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Open Access
Book part
Publication date: 12 December 2022

Jessica H. Williams, Geoffrey A. Silvera and Christy Harris Lemak

In the US, a growing number of organizations and industries are seeking to affirm their commitment to and efforts around diversity, equity, and inclusion (DEI) as recent events…

Abstract

In the US, a growing number of organizations and industries are seeking to affirm their commitment to and efforts around diversity, equity, and inclusion (DEI) as recent events have increased attention to social inequities. As health care organizations are considering new ways to incorporate DEI initiatives within their workforce, the anticipated result of these efforts is a reduction in health inequities that have plagued our country for centuries. Unfortunately, there are few frameworks to guide these efforts because few successfully link organizational DEI initiatives with health equity outcomes. The purpose of this chapter is to review existing scholarship and evidence using an organizational lens to examine how health care organizations can advance DEI initiatives in the pursuit of reducing or eliminating health inequities. First, this chapter defines important terms of DEI and health equity in health care. Next, we describe the methods for our narrative review. We propose a model for understanding health care organizational activity and its impact on health inequities based in organizational learning that includes four interrelated parts: intention, action, outcomes, and learning. We summarize the existing scholarship in each of these areas and provide recommendations for enhancing future research. Across the body of knowledge in these areas, disciplinary and other silos may be the biggest barrier to knowledge creation and knowledge transfer. Moving forward, scholars and practitioners should seek to collaborate further in their respective efforts to achieve health equity by creating formalized initiatives with linkages between practice and research communities.

Details

Responding to the Grand Challenges in Health Care via Organizational Innovation
Type: Book
ISBN: 978-1-80382-320-1

Keywords

Book part
Publication date: 13 December 2023

Nimesh P. Bhojak, Suresh N. Patel and Mohammadali K. Momin

Digital healthcare once again emerges due to pandemic (Covid-19). Digital healthcare can be minimising the issue of accessibility, availability, accuracy and affordability of…

Abstract

Digital healthcare once again emerges due to pandemic (Covid-19). Digital healthcare can be minimising the issue of accessibility, availability, accuracy and affordability of healthcare service during a pandemic. Digital healthcare playsa significant role to provide healthcare equity during the pandemic. This article presents the current trends and scenario of digital healthcare with a focus on health equity. The main objective of this chapter is to review the four aces of health equity in the digital healthcare literature. The scope and challenges faced by the policymakers to implementation of digital healthcare to improve health equity. This chapter considers the hybrid literature review based on the bibliometric and the systematic literature based on the various theme, sub-theme, concept and context-related health equity through digital healthcare. This study provides the previous and current research trends and preposition for the future researcher, healthcare professional, policymakers and digital healthcare innovators to invent the tool which leads the health equity through the digital healthcare in the healthcare.

Details

Fostering Sustainable Development in the Age of Technologies
Type: Book
ISBN: 978-1-83753-060-1

Keywords

Open Access
Article
Publication date: 2 February 2023

Amanda J. Wilson, Catherine Staley, Brittney Davis and Blair Anton

Progress toward health equity is necessary to reduce health disparities, and health literacy is key to achieving this goal. Because libraries provide access to knowledge and…

1824

Abstract

Purpose

Progress toward health equity is necessary to reduce health disparities, and health literacy is key to achieving this goal. Because libraries provide access to knowledge and insights about their communities, they are effective partners in advancing health equity and implementing programs to reduce health disparities. A literature review on library programs and activities that focus on promoting health equity was conducted.

Design/methodology/approach

A literature review on library programs and activities concerning health equity and social determinants of health was conducted. Relevant literature was identified from searches of databases, library publications and grey literature.

Findings

The authors found 224 eligible sources and many types of libraries advancing health equity. Libraries frame their role in advancing health equity through external programs in three ways: (1) providing access to high-quality health information, (2) delivering health literacy training and resources and (3) connecting their communities with community health services. Libraries also advance health equity by focusing on internal library operations and providing research services focused on cultural humility and competence as they apply to health care.

