable groups in poor populations. Lack of disability specific strategies in the local health services may be part of the reason why individuals with disability to not access such services. PMID:25830950

  19. Access to tuberculosis services for individuals with disability in rural Malawi, a qualitative study.

    PubMed

    Grut, Lisbet; Sanudi, Lifah; Braathen, Stine Hellum; Jürgens, Thomas; Eide, Arne H

    2015-01-01

    Tuberculosis occurs in all populations, but with higher prevalence in poor contexts. Vulnerable groups, including individuals with disability, run a particular risk due to poorer access to information and health services. Studying access to tuberculosis services for vulnerable groups in poor contexts may provide useful insight into the quality of such services in low-income contexts. This article aims to present a contextual understanding of access to tuberculosis services for people with disabilities in one district in southern Malawi. A qualitative method with semi-structured interviews and site observations was applied. In all, 89 participants were interviewed: 47 persons with disability, 11 parents/guardians of youths with disability, and the remaining 31 comprising eight health workers, four community rehabilitation assistants and volunteers, and 19 leaders in the community.Our main findings are that lack of information and knowledge, and considerable confusion related to tuberculosis, its cause and how to protect oneself, are major barrier to accessing services. Disease awareness and personal risk perception are key factors in this regard. Further findings concerns the pathways to tuberculosis related health services, in particular having a test and completing the treatment. The combination of lack of knowledge and barriers in accessing tests implies substantial availability and access problems.It is of importance to understand the combined impact of individual, social, contextual, and systems barriers to fully address the complexity of accessing tuberculosis services for vulnerable groups in poor populations. Lack of disability specific strategies in the local health services may be part of the reason why individuals with disability to not access such services. PMID:25830950

  20. Gender-planned health services.

    PubMed

    Raikes, A; Shoo, R; Brabin, L

    1992-08-01

    Gender-planned health services are planned on the basis that women and men play different roles in society and have different medical needs. The feminist movement has provided a broad charter of rights for women, reflecting women's needs, but these have yet to be translated into operational programmes. National programmes for women would allow co-ordination of broad-based programmes to improve women's health and social position. To change social norms discriminating against women will require changing male attitudes. Health programmes for males have received little attention, except from family planning organizations, although in most countries, males have a high rate of accidents, infections and parasitic disease. Controlled studies are required to evaluate the benefits of gender-planned health services. PMID:1489242

  1. Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers

    PubMed Central

    2014-01-01

    Background Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Methods Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women’s health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Results Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion

  2. Access Control of Cloud Service Based on UCON

    NASA Astrophysics Data System (ADS)

    Danwei, Chen; Xiuli, Huang; Xunyi, Ren

    Cloud computing is an emerging computing paradigm, and cloud service is also becoming increasingly relevant. Most research communities have recently embarked in the area, and research challenges in every aspect. This paper mainly discusses cloud service security. Cloud service is based on Web Services, and it will face all kinds of security problems including what Web Services face. The development of cloud service closely relates to its security, so the research of cloud service security is a very important theme. This paper introduces cloud computing and cloud service firstly, and then gives cloud services access control model based on UCON and negotiation technologies, and also designs the negotiation module.

  3. Metadata Access Tool for Climate and Health

    NASA Astrophysics Data System (ADS)

    Trtanji, J.

    2012-12-01

    The need for health information resources to support climate change adaptation and mitigation decisions is growing, both in the United States and around the world, as the manifestations of climate change become more evident and widespread. In many instances, these information resources are not specific to a changing climate, but have either been developed or are highly relevant for addressing health issues related to existing climate variability and weather extremes. To help address the need for more integrated data, the Interagency Cross-Cutting Group on Climate Change and Human Health, a working group of the U.S. Global Change Research Program, has developed the Metadata Access Tool for Climate and Health (MATCH). MATCH is a gateway to relevant information that can be used to solve problems at the nexus of climate science and public health by facilitating research, enabling scientific collaborations in a One Health approach, and promoting data stewardship that will enhance the quality and application of climate and health research. MATCH is a searchable clearinghouse of publicly available Federal metadata including monitoring and surveillance data sets, early warning systems, and tools for characterizing the health impacts of global climate change. Examples of relevant databases include the Centers for Disease Control and Prevention's Environmental Public Health Tracking System and NOAA's National Climate Data Center's national and state temperature and precipitation data. This presentation will introduce the audience to this new web-based geoportal and demonstrate its features and potential applications.

  4. 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…

  5. Access to Libraries and Information Services.

    ERIC Educational Resources Information Center

    Bob, Murray L.

    The unresolved aspects of access that were handled in the "Report of the Commissioner of Education's Committee on Library Development, 1970" and the "Report of the Commissioner of Education's Committee on Direct Access, 1974" are discussed. Travel distance to libraries providing reference and referral, interlibrary loan, and on-line data base…

  6. Students' Motivation to Access Academic Advising Services

    ERIC Educational Resources Information Center

    Henning, Marcus A.

    2009-01-01

    The interrelationships between motivation for choosing a program of study, intention to access academic advisors, academic difficulty, and actual appointments with academic advisors were based on student self-reports of motivation and intentions. In addition, academic achievement measures and data on student access to academic advisors were…

  7. [Female migrants in the health care system. Health care utilisation, access barriers and health promotion strategies].

    PubMed

    Wimmer-Puchinger, B; Wolf, H; Engleder, A

    2006-09-01

    Due to the evident interaction between social factors and health, migrants are exposed to specific risk factors and access barriers to health services. Some examples are the lower education level, the low social position and/or the insufficient language skills. This concept is further elaborated in the multi-factorial impacts of health literacy. Female migrants often experience additional discrimination because of their gender. Despite the lack of representative data, consistent studies show that female migrants do not regularly take advantage of health care prevention and present themselves with higher degrees of stress. The current "inadequate health care" manifests itself in a lack of care in the areas of prevention and health education and an abundance in the context of medication and diagnostic procedures. To meet these demands and to further reduce barriers, in particular language barriers, specific strategies for this target group involving both politics and the health care system have to be developed. Besides the employment of interpreters with a native cultural background and the distribution of information booklets, it is an important strategy to reduce structural obstacles such as cultural diversity. To contact these women in their living environment should help to increase their self-determined health promotion. Selected models of good practice in Austria with regard to the themes of FGM (female genital mutilation), violence, heart disease and breast cancer are presented to highlight the specific health situation and risk factors of female migrants as well as successful strategies to confront them. PMID:16927035

  8. 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…

  9. 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…

  10. Mental health nurse practitioners in Australia: improving access to quality mental health care.

    PubMed

    Fisher, Jacklin E

    2005-12-01

    Under The Nurses Amendment (Nurse Practitioners) Act 1998, New South Wales became the first state in Australia to legislate for nurse practitioners. Mental health was identified as a priority 'area of practice' for nurse practitioners. Issues surrounding the implementation of the nurse practitioner role in Australia and the potential for the role to address the current crisis in mental health nursing and the mental health sector will be discussed. The potential for partnerships with other health-care providers, in particular medical practitioners, will demonstrate how successful implementation of the role can fulfil consumer demand for primary prevention counselling, improve access to mental health services and early intervention, and provide mental health services that better reflect national priorities. This examination of the Australian context will be contrasted with a review of the overseas literature on mental health nurse practitioners. PMID:16296989

  11. 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. PMID:25452590

  12. Access to general practitioner services amongst underserved Australians: a microsimulation study

    PubMed Central

    2012-01-01

    Background One group often identified as having low socioeconomic status, those living in remote or rural areas, are often recognised as bearing an unequal burden of illness in society. This paper aims to examine equity of utilisation of general practitioner services in Australia. Methods Using the 2005 National Health Survey undertaken by the Australian Bureau of Statistics, a microsimulation model was developed to determine the distribution of GP services that would occur if all Australians had equal utilisation of health services relative to need. Results It was estimated that those who are unemployed would experience a 19% increase in GP services. Persons residing in regional areas would receive about 5.7 million additional GP visits per year if they had the same access to care as Australians residing in major cities. This would be a 18% increase. There would be a 20% increase for inner regional residents and a 14% increase for residents of more remote regional areas. Overall there would be a 5% increase in GP visits nationally if those in regional areas had the same access to care as those in major cities. Conclusion Parity is an insufficient goal and disadvantaged persons and underserved areas require greater access to health services than the well served metropolitan areas due to their greater poverty and poorer health status. Currently underserved Australians suffer a double disadvantage: poorer health and poorer access to health services. PMID:22264385

  13. Developing School Health Services in Massachusetts: A Public Health Model

    ERIC Educational Resources Information Center

    Sheetz, Anne H.

    2003-01-01

    In 1993 the Massachusetts Department of Public Health (MDPH) began defining essential components of school health service programs, consistent with the public health model. The MDPH designed and funded the Enhanced School Health Service Programs to develop 4 core components of local school health services: (a) strengthening the administrative…

  14. The Health and Social Service Needs of Gay and Lesbian Elders and Their Families in Canada.

    ERIC Educational Resources Information Center

    Brotman, Shari; Ryan, Bill; Cormier, Robert

    2003-01-01

    Studies the experiences of gay and lesbian seniors and their families in accessing a broad range of health and social services in the community. Results reveal that specific reference was made to the impact of discrimination on the health and access to health services of these populations. Recommendations for change are highlighted. (Contains 71…

  15. Service Accessibility for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth

    ERIC Educational Resources Information Center

    Acevedo-Polakovich, Ignacio David; Bell, Bailey; Gamache, Peter; Christian, Allison S.

    2013-01-01

    Although Lesbian, Gay, Bisexual, Transgender, Queer and/or Questioning (LGBTQ) youth experience alarming rates of behavioral and social problems, service use among these youth is disproportionately low. It is likely that decreased service accessibility plays a causal role in service underutilization among LGBTQ youth. To expand the existing…

  16. 45 CFR 1624.5 - Accessibility of legal services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... qualified person with a disability shall, because a legal services program's facilities are inaccessible to... 45 Public Welfare 4 2011-10-01 2011-10-01 false Accessibility of legal services. 1624.5 Section 1624.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES...

  17. 45 CFR 1624.5 - Accessibility of legal services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... qualified person with a disability shall, because a legal services program's facilities are inaccessible to... 45 Public Welfare 4 2010-10-01 2010-10-01 false Accessibility of legal services. 1624.5 Section 1624.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES...

  18. 34 CFR 303.13 - Health services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Health services. 303.13 Section 303.13 Education... DISABILITIES General Purpose, Eligibility, and Other General Provisions § 303.13 Health services. (a) As used in this part, health services means services necessary to enable a child to benefit from the...

  19. 34 CFR 303.13 - Health services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Health services. 303.13 Section 303.13 Education... DISABILITIES General Purpose, Eligibility, and Other General Provisions § 303.13 Health services. (a) As used in this part, health services means services necessary to enable a child to benefit from the...

  20. Afghanistan's basic package of health services: its development and effects on rebuilding the health system.

    PubMed

    Newbrander, William; Ickx, Paul; Feroz, Ferozuddin; Stanekzai, Hedayatullah

    2014-01-01

    In 2001, Afghanistan's Ministry of Public Health inherited a devastated health system and some of the worst health statistics in the world. The health system was rebuilt based on the Basic Package of Health Services (BPHS). This paper examines why the BPHS was needed, how it was developed, its content and the changes resulting from the rebuilding. The methods used for assessing change were to review health outcome and health system indicator changes from 2004 to 2011 structured along World Health Organisation's six building blocks of health system strengthening. BPHS implementation contributed to success in improving health status by translating policy and strategy into practical interventions, focusing health services on priority health problems, clearly defining the services to be delivered at different service levels and helped the Ministry to exert its stewardship role. BPHS was expanded nationwide by contracting out its provision of services to non-governmental organisations. As a result, access to and utilisation of primary health care services in rural areas increased dramatically because the number of BPHS facilities more than doubled; access for women to basic health care improved; more deliveries were attended by skilled personnel; supply of essential medicines increased; and the health information system became more functional. PMID:24865404

  1. Afghanistan's Basic Package of Health Services: Its development and effects on rebuilding the health system

    PubMed Central

    Newbrander, William; Ickx, Paul; Feroz, Ferozuddin; Stanekzai, Hedayatullah

    2014-01-01

    In 2001, Afghanistan's Ministry of Public Health inherited a devastated health system and some of the worst health statistics in the world. The health system was rebuilt based on the Basic Package of Health Services (BPHS). This paper examines why the BPHS was needed, how it was developed, its content and the changes resulting from the rebuilding. The methods used for assessing change were to review health outcome and health system indicator changes from 2004 to 2011 structured along World Health Organisation's six building blocks of health system strengthening. BPHS implementation contributed to success in improving health status by translating policy and strategy into practical interventions, focusing health services on priority health problems, clearly defining the services to be delivered at different service levels and helped the Ministry to exert its stewardship role. BPHS was expanded nationwide by contracting out its provision of services to non-governmental organisations. As a result, access to and utilisation of primary health care services in rural areas increased dramatically because the number of BPHS facilities more than doubled; access for women to basic health care improved; more deliveries were attended by skilled personnel; supply of essential medicines increased; and the health information system became more functional. PMID:24865404

  2. Health Services Research and Development: the Veterans Administration Program.

    PubMed Central

    Goldschmidt, P G

    1986-01-01

    Health expenditures are rising inexorably; health status shows relatively little gain; technological possibilities are outstripping our ability or willingness to provide a commensurate level of resources. Clinical and administrative managers face increasingly difficult choices among alternative interventions in attempting to resolve these problems. If health services research is to succeed as a tool for assisting these decisions, clinicians, administrators, and researchers must view it as an integral part of management. This paper describes this concept of health services research and its implementation by the VA HSR&D Service, results from 1981 to date, and future directions. Four programs implement the Service's system to make relevant, valid information accessible to VA staff who can use it to improve veterans' health care: Investigator-Initiated Research (IIR) Program; HSR&D Field Program, which implements the Service's mission in various local areas VA-wide; Special Projects Program, responsive to system-wide issues, including technology assessment and transfer; and Resources Program, the Service's own management system. The Service's impact on improving veterans health care is already apparent. However, the true value of the HSR&D system will become apparent only in the 1990s, after the capacity for conducting health services research has been built and integrated fully with clinical and administrative practice. The VA, the nation's largest health care system, has a unique opportunity to demonstrate how health services research can improve health care. PMID:3081467

  3. 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. PMID:26898401

  4. Providing primary health care through integrated microfinance and health services in Latin America.

    PubMed

    Geissler, Kimberley H; Leatherman, Sheila

    2015-05-01

    The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic

  5. Rating maternal and neonatal health services in developing countries.

    PubMed Central

    Bulatao, Rodolfo A.; Ross, John A.

