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Article
Publication date: 19 December 2016

Michelle Sandoval-Rosario, Theresa Marie Hunter, Adrienne Durnham, Antoniette Holt, Pam Pontones and Geraldine Perry

Migrant and seasonal farmworkers (MSFWs) have many health challenges due to the nature of their work, low wages, living conditions, mobility, and lack of health insurance…

Abstract

Purpose

Migrant and seasonal farmworkers (MSFWs) have many health challenges due to the nature of their work, low wages, living conditions, mobility, and lack of health insurance. The purpose of this paper is to assess the availability of health services, barriers to accessing health care, and the prevalence of chronic conditions among MSFWs in Indiana.

Design/methodology/approach

A site-based convenience sample of MSFWs aged 14 years and older completed a cross-sectional survey. A total of 97 participants who currently or previously identified as farmworkers completed the questionnaire.

Findings

Almost one-third of the respondents reported no access to a health care provider. Of those, 43 percent reported that cost prevented them from seeking care. Of those who reported chronic conditions ( n=22), over 50 percent did not have access to a health care provider. These findings highlight the need to further investigate the magnitude of the problem and begin exploring ways to improve affordable health care access among MSFWs in Northeastern Indiana.

Originality/value

The results from this study highlight the need for the development and implementation of community health education programs that target MSFWs in Indiana. The findings, although not generalized, offer important insights into health care challenges and barriers to access in Indiana. The authors recommend that assistance programs should be implemented for providing affordable health care services for Hispanic MSFWs.

Details

International Journal of Human Rights in Healthcare, vol. 9 no. 4
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 10 June 2021

Ibraheem Khaled Abu Siam and María Rubio Gómez

Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing…

Abstract

Purpose

Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing countries. Throughout refugee’s crisis, the Jordanian Government has adopted several healthcare access policies to meet the health needs of Syrian refugees while maintaining the stability of the health-care system. The adopted health-care provision policies ranged from enabling to restricting and from affordable to unaffordable. The purpose of this paper is to identify the influence of restricted level of access to essential health services among Syrian refugees in Jordan.

Design/methodology/approach

This paper used findings of a cross-sectional surveys conducted over urban Syrian refugees in Jordan in 2017 and 2018 over two different health-care access policies. The first were inclusive and affordable, whereas the other considered very restricting policy owing to high inflation in health-care cost. Access indicators from four main thematic areas were selected including maternal health, family planning, child health and monthly access of household. A comparison between both years’ access indicators was conducted to understand access barriers and its impact.

Findings

The comparison between findings of both surveys shows a sudden shift in health-care access and utilization behaviors with increased barriers level thus increased health vulnerabilities. Additionally, the finding during implementation of restricted access policy proves the tendency among some refugees groups to adopt negative adaptation strategies to reduce health-care cost. The participants shifted to use a fragmented health-care, reduced or delayed care seeking and use drugs irrationally weather by self-medication or reduce drug intake.

Originality/value

Understanding access barriers to health services and its negative short-term and long-term impact on refugees’ health status as well as the extended risks to the host communities will help states that hosting refugees building rational access policy to protect whole community and save public health gains during and post crisis. Additionally, it will support donors to better mobilize resources according to the needs while the humanitarian actors and service providers will better contribute to the public health stability during refugee’s crisis.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

Open Access
Book part
Publication date: 6 May 2019

Pierre-André Michaud, Johanna P.M. Vervoort and Danielle Jansen

Adolescence is a time when a young person develops his or her identity, acquires greater autonomy and independence, experiments and takes risks and grows mentally and…

Abstract

Adolescence is a time when a young person develops his or her identity, acquires greater autonomy and independence, experiments and takes risks and grows mentally and physically. To successfully navigate these changes, an accessible and health system when needed is essential.

We assessed the structure and content of national primary care services against these standards in the field of adolescent health services. The main criteria identified by adolescents as important for primary care are as follows: accessibility, staff attitude, communication in all its forms, staff competency and skills, confidential and continuous care, age appropriate environment, involvement in health care, equity and respect and a strong link with the community.

We found that although half of the Models of Child Health Appraised countries have adopted adolescent-specific policies or guidelines, many countries do not meet the current standards of quality health care for adolescents. For example, the ability to provide emergency mental health care or respond to life-threatening behaviour is limited. Many countries provide good access to contraception, but specialised care for a pregnant adolescent may be hard to find.

Access needs to be improved for vulnerable adolescents; greater advocacy should be given to adolescent health and the promotion of good health habits. Adolescent health services should be well publicised, and adolescents need to feel empowered to access them.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

Keywords

Article
Publication date: 25 May 2020

Adam Capon, Lien McGowan and Julia Bowman

Patient-centred care is a key approach used in Australia for the delivery of quality health care, and understanding experiences and perceptions is a key part to this. This…

Abstract

Purpose

Patient-centred care is a key approach used in Australia for the delivery of quality health care, and understanding experiences and perceptions is a key part to this. This paper aims to explore prisoners’ experiences and perceptions of health-care service provision in New South Wales, Australia.