Originality/value

This literature review will help the National Library of Medicine (NLM) develop a strategy to support libraries advancing health equity through information made available by programs and activities of NLM and the Network of the National Library of Medicine.

Details

Reference Services Review, vol. 51 no. 1
Type: Research Article
ISSN: 0090-7324

Keywords

Article
Publication date: 2 July 2021

Richard Cookson, Matthew Robson, Ieva Skarda and Tim Doran

We review quantitative methods for analysing the equity impacts of health care and public health interventions: who benefits most and who bears the largest burdens (opportunity…

Abstract

Purpose

We review quantitative methods for analysing the equity impacts of health care and public health interventions: who benefits most and who bears the largest burdens (opportunity costs)? Mainstream health services research focuses on effectiveness and efficiency but decision makers also need information about equity.

Design/methodology/approach

We review equity-informative methods of quantitative data analysis in three core areas of health services research: effectiveness analysis, cost-effectiveness analysis and performance measurement. An appendix includes further readings and resources.

Findings

Researchers seeking to analyse health equity impacts now have a practical and flexible set of methods at their disposal which builds on the standard health services research toolkit. Some of the more advanced methods require specialised skills, but basic equity-informative methods can be used by any health services researcher with appropriate skills in the three core areas.

Originality/value

We hope that this review will raise awareness of equity-informative methods of health services research and facilitate their entry into the mainstream so that health policymakers are routinely presented with information about who gains and who loses from their decisions.

Article
Publication date: 26 March 2018

Alexandra Edelman, Judy Taylor, Pavel V. Ovseiko and Stephanie M. Topp

Academic health centres (AHCs) are organisations that pursue a “tripartite” mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train…

Abstract

Purpose

Academic health centres (AHCs) are organisations that pursue a “tripartite” mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train future health professionals. The last decade has seen a global spread of AHC models and a growing interest in the role of AHCs in addressing health system equity. The purpose of this paper is to synthesise and critically appraise the evidence on the role of AHCs in improving health equity.

Design/methodology/approach

Peer-reviewed and grey literature published in English between 2000 and 2016 were searched. Articles that identified AHCs as the primary unit of analysis and that also addressed health equity concepts in relation to the AHC’s activity or role were included.

Findings

In total, 103 publications met the inclusion criteria of which 80 per cent were expert opinion. Eight descriptive themes were identified through which health equity concepts in relation to AHCs were characterised, described and operationalised: population health, addressing health disparities, social determinants of health, community engagement, global health, health system reform, value-based and accountable financing models, and role clarification/recalibration. There was consensus that AHCs can and should address health disparities, but there is a lack of empirical evidence to show that AHCs have a capacity to contribute to health equity goals or are demonstrating this contribution.

Originality/value

This review highlights the relevance of health equity concepts in discussions about the role and missions of AHCs. Future research should improve the quality of the evidence base by empirically examining health equity strategies and interventions of AHCs in multiple countries and contexts.

Details

Journal of Health Organization and Management, vol. 32 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Book part
Publication date: 11 June 2009

Phusit Prakongsai, Supon Limwattananon and Viroj Tangcharoensathien

Objective – This chapter assesses health equity achievements of the Thai health system before and after the introduction of the universal coverage (UC) policy. It examines five…

Abstract

Objective – This chapter assesses health equity achievements of the Thai health system before and after the introduction of the universal coverage (UC) policy. It examines five dimensions of equity: equity in financial contributions, the incidence of catastrophic health expenditure, the degree of impoverishment as a result of household out-of-pocket payments for health, equity in health service use and the incidence of public subsidies for health.

Methodology – The standard methods proposed by O’Donnell, van Doorslaer, and Wagstaff (2008b) were used to measure equity in financial contribution, healthcare utilization and public subsidies, and in assessing the incidence of catastrophic health expenditure and impoverishment. Two major national representative household survey datasets were used: Socio-Economic Surveys and Health and Welfare Surveys.