    2002-01-01

    OBJECTIVE: To assess maternal and neonatal health services in 49 developing countries. METHODS: The services were rated on a scale of 0 to 100 by 10 - 25 experts in each country. The ratings covered emergency and routine services, including family planning, at health centres and district hospitals, access to these services for both rural and urban women, the likelihood that women would receive particular forms of antenatal and delivery care, and supporting elements of programmes such as policy, resources, monitoring, health promotion and training. FINDINGS: The average rating was only 56, but countries varied widely, especially in access to services in rural areas. Comparatively good ratings were reported for immunization services, aspects of antenatal care and counselling on breast feeding. Ratings were particularly weak for emergency obstetric care in rural areas, safe abortion and HIV counselling. CONCLUSION: Maternal health programme effort in developing countries is seriously deficient, particularly in rural areas. Rural women are disadvantaged in many respects, but especially regarding the treatment of emergency obstetric conditions. Both rural and urban women receive inadequate HIV counselling and testing and have quite limited access to safe abortion. Improving services requires moving beyond policy reform to strengthening implementation of services and to better staff training and health promotion. Increased financing is only part of the solution. PMID:12378290

  6. Mexican immigrant mothers' expectations for children's health services.

    PubMed

    Clark, Lauren; Redman, Richard W

    2007-10-01

    Women of Mexican descent living in the United States raise children who use health care services. What do immigrant Mexican mothers expect from children's health care services? And how do their expectations for children's health services compare to acculturated Mexican American mothers' expectations? This focused ethnographic study, based on repeated interviews with 28 mothers of varying acculturation levels, describes their expectations and experiences with children's health care services in the United States. Findings support a shared core of expectations for both Mexican immigrant and Mexican American mothers, and differences in health care access and financing, time spent in health care encounters, and cultural and linguistic expectations for care. Health care providers can use this information to approach Mexican-descent mothers and children with their expectations in mind, and craft a negotiated plan of care congruent with their expectations. PMID:17557932

  7. Providing Access to Justice through Service Learning

    ERIC Educational Resources Information Center

    Kubichek, Mary

    2010-01-01

    In the Casper College Legal Service (CCLS) program, Casper College paralegal students, under supervision of pro bono attorneys, use paralegal skills to provide legal services and work product. CCLS is different from other legal clinics; it is not law school based, bar based, or court based. CCLS is paralegal based.

  8. [Universal coverage of health services in Mexico].

    PubMed

    2013-01-01

    The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people. PMID:24570037

  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. A geographical perspective on access to sexual and reproductive health care for women in rural Africa.

    PubMed

    Yao, Jing; Murray, Alan T; Agadjanian, Victor

    2013-11-01

    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

  11. 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

  12. 47 CFR 51.217 - Nondiscriminatory access: Telephone numbers, operator services, directory assistance services...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., operator services, directory assistance services, and directory listings. 51.217 Section 51.217... Obligations of All Local Exchange Carriers § 51.217 Nondiscriminatory access: Telephone numbers, operator... carrier (LEC) in that LEC's service area. (2) Nondiscriminatory access. “Nondiscriminatory access”...

  13. Describing Simple Data Access Services Version 1.0

    NASA Astrophysics Data System (ADS)

    Plante, Raymond; Delago, Jesus; Harrison, Paul; Tody, Doug; IVOA Registry Working Group; Plante, Raymond

    2013-11-01

    An application that queries or consumes descriptions of VO resources must be able to recognize a resource's support for standard IVOA protocols. This specification describes how to describe a service that supports any of the four fundamental data access protocols Simple Cone Search (SCS), Simple Image Access (SIA), Simple Spectral Access (SSA), Simple Line Access (SLA) using the VOResource XML encoding standard. A key part of this specification is the set of VOResource XML extension schemas that define new metadata that are specific to those protocols. This document describes in particular rules for describing such services within the context of IVOA Registries and data discovery as well as the VO Standard Interface (VOSI) and service selfdescription. In particular, this document spells out the essential markup needed to identify support for a standard protocol and the base URL required to access the interface that supports that protocol.

  14. Fair and Equitable Postal Service Access Act

    THOMAS, 112th Congress

    Rep. Moore, Gwen [D-WI-4

    2011-09-15

    10/03/2011 Referred to the Subcommittee on Federal Workforce, U.S. Postal Service, and Labor Policy . (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  15. International survey of occupational health nurses' roles in multidisciplinary teamwork in occupational health services.

    PubMed

    Rogers, Bonnie; Kono, Keiko; Marziale, Maria Helena Palucci; Peurala, Marjatta; Radford, Jennifer; Staun, Julie

    2014-07-01

    Access to occupational health services for primary prevention and control of work-related injuries and illnesses by the global workforce is limited (World Health Organization [WHO], 2013). From the WHO survey of 121 (61%) participating countries, only one-third of the responding countries provided occupational health services to more than 30% of their workers (2013). How services are provided in these countries is dependent on legal requirements and regulations, population, workforce characteristics, and culture, as well as an understanding of the impact of workplace hazards and worker health needs. Around the world, many occupational health services are provided by occupational health nurses independently or in collaboration with other disciplines' professionals. These services may be health protection, health promotion, or both, and are designed to reduce health risks, support productivity, improve workers' quality of life, and be cost-effective. Rantanen (2004) stated that basic occupational health services must increase rather than decline, especially as work becomes more complex; workforces become more dynamic and mobile, creating new models of work-places; and jobs become more precarious and temporary. To better understand occupational health services provided by occupational health nurses globally and how decisions are made to provide these services, this study examined the scope of services provided by a sample of participating occupational health nurses from various countries. PMID:25000546

  16. Equity of access under Korean universal health insurance.

    PubMed

    Park, Ju Moon

    2015-03-01

    This study examined the extent to which equity in the use of physician services has been achieved in the Republic of Korea. Descriptive and logistic regression analysis was performed examining the relationship between the dependent variable and the independent variables and the relative importance of factors. The results indicate that a universal health insurance system has not yielded a fully equitable distribution of services. Access differences arise from coverage limitation, as well as urban/rural variations in the distributions of providers. The policy options for expansion of coverage should be encouraged to ease the financial burden of out-of-pocket payments on patients and to limit the range of noninsured services. Urban/rural variations in the distributions of providers are caused by the government's "laissez-faire" policy for the private medical sector. To solve this geographic misdistribution, the attention of policy makers is required, with changing of the government's "laissez-faire" policy. PMID:22652252

  17. African Americans' Access to Vocational Rehabilitation Services after Antidiscrimination Legislation

    ERIC Educational Resources Information Center

    Mwachofi, Ari K.

    2008-01-01

    The purpose of this study was to determine changes in African Americans' access to occasional rehabilitation (VR) services subsequent to landmark legislative and judicial antidiscrimination provisions of the mid-20th century. This study compared African American VR access before the antidiscrimination legislation in 1937 and after the legislation…

  18. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Access to emergency medical services. 115.182 Section 115.182 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Medical and Mental Care § 115.182 Access to...

  19. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Access to emergency medical services. 115.182 Section 115.182 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Medical and Mental Care § 115.182 Access to...

  20. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Access to emergency medical services. 115.182 Section 115.182 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Medical and Mental Care § 115.182 Access to...

  1. Equality, accessibility, and availability of physical therapy services in Israel-Perception of national directors.

    PubMed

    Jacob, Tamar; Parag, Ayala

    2015-07-01

    To date no research has described Israeli physical therapy (PT) services to determine whether they are provided in the spirit intended by the National Health Insurance Law (NHIL). This study aimed to assess the equality, accessibility, and availability of PT services in Israel. Qualitative research was based on semi-structured, personal interviews with all national directors of PT services in Israel, followed by content analysis of the data obtained. According to the findings, PT services are provided by all Health Maintenance Organisations (HMOs) throughout Israel. In peripheral areas, access to services is limited; availability of services at most clinics is poor, a problem which is solved mainly by referring patients to PT outsourcing. The number of treatment sessions is determined by the NHIL; however, all directors agreed that the number of treatments provided should be based on a professional decision following patient evaluation and progress, rather than on administrative considerations. Inequality of service to peripheral areas could be reduced by creating cooperation between HMOs, thereby establishing clinics capable of providing services that are both accessible and equitable. In addition, the number of sessions provided to patients in the health-care basket should be reassessed, and a set of uniform criteria should be created for determining the optimal number of PT sessions. This could lead to greater uniformity in distribution of PT services provided by the HMOs. PMID:25600829

  2. Department of Health and Human Services

    MedlinePlus

    ... content HHS .gov Search U.S. Department of Health & Human Services Search Close A-Z Index About HHS ... Start Standards The U.S. Department of Health and Human Services announced new standards to further strengthen the ...

  3. Retrospective chart review of obesity and episodic and chronic illness among rural Mexican-American adolescents accessing rural health clinic services.

    PubMed

    Champion, Jane Dimmitt; Pierce, Sherrie; Collins, Jennifer L

    2015-06-01

    Obesity impacts the physical and psychological health of children and adolescents, and is a risk factor for development of episodic and chronic illness. Rural Mexican-American adolescents are at risk for obesity and associated chronic illnesses.The study used a retrospective chart review of data collected routinely in a rural health clinic setting from 1 January 2005 to 31 December 2010 to assess incidence of overweight/obesity status and episodic or chronic illness among Mexican-American adolescents aged 12-18 years. Analyses included body mass index, age, gender, and episodic or chronic illness diagnoses. Two hundred twelve charts were audited; women (n = 114, 53.8%), men (n = 98 46.2%); normal (n = 105, 49.5%), overweight/obese (n = 107, 50.5%). There were more female normal (n = 61, 53.5%) vs. overweight/obese (n = 53, 46.5%). More male overweight/obese (n = 54, 55.1%) than normal weight (n = 44, 44.9%). Age at first documented overweight/obesity status occurred in early adolescence (median = 13 years, mode = 12 years). Chronic illness incidence was higher among men than women, and overweight/obese vs. normal weight adolescents and in sub-categorizations by weight and specific illness. Incidence of episodic illness was higher among women than men, with variation by weight and specific illness. Disproportionately high incidence of episodic or chronic illness and overweight/obesity identified among rural Mexican-American adolescents compels intervention modification to improve effectiveness. PMID:24674302

  4. Making Spatial Statistics Service Accessible On Cloud Platform

    NASA Astrophysics Data System (ADS)

    Mu, X.; Wu, J.; Li, T.; Zhong, Y.; Gao, X.

    2014-04-01

    Web service can bring together applications running on diverse platforms, users can access and share various data, information and models more effectively and conveniently from certain web service platform. Cloud computing emerges as a paradigm of Internet computing in which dynamical, scalable and often virtualized resources are provided as services. With the rampant growth of massive data and restriction of net, traditional web services platforms have some prominent problems existing in development such as calculation efficiency, maintenance cost and data security. In this paper, we offer a spatial statistics service based on Microsoft cloud. An experiment was carried out to evaluate the availability and efficiency of this service. The results show that this spatial statistics service is accessible for the public conveniently with high processing efficiency.

  5. 42 CFR 136.24 - Authorization for contract health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Authorization for contract health services. 136.24 Section 136.24 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Contract Health Services §...

  6. The use of information and communications technology for health service delivery in Namibia: perspectives of the health service providers.

    PubMed

    Shivute, Meke I; Maumbe, Blessing M; Owei, Vesper T

    2008-01-01

    We surveyed health service providers in Namibia to find out how they used information and communication technologies (ICTs) to deliver health services to their patients. A structured questionnaire was administered to 21 health service providers in two regions of the country (one urban, one rural). There was overwhelming consensus among the health service providers that ICTs were very important, especially for medical services (100%). Ninety-one percent of health service providers viewed ICT as helping them to interact with other providers in other health institutions. The most commonly used ICT was the telephone, which was used in the admission areas of most health institutions (36%); the next most commonly used ICT was the PC (23%). The most commonly used channels for communication with patients were the telephone followed by TV. Some of the problems common to all health institutions in Namibia were poor budgetary resources and lack of basic infrastructure such as electricity or telephone lines. There is a need to promote ICT use for health service delivery and also to stimulate patients to use ICT to access health services and relevant information. PMID:18776072

  7. Unifying Access to National Hydrologic Data Repositories via Web Services

    NASA Astrophysics Data System (ADS)

    Valentine, D. W.; Jennings, B.; Zaslavsky, I.; Maidment, D. R.

    2006-12-01

    The CUAHSI hydrologic information system (HIS) is designed to be a live, multiscale web portal system for accessing, querying, visualizing, and publishing distributed hydrologic observation data and models for any location or region in the United States. The HIS design follows the principles of open service oriented architecture, i.e. system components are represented as web services with well defined standard service APIs. WaterOneFlow web services are the main component of the design. The currently available services have been completely re-written compared to the previous version, and provide programmatic access to USGS NWIS. (steam flow, groundwater and water quality repositories), DAYMET daily observations, NASA MODIS, and Unidata NAM streams, with several additional web service wrappers being added (EPA STORET, NCDC and others.). Different repositories of hydrologic data use different vocabularies, and support different types of query access. Resolving semantic and structural heterogeneities across different hydrologic observation archives and distilling a generic set of service signatures is one of the main scalability challenges in this project, and a requirement in our web service design. To accomplish the uniformity of the web services API, data repositories are modeled following the CUAHSI Observation Data Model. The web service responses are document-based, and use an XML schema to express the semantics in a standard format. Access to station metadata is provided via web service methods, GetSites, GetSiteInfo and GetVariableInfo. The methdods form the foundation of CUAHSI HIS discovery interface and may execute over locally-stored metadata or request the information from remote repositories directly. Observation values are retrieved via a generic GetValues method which is executed against national data repositories. The service is implemented in ASP.Net, and other providers are implementing WaterOneFlow services in java. Reference implementation of

  8. 45 CFR 96.45 - Preventive health and health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health...

