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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

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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.

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

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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

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

Book part
Publication date: 15 September 2014

Claudia Chaufan and Yi-Chang Li

Over the last few decades, information technology (IT) has significantly altered the nature of work and organizational structures in many industries, including health care. The…

Abstract

Purpose

Over the last few decades, information technology (IT) has significantly altered the nature of work and organizational structures in many industries, including health care. The purpose of this analysis is to compare how system-level differences affect IT implementation in health care (HIT) and the implications of these differences for health care equity.

Methodology/approach

We critically analyzed selected claims concerning the capacity of HIT to provide better care to more individuals at lower costs, thus contributing to health care equity, in the context of current health care reform efforts in the United States. We used the case of HIT implementation in Taiwan’s National Health Insurance system as a contrasting case.

Findings

We argue that however much HIT may yield in quality improvements or savings in the context of a universal and publicly financed single payer system, such savings simply cannot be accrued by a system of multiple health plans competing for better customers (i.e., less costly patients) and driven by profit.

Implications

It is important to define the level of analysis in debates about the potential of HIT to produce better health care at lower costs and the equity implications of this potential. In these debates, US policy makers should consider the commitment to health care equity that informed the design of Taiwan’s health care system and of HIT implementation in that country. HIT merely provides enabling tools that are of little value without major systemic changes

Originality/value of the chapter

To our knowledge, the health IT expert literature has overlooked when not ignored the ethical principles informing health care systems, an omission which makes it difficult if not impossible to evaluate the potential of HIT to increase equity in health care.

Details

Technology, Communication, Disparities and Government Options in Health and Health Care Services
Type: Book
ISBN: 978-1-78350-645-3

Keywords

Open Access
Book part
Publication date: 6 May 2019

Mitch Blair and Denise Alexander

Equity is an issue that pervades all aspects of primary care provision for children and as such is a recurring theme in the Models of Child Health Appraised project. All European…

Abstract

Equity is an issue that pervades all aspects of primary care provision for children and as such is a recurring theme in the Models of Child Health Appraised project. All European Union member states agree to address inequalities in health outcomes and include policies to address the gradient of health across society and target particularly vulnerable population groups. The project sought to understand the contribution of primary care services to reducing inequity in health outcomes for children. We focused on some key features of inequity as they affect children, such as the importance of good health services in early childhood, and the effects of inequity on children, such as the higher health needs of underprivileged groups, but their generally lower access to health services. This indicates that health services have an important role in buffering the effects of social determinants of health by providing effective treatment that can improve the health and quality of life for children with chronic disorders. We identified common risk factors for inequity, such as gender, family situation, socio-economic status (SES), migrant or minority status and regional differences in healthcare provision, and attempted to measure inequity of service provision. We did this by analysing routine data of universal primary care procedures, such as vaccination, age at diagnosis of autism or emergency hospital admission for conditions that can be generally treated in primary care, against variables of inequity, such as indicators of SES, migrant/ethnicity or urban/rural residency. In addition, we focused on the experiences of child population groups particularly at risk of inequity of primary care provision: migrant children and children in the state care system.

Details

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

Keywords

Book part
Publication date: 16 November 2020

Lake Sagaris and Ignacio Tiznado-Aitken

Sustainable transport is often defined according to energy efficiency and environmental impacts. With global approval during Habitat III, however, a set of Sustainable Development…

Abstract

Sustainable transport is often defined according to energy efficiency and environmental impacts. With global approval during Habitat III, however, a set of Sustainable Development Goals have become the focus for human development until 2030, underlining the relevance of health, equity and other social issues.

These goals raise the challenge of achieving significant progress towards ‘transport justice’ in diverse societies and contexts. While exclusion occurs for different reasons, discrimination, based on cultural roles, combines with sexual harassment and other mobility barriers to limit women’s mobility. This makes gender an area of particular interest and potential insight for considering equity within sustainability and its social components.

Using data from Metropolitan Santiago to ground a conceptual exploration, this chapter examines the equity implications of women’s travel patterns and sustainable transport. Key findings underline the importance of considering non-work trip purposes and achieving better land-use combinations to accommodate care-oriented trips. Moreover, barriers linked to unsafe public transport environments limit women’s mobility and, therefore, their participation. Women account for a disproportionately high number of walking trips, a situation that can be interpreted as ‘greater sustainability’ in terms of energy use and emissions, but suggests significant inequalities in access. Environmental and economic sustainability gains may be achieved at a high social cost, unless specific measures are taken.

Details

Urban Mobility and Social Equity in Latin America: Evidence, Concepts, Methods
Type: Book
ISBN: 978-1-78769-009-7

Keywords

Book part
Publication date: 29 December 2023

Nirupama Patwardhan

The foremost objective of this chapter was to present an overview of the cooperative healthcare sector in Argentina by reviewing its brief history, components and the role these…

Abstract

The foremost objective of this chapter was to present an overview of the cooperative healthcare sector in Argentina by reviewing its brief history, components and the role these healthcare cooperatives play in the society. The second objective was to look at how these cooperatives have helped women and the local communities in which they operate.

This paper has used chiefly secondary data derived from various academic papers and official and government websites which publish cooperative sector-related information. The intention was to construct a concise yet detailed study that would be of help to other researchers in the field of healthcare cooperatives since the data related to Argentina is highly scattered and frequently found not up to date.

The research has found that health cooperatives in Argentina have aided in overcoming problems in the sector such as sectoral fragmentation, negligence and frequently inadequate standards of care management as well as operational and implementation failures that the private and government healthcare players have been accused of being fraught with. Furthermore, the cooperatives have frequently played a complementary or supplementary role rather than a competitive one with the private and government players.

Through the examples presented in this chapter, it is evident that health cooperatives in Argentina are making large impacts in the healthcare domain along with positively impacting women, marginalised and vulnerable sections of the society and the community. It only remains to be seen now how far this sector will grow in the future and how many more lives will be benefitted.

Details

World Healthcare Cooperatives: Challenges and Opportunities
Type: Book
ISBN: 978-1-80455-775-4

Keywords

Book part
Publication date: 19 March 2024

Cara A. Chiaraluce and Lloyd Levine

This chapter demonstrates the ways in which digital inclusion functions as a super social determinant of health, particularly within the arena of family carework and healthcare…

Abstract

This chapter demonstrates the ways in which digital inclusion functions as a super social determinant of health, particularly within the arena of family carework and healthcare for vulnerable disabled US communities. The focus on vulnerable populations, including the elderly, chronically ill, young disabled, neurodivergent, and/or medically complex children and the families that care for them, is a useful case to present a compelling argument for the need to take seriously digital inclusion to maximize health, safety, and well-being for growing populations of Americans today. The authors argue that digital inclusion is an increasingly influential social determinant of health and a key dimension of health equity that offers important benefits and potentials, especially for vulnerable patient populations, for whom in-home and family-centered care are necessary parts of health maintenance, prevention, and well-being. The chapter ends with a discussion of ways that the US government can mitigate digital barriers and facilitate equitable access to broadband internet and e-health resources that address the intersections of digital, health, and care inequalities, with significant impacts in all three dimensions.

Details

Technology vs. Government: The Irresistible Force Meets the Immovable Object
Type: Book
ISBN: 978-1-83867-951-4

Keywords

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