Findings – General tax was the most progressive source of finance in Thailand. Because this source dominates total financing, the overall outcome was progressive, with the rich contributing a greater share of their income than the poor. The low incidence of catastrophic health expenditure and impoverishment before UC was further reduced after UC. Use of healthcare and the distribution of government subsidies were both pro-poor: in particular, the functioning of primary healthcare (PHC) at the district level serves as a “pro-poor hub” in translating policy into practice and equity outcomes.

Policy implications – The Thai health financing reforms have been accompanied by nationwide extension of PHC coverage, mandatory rural health service by new graduates and systems redesign, especially the introduction of a contracting model and closed-ended provider payment methods. Together, these changes have led to a more equitable and more efficient health system. Institutional capacity to generate evidence and to translate it into policy decisions, effective implementation and comprehensive monitoring and evaluation are essential to successful system-level reforms.

Details

Innovations in Health System Finance in Developing and Transitional Economies
Type: Book
ISBN: 978-1-84855-664-5

Book part
Publication date: 30 December 2013

John E. Roemer

Equality of opportunity (EOp) for health is defined and advocated as the right conceptualization of equity in the allocation of health care resources. EOp is contrasted with the…

Abstract

Equality of opportunity (EOp) for health is defined and advocated as the right conceptualization of equity in the allocation of health care resources. EOp is contrasted with the traditional view that equity consists in “horizontal equity,” a state in which all persons in a society with similar health needs receive similar amounts of medical resources. We argue the horizontal equity is neither sufficient nor necessary for distributive justice in this domain. The EOp view holds individuals partially responsible for the quality of lifestyle that they live, in so far as it affects their health, but compensates individuals for the effect on health of circumstances beyond their control, including the effect of circumstances on their lifestyle. EOp generally recommends a distribution of medical resources that is more egalitarian than the utilitarianism recommends, but less egalitarian than the (Rawlsian) maximin view recommends. An example is computed to illustrate the difference between opportunity equalizing and utilitarian health delivery policies.

Details

Health and Inequality
Type: Book
ISBN: 978-1-78190-553-1

Keywords

Article
Publication date: 9 April 2021

Melissa Jane Carey and Melissa Taylor

The purpose of this review was to explore the literature for evidence of the impact of interprofessional practice models on health service inequity, particularly within community…

1312

Abstract

Purpose

The purpose of this review was to explore the literature for evidence of the impact of interprofessional practice models on health service inequity, particularly within community care settings for diverse ageing populations.

Design/methodology/approach

An integrative systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework combined with the EndNote reference management system. Following the collection and comprehensive screening process completion, a thematic analysis of the included articles occurred utilising within NVivo 12 software.

Findings

The review found that there was a paucity of evidence related to the relationship between interprofessional practice models (IPM) and health service equity for ageing populations. There is a need to improve collaborative practices between social care, public health care and health service providers to more clearly define team member roles. Key aspirations included the need for future innovations in health service delivery to place health service equity as a goal for interprofessional practice. There is a need to find ways to measure and articulate the impact for vulnerable populations and communities.

Research limitations/implications

The review offers insight into the need for health care delivery models to place health service equity at the centre of the model design. In practice settings, this includes setting interprofessional team goals around achieving equitable care outcomes for, and with, vulnerable populations. Implications for practice relate to improving how interprofessional teams work with communities to achieve health care equity.

Originality/value

There is a consensus across the literature that there continues to be health service inequity, yet IPE and interprofessional collaborative practice (IPC) have been growing in momentum for some time. Despite many statements that there is a link between interprofessional practice and improved health service equity and health outcomes, evidence for this is yet to be fully realised. This review highlights the urgent need to review the link between education and practice, and innovative health models of care that enable heath care professionals and social care providers to work together towards achieving health equity for ageing populations. It is clear that more evidence is required to establish evidence for best practice in interprofessional care that has the mitigation of health care inequity as a central objective.