  9. 45 CFR 96.45 - Preventive health and health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health...

  10. 45 CFR 96.45 - Preventive health and health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health...

  11. 45 CFR 96.45 - Preventive health and health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health...

  12. 45 CFR 96.45 - Preventive health and health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health...

  13. Student Health Services at Orchard Ridge.

    ERIC Educational Resources Information Center

    Nichols, Don D.

    This paper provides a synoptic review of student health services at the community college level while giving a more detailed description of the nature of health services at Orchard Ridge, a campus of Oakland Community College. The present College Health Service program provides for a part-time (24 hrs./wk.) nurse at Orchard Ridge. A variety of…

  14. The effects of Taiwan's National Health Insurance on access and health status of the elderly.

    PubMed

    Chen, Likwang; Yip, Winnie; Chang, Ming-Cheng; Lin, Hui-Sheng; Lee, Shyh-Dye; Chiu, Ya-Ling; Lin, Yu-Hsuan

    2007-03-01

    The primary objective of this paper is to evaluate the impact of Taiwan's National Health Insurance program (NHI), established in 1995, on improving elderly access to care and health status. Further, we estimate the extent to which NHI reduces gaps in access and health across income groups. Using data from a longitudinal survey, we adopt a difference-in-difference methodology to estimate the causal effect of Taiwan's NHI. Our results show that Taiwan's NHI has significantly increased utilization of both outpatient and inpatient care among the elderly, and such effects were more salient for people in the low- or middle-income groups. Our findings also reveal that although Taiwan's NHI greatly increased the utilization of both outpatient and inpatient services, this increased utilization of health services did not reduce mortality or lead to better self-perceived general health status for Taiwanese elderly. Measures more sensitive than mortality and self-perceived general health may be necessary for discerning the health effects of NHI. Alternatively, the lack of NHI effects on health may reflect other quality and efficiency problems inherent in the system not yet addressed by NHI. PMID:16929478

  15. Access Answers: A Digest of LISTSERVS of Interest to Access Services

    ERIC Educational Resources Information Center

    Smith, Fred W.

    2011-01-01

    This article presents a digest of LISTSERVS of interest to access services for the period of April to June 2011. It presents questions and answers from Interlibrary Loan (ILL) people, CIRCPLUS, and OFFCAMP.

  16. 47 CFR 64.1508 - Blocking access to 900 service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Blocking access to 900 service. 64.1508 Section 64.1508 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Interstate Pay-Per-Call and Other...

  17. Public and Private Adoption: A Comparison of Service and Accessibility.

    ERIC Educational Resources Information Center

    Daly, Kerry J.; Sobol, Michael P.

    1994-01-01

    Used data from national survey of public and private adoption service providers in Canada to examine similarities and differences with respect to clients served, issues associated with adoption accessibility, and nature of postadoption services. Found high degree of homogeneity that cut across public and private division, with typical adoptive…

  18. Universalizing health services in India: the techno-managerial fix.

    PubMed

    Nayar, K R

    2013-01-01

    The non-universal nature of health services in India can also be the result of many reforms and milestones the health services had passed through since independence. The reform era during the post-nineties is replete with many new trends in organizational strategies which could have led to crises in health services. The salient crises need to be dissected from a larger societal crisis and the specific crises in the health services system. It is evident that non-accessibility and non-availability and the sub-optimal functioning of the primary health centers are perennial issues which could not be addressed by indigenous, imposed or cocktail reforms (such as National Rural Health Mission) and by targeting as these only tinker with the health services. Needless to reiterate that there is a need to address the social dimensions which fall outside the technical sphere of health services. This paper based on an analytical review of relevant literature concludes that any efforts to universalize health and health-care can not only focus on technical components but need to address the larger social determinants and especially the societal crisis, which engender ill-health. PMID:24351387

  19. An authentication scheme for secure access to healthcare services.

    PubMed

    Khan, Muhammad Khurram; Kumari, Saru

    2013-08-01

    Last few decades have witnessed boom in the development of information and communication technologies. Health-sector has also been benefitted with this advancement. To ensure secure access to healthcare services some user authentication mechanisms have been proposed. In 2012, Wei et al. proposed a user authentication scheme for telecare medical information system (TMIS). Recently, Zhu pointed out offline password guessing attack on Wei et al.'s scheme and proposed an improved scheme. In this article, we analyze both of these schemes for their effectiveness in TMIS. We show that Wei et al.'s scheme and its improvement proposed by Zhu fail to achieve some important characteristics necessary for secure user authentication. We find that security problems of Wei et al.'s scheme stick with Zhu's scheme; like undetectable online password guessing attack, inefficacy of password change phase, traceability of user's stolen/lost smart card and denial-of-service threat. We also identify that Wei et al.'s scheme lacks forward secrecy and Zhu's scheme lacks session key between user and healthcare server. We therefore propose an authentication scheme for TMIS with forward secrecy which preserves the confidentiality of air messages even if master secret key of healthcare server is compromised. Our scheme retains advantages of Wei et al.'s scheme and Zhu's scheme, and offers additional security. The security analysis and comparison results show the enhanced suitability of our scheme for TMIS. PMID:23828650

  20. [Health services research--from the Health Research Council's perspective].

    PubMed

    Adler, Guido

    2006-01-01

    As early as 1994, the Health Research Council of the Federal Ministry of Education and Research started activities to outline a strategic concept for health services research in Germany. The Health Research Council set the stage for the initiation of a common funding program on health services research of the statutory health insurance funds, the Federal Ministry for Education and Research and the Federal Ministry of Health. This funding program has provided an important stimulus to health services research in Germany. Moreover, it has promoted the involvement and responsibility of the statutory health insurance funds in health services research. In future the funding program will be continued and additionally involve pension insurance funds as well as private health insurance funds. In addition to this special funding program there is a need for a coordinated approach to the further development of health services research in Germany--a common task for both research and funding organizations in health research. PMID:17175754

  1. Health Service Delivery in Developing Countries

    ERIC Educational Resources Information Center

    Benyoussef, Amor

    1977-01-01

    Reviews recent work dealing with methodological and technical issues in health and development; presents examples of the application of social sciences, including health demography and economics, in questions of health services delivery; and analyzes delivery of health services to rural and nomadic populations in Africa, Asia, and Latin America.…

  2. Guidelines for Health Services for Migrant Students.

    ERIC Educational Resources Information Center

    Strazicich, Mirko, Ed.

    This publication provides a standard by which California migrant education health staff can plan, implement, and evaluate a health program for students in grades K-12. Following sections which describe current state legislation, the need for health services, and California's objectives and activities regarding health services for migrant students…

  3. Health Services Manual. Hicksville Public Schools.

    ERIC Educational Resources Information Center

    1987

    This procedure manual describes the uniform procedures used by the Hicksville, New York School District's Health Services Program. Its objectives are to establish a uniform set of health services guidelines and procedures, to update all health forms, to maintain an awareness of the current changes in health laws that govern school districts, and…

  4. [Patient-Proposed Health Services].

    PubMed

    Fujiwara, Yasuhiro

    2016-06-01

    The Patient-Proposed Health Services(PPHS)was launched in April 2016. PPHS was proposed by the Council for Regulatory Reform, which was established in January 2013 under the Second Abe Administration. After discussion within the council, PPHS was published in the Japan Revitalization Strategy(2014 revised edition), which was endorsed by the Cabinet on June 24, 2014. PPHS was proposed therein as a new mechanism within the mixed billing system to apply for a combination of treatment not covered by the public health insurance with treatment covered by the insurance. Subsequently, PPHS was submitted for diet deliberations in April and May 2015 and inserted into article 63 of the health insurance act in accordance with "a law for making partial amendments to the National Health Insurance Act, etc., in order to create a sustainable medical insurance system", which was promulgated on May 29, 2015. In this paper I will review the background of the birth of PPHS and discuss its overview. PMID:27306801

  5. Home health services in New Hampshire.

    PubMed

    Hale, F A; Jacobs, A R

    1976-01-01

    While home health services have traditionally been an underused component of the health care system, current trends suggest the desirability of expanding these services. These trends include an increase in the number of elderly who need the benefits of home care, the recognition that long-term chronic illnesses require appropriate management at home, and concern that patients have access to care at the level most appropriate to their illnesses. In New Hampshire, 41 certified home health agencies offer services. Little systematic research has been conducted on the kinds of services they provide and the patients seen by their staffs. Patient encounter data were collected from a sample of eight agencies for a 4-week period. Staff of the agencies used the patient contact record developed by the National Functional Task Analysis Cooperative Study to collect data. The data reflected differences among the agencies in the size of the populations they serve, organizational characteristics, reasons for patients' visits, expected sources of the revenue that supported them, and the diagnosis of the patients they cared for. The agencies served areas with populations ranging from 1,000 to 40,000. The staffs ranged from 1 to 14 full-time persons. Two were public agencies; the others had voluntary sponsorship. When data on reasons for visits were averaged for the eight agencies, it was shown that 72% of the visits were made for disease control activities such as care for a chronic or acute condition or for treatment or a laboratory test. Disease prevention activities such as a checkup for adults, children, prenatal or postnatal care, or health education accounted for only 24% of the visits. This result may indicate that, in areas short of physician manpower, the community health nurse is taking on increasing responsibility for medical care as well as health and education. Reimbursement for the visits came from Medicare, 25%; Medicaid-welfare, 14%; the patients, 18%; and health

  6. 42 CFR 136a.13 - Authorization for contract health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Authorization for contract health services. 136a.13 Section 136a.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who...

  7. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  8. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  9. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  10. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  11. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  12. 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

  13. 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. PMID:24277789

  14. Diabetes care and service access among elderly Vietnamese with type 2 diabetes

    PubMed Central

    2013-01-01

    Background Vietnamese patients are disproportionately represented in type 2 diabetes mellitus statistics and also incur high rates of diabetes complications. This situation is compounded by limited access to health care. The aim of this project was to gain a deeper understanding of the difficulties Vietnamese patients experience when accessing services and managing their type 2 diabetes mellitus, and to identify factors that are important in promoting health service use. Methods Three focus groups with 15 Vietnamese participants with type 2 diabetes mellitus, 60 to >70 years of age, were conducted in Vietnamese. Open-ended questions were used and focussed on experiences of living with diabetes and access to healthcare services in the Inner Northwest Melbourne region. Audio recordings were transcribed and then translated into English. Data were analysed using a thematic analysis framework. Results Findings indicate four main themes, which together provide some insight into the experiences of living with diabetes and accessing ongoing care and support, for elderly Vietnamese with type 2 diabetes. Themes included: (1) the value of being healthy; (2) controlling diabetes; (3) staying healthy; and (4) improving services and information access. Conclusions Participants in this study were encouraged to adhere to diabetes self-management principles, based largely on a fear of medical complications. Important aspects of healthcare access were identified as; being treated with respect, having their questions answered and having access to interpreters and information in Vietnamese. Attention to these details is likely to lead to improved access to healthcare services and ultimately to improve glycemic control and overall health status for this community. PMID:24168109

  15. Sexual reproductive health service provision to young people in Kenya; health service providers’ experiences

    PubMed Central

    2013-01-01

    Background Addressing the sexual and reproductive health (SRH) needs of young people remains a challenge for most developing countries. This study explored the perceptions and experiences of Health Service Providers (HSP) in providing SRH services to young people in Kenya. Methods Qualitative study conducted in eight health facilities; five from Nairobi and three rural district hospitals in Laikipia, Meru Central, and Kirinyaga. Nineteen in-depth interviews (IDI) and two focus group discussions (FGD) were conducted with HSPs. Interviews were tape recorded and transcribed. Data was coded and analysed using the thematic framework approach. Results The majority of HSPs were aware of the youth friendly service (YFS) concept but not of the supporting national policies and guidelines. HSP felt they lacked competency in providing SRH services to young people especially regarding counselling and interpersonal communication. HSPs were conservative with regards to providing SRH services to young people particularly contraception. HSP reported being torn between personal feelings, cultural and religious values and beliefs and their wish to respect young people’s rights to accessing and obtaining SRH services. Conclusion Supporting youth friendly policies and competency based training of HSP are two common approaches used to improve SRH services for adolescents. However, these may not be sufficient to change HSPs’ attitude to adolescents seeking help. There is need to address the cultural, religious and traditional value systems that prevent HSPs from providing good quality and comprehensive SRH services to young people. Training updates should include sessions that enable HSPs to evaluate how their personal and cultural values and beliefs influence practice. PMID:24229365

  16. Health Service Utilization and Poor Health Reporting in Asthma Patients

    PubMed Central

    Behr, Joshua G.; Diaz, Rafael; Akpinar-Elci, Muge

    2016-01-01

    The management and treatment of adult asthma has been associated with utilization of health services. Objectives: First, to investigate the likelihood of health service utilization, including primary care, emergency department, and hospital stays, among persons diagnosed with an asthma condition relative to those that do not have an asthma condition. Second, to examine the likelihood of poor physical health among asthma respondents relative to those that do not have an asthma condition. Third, to demonstrate that these relationships vary with frequency of utilization. Fourth, to discuss the magnitude of differences in frequent utilization between asthma and non-asthma respondents. Data Source: Data is derived from a random, stratified sampling of Hampton Roads adults, 18 years and older (n = 1678). Study Design: Study participants are interviewed to identify asthma diagnosis, access to primary care, frequency of emergency department utilization, hospital admissions, and days of poor physical health. Odds-ratios establish relationships with the covariates on the outcome variable. Findings: Those with asthma are found more likely (OR 1.50, 95% CI 1.05–2.15) to report poor physical health relative to non-asthma study participants. Further, asthma respondents are found more likely (OR 4.23, 95% CI 1.56–11.69) to frequently utilize primary care that may be associated with the management of the condition and are also more likely to utilize treatment services, such as the emergency department (OR 1.87, 95% CI 1.32–2.65) and hospitalization (OR 2.21, 95% CI 1.39–3.50), associated with acute and episodic care. Further, it is a novel finding that these likelihoods increase with frequency of utilization for emergency department visits and hospital stays. Conclusion: Continuity in care and better management of the diseases may result in less demand for emergency department services and hospitalization. Health care systems need to recognize that asthma patients are

  17. Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

    ERIC Educational Resources Information Center

    Dixon, Decia Nicole

    2009-01-01

    Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…

  18. Too Costly To Be Ill: Health Care Access and Health Seeking Behaviors among Rural-to-urban Migrants in China

    PubMed Central

    Hong, Yan; Li, Xiaoming; Stanton, Bonita; Lin, Danhua; Fang, Xiaoyi; Rong, Mao; Wang, Jing

    2007-01-01

    Of the 114 million rural-to-urban migrants in China, most have only temporary employment in the cities. Because of their non-urban residence, they are not entitled to many benefits and services accorded to most urban dwellers. Only limited research has been conducted on the health care access and health seeking behaviors of this population. This study, based on qualitative data from in-depth interviews with 90 rural-to-urban migrants, found that migrants had limited access to regular medical services. Lack of insurance coverage, high cost, and exacting work schedules have resulted in use of unsupervised self-treatment or substandard care. Their health seeking behaviors have led to suboptimal health consequences including delayed treatment of illnesses. Findings from this study underscore the importance of reducing institutional barriers to health services and providing affordable health care to this population. PMID:18277099

  19. Quantifying Access Disadvantage and Gathering Information in Rural and Remote Localities: The Griffith Service Access Frame.

