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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

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…

1507

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

Open Access
Article
Publication date: 23 March 2020

Yara Ahmed, Racha Ramadan and Mohamed Fathi Sakr

This paper aims to evaluate the progressivity of health-care financing in Egypt by assessing all five financing sources individually and then combining them to analyze the equity

5620

Abstract

Purpose

This paper aims to evaluate the progressivity of health-care financing in Egypt by assessing all five financing sources individually and then combining them to analyze the equity of the whole financing system.

Design/methodology/approach

Lorenz dominance analysis and Kakwani progressivity index were applied on data from 2010/2011 Household Income, Expenditure, and Consumption Survey and the National Health Accounts 2011 using Stata to evaluate the progressivity of each source of health-care finance and the financing system overall.

Findings

The data show that Egypt’s health-care system, which is largely financed by out-of-pocket (OOP) payments, is slightly regressive, with an overall Kakwani index of −0.079. The overall regressive effect was the result of three regressive sources (OOP payments, an earmarked cigarette tax and direct taxes), one proportional finance source (social health insurance) and two slightly progressive sources (indirect taxes and private health insurance). This shows that the burden of financing health care falls more on the poor. These results signal the need for reform of health-care financing in Egypt to reduce dependence on OOP payments to achieve more equitable financing.

Originality/value

The paper seeks to augment the literature on health-care financing in Egypt by calculating specific progressivity estimates for all five sources of financing the Egyptian health-care system and analyzing the overall equity of this financing system. It will, therefore, provide a benchmark for monitoring the equity of finance in the Egyptian health-care system in future studies and allow one to assess the impact of implemented financing reforms in the future on the level of progressivity of health system financing.

Details

Journal of Humanities and Applied Social Sciences, vol. 3 no. 1
Type: Research Article
ISSN: 2632-279X

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

Article
Publication date: 3 April 2018

Mohsin Altaf, Nageena Tabassum and Sany Sanuri Mohd Mokhtar

The purpose of this paper is to investigate the impact of health-care quality of emergency medical services on brand equity of cardiac institutes by using industry-specific…

Abstract

Purpose

The purpose of this paper is to investigate the impact of health-care quality of emergency medical services on brand equity of cardiac institutes by using industry-specific measure, 5Qs model of health-care service quality (HCSQ).

Design/methodology/approach

Survey method technique has been used to collect data from the patients availing emergency medical services from 12 cardiac institutes. Effective responses have been received from 393 patients from four localities. Systematic sampling technique has been used to collect data from the respondents. Partial least square structural equation modeling using smartPLS 2.0 has been used to analyze the results.

Findings

Findings of the study reveal that HCSQ has weak relationship with hospital brand loyalty but strong relationship with brand image and brand awareness. Furthermore, brand awareness and brand image have strong relationship with brand loyalty. Furthermore, brand image and brand loyalty have strong relationship with overall hospital brand equity but found nonsignificant relationship of brad awareness with overall hospital brand equity.

Originality/value

The principal contribution of the paper is to provide the insight on the impact of emergency HCSQ on brand equity of the private cardiac hospitals. Second, this study is first in branding literature that has used industry-specific scale 5Qs model to measure the service quality of emergency medical care and its impact on private sector cardiac hospital’s brand equity. Previously researchers used generic scales that were insufficient to measure the service quality of specialized industries (Babakus and Mangold, 1992; Carman, 1990; Caro and Garcia, 2007).

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 12 no. 1
Type: Research Article
ISSN: 1750-6123

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

Article
Publication date: 23 December 2020

Hanna Carlsson and Roos Pijpers

This paper analyses how neighbourhood governance of social care affects the scope for frontline workers to address health inequities of older ethnic minorities. We critically…

Abstract

Purpose

This paper analyses how neighbourhood governance of social care affects the scope for frontline workers to address health inequities of older ethnic minorities. We critically discuss how an area-based, generic approach to service provision limits and enables frontline workers' efforts to reach out to ethnic minority elders, using a relational approach to place. This approach emphasises social and cultural distances to social care and understands efforts to bridge these distances as “relational work”.

Design/methodology/approach

The authors conducted a two-year multiple case study of the cities of Nijmegen and The Hague, the Netherlands, following the development of policies and practices relevant to ethnic minority elders. They conducted 44 semi-structured interviews with managers, policy officers and frontline workers as well as 295 h of participant observation at network events and meeting activities.

Findings

Relational work was open-ended and consisted of a continuous reorientation of goals and means. In some cases, frontline workers spanned neighbourhood boundaries to connect with professional networks, key figures and places meaningful to ethnic minority elders. While neighbourhood governance is attuned to equality, relational work practice fosters possibilities for achieving equity.

Research limitations/implications

Further research on achieving equity in relational work practice and more explicit policy support of relational work is needed.

Originality/value

The paper contributes empirical knowledge about how neighbourhood governance of social care affects ethnic minority elders. It translates a relational view of place into a “situational” social justice approach.

Details

Journal of Health Organization and Management, vol. 35 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 15 August 2011

Akwatu Khenti, Jaime C. Sapag, Consuelo Garcia‐Andrade, Fernando Poblete, Ana Raquel Santiago de Lima, Andres Herrera, Pablo Diaz, Henok Amare, Avra Selick and Sandra Reid

Since 2002, the Centre for Addiction and Mental Health in Ontario, Canada, has been working closely with partners in Latin America and the Caribbean (LAC) to implement mental…

308

Abstract

Purpose

Since 2002, the Centre for Addiction and Mental Health in Ontario, Canada, has been working closely with partners in Latin America and the Caribbean (LAC) to implement mental health capacity‐building focused on primary health care. From an equity perspective, this article seeks to critically analyze the process and key results of this capacity‐building effort and to identify various implications for the future.

Design/methodology/approach

This analysis of capacity‐building approaches is based on a critical review of existing documents such as needs assessments and evaluation reports, as well as reflective discussion. Previous health equity literature is used as a framework for analysis.

Findings

More than 1,000 professionals have been engaged in various kinds of training in Chile, Peru, Brazil, Nicaragua, Mexico, and Trinidad and Tobago. These capacity‐building initiatives have had an impact on primary health care from both an equity and systems perspective because participants were engaged at all stages of the process and implementation lessons incorporated into the final efforts. Stigma was also reduced through the collaborations.

Originality/value

Using concrete examples of capacity‐building in mental primary healthcare in LAC, as well as evidence gathered from the literature, this article demonstrates how primary healthcare can play a strong role in addressing health equity and human rights protection for people with mental health and/or substance abuse problems.

Details

Ethnicity and Inequalities in Health and Social Care, vol. 4 no. 3
Type: Research Article
ISSN: 1757-0980

Keywords

Book part
Publication date: 7 October 2011

Rohit Pradhan and Robert Weech-Maldonado

Private equity has acquired multiple large nursing home chains within the past few years; by 2007, it owned 6 of the 10 largest chains. Despite widespread public and policy…

Abstract

Private equity has acquired multiple large nursing home chains within the past few years; by 2007, it owned 6 of the 10 largest chains. Despite widespread public and policy interest, evidence on the purported impact of private equity on nursing home performance is limited. In our review, we begin by briefly reviewing the organizational and environmental changes in the nursing home industry that facilitated private equity investments. We offer a conceptual framework to hypothesize the relationship between private equity ownership and nursing home performance. Finally, we offer a research agenda focused on the important parameters of nursing home performance: financial performance, and quality of care.

Details

Biennial Review of Health Care Management
Type: Book
ISBN: 978-0-85724-714-8

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