Details

Journal of Health Organization and Management, vol. 35 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Book part
Publication date: 12 December 2022

Cynthia J. Sieck, Shannon E. Nicks, Jessica Salem, Tess DeVos, Emily Thatcher and Jennifer L. Hefner

Patient engagement has been a focus of patient-centered care in recent years, encouraging health care organizations to increase efforts to facilitate a patient's ability to…

Abstract

Patient engagement has been a focus of patient-centered care in recent years, encouraging health care organizations to increase efforts to facilitate a patient's ability to participate in health care. At the same time, a growing body of research has examined the impact that social determinants of health (SDOH) have on patient health outcomes. Additionally, health care equity is increasingly becoming a focus of many organizations as they work to ensure that all patients receive equitable care. These three domains – patient engagement, SDOH, and health care equity – can intersect in the implementation of social needs screenings among health care organizations. We present a case study on a two-phase social needs screening implementation project and describe how this process focuses on equity. As health care organizations seek to increase patient engagement, address SDOH, and improve health equity, we highlight the need to move away from a siloed approach and view these efforts as interrelated. By approaching efforts to address these challenges and barriers as the duty of all those involved in the patient care process, there may be larger strides made toward equitable health care.

Details

Responding to the Grand Challenges in Health Care via Organizational Innovation
Type: Book
ISBN: 978-1-80382-320-1

Keywords

Article
Publication date: 19 September 2018

Telma Zahirian Moghadam, Pouran Raeissi and Mehdi Jafari-Sirizi

Health Sector Evolution Plan (HSEP) is known as the biggest and most comprehensive reform in Iran’s health system. One of the goals of HSEP is to reduce inequity in the healthcare…

Abstract

Purpose

Health Sector Evolution Plan (HSEP) is known as the biggest and most comprehensive reform in Iran’s health system. One of the goals of HSEP is to reduce inequity in the healthcare financing. The purpose of this paper is to demonstrate HSEP agenda setting from the perspective of equity in healthcare financing (EHCF) using the multiple streams model.

Design/methodology/approach

This qualitative study was conducted by 26 documents review and analysis, and 30 semi-structured interview with Iranian key informants in the field of HSEP that were selected based on purposeful and snowball sampling method. Data were collected using a researcher-made checklist based on the goals. All audio-taped interviews were transcribed and analyzed thematically. Data management and analysis were performed using the framework analysis in MAXQDA software.

Findings

The framework analysis identified 12 complementary sub-themes totally. Problem stream included four sub-themes (high share of Out Of Pocket, high index of catastrophic health expenditures, low EHCF index, and inappropriate economic state and sanctions). Focus on EHCF in general policies of the Iran World Health Organization’s report in 2000, the Targeted Subsidies Law and emphasis on equalizing healthcare financing in the Fourth and Fifth Development Plan were considered as policy stream sub-themes. Finally, political stream showed four sub-themes including strong support from the Minister of Health for HSEP, mass media, the pressure of WHO and people’s request to reduce health costs.

Research limitations/implications

The limitations of the present study included paying attention to one package (evolution in the treatment sector) of three health packages to assess EHCF, as well as the lack of similar national and international evidence in implementation framework.

Practical implications

The results of this study can be used to analyze other health sector reforms around the word and can help the formulation and implementation of most practical reforms, especially in field of health system financing.

Social implications

This study gives a holistic view about health system policy setting that can be used for understanding policy-making streams to population.

Originality/value

This is the first study that has examined HSEP (the biggest health sector reform in Iran) from the perspective of agenda setting. In addition, using the popular and well-known Kingdon’s model to explain HSEP agenda setting is one of the strengths of this study. Furthermore, taking advantage of a wide range of related views by including highly informed people increased the strength of the results of the study. In addition, the short interval between the interview and reviewing the results on reforms reduced the recall bias of the participants in the study.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 2
Type: Research Article
ISSN: 2056-4902

Keywords

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