    ERIC Educational Resources Information Center

    Griffith, Dennis A.

    2003-01-01

    A purely geographic classification is not the best way to measure rural disadvantage in Australia. A service access model is described that incorporates the following elements: population center size; distance, time, and cost of travel to the service center; and a measure of the economic capacity of residents to overcome the cost of travel.…

  20. [Cervical cancer: integral care to the woman in health services].

    PubMed

    Soares, Marilu Correa; Mishima, Silvana Martins; da Silva, Renata Cunha; Ribeiro, Caroline Vargas; Meincke, Sonia Maria Könzgen; Corrêa, Ana Cândida Lopes

    2011-09-01

    This study aims to understand how the health services of the Brazilian Public Health System (BPHS) are organized to give an integral care to the woman with cervical cancer. This is a descriptive, qualitative research with 20 women. Semistructured interviews were coupled with participant observation in data collection. The thematic analysis revealed the theme: "The search for care: access to BPHS and use of health services in the search for integral care". In the use of health services, women have exposed their views on the received care, and on the potentialities and limits of integrality in this context. The conclusion is that the effectivation of health actions that aim at the integrality of care for women requires courage and the promotion of a dialogue between social actors as a way to build a health awareness that allows an ethical commitment pointing towards the necessary changes in care. PMID:22165396

  1. 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

  2. Cultural orientation: an emerging dimension of quality in women's health services.

    PubMed

    Stone, C E

    2000-01-01

    There are many efforts underway to document the differences in health status and health services access of women in distinct cultural segments in the U.S. Along with the measurable aspects of health status and utilization, each cultural segment carries its unique perspective on what constitutes "quality" in women's health services. These definitions of quality may reflect access, interactions, process, and outcomes. Health care providers that aspire to provide quality women's health care need to identify the distinct cultural segments in their own communities; document the gaps in women's health services; and develop programs that are specific to clinical needs and quality criteria of these populations. PMID:11183584

  3. 42 CFR 422.112 - Access to services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... services in accordance with § 422.113. (10) Prevailing patterns of community health care delivery. MA plans... must do so consistent with the prevailing community pattern of health care delivery in the areas where the network is being offered. Factors making up community patterns of health care delivery that...

  4. 42 CFR 422.112 - Access to services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... services in accordance with § 422.113. (10) Prevailing patterns of community health care delivery. MA plans... must do so consistent with the prevailing community pattern of health care delivery in the areas where the network is being offered. Factors making up community patterns of health care delivery that...

  5. 42 CFR 422.112 - Access to services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... services in accordance with § 422.113. (10) Prevailing patterns of community health care delivery. MA plans... must do so consistent with the prevailing community pattern of health care delivery in the areas where the network is being offered. Factors making up community patterns of health care delivery that...

  6. 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…

  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. BioServices: a common Python package to access biological Web Services programmatically

    PubMed Central

    Cokelaer, Thomas; Pultz, Dennis; Harder, Lea M.; Serra-Musach, Jordi; Saez-Rodriguez, Julio

    2013-01-01

    Motivation: Web interfaces provide access to numerous biological databases. Many can be accessed to in a programmatic way thanks to Web Services. Building applications that combine several of them would benefit from a single framework. Results: BioServices is a comprehensive Python framework that provides programmatic access to major bioinformatics Web Services (e.g. KEGG, UniProt, BioModels, ChEMBLdb). Wrapping additional Web Services based either on Representational State Transfer or Simple Object Access Protocol/Web Services Description Language technologies is eased by the usage of object-oriented programming. Availability and implementation: BioServices releases and documentation are available at http://pypi.python.org/pypi/bioservices under a GPL-v3 license. Contact: cokelaer@ebi.ac.uk or bioservices@googlegroups.com Supplementary information: Supplementary data are available at Bioinformatics online. PMID:24064416

  9. Substance Abuse and Mental Health Services Administration (SAMHSA) Behavioral Health Disaster Response App.

    PubMed

    Seligman, Jamie; Felder, Stephanie S; Robinson, Maryann E

    2015-10-01

    The Substance Abuse and Mental Health Services Administration (SAMHSA) in the Department of Health and Human Services offers extensive disaster behavior health resources to assist disaster survivors in preparing for, responding to, and recovering from natural and manmade disasters. One of SAMHSA's most innovative resources is the SAMHSA Behavioral Health Disaster Response App (SAMHSA Disaster App). The SAMHSA Disaster App prepares behavioral health responders for any type of traumatic event by allowing them to access disaster-related materials and other key resources right on their phone, at the touch of a button. The SAMHSA Disaster App is available on iPhone, Android, and BlackBerry devices. PMID:26165522

  10. Access to Services and Meeting the Needs of People with Learning Disabilities.

    ERIC Educational Resources Information Center

    Lennox, Tamsin N.; Nadkarni, Joanne; Moffat, Peter; Robertson, Caroline

    2003-01-01

    A survey in one English community of 49 adults with intellectual disabilities found basic health needs (such as feet problems, incontinence, eyesight problems, and specific medical conditions) were often not being met. Access to primary care services to address these needs is discussed along with suggestions for future research and recommendations…

  11. NASA's Eos ClearingHOuse: Integrating Access to Data Services

    NASA Astrophysics Data System (ADS)

    Burnett, M. T.; Pfister, R.; Wichman, K.

    2002-12-01

    ECHO (The Earth Observing System (EOS) ClearingHOuse) is being developed to provide flexibility to NASA's EOS to better meet the needs of the science community. ECHO is a clearinghouse of metadata, representing the data offerings of participating data providers. ECHO is being built with the goal of being an enabling system: Enabling a variety of Data Providers to participate. Enabling access to an ever-changing variety of Earth Science Data. Enabling access to an ever-growing suite of services, provided by the Science Community, which improves the usefulness of this data, including the binding of those services to the data represented in the clearinghouse. The purpose of this enabling philosophy is to support current Science efforts, but also to give the opportunity for creative organizations and individuals to break the traditional paradigm for discovering and leveraging Earth Science Data and Services in completely new ways. This presentation will focus on ECHO's approach to integrating Data Services from varied Service Providers, and facilitating access to those services by the user community. ECHO can be viewed as a typical Service oriented architecture. The fundamental interactions that it supports are (abstractly) Publish, Find and Bind. ECHO provides interfaces and mechanisms that allow organizations to publish their services. Using these interfaces, Service Providers can effectively "plug-in" their capabilities. There are mechanisms that allow the correlation of their service to the data types in the clearinghouse. ECHO's user community can find, or discover, services through a separate set of interfaces. Bindings are the mechanisms that support the invocation of services by ECHO's user community. ECHO supports binding either directly between the user and the service provider, or indirectly by using ECHO as a Service Broker. ECHO is supporting all of these Service capabilities by leveraging the contemporary (and evolving) "standards" of Web Services. Web

  12. Improving Coordination of Addiction Health Services Organizations with Mental Health and Public Health Services.

    PubMed

    Guerrero, Erick G; Andrews, Christina; Harris, Lesley; Padwa, Howard; Kong, Yinfei; M S W, Karissa Fenwick

    2016-01-01

    In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform. PMID:26350114

  13. 28 CFR 1100.33 - Access to information and translation services for victims of severe forms of trafficking in...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Department of Health and Human Services (HHS) are eligible for assistance that is administered or funded by...; (8) The right to restitution; (9) The right to notification of case status; and (10) The availability... reasonable access to translation services and/or oral interpreter services in the event the victim is...

  14. 28 CFR 1100.33 - Access to information and translation services for victims of severe forms of trafficking in...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Department of Health and Human Services (HHS) are eligible for assistance that is administered or funded by...; (8) The right to restitution; (9) The right to notification of case status; and (10) The availability... reasonable access to translation services and/or oral interpreter services in the event the victim is...

  15. 28 CFR 1100.33 - Access to information and translation services for victims of severe forms of trafficking in...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Department of Health and Human Services (HHS) are eligible for assistance that is administered or funded by...; (8) The right to restitution; (9) The right to notification of case status; and (10) The availability... reasonable access to translation services and/or oral interpreter services in the event the victim is...

  16. Regional health library service in northern Ireland.

    PubMed

    Crawford, D S

    1990-10-01

    The regional medical library service provided to physicians, hospitals, nurses, social workers, and health care administrators throughout Northern Ireland by the Queen's University of Belfast is described. A brief outline of the National Health Service in the United Kingdom is given, and the library service is described in terms of collections, cataloging, interlibrary loan, and reference. PMID:2224299

  17. Regional health library service in northern Ireland.

    PubMed Central

    Crawford, D S

    1990-01-01

    The regional medical library service provided to physicians, hospitals, nurses, social workers, and health care administrators throughout Northern Ireland by the Queen's University of Belfast is described. A brief outline of the National Health Service in the United Kingdom is given, and the library service is described in terms of collections, cataloging, interlibrary loan, and reference. PMID:2224299

  18. Accessing the Health Care Financing System: A Resource Guide for Local Education Agencies. Bulletin No. 91298.

    ERIC Educational Resources Information Center

    Wisconsin State Dept. of Public Instruction, Madison.

    This guide is intended to assist Wisconsin school districts in accessing the health care financing system as a means of supporting specialized services. Topics covered include: determination of a local education agency's potential for third-party covered services; the need to become a certified provider dependent upon the funding source;…

  19. Context-Based E-Health System Access Control Mechanism

    NASA Astrophysics Data System (ADS)

    Al-Neyadi, Fahed; Abawajy, Jemal H.

    E-Health systems logically demand a sufficiently fine-grained authorization policy for access control. The access to medical information should not be just role-based but should also include the contextual condition of the role to access data. In this paper, we present a mechanism to extend the standard role-based access control to incorporate contextual information for making access control decisions in e-health application. We present an architecture consisting of authorisation and context infrastructure that work cooperatively to grant access rights based on context-aware authorization policies and context information.

  20. Recommendations for a service framework to access astronomical archives

    NASA Technical Reports Server (NTRS)

    Travisano, J. J.; Pollizzi, J.

    1992-01-01

    There are a large number of astronomical archives and catalogs on-line for network access, with many different user interfaces and features. Some systems are moving towards distributed access, supplying users with client software for their home sites which connects to servers at the archive site. Many of the issues involved in defining a standard framework of services that archive/catalog suppliers can use to achieve a basic level of interoperability are described. Such a framework would simplify the development of client and server programs to access the wide variety of astronomical archive systems. The primary services that are supplied by current systems include: catalog browsing, dataset retrieval, name resolution, and data analysis. The following issues (and probably more) need to be considered in establishing a standard set of client/server interfaces and protocols: Archive Access - dataset retrieval, delivery, file formats, data browsing, analysis, etc.; Catalog Access - database management systems, query languages, data formats, synchronous/asynchronous mode of operation, etc.; Interoperability - transaction/message protocols, distributed processing mechanisms (DCE, ONC/SunRPC, etc), networking protocols, etc.; Security - user registration, authorization/authentication mechanisms, etc.; Service Directory - service registration, lookup, port/task mapping, parameters, etc.; Software - public vs proprietary, client/server software, standard interfaces to client/server functions, software distribution, operating system portability, data portability, etc. Several archive/catalog groups, notably the Astrophysics Data System (ADS), are already working in many of these areas. In the process of developing StarView, which is the user interface to the Space Telescope Data Archive and Distribution Service (ST-DADS), these issues and the work of others were analyzed. A framework of standard interfaces for accessing services on any archive system which would benefit

  1. Health care access and utilization among ex-offenders in Baltimore: implications for policy.

    PubMed

    Hawkins, Anita Smith; O'Keefe, Anne Marie; James, Xanthia

    2010-05-01

    The U.S. has the highest rate of incarceration in the world, releasing 12 million ex-offenders each year. These ex-offenders are disproportionately male, Black, poor, under-educated, and unhealthy, and return to our nation's poorest neighborhoods. Through a survey questionnaire and focus groups, this study examined the health status, health needs, access to and utilization of health care services among a sample of ex-offenders living in transitional housing in Baltimore City. More than half reported at least two major, chronic health problems. Only 40% had any form of health coverage; even more predictive of the ability to obtain health services was being able to name a specific provider (doctor, clinic or health organization). Recommendations for halting the downward spiral of poverty and sickness for this population and their communities include providing assistance with accessing, understanding, and navigating our complex and consumer-unfriendly health care system. PMID:20453363

  2. Database Access Integration Services (DAIS). Volume 2, Specification: Final report

    SciTech Connect

    Mitchell, P.; Nordell, D.