Design/methodology/approach

In February and March 2017, 24 focus groups, consisting of 128 participants, were undertaken using semi-structured interviews that explored experiences of health care in prison.

Findings

A conceptualisation of the prisoners’ health-care experience around the core category of access to health care emerged from the data. Enablers or barriers to this access were driven by three categories: a prison construct – how the prisoners “see” the prison system influencing access to health care; a health-care system construct – how the prisoners “see” the prison health-care system and the pathways to navigate it; and personal factors. Communication was the category with the greatest number of relational connections.

Research limitations/implications

This study takes a pragmatic approach to the analysis of data, the findings forming the basis for a future quantitative study. The findings identify communication as a key issue for access to health care.

Originality/value

This study provides first-hand accounts of enablers and barriers to accessing health-care services in the prison environment. To the best of the authors’ knowledge, this study is the first of its kind to identify access to health care as a core category and is of value to health workers and researchers that work with the prison population.

Details

International Journal of Prisoner Health, vol. 16 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

Article
Publication date: 1 November 2003

Teresa Zayas‐Cabán

Health disparities have been a growing concern in the USA. Differences in access to healthcare play a role in these health disparities. This article presents a model that…

Abstract

Health disparities have been a growing concern in the USA. Differences in access to healthcare play a role in these health disparities. This article presents a model that illustrates access to healthcare in two rural Midwestern communities. The simulation model developed helps determine if people in these communities have equal access to health care and if physician’s insurance coverage practices prevent certain people from accessing care. From the simulation, it can be determined which characteristics may lead to the disparities in access to health care. Using the results of such a simulation model, the community may then begin to take action in order to ensure equal access to health care for all people within the community and help reduce health disparities.

Details

International Journal of Health Care Quality Assurance, vol. 16 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 22 February 2022

Kayla Halsey, Salameh Alarood, Mohammed Nawaiseh and Ghazala Mir

Refugees commonly face inequitable access to health care services in their host country. This study aimed to identify factors influence refugee access to health services…

Abstract

Purpose

Refugees commonly face inequitable access to health care services in their host country. This study aimed to identify factors influence refugee access to health services and to assess perceptions of barriers to health care for different refugee groups in Jordan.

Design/methodology/approach

In-depth interviews were combined with document analysis and analyzed using thematic and framework methods.

Findings

Findings highlighted inequitable access to health services between different refugee groups. Unlike Palestinian refugees from the West Bank, Palestinian refugees from Gaza faced financial barriers to access health care as a result of citizenship status, which affected their health insurance, referrals for health care and legal right to work. Syrian refugees similarly lacked Jordanian citizenship and health insurance and mainly depended on UNHCR for health services, though some were able to acquire work permits and pay for private care.

Originality/value

This study demonstrates a need for politically and economically appropriate policies to minimize the disparity of health care access among these refugee groups.

Details

International Journal of Migration, Health and Social Care, vol. 18 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

Book part
Publication date: 8 August 2016

Luma AlMasarweh and Carol Ward

This study aims to provide a better understanding of Native American women veterans’ experiences with Veteran Administration and Indian Health Services. Eighteen…

Abstract

Purpose

This study aims to provide a better understanding of Native American women veterans’ experiences with Veteran Administration and Indian Health Services. Eighteen interviews were conducted with special attention to the quality and quantity of health and mental health care services veterans accessed, the barriers and local contextual factors in accessing and utilizing services, and potential solutions to service gaps for women veterans from two Montana reservations, the Northern Cheyenne Reservation and the Confederated Salish and Kootenai Tribes of the Flathead Reservation.

Methodology/approach

We examine the barriers and needs of Native American veterans in both reservations using qualitative methods. The research analyzed 18 interviews with women veterans from the Northern Cheyenne and Flathead reservations.

Findings

Native American women veterans identified a number of barriers to accessing care, some of which include lack of information regarding eligibility and the types of services available. Women often found the application process to be confusing and difficult. Other barriers included distance, cost of travel, and conflicts with their work schedule.

Research limitations/implications

This exploratory case study served to clarify the challenges and obstacles Native American women veterans experience with accessing health and mental health services. This research revealed several patterns and themes in the experience of Native American women veterans in both reservation communities when attempting to access and seek care at Veterans Administration (VA) facilities and Indian Health Services (IHS). This research calls for policy changes and research to clarify how resources can be more efficiently and effectively distributed to rural veterans.

Originality/value

Little research has addressed the needs of Native American veterans. American Indians and Alaska Natives serve at a higher rate in the U.S. military than any other population. This research provides important information about Native American veterans who are often underrepresented in survey research, yet a rapidly growing segment of the United States military and veteran population.