    1992-12-01

    The Database Access Integration Services (DAIS) is a collection of services that facilitate access to data among diverse data systems in an electric utility communications network. DAIS provides access to data in distributed, heterogeneous data systems that include relational database management systems, other database management systems, control systems, file systems, and application systems. It also provides a common method for describing data, common data access operations and essential support services including a data dictionary, a data directory and distributed data access management capabilities. The DAIS project has developed specifications intended for vendor and third-party implementation. The software developed is only to implement a data access integration demonstration. These specifications can serve as a basis for influencing industry standards development. One important consequence of this strategy is that most actual software development will be performed by vendors, not utilities. DAIS is a tool to support data access. It is policy neutral regarding issues such as local or central administration of data or standardization of information model contents (e.g., EPRI Plant Information Network). As a tool, it can be used to help realize such policies. The DAIS does not provide data storage facilities, schema integration, distributed query processing, distributed applications or cooperative processing. Rather, DAIS is complementary to these functions and can be used with other software that does provide these functions. This project documented the requirements for the DAIS. These requirements are the basis for design of the DAIS specifications. The key requirements for a DAIS are: Uniform access to heterogeneous utility data systems, remote update; coexistence with local data systems; local autonomy ; Security and access restriction enforcement; OSI compatibility; open architecture and extensibility; and operating platform independence.

  3. 39 CFR 254.1 - Adoption of U.S. Access Board Standards as Postal Service Standards of Facility Accessibility.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Barriers Act (ABA) “Standards for Facility Accessibility,” the following sections of 36 CFR part 1191... 39 Postal Service 1 2012-07-01 2012-07-01 false Adoption of U.S. Access Board Standards as Postal Service Standards of Facility Accessibility. 254.1 Section 254.1 Postal Service UNITED STATES...

  4. 39 CFR 254.1 - Adoption of U.S. Access Board Standards as Postal Service Standards of Facility Accessibility.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Barriers Act (ABA) “Standards for Facility Accessibility,” the following sections of 36 CFR part 1191... 39 Postal Service 1 2014-07-01 2014-07-01 false Adoption of U.S. Access Board Standards as Postal Service Standards of Facility Accessibility. 254.1 Section 254.1 Postal Service UNITED STATES...

  5. 39 CFR 254.1 - Adoption of U.S. Access Board Standards as Postal Service Standards of Facility Accessibility.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Barriers Act (ABA) “Standards for Facility Accessibility,” the following sections of 36 CFR part 1191... 39 Postal Service 1 2013-07-01 2013-07-01 false Adoption of U.S. Access Board Standards as Postal Service Standards of Facility Accessibility. 254.1 Section 254.1 Postal Service UNITED STATES...

  6. Hispanics and Culturally Sensitive Mental Health Services.

    ERIC Educational Resources Information Center

    Hispanic Research Center Research Bulletin, 1985

    1985-01-01

    The objective of improving mental health care for Hispanics has been reviewed, most often, as dependent upon the provision of culturally sensitive mental health services. "Cultural sensitivity," however, is an imprecise term, especially when efforts are made to put it into operation when providing mental health services to Hispanic clients.…

  7. Children's Health Services Manual. Revised Edition.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Health and Environmental Control, Columbia.

    This manual for South Carolina's child health personnel covers program planning, evaluation, monitoring, and administration, and provides standards, procedures, policies, and regulations concerning health services for children in the state. An initial section on children's health services covers eligibility; the Women, Infants and Children…

  8. Health Services Assistant. Revised. Instructor Guide.

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Instructional Materials Lab.

    This color-coded curriculum guide was developed to help health services educators prepare students for health services occupations. The curriculum is organized in 20 units that cover the following topics: interpersonal relationships and the health care team; communication and observation skills; safety considerations; microbiology; the body as a…

  9. A Service Access Security Control Model in Cyberspace

    NASA Astrophysics Data System (ADS)

    Qianmu, Li; Jie, Yin; Jun, Hou; Jian, Xu; Hong, Zhang; Yong, Qi

    A service access control model in cyberspace is proposed, which provides a generalized and effective mechanism of security management with some items constraint specifications. These constraint specifications are organized to form a construction, and an enact process is proposed to make it scalable and flexible to meet the need of diversified service application systems in cyberspace. The model of this paper erases the downward information flow by extended rules of read/write, which is the breakthrough of the limitations when applying the standard role-based access control in cyberspace.

  10. 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…

  11. Preventive Health Services Utilization Among Korean Americans.

    PubMed

    Kim, Kyeongmo; Casado, Banghwa Lee

    2016-01-01

    This study examined the use of preventive health services among Korean American adults. Data were drawn from a cross-sectional survey of 212 Korean Americans in the Chicago, Illinois, metropolitan area. Guided by the Andersen's behavioral model, the authors examined whether predisposing (age, gender, marital status, household size, education), enabling (income, health insurance, English proficiency, citizenship, social network), and need (health status) factors are predictive of Korean Americans' preventive health services utilization. A binomial logistic regression showed that younger age, male, noncitizen, low income, no insurance, a larger family network, and better perceived health were associated with decreased odds of using preventive health services. PMID:27171558

  12. Accessing Geospatial Services in Limited Bandwidth Service-Oriented Architecture (SOA) Environments

    ERIC Educational Resources Information Center

    Boggs, James D.

    2013-01-01

    First responders are continuously moving at an incident site and this movement requires them to access Service-Oriented Architecture services, such as a Web Map Service, via mobile wireless networks. First responders from inside a building often have problems in communicating to devices outside that building due to propagation obstacles. Dynamic…

  13. VODance: VO Data Access Layer Service Creation Made Easy

    NASA Astrophysics Data System (ADS)

    Smareglia, R.; Laurino, O.; Knapic, C.

    2011-07-01

    We present a tool for rapid deployment of Virtual Observatory compliant services. Users who want to publish their datasets to the Virtual Observatory can achieve this goal without having to deal with the technical details of standard services development and without having to move their data. With VODance users just have to provide a database connection to our center that points to their available data and fill out a metadata description form without having to export their data. Data Access Layer services are created on the fly and published, through the Italian Astronomical Archive Center (IA2), to the Virtual Observatory. VODance has been successfully used to publish Cone Search and Simple Image Access Protocol services out of MySQL and Oracle database management systems.

  14. 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

  15. Poor People, Poor Places and Access to Health Care in the United States

    ERIC Educational Resources Information Center

    Kirby, James B.

    2008-01-01

    Research suggests that community-level poverty is associated with access to health care net of individual-level characteristics, but no research investigates whether this association differs by individual-level income. Using data from the Medical Expenditure Panel Surveys, the U.S. Census Bureau and the Health Resource and Services Administration,…

  16. LGBT Health Care Access: Considering the Contributions of an Invitational Approach

    ERIC Educational Resources Information Center

    MacDonnell, Judith A.

    2014-01-01

    Lesbian, gay, bisexual and transgender (LGBT) people have historically, and continue today to encounter barriers to accessing health services. This has been attributed to the well-documented heterosexism, homophobia, biphobia, and transphobia that shape all health and social institutions. In this paper, invitational theory offers insight into the…

  17. Access to care: beyond health insurance.

    PubMed

    Strand de Oliveira, Justine

    2013-11-01

    Access to healthcare is derived from a complex mix of personal beliefs, cultural norms, and social structure, combined with available individual and community resources. This article reviews the concept of access to care and its evolution since the 1960s. The difference between potential and realized access and the question of social justice as it relates to access to care also are explored. PMID:24153091

  18. Decentralisation of Health Services in Fiji: A Decision Space Analysis

    PubMed Central

    Mohammed, Jalal; North, Nicola; Ashton, Toni

    2016-01-01

    Background: Decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. Fiji has attempted two approaches to decentralisation. The current approach reflects a model of deconcentration of outpatient services from the tertiary level hospital to the peripheral health centres in the Suva subdivision. Methods: Using a modified decision space approach developed by Bossert, this study measures decision space created in five broad categories (finance, service organisation, human resources, access rules, and governance rules) within the decentralised services. Results: Fiji’s centrally managed historical-based allocation of financial resources and management of human resources resulted in no decision space for decentralised agents. Narrow decision space was created in the service organisation category where, with limited decision space created over access rules, Fiji has seen greater usage of its decentralised health centres. There remains limited decision space in governance. Conclusion: The current wave of decentralisation reveals that, whilst the workload has shifted from the tertiary hospital to the peripheral health centres, it has been accompanied by limited transfer of administrative authority, suggesting that Fiji’s deconcentration reflects the transfer of workload only with decision-making in the five functional areas remaining largely centralised. As such, the benefits of decentralisation for users and providers are likely to be limited. PMID:26927588

  19. The Marriage Checkup: Increasing Access to Marital Health Care

    PubMed Central

    Morrill, Melinda

    2016-01-01

    Despite the ongoing prevalence of marital distress, very few couples seek therapy. Researchers and clinicians have increasingly been calling for innovative interventions that can reach a larger number of untreated couples. Based on a motivational marital health model, the Marriage Checkup (MC) was designed to attract couples who are unlikely to seek traditional tertiary therapy. The objective of the MC is to promote marital health for as broad of a population of couples as possible, much like regular physical health checkups. This first paper from the largest MC study to date examines whether the MC engaged previously unreached couples who might benefit from intervention. Interview and survey data suggested that the MC attracted couples across the distress continuum and was perceived by couples as more accessible than traditional therapy. Notably, the MC attracted a substantial number of couples who had not previously participated in marital interventions. The motivational health checkup model appeared to encourage a broad range of couples who might not have otherwise sought relationship services to deliberately take care of their marital health. Clinical implications are discussed. PMID:22145720

  20. Psychotherapy services outside the National Health Service.

    PubMed

    Kroll, U

    1976-02-01

    With the help of an Upjohn Travelling Fellowship, I visited 15 units providing services for people under stress. There were nine residential units and six non-residential units, all were Christian charitable organisations and in all there was close co-operation with the medical profession.All these organisations accept referrals from general practitioners and deserve to be more widely known. PMID:1255548

  1. HIV multidisciplinary teams work: support services improve access to and retention in HIV primary care.

    PubMed

    Sherer, R; Stieglitz, K; Narra, J; Jasek, J; Green, L; Moore, B; Shott, S; Cohen, M

    2002-08-01

    The multidisciplinary team model of HIV care evolved out of necessity due to the diverse characteristics and needs of people living with HIV disease. Though it is now accepted as the international standard of care, it represents a significant departure from methods of care for other infectious diseases, and debate continues regarding the effectiveness of its interventions. The debate has been largely uninformed by data; for example, little is known about the relationship between ancillary support services and primary care outcomes. We hypothesized that support services increase access to and retention in HIV primary care in an inner city public hospital clinic. We conducted a retrospective analysis of clinical data sets on 2,647 patients at the CORE Center, Chicago from 1997-1998 to investigate the relationship between four support services-case management (CM), transportation (TRANS), mental health (MH) and chemical dependency (CD)-and access to and retention in HIV primary care. We found that patients who received each of these services were significantly more likely to receive any care, regular care and had more visits than patients with no service, and retention increased by 15-18%. Female gender, younger age, self-pay status and IDU predicted less regular care. Need for all services was substantial and significantly greater in women. Outcomes improved to the greatest extent among patients who needed and received each service. We conclude that support services significantly increased access to and retention in HIV primary care. Our findings validate the multidisciplinary team model of HIV care, and suggest that health services that are tailored to the express needs of patients lead to better care and improved health outcomes. Further testing of changes in health care delivery to meet the rapidly changing needs of people living with HIV disease and respond to the constantly changing practice of HIV medicine is urgently needed to maintain and extend the advances

  2. 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. PMID:24186359

  3. Health services research: why and how?

    PubMed

    Hjort, P F

    1976-01-01

    It is useful to divide medical research into three areas: biomedical, clinical, and health services research. The areas partly overlap, and health services research is also related to social services research. Research is carried out to solve problems and is an instrument for change. Health services research has developed over the last ten years in response to increasing problems in many health services. Superficially, these problems are caused by insufficient resources, but no service can hope to pay its way out of them. Some may be fairly accurately investigated, like need, demand, and utilization of care. Others are more complicated, e.g. evaluation of care, defining standards, and cost--benefit analyses. A few deal with fundamental values, like quality of life and responsibility of individuals and societies. So far, health services research has led to greater emphasis on primary care, but it is fair to say that it has not managed to infiltrate the service and influence people's attitudes and ambitions. In the future, one must bring health services research inside the service and involve the professionals more deeply. One must support prevention studies, attack the ethical and clinical problems related to quality of life, study the potential of non-professional support in the community, and promote rational attitudes among professions, patients, people and politicians. The task is never-ending and health services research, therefore, must be part of the programme of all medical schools. PMID:829768

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

    PubMed

    Souliotis, Kyriakos; Hasardzhiev, Stanimir; Agapidaki, Eirini

    2016-01-01

    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. PMID:27237814

  5. Veterans Affairs Health System and Mental Health Treatment Retention among Patients with Serious Mental Illness: Evaluating Accessibility and Availability Barriers

    PubMed Central

    McCarthy, John F; Blow, Frederic C; Valenstein, Marcia; Fischer, Ellen P; Owen, Richard R; Barry, Kristen L; Hudson, Teresa J; Ignacio, Rosalinda V

    2007-01-01

    Objective We examine the impact of two dimensions of access—geographic accessibility and availability—on VA health system and mental health treatment retention among patients with serious mental illness (SMI). Methods Among 156,631 patients in the Veterans Affairs (VA) health care system with schizophrenia or bipolar disorder in fiscal year 1998 (FY98), we used Cox proportional hazards regression to model time to first 12-month gap in health system utilization, and in mental health services utilization, by the end of FY02. Geographic accessibility was operationalized as straight-line distance to nearest VA service site or VA psychiatric service site, respectively. Service availability was assessed using county-level VA hospital beds and non-VA beds per 1,000 county residents. Patients who died without a prior gap in care were censored. Results There were 32, 943 patients (21 percent) with a 12-month gap in health system utilization; 65,386 (42 percent) had a 12-month gap in mental health services utilization. Gaps in VA health system utilization were more likely if patients were younger, nonwhite, unmarried, homeless, nonservice-connected, if they had bipolar disorder, less medical morbidity, an inpatient stay in FY98, or if they lived farther from care or in a county with fewer VA inpatient beds. Similar relationships were observed for mental health, however being older, female, and having greater morbidity were associated with increased risks of gaps, and number of VA beds was not significant. Conclusions Geographic accessibility and resource availability measures were associated with long-term continuity of care among patients with SMI. Increased distance from providers was associated with greater risks of 12-month gaps in health system and mental health services utilization. Lower VA inpatient bed availability was associated with increased risks of gaps in health system utilization. Study findings may inform efforts to improve treatment retention. PMID

  6. Distance Learning: Information Access and Services for Virtual Users.

    ERIC Educational Resources Information Center

    Iyer, Hemalata, Ed.