Details

Special Social Groups, Social Factors and Disparities in Health and Health Care
Type: Book
ISBN: 978-1-78635-467-9

Keywords

Book part
Publication date: 10 November 2005

Petri Parvinen and Grant T. Savage

A common observation is that both single- and multi-payer health care systems will achieve lower overall costs if they use primary care gatekeeping. Questioning this…

Abstract

A common observation is that both single- and multi-payer health care systems will achieve lower overall costs if they use primary care gatekeeping. Questioning this common wisdom, we focus on the health care access system, that is, the way in which patients gain access to health care. Gatekeeping, the use of primary care providers to control access to more specialized physician and hospital services, has come under intense scrutiny in the United States and in Europe. The few international comparative studies that have focused on the issues of quality of care, cost containment, and patient satisfaction find weak or no support for common assumptions about gatekeeping. Hence, we examine the institutional environments in seven countries in order to: (a) define and categorize health care access systems; (b) identify the components of a health care access system; (c) explore the notion of a strategic fit between health care financing systems and access system configurations; and (d) propose that the health care access system is a key determinant of process-level cost efficiency. Drawing upon institutional and governance theories, we posit that the structure and organization of an access system is determined by how it addresses six essential questions: Who is covered? Which services are included? What are the points of access? How much time elapses before access? What are the ways of selecting among points of access? and Are services and their quality the same for everyone? This analytical framework reveals that national health care access systems vary the most in their points of access, access times, and selection mechanisms. These findings and our explanations imply that access systems are one of the only tools for demand management, that any lasting change to an access system typically is implemented over an extended time period, and that managers of health care organizations often have limited freedom to define governance structures and shape health care service production systems.

Details

International Health Care Management
Type: Book
ISBN: 978-0-76231-228-3

Book part
Publication date: 9 August 2012

Kathryn Freeman Anderson and Andrew S. Fullerton

A developing body of research has demonstrated the impact of racial residential segregation on a variety of negative health outcomes. However, little is known about the…

Abstract

A developing body of research has demonstrated the impact of racial residential segregation on a variety of negative health outcomes. However, little is known about the effect of residential segregation on access to health care.

This study utilizes multilevel binary logit models based on individual-level health data from the 2008 Behavioral Risk Factor Surveillance System linked to metropolitan-area level data to examine the association between Black-White segregation in 136 metropolitan statistical areas in the United States and health-care coverage.

Overall, an increase in Black-White segregation is related to a decrease in the likelihood of having health insurance for Black residents and an increase in the Black-White gap in health-care coverage. These effects are substantial even when controlling for the effects of educational, social, and economic factors.

This study is the first to examine the impact of segregation on an individual's ability to access health-care coverage, which is an essential starting point for accessing health care in the United States.

Details

Issues in Health and Health Care Related to Race/Ethnicity, Immigration, SES and Gender
Type: Book
ISBN: 978-1-78190-125-0

Keywords

Book part
Publication date: 28 March 2022

Jingqiu Ren, Ryan Earl and Ernesto F. L. Amaral

Micro hospitals are a new form of for-profit health-care facility with rapid expansion in some parts of the country. They continue to grow in Texas without in-depth public…

Abstract

Purpose

Micro hospitals are a new form of for-profit health-care facility with rapid expansion in some parts of the country. They continue to grow in Texas without in-depth public understanding or explicit policy guidance on their role in the health-care system. Our project aims to define socioeconomic and demographic characteristics of areas served by micro and regular hospitals, and by doing so help assess micro hospitals' impact in expanding health-care access for disadvantaged populations in Texas.

Methodology/Approach

We (1) estimated hospital service areas (catchment areas) with a spatial model based on advanced Geographic Information System (GIS) methods using a proprietary ESRI traffic network; (2) assigned population socioeconomic measures to the catchment areas from the 2014–2018 American Community Survey 5-Year Estimates, weighted with an empirically tested Gaussian distribution; (3) used two-tailed t-tests to compare means of population characteristics between micro and regular hospital catchment areas; and (4) conducted logistic regressions to examine relationships between selected population variables and the associated odds of micro hospital presence.

Findings

We found micro hospitals in Texas tend to serve a population less stressed in health-care access compared to those who are more in need as measured by various dimensions of disadvantages.

Research Limitations/Implications

Our analysis takes a cross sectional look at the population characteristics of micro hospital service areas. Even though the initial geographic choices of micro hospitals may not reflect the long-term population changes in specific neighborhoods, our analysis can provide policy makers a tool to examine health-care access for disadvantaged populations at given point in time. As the population socioeconomic characteristics have long been associated with health-care inequality, we hope our analysis will help foster structural policy considerations that balance growing health-care delivery innovations and their social accountability.

Originality/Value of Paper

We used GIS based spatial modeling to dynamically capture the potential patient basis by travel time calculated with a street network dataset, rather than using the traditional static census tract to define hospital service areas. By integrating both spatial and nonspatial dimensions of healthcare access, we demonstrated that the policy considerations on the implications of equal opportunity for health-care access need to take into account the social realities and lived experiences of those experiencing the most vulnerability in our society, rather than a conceptual “equality” existing in the spatial and market abstraction.

Details

Health and Health Care Inequities, Infectious Diseases and Social Factors
Type: Book
ISBN: 978-1-80117-940-9

Keywords

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