    This volume centers broadly on information support services for distance education. The articles in this book can be categorized into two areas: access to information resources for distance learners, and studies of distance learning programs. Contents include: "The Challenges and Benefits of Asynchronous Learning Networks" (Daphne Jorgensen);…

  7. Open Access, Satellite Education Service (OASES): Final Annual Report.

    ERIC Educational Resources Information Center

    South Oklahoma City Junior Coll., OK.

    This report assesses the Open Access, Satellite Education Services (OASES) program, a joint venture between South Oklahoma City Junior College and the Metropolitan Library System of Oklahoma County designed to provide adult education opportunities to all segments of the area's urban population. Program goals are outlined in terms of numbers of…

  8. Gender Differences in Access to Extension Services and Agricultural Productivity

    ERIC Educational Resources Information Center

    Ragasa, Catherine; Berhane, Guush; Tadesse, Fanaye; Taffesse, Alemayehu Seyoum

    2013-01-01

    Purpose: This article contributes new empirical evidence and nuanced analysis on the gender difference in access to extension services and how this translates to observed differences in technology adoption and agricultural productivity. Approach: It looks at the case of Ethiopia, where substantial investments in the extension system have been…

  9. Network-Accessible Resources and the Redefinition of Technical Services.

    ERIC Educational Resources Information Center

    Jones, Neil

    1998-01-01

    Discussion of the use of computer networks in academic libraries focuses on a technical-services perspective in the United Kingdom. Topics include access to electronic resources; standards; change management; the changing nature of the library catalog; redefining the local catalog; cataloging versus indexing; the Z39.50 information retrieval…

  10. Health Services and Women's Oral Health.

    ERIC Educational Resources Information Center

    O'Mullane, Denis; And Others

    1993-01-01

    Data on the relative levels of men's and women's dental health are scarce, but the available data do indicate differences in tooth loss and health-related behavior patterns. Better methods for recording and reporting this information are recommended. (MSE)

  11. Accessibility to tuberculosis control services and tuberculosis programme performance in southern Ethiopia

    PubMed Central

    Dangisso, Mesay Hailu; Datiko, Daniel Gemechu; Lindtjørn, Bernt

    2015-01-01

    Background Despite the expansion of health services and community-based interventions in Ethiopia, limited evidence exists about the distribution of and access to health facilities and their relationship with the performance of tuberculosis (TB) control programmes. We aim to assess the geographical distribution of and physical accessibility to TB control services and their relationship with TB case notification rates (CNRs) and treatment outcome in the Sidama Zone, southern Ethiopia. Design We carried out an ecological study to assess physical accessibility to TB control facilities and the association of physical accessibility with TB CNRs and treatment outcome. We collected smear-positive pulmonary TB (PTB) cases treated during 2003–2012 from unit TB registers and TB service data such as availability of basic supplies for TB control and geographic locations of health services. We used ArcGIS 10.2 to measure the distance from each enumeration location to the nearest TB control facilities. A linear regression analysis was employed to assess factors associated with TB CNRs and treatment outcome. Results Over a decade the health service coverage (the health facility–to-population ratio) increased by 36% and the accessibility to TB control facilities also improved. Thus, the mean distance from TB control services was 7.6 km in 2003 (ranging from 1.8 to 25.5 km) between kebeles (the smallest administrative units) and had decreased to 3.2 km in 2012 (ranging from 1.5 to 12.4 km). In multivariate linear regression, as distance from TB diagnostic facilities (b-estimate=−0.25, p<0.001) and altitude (b-estimate=−0.31, p<0.001) increased, the CNRs of TB decreased, whereas a higher population density was associated with increased TB CNRs. Similarly, distance to TB control facilities (b-estimate=−0.27, p<0.001) and altitude (b-estimate=−0.30, p<0.001) were inversely associated with treatment success (proportion of treatment completed or cured cases). Conclusions

  12. [Maternal and infant health services and the public health clinic].

    PubMed

    Urasaki, S

    1986-11-01

    The public health clinic under the jurisdiction of prefectural government should continue to play a major role in maternal-child health services. Ministry of Health's revision plan for Maternal-child Health Law, according to which maternal-child health services are to be transferred totally to municipal (city-town-village) government, is strongly opposed by public health nurses and others. The plan goes against the current movement and effort to revitalize public health clinics, where more 50% of services rendered are maternal-child health related. Secondly, municipal health centers would have much more difficulty providing quality services than prefectural public health clinics which receive annual federal aid for their operation. Federal funding for maternal-child health care, regardless of jurisdictions, is currently 1/3 of standard unit cost. Extreme financial strain on municipal governments would result in regional differences in the quality of services and/or eventual financial burden on the patients. While the national government is trying to emphasize administrative aspects of the public health clinic, it is ordinary citizens' day to day health problems that people expect the clinic to deal with, individually, via check-ups, health counseling, home visits, public health education and telephone health hot line. PMID:3642046

  13. Monitoring access to out-of-hours care services in Scotland – a review

    PubMed Central

    Godden, Sylvia; Hilton, Simon; Pollock, Allyson M

    2011-01-01

    Objectives Changes in the contractual responsibilities of primary care practitioners and health boards have resulted in a plethora of arrangements relating to out-of-hours healthcare services. Rather than being guaranteed access to a GP (usually either their own or another through a local GP co-operative), patients have a number of alternative routes to services. Our objective was to identify and assess the availability and adequacy of relevant standards, responsibilities and information systems in Scotland to monitor the impact of contractual changes to out-of-hours healthcare services on equity of access. Design Cross-sectional study. Setting All providers of primary care out-of-hours services in Scotland. Participants Not applicable. Main outcome measures First, identification and policy review of current standards and performance monitoring systems, data and information, primarily through directly contacting national and local organizations responsible for monitoring out-of-hours care, supplemented by literature searches to highlight specific issues arising from the review; and second, mapping of data items by out-of-hours provider type to identify overlap and significant gaps. Results In Scotland, data monitoring systems have not kept pace with changes in the organization of out-of-hours care, so the impact on access to services for different population groups is unknown. There are significant gaps in information collected with respect to workforce, distribution of services, service utilisation and clinical outcomes. Conclusions Since 2004 there have been major changes to the way patients access out-of-hours healthcare in the UK. In Scotland, none of the current systems provide information on whether the new services satisfy the key NHS principle of equity of access. There is an urgent need for a comprehensive review of data standards and systems relating to out-of-hours care in order to monitor and evaluate inputs, processes and outcomes of care not least in

  14. 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. PMID:24901350

  15. 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

  16. Culturally Competent Children's Mental Health Services: Advances & Challenges. Data Trends #126

    ERIC Educational Resources Information Center

    Research and Training Center on Family Support and Children's Mental Health, 2005

    2005-01-01

    "Data Trends" reports present summaries of research on mental health services for children and adolescents and their families. The article summarized in this "Data Trends" discusses the role of culture in children's development and mental health, disparities, and cultural competence in children's mental health services. Access to linguistically…

  17. 77 FR 69865 - 60-Day Proposed Information Collection; Request for Public Comment: Indian Health Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-21

    ... Office of Resource Access and Partnerships, needs this information to certify that the health care... validate services provided; to process payments for health care services performed by such providers; and to serve as a legal document for health and medical care authorized by IHS and rendered by...

  18. Oregon School-Based Health Centers 1996-1997 Services Report.

    ERIC Educational Resources Information Center

    Alexander, Tammis; Nystrom, Robert J.; Spitz, Lauren

    School based health centers (SBHC) are effective providers of health services and education because they are easy for students to access, they take an integrated and developmentally appropriate approach to meeting health needs, and they are prevention-oriented. This report describes the 1996-1997 services provided in 15 of 19 state-supported…

  19. Indian Health Trends and Services, 1974 Edition.

    ERIC Educational Resources Information Center

    Public Health Service (DHEW), Washington, DC. Div. of Indian Health.

    The American Indian Health Service (AIHS), subsidiary of the Department of Health, Education, and Welfare, is dedicated to elevating the health status of Indian and Alaskan Native peoples by: developing modern health facilities; encouraging Indian acquaintance with and participation in existing programs; being responsive to the concept of…

  20. 47 CFR 61.26 - Tariffing of competitive interstate switched exchange access services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... equivalent of the ILEC interstate exchange access services typically associated with following rate elements... switched exchange access services shall mean the composite, per-minute rate for these services, including... switched exchange access services that prices those services above the higher of: (1) The rate charged...

  1. 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. PMID:21219281

  2. Timely Access to Quality Health Care Among Georgia Children Ages 4 to 17 Years

    PubMed Central

    Ogbuanu, Chinelo; Goodman, David A.; Kahn, Katherine; Long, Cherie; Noggle, Brendan; Bagchi, Suparna; Barradas, Danielle; Castrucci, Brian

    2015-01-01

    We examined factors associated with children's access to quality health care, a major concern in Georgia, identified through the 2010 Title V Needs Assessment. Data from the 2007 National Survey of Children's Health were merged with the 2008 Area Resource File and Health Resources and Services Administration medically under-served area variable, and restricted to Georgia children ages 4–17 years (N = 1,397). The study outcome, access to quality health care was derived from access to care (timely utilization of preventive medical care in the previous 12 months) and quality of care (compassionate/culturally effective/family-centered care). Andersen's behavioral model of health services utilization guided independent variable selection. Analyses included Chi-square tests and multinomial logit regressions. In our study population, 32.8 % reported access to higher quality care, 24.8 % reported access to moderate quality care, 22.8 % reported access to lower quality care, and 19.6 % reported having no access. Factors positively associated with having access to higher/moderate versus lower quality care include having a usual source of care (USC) (adjusted odds ratio, AOR:3.27; 95 % confidence interval, 95 % CI 1.15–9.26), and special health care needs (AOR:2.68; 95 % CI 1.42–5.05). Lower odds of access to higher/moderate versus lower quality care were observed for non-Hispanic Black (AOR:0.31; 95 % CI 0.18–0.53) and Hispanic (AOR:0.20; 95 % CI 0.08–0.50) children compared with non-Hispanic White children and for children with all other forms of insurance coverage compared with children with continuous-adequate-private insurance. Ensuring that children have continuous, adequate insurance coverage and a USC may positively affect their access to quality health care in Georgia. PMID:23054451

  3. Barriers to care and service satisfaction following homicide loss: associations with mental health outcomes.

    PubMed

    Williams, Joah L; Rheingold, Alyssa A

    2015-01-01

    Homicide survivors are at increased risk for mental health problems, including depression, posttraumatic stress disorder, and complicated grief. Therefore, improving access to community and mental health resources is critical for this population. The atuhors sought to examine barriers to accessing services and service satisfaction among 47 homicide survivors. Over half of the sample met criteria for a mental disorder, with depression being the most prevalent problem. Frequently endorsed barriers to care included financial barriers, inadequate information, and health-related problems. However, participants who engaged in services were generally satisfied with those services. Only depression was uniquely associated with worse overall service satisfaction. PMID:24766188

  4. Improving access to health care for foster children: the Illinois model.

    PubMed

    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 in HealthWorks and with children in Aid to Families with Dependent Children (AFDC) who had never entered foster care. Children enrolled in HealthWorks were more likely than were other children to receive all of the services except general inpatient hospitalizations. They had greater odds of receiving general exams and physicians' services and were more likely to visit the emergency room than children who were not enrolled. They were more likely to receive all of the measured services when compared with children receiving Medicaid through AFDC. PMID:15202800

  5. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2014-10-01 2014-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  6. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2013-10-01 2013-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  7. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2012-10-01 2012-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  8. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2011-10-01 2011-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  9. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES...

  10. Increasing access to quality health care for the poor: Community perceptions on quality care in Uganda

    PubMed Central

    Kiguli, Julie; Ekirapa-Kiracho, Elizabeth; Okui, Olico; Mutebi, Aloysius; MacGregor, Hayley; Pariyo, George William

    2009-01-01

    This paper examines the community’s perspectives and perceptions on quality of health care delivery in two Uganda districts. The paper addresses community concerns on service quality. It focuses on the poor because they are a vulnerable group and often bear a huge burden of disease. Community views were solicited and obtained using eight focus group discussions, six in-depth and 12 key informant interviews. User perceptions and definitions of the quality of health services depended on a number of variables related to technical competence, accessibility to services, interpersonal relations and presence of adequate drugs, supplies, staff, and facility amenities. Results indicate that service delivery to the poor in the general population is perceived to be of low quality. The factors that were mentioned as affecting the quality of services delivered were inadequate trained health workers, shortage of essential drugs, poor attitude of the health workers, and long distances to health facilities. This paper argues that there should be an improvement in the quality of health services with particular attention being paid to the poor. Despite wide focus on improvement of the existing infrastructure and donor funding, there is still low satisfaction with health services and poor perceived accessibility. PMID:19936148

  11. Congolese and Somali beliefs about mental health services.

    PubMed

    Piwowarczyk, Linda; Bishop, Hillary; Yusuf, Abdirahman; Mudymba, Francine; Raj, Anita

    2014-03-01

    Despite high levels of traumatic exposure, refugees often do not seek mental health services upon resettlement. The purpose of this study was to examine both concepts of mental illness in addition to attitudes and beliefs about treatment as well as potential barriers to accessing mental health services. To that end, qualitative research was done using focus groups with Congolese and Somali men and women in the United States (n = 48) in addition to a community survey with women from those communities (n = 296) administered by staff of a community-based organization. Mental health concerns, although identified, were often dealt with first in the communities themselves with the help of family or friends. Great emphasis was placed on their respective communities of faith. The actual role of mental health professionals was not well understood, and there was apparent hesitancy to use services, which also relates to issues of stigma. PMID:24566506

  12. School Mental Health Resources and Adolescent Mental Health Service Use

    PubMed Central

    Green, Jennifer Greif; McLaughlin, Katie A.; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A,; Kessler, Ronald C.

    2014-01-01

    Objective Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This paper examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources-policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Results Roughly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students-to-mental health providers was not associated with overall service use, but was associated with sector of service use. Conclusions School mental health resources, particularly those related to early identification, may facilitate mental health service use and influence sector of service use for youths with DSM disorders. PMID:23622851

  13. Funding Early Childhood Mental Health Services & Supports.

    ERIC Educational Resources Information Center

    Wishmann, Amy; Kates, Donald; Kaufmann, Roxane

    This paper is the first of a two-part series on financing early childhood mental health services. It discusses the need for a systemic approach to financing early childhood mental health services and supports and presents a matrix to assist states and communities in the design of comprehensive financing systems. The vertical axis of the matrix…

  14. Acceptance of Swedish e-health services

    PubMed Central

    Jung, Mary-Louise; Loria, Karla

    2010-01-01

    Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860

  15. Improving Immigrants' Access to Public Services in the United States: Language Access Policy and Policy Implementation

    ERIC Educational Resources Information Center

    Sperling, Jessica

    2009-01-01

    Language access mandates in the USA, which require that governmental services be provided in any needed language, have been largely ignored since their first enacting. However, the past decade has seen an increase in the number of national, state, and local efforts to accommodate limited English-proficient individuals. This article provides an…

  16. The contribution of Portuguese nursing to universal health access and coverage

    PubMed Central

    Fernandes, Ananda Maria; Mendes, Aida Maria de Oliveira Cruz; Leitão, Maria Neto da Cruz; Gomes, Sérgio David Lourenço; Amaral, António Fernando Salgueiro; Bento, Maria da Conceição Saraiva da Silva Costa

    2016-01-01

    Objective: to analyze the contribution of Portuguese nursing to improving universal health access and coverage by means of the identification of nurses in the health system; evolution of health indicators; and access-promoting systems, in which nurses play a relevant role. Method: this was documentary research of publications fromnational and international organizations on planning and health outcomes. Statistical databases and legislation on health reforms were consulted. Results: nurses represent 30.18% of human resources in the national health service; the systems of access promotion performed by nurses have good levels of efficacy (95.5%) and user satisfaction (99% completely satisfied); in the local care the creation of Community Care Units (185) occurred, and 85.80% of home consultations were performed by nurses. Conclusion: political strategies, the National Health Service and strengthening of human resourcesin healthcareare the main determinants. Nursing is the most numerous professional group in the National Health Service, however numbers remaindeficient in primary health care. The improvement of academic qualification and self-regulation of this professional group has allowed for better answers inimproving health for the Portuguese. PMID:26959331

  17. [Consumer health web service at DIMDI].

    PubMed

    Hasky-Günther, K

    2004-10-01

    The German Institute of Medical Documentation and Information (DIMDI) extended its Internet services targeted at patients in order to meet the rising interest of the public for understandable, high-quality medical information. Medical terminology is made clear to nonprofessionals by voluminous reference books such as the Roche Encyclopedia of Medicine. By using free offers, such as the possibilities to search in up-to-date medical literature and studies, laypersons can find valuable and quality assured information on their fields of interest. Graphic and film material, which is offered in the virtual medical video shop (VVFM), covers the en-tire spectrum of specific medical fields and brings the areas of prevention, diagnostics, therapy, aftercare as well as nursing care up for discussion. It is easy to find physicians, hospitals, and self-help groups. Future plans include an extension of the offer to a substantial database-supported information portal for health-related subjects, which will provide the public with simple and speedy access to the health information of the DIM-DI and other trustworthy providers under one interface. PMID:15490083

  18. Private equity investment in health care services.

    PubMed

    Robbins, Catherine J; Rudsenske, Todd; Vaughan, James S

    2008-01-01

    Sophisticated private equity investors in health services provide venture capital for early-stage companies, growth capital for mid-stage companies, and equity capital for buyouts of mid-stage and mature companies. They pursue opportunities in provider sectors that are large and have a stable reimbursement environment, such as acute care services; sectors with room to execute consolidation strategies, such as labs; alternative-site sectors, such as "storefront" medicine; and clinical services, such as behavioral health, that are subject to profitably increasing quality and lowering costs. The innovations created through private equity investments could challenge established health services organizations. PMID:18780929

  19. Health InfoNet of Jefferson County: collaboration in consumer health information service.

    PubMed

    Smith, K H

    2001-01-01

    Health InfoNet of Jefferson County is a new collaborative consumer health information service of the Jefferson County public libraries and the UAB Lister Hill Library of the Health Sciences. Working with the input and cooperation of local voluntary health agencies, health care professionals and other health information providers, the intent is to improve the efficiency with which consumers might access such information while avoiding duplication of effort on the part of the information providers. Various considerations in InfoNet's mission include providing service not only to established library and Internet users, but also those on the other side of the "digital divide" as well as those with low literacy skills or English as a second language. The role of health care professionals in guiding their patients to the best consumer health information resources is emphasized. PMID:11757392

  20. Health and health services in Central America.

    PubMed

    Garfield, R M; Rodriguez, P F

    1985-08-16

    Despite rapid economic growth since World War II, health conditions improved only slowly in most of Central America. This is a result of poor medical, social, and economic infrastructure, income maldistribution, and the poor utilization of health investments. The economic crisis of the 1980s and civil strife have further endangered health in the region. Life expectancy has fallen among men in El Salvador and civil strife has become the most common cause of death in Guatemala, Nicaragua, and El Salvador. Large-scale US assistance has done little to improve conditions, and refugees continue to pour into North America. It is estimated that there are more than a million refugees within Central America, while a million have fled to the United States. Costa Rica and Nicaragua are partial exceptions to this dismal health picture. An effective approach to the many health problems in Central America will require joint planning and cooperation among all countries in the region. PMID:4021026

  1. Local Government Health Services in Interwar England:

    PubMed Central

    Gorsky, Martin

    2011-01-01

    Summary This article provides a critical discussion of recent work on local government health care and health services in interwar England. A literature review examines case study approaches and comparative quantitative surveys, highlighting conventional and revisionist interpretations. Noting the differing selection criteria evident in some works, it argues that studies based upon a limited number of personal health services provide an insufficient basis for assessing local health activity and policy. There follows a regional study demonstrating various discrepancies between health financing data in local sources and those in nationally collated returns. These in turn give rise to various problems of assessment and interpretation in works relying on the latter, particularly with respect to services for schoolchildren and long-stay patients. The case study points to the importance of integrating poor law medical services in evaluations, and of learning more about the role of government subsidy in supporting expanding services. PMID:22080797

  2. Designing online health services for patients.

    PubMed

    Crotty, Bradley H; Slack, Warner V

    2016-01-01

    Patients are increasingly interacting with their healthcare system through online health services, such as patient portals and telehealth programs. Recently, Shabrabani and Mizrachi provided data outlining factors that are most important for users or potential users of these online services. The authors conclude convincingly that while online health services have great potential to be helpful to their users, they could be better designed. As patients and their families play an increasingly active role in their health care, online health services should be made easier for them to use and better suited to their health-related needs. Further, the online services should be more welcoming to people of all literacy levels and from all socioeconomic backgrounds. PMID:27307985

  3. "The Bad People Go and Speak to Her": Young People's Choice and Agency when Accessing Mental Health Support in School

    ERIC Educational Resources Information Center

    Spratt, Jennifer; Shucksmith, Janet; Philip, Kate; Watson, Cate

    2010-01-01

    Concerns about the mental health and well-being of children and young people have been articulated in health and education policy fields as a call for closer working between schools and providers of mental health support services. Drawing from a Scottish study, this article explores issues of access, when mental health initiatives are sited in…

  4. 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 health-related…

  5. Differences in Access to Services in Rural Emergency Departments of Quebec and Ontario

    PubMed Central

    Archambault, Patrick; Audette, Louis David; Plant, Jeff; Bégin, François; Poitras, Julien

    2015-01-01

    Introduction Rural emergency departments (EDs) are important safety nets for the 20% of Canadians who live there. A serious problem in access to health care services in these regions has emerged. However, there are considerable geographic disparities in access to trauma center in Canada. The main objective of this project was to compare access to local 24/7 support services in rural EDs in Quebec and Ontario as well as distances to Levels 1 and 2 trauma centers. Materials and Methods Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities. There were 26 rural EDs in Quebec and 62 in Ontario meeting these criteria. Data were collected from ministries of health, local health authorities, and ED statistics. Fisher’s exact test, the t-test or Wilcoxon-Mann-Whitney test, were performed to compare rural EDs of Quebec and Ontario. Results All selected EDs of Quebec and Ontario agreed to participate in the study. The number of EDs visits was higher in Quebec than in Ontario (19 322 ± 6 275 vs 13 446 ± 8 056, p = 0.0013). There were no significant differences between Quebec and Ontario’s local population and small town population density. Quebec’s EDs have better access to advance imaging services such as CT scanner (77% vs 15%, p < .0001) and most the consultant support and ICU (92% vs 31%, p < .0001). Finally, more than 40% of rural EDs in Quebec and Ontario are more than 300 km away from Levels 1 and 2 trauma centers. Conclusions Considering that Canada has a Universal health care system, the discrepancies between Quebec and Ontario in access to support services are intriguing. A nationwide study is justified to address this issue. PMID:25874948

  6. HIV risk behavior and access to services: what predicts HIV testing among heterosexually active homeless men?

    PubMed

    Wenzel, Suzanne L; Rhoades, Harmony; Tucker, Joan S; Golinelli, Daniela; Kennedy, David P; Zhou, Annie; Ewing, Brett

    2012-06-01

    HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV testing behavior of homeless men. This study examined the association between individual (HIV risk) and structural (service access) factors and past year HIV testing. Participants were a representative sample of 305 heterosexually active homeless men interviewed from meal programs in the Skid Row region of Los Angeles. Logistic regression examined the association between past year HIV testing and demographic characteristics, HIV risk behavior, and access to other services in the Skid Row area in the past 30 days. Despite high rates of past year HIV testing, study participants also reported high rates of HIV risk behavior, suggesting there is still significant unmet need for HIV prevention among homeless men. Having recently used medical/dental services in the Skid Row area (OR: 1.91; CI: 1.09, 3.35), and being a military veteran (OR: 2.10; CI: 1.01-4.37) were significantly associated with HIV testing service utilization. HIV testing was not associated with HIV risk behavior, but rather with access to services and veteran status, the latter of which prior research has linked to increased service access. We suggest that programs encouraging general medical service access may be important for disseminating HIV testing services to this high-risk, vulnerable population. PMID:22676465

  7. Access to Specialist Care in Rural Saskatchewan: The Saskatchewan Rural Health Study

    PubMed Central

    Karunanayake, Chandima P.; Rennie, Donna C.; Hagel, Louise; Lawson, Joshua; Janzen, Bonnie; Pickett, William; Dosman, James A.; Pahwa, Punam

    2015-01-01

    The role of place has emerged as an important factor in determining people’s health experiences. Rural populations experience an excess in mortality and morbidity compared to those in urban settings. One of the factors thought to contribute to this rural-urban health disparity is access to healthcare. The objective of this analysis was to examine access to specialized medical care services and several possible determinants of access to services in a distinctly rural population in Canada. In winter 2010, we conducted a baseline mail survey of 11,982 households located in rural Saskatchewan, Canada. We obtained 4620 completed household surveys. A key informant for each household responded to questions about access to medical specialists and the exact distance traveled to these services. Correlates of interest included the location of the residence within the province and within each household, socioeconomic status, household smoking status, median age of household residents, number of non-respiratory chronic conditions and number of current respiratory conditions. Analyses were conducted using log binomial regression for the outcome of interest. The overall response rate was 52%. Of households who required a visit to a medical specialist in the past 12 months, 23% reported having difficulty accessing specialist care. The magnitude of risk for encountering difficulty accessing medical specialist care services increased with the greatest distance categories. Accessing specialist care professionals by rural residents was particularly difficult for persons with current respiratory conditions.

  8. Uses of the 1980 census for Hispanic health services research.

    PubMed

    Giachello, A L; Bell, R; Aday, L A; Andersen, R M

    1983-03-01

    The 1980 Census data provide a valuable resource for health services research on Hispanics. Hispanics are the fastest growing minority group in the United States and yet there is a paucity of large-scale empirical research on their health care and access needs. This paper describes how the census can assist in: 1) estimating the overall health care needs of this group, 2) identifying target groups within the Hispanic population who may have special health care problems (e.g., children, elderly, pregnant women, etc.); and 3) using other data sources to improve the quality of studies carried out on Hispanics. It also discusses problems in using the census for Hispanic health services research and some strategies for dealing with these problems. PMID:6824113

  9. Access to and use of infertility services in the United States: framing the challenges.

    PubMed

    Adashi, Eli Y; Dean, Laura A

    2016-05-01

    An overview of access to and use of general infertility and assisted reproductive technology (ART) services in the United States (U.S.) shows a declining trend for the ever-use of infertility services. Moreover, the use of ART services lags relative to other member nations of the Organization for Economic Co-operation and Development (OECD). Access to and use of general infertility and ART services is primarily undermined by a severely constrained underwriting universe dominated by self-insured employers and by a finite number of state infertility insurance mandates. The contribution of traditional public and private payers to the underwriting of ART is limited. As compared with OECD member nations wherein the access to and underwriting of general infertility and ART services is universal, the current status quo in the U.S. can only be characterized as dismal. Further, the current state of affairs is socially unjust in that the right to build a family in the face of infertility appears to have become a function of economic prowess. Given the dominance of the self-insured employers as underwriters of general infertility and ART services, advocacy directed at this interest group is likely to prove most productive. Improving the state of underwriting of general infertility and ART services in the U.S. must be embraced as a central moral imperative and as an unwavering strategic goal of the professional societies entrusted with the reproductive health of women and men. PMID:26826275

  10. Mental Health Care in a High School Based Health Service.

    ERIC Educational Resources Information Center

    Jepson, Lisa; Juszczak, Linda; Fisher, Martin

    1998-01-01

    Describes the mental-health and medical services provided at a high-school-based service center. Five years after the center's inception mental health visits had quadrupled. One third of students utilizing the center reported substance abuse within their family. Other reasons for center use included pregnancy, suicidal ideation, obesity,…

  11. Health Services for Migrant Children.

    ERIC Educational Resources Information Center

    Bove, Beverly A.

    Intended as a resource for administrators, teachers, nurses, paraprofessionals, health coordinators, and community action personnel who are interested in meeting the health needs of migrant children, this handbook offers suggestions for organizing community resources in providing health care to migrant children. Poor nutrition, the lack of dental…

  12. A SOAP Web Service for accessing MODIS land product subsets

    SciTech Connect

    SanthanaVannan, Suresh K; Cook, Robert B; Pan, Jerry Yun; Wilson, Bruce E

    2011-01-01

    Remote sensing data from satellites have provided valuable information on the state of the earth for several decades. Since March 2000, the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor on board NASA s Terra and Aqua satellites have been providing estimates of several land parameters useful in understanding earth system processes at global, continental, and regional scales. However, the HDF-EOS file format, specialized software needed to process the HDF-EOS files, data volume, and the high spatial and temporal resolution of MODIS data make it difficult for users wanting to extract small but valuable amounts of information from the MODIS record. To overcome this usability issue, the NASA-funded Distributed Active Archive Center (DAAC) for Biogeochemical Dynamics at Oak Ridge National Laboratory (ORNL) developed a Web service that provides subsets of MODIS land products using Simple Object Access Protocol (SOAP). The ORNL DAAC MODIS subsetting Web service is a unique way of serving satellite data that exploits a fairly established and popular Internet protocol to allow users access to massive amounts of remote sensing data. The Web service provides MODIS land product subsets up to 201 x 201 km in a non-proprietary comma delimited text file format. Users can programmatically query the Web service to extract MODIS land parameters for real time data integration into models, decision support tools or connect to workflow software. Information regarding the MODIS SOAP subsetting Web service is available on the World Wide Web (WWW) at http://daac.ornl.gov/modiswebservice.

  13. 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

  14. The effect of water accessibility on child health in China.

    PubMed

    Mangyo, Eiji

    2008-09-01

    Using a dynamic panel model of child anthropometrics from China, the effect of an in-yard water source on child health was measured. Changes in within-community averages of household access to in-yard water were used as the instrument for changes in access to in-yard water sources. Further, to address the concern of non-random placements of water projects, correlations between changes in disease symptoms and community-level changes in access to in-yard water sources were examined. It was found that access to in-yard water sources improved child health only when mothers were relatively well educated. PMID:18511138

  15. Lack of access and continuity of adult health care: a national population-based survey

    PubMed Central

    Dilélio, Alitéia Santiago; Tomasi, Elaine; Thumé, Elaine; da Silveira, Denise Silva; Siqueira, Fernando Carlos Vinholes; Piccini, Roberto Xavier; Silva, Suele Manjourany; Nunes, Bruno Pereira; Facchini, Luiz Augusto

    2015-01-01

    OBJECTIVE To describe the lack of access and continuity of health care in adults. METHODS A cross-sectional population-based study was performed on a sample of 12,402 adults aged 20 to 59 years in urban areas of 100 municipalities of 23 states in the five Brazilian geopolitical regions. Barriers to the access and continuity of health care and were investigated based on receiving, needing and seeking health care (hospitalization and accident/emergency care in the last 12 months; care provided by a doctor, by other health professional or home care in the last three months). Based on the results obtained by the description of the sample, a projection is provided for adults living in Brazilian urban areas. RESULTS The highest prevalence of lack of access to health services and to provision of care by health professionals was for hospitalization (3.0%), whilst the lowest prevalence was for care provided by a doctor (1.1%). The lack of access to care provided by other health professionals was 2.0%; to accident and emergency services, 2.1%; and to home care, 2.9%. As for prevalences, the greatest absolute lack of access occurred in emergency care (more than 360,000 adults). The main reasons were structural and organizational problems, such as unavailability of hospital beds, of health professionals, of appointments for the type of care needed and charges made for care. CONCLUSIONS The universal right to health care in Brazil has not yet been achieved. These projections can help health care management in scaling the efforts needed to overcome this problem, such as expanding the infrastructure of health services and the workforce. PMID:26061454

  16. Lack of access and continuity of adult health care: a national population-based survey.

    PubMed

    Dilélio, Alitéia Santiago; Tomasi, Elaine; Thumé, Elaine; Silveira, Denise Silva da; Siqueira, Fernando Carlos Vinholes; Piccini, Roberto Xavier; Silva, Suele Manjourany; Nunes, Bruno Pereira; Facchini, Luiz Augusto

    2015-01-01

    OBJECTIVE To describe the lack of access and continuity of health care in adults. METHODS A cross-sectional population-based study was performed on a sample of 12,402 adults aged 20 to 59 years in urban areas of 100 municipalities of 23 states in the five Brazilian geopolitical regions. Barriers to the access and continuity of health care and were investigated based on receiving, needing and seeking health care (hospitalization and accident/emergency care in the last 12 months; care provided by a doctor, by other health professional or home care in the last three months). Based on the results obtained by the description of the sample, a projection is provided for adults living in Brazilian urban areas. RESULTS The highest prevalence of lack of access to health services and to provision of care by health professionals was for hospitalization (3.0%), whilst the lowest prevalence was for care provided by a doctor (1.1%). The lack of access to care provided by other health professionals was 2.0%; to accident and emergency services, 2.1%; and to home care, 2.9%. As for prevalences, the greatest absolute lack of access occurred in emergency care (more than 360,000 adults). The main reasons were structural and organizational problems, such as unavailability of hospital beds, of health professionals, of appointments for the type of care needed and charges made for care. CONCLUSIONS The universal right to health care in Brazil has not yet been achieved. These projections can help health care management in scaling the efforts needed to overcome this problem, such as expanding the infrastructure of health services and the workforce. PMID:26061454

  17. Physical access to primary health care in Andean Bolivia.

    PubMed

    Perry, B; Gesler, W

    2000-05-01

    Limited physical access to primary health care is a major factor contributing to the poor health of populations in developing countries, particularly in mountain areas with rugged topography, harsh climates and extensive socioeconomic barriers. Assessing physical access to primary health care is an important exercise for health care planners and policy makers. The development of geographic information system (GIS) technology has greatly improved this assessment process in industrialized countries where digital cartographic data are widely available. In developing countries particularly in mountain areas, however, detailed cartographic data, even in hardcopy form, are nonexistent, inaccurate or severely lacking. This paper uses GIS technology to assess physical access to primary health care in a remote and impoverished region of Andean Bolivia. In addition, it proposes an alternative model of health personnel distribution to maximize physical accessibility. Methods involved extensive fieldwork in the region, utilizing GPS (global positioning system) technology in the development of the GIS and gathering other pertinent health data for the study. Satellite imagery also contributed to the development of the GIS and in the modeling process. The results indicate significant variation in physical access to primary health care across the three study sites. More importantly, this paper highlights the use of GIS technology as a powerful tool in improving physical accessibility in mountain areas of developing countries. PMID:10728839

  18. America's Children: Health Insurance and Access to Care.

    ERIC Educational Resources Information Center

    Edmunds, Margaret, Ed.; Coye, Molly Joel, Ed.

    The National Academy of Sciences Committee on Children, Health Insurance, and Access to Care was assembled to address questions about health insurance for children, evaluating the strengths and limitations of insurance as a means of improving children's health from a variety of approaches and policies. Meeting between March 1997 and January 1998,…

  19. Health Services, Student Services Department: Program Evaluation. 1990-91.

    ERIC Educational Resources Information Center

    Jeschke, Thomas; And Others

    This document evaluates the Des Moines Public Schools health services and education program, which utilizes the professional expertise of school nurses throughout the district. The program promotes success in the learning process for students (including those with complex health care needs, conditions, and disabilities), employees, and the…

  20. Intelligent Healthcare Service Using Health Lifelog Analysis.

    PubMed

    Choi, Junho; Choi, Chang; Ko, Hoon; Kim, Pankoo

    2016-08-01

    Recently, there have been many studies of health services combined with smart devices, gathering a user' health lifelog and managing his or her health for the improvement of the quality of his or her life, using various sensors. However, previous works have problems in the extraction of patterns in person's complex health lifelog, the analysis of complex relations among those patterns, the extension of them to related services, and reuse of lifelog patterns. The healthcare lifelogs should search efficiently data necessary for users from big data because those gather real-time data of various types of data. The healthcare lifelogs should search efficiently data necessary for users from big data because those gather real-time data of various types of data. In this paper, we propose the intelligent healthcare service for reasoning personal health state with data extraction, pattern analysis, health life ontology modeling using health lifelog analysis based on smart devices. The proposed health information service provided more and more appropriate service with users if more reasoning rules related to more and various healthcare lifelog information gathering are included in the service. PMID:27352004

  1. 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

  2. Access to HIV prevention services among gender based violence survivors in Tanzania

    PubMed Central

    Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth

    2012-01-01

    Introduction Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. Methods In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. Results Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. Conclusion GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended. PMID:23467278

  3. 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. PMID:22724668

  4. Youth Homelessness: The Relationships among Mental Health, Hope, and Service Satisfaction

    PubMed Central

    Hughes, Jean R.; Clark, Sharon E.; Wood, William; Cakmak, Susan; Cox, Andy; MacInnis, Margie; Warren, Bonnie; Handrahan, Elaine; Broom, Barbara

    2010-01-01

    Introduction: This paper reports a mental health assessment of 60 homeless youth. Our study explored the mental health needs of youth accessing an overnight youth shelter (maximum stay 8 weeks). Methods: Participants completed an interview (45 to 120 minutes in duration) using one demographic form and one of two standardized questionnaires (Youth Self Report, Adult Self Report). Questions assessed youth mental health symptoms, examined various contacts that youth made with mainstream society (services, family), and identified potential motivating factors (hope, service satisfaction) that may play a role in fostering street survival during adolescence. Results: Forty-eight percent of the youth were clinically symptomatic and most youth accessed a range of general health services. Conclusion: However, those most in need had significantly less service satisfaction, less hope about the future, and had not accessed mental health services. PMID:21037918

  5. Health Behavior, Health Education, Health Service Utilization and Compliance with Health Regimes: An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Toledo, J. R.; Hughes, Howard

    This bibliography includes references from major articles, Index Medicus (1972- 1977), and Psychological Abstracts (1967-1977). The material is arranged under four major headings--health behavior, health education, health services utilization, and compliance with health regimes. It will be of interest to persons working in medical settings and…

  6. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  7. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  8. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  9. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  10. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  11. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  12. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  13. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  14. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  15. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  16. MAIN TRENDS IN ACCESS TO PRIMARY HEALTH CARE FOR ADOLESCENTS IN GEORGIA.

    PubMed

    Mirzikashvili, N; Kazakhashvili, N

    2016-03-01

    This study identifies barriers to accessing primary health care among youth in Georgia to inform strategies for improving the appropriateness, quality and usage of primary health care services. The quantitative survey was conducted throughout Georgia among 1000 adolescents 11-19 years of age via interview. Multi stage probability sampling was used to administer questionnaires in the schools, universities and in the streets between March-May 2014 and September-October 2014. Young people in Georgia identified a range of problems in accessing primary health services. By far the most important issues were preventive checkups, geographical access, cost of care, and perceptions about the quality of care. The majority of respondents (78.4%) declared that they do not visit family doctor when well, and 81.9% said that no information was provided about reproductive health issues. Most (77.3%) stated that their family doctor had never talked about health promotion or life style risk factors. Access to health care is still problematic in the villages; and in some areas young people must travel more than 30 minutes by public transport. Limited access in rural areas compared to urban areas was statistically significant (p<0.05). As our survey data shows, most adolescents do not visit a health provider annually, obviating opportunities to integrate prevention into clinical encounters. Because repeated contacts with a primary care provider may occur over several years, clinicians should ideally have multiple opportunities to screen and counsel an adolescent patient for risky health behaviors. However, young people report that there is little screening or discussion about healthy lifestyles. The biggest health challenge for young people in Georgia is overcoming barriers (socioeconomic, geographic, trust, and perceived competence) to visit a doctor for regular preventive checkups and to get health behavior advice from health professional. Addressing the health and development needs

  17. Identifying Barriers and Facilitators to Breast Health Services among Women with Disabilities.

    PubMed

    Welch Saleeby, Patricia; Hunter-Jones, Josalin

    2016-07-01

    Women with disabilities experience significant disparities in accessing breast health services. Many studies have focused on barriers, but few have explored facilitators to improving breast health services. This study used a participatory-research approach involving women with physical, mobility, sensory, and developmental disabilities to explore facilitators and barriers affecting the access and quality of breast health services. Findings confirmed commonly cited barriers including attitudinal, environmental, financial, and structural issues but also identified multiple facilitators such as enhancing accessibility of breast health facilities and equipment, improving information sources, and increasing training of health professionals. Findings from this study can be used in improving breast health services among women with disabilities by targeting not only the removal of barriers but also the increase in proven facilitators. PMID:27092980

  18. School Health Services Guidelines, Revised.

    ERIC Educational Resources Information Center

    Haufler, Lillian H.

    This manual is intended to serve as a guideline for school administrators and personnel who are concerned with the health education of school age children. Because of the different and complicated health problems now facing children and youth, it is deemed imperative that new priorities be established. Thus, policies and methods of school health…

  19. Emergency Health Services Selected Bibliography.

    ERIC Educational Resources Information Center

    Health Services and Mental Health Administration (DHEW), Bethesda, MD.

    This annotated bibliography contains books, journal articles, visual aids, and other documents pertaining to emergency health care, which are organized according to: (1) publications dealing with day-to-day health emergencies that occur at home, work, and play, (2) documents that will help communities prepare for emergencies, including natural…

  20. Transforming Community Access Services through Client- and Family-Centred Homecare Transitions.

    PubMed

    Meadows, Carl; Camus, Susann; Fraser, Julie

    2015-03-01

    This article describes how one provincial health region adopted a client- and family-centred approach to improve access to community health services. Transition best practices and the "Triple Aim" supplied a framework for the transformation of transition of clients needing home healthcare services (Berwick et al. 2008). The need to improve the patient and family experience, establish and streamline professional practice standards, strengthen interprofessional collaborations, increase efficiency, create a critical mass of experts in the clinical domain of care transitions and program access, and evaluate customer experience were the organizational drivers for this transformation. The new framework identifies clients' needs and assigns a priority code. It also identifies which family member provides what support to the client and offers a one-stop service number staffed by individuals trained to provide client- and family-centred homecare services. This transformation of home healthcare transitions has improved the client and family experience, strengthened service provider satisfaction and generated efficiencies in prioritizing and delivering community healthcare services. PMID:26154123