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Health care inequality

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https://www.readbyqxmd.com/read/28745803/measuring-socioeconomic-inequalities-in-the-use-of-dental-care-services-among-older-adults-in-brazil
#1
Fabíola Bof de Andrade, Flávia Cristina Drumond Andrade, Kenya Noronha
OBJECTIVES: The primary objectives are to assess socioeconomic inequality in the use of dental care among older Brazilian adults and to analyse the extent to which certain determinants contribute to that inequality. METHODS: A cross-sectional study using data from the National Oral Health Survey conducted in 2010. All individuals answered a structured questionnaire containing questions on their use of dental care and socioeconomic conditions and underwent a clinical oral examination by a dentist...
July 26, 2017: Community Dentistry and Oral Epidemiology
https://www.readbyqxmd.com/read/28742825/impact-of-maternal-and-neonatal-health-initiatives-on-inequity-in-maternal-health-care-utilization-in-bangladesh
#2
Mohammad Rifat Haider, Mohammad Masudur Rahman, Md Moinuddin, Ahmed Ehsanur Rahman, Shakil Ahmed, M Mahmud Khan
BACKGROUND: Despite remarkable progress in maternal and child health, inequity persists in maternal care utilization in Bangladesh. Government of Bangladesh (GOB) with technical assistance from United Nation Population Fund (UNFPA), United Nation Children's Fund (UNICEF) and World Health Organization (WHO) started implementing Maternal and Neonatal Health Initiatives in selected districts of Bangladesh (MNHIB) in 2007 with an aim to reduce inequity in healthcare utilization. This study examines the effect of MNHIB on inequity in maternal care utilization...
2017: PloS One
https://www.readbyqxmd.com/read/28739534/insurance-coverage-and-well-child-visits-improved-for-youth-under-the-affordable-care-act-but-latino-youth-still-lag-behind
#3
Alexander N Ortega, Ryan M McKenna, Jie Chen, Héctor E Alcalá, Brent A Langellier, Dylan H Roby
OBJECTIVE: To examine whether there have been changes in insurance coverage and health care utilization for youth before and after the national implementation of the Patient Protection and Affordable Care Act (ACA) and to assess whether racial and ethnic inequities have improved. METHODS: Data are from 64,565 youth (ages 0-17) participants in the 2011-2015 National Health Interview Survey (NHIS). We conducted multivariate logistic regression analyses to determine how the period after national implementation of the ACA (years 2011-2013 versus years 2014-2015) was associated with health insurance coverage and utilization of health care services (well-child visits, having visited an emergency department, and having visited a physician, all in the past 12 months), and whether changes over the pre- and post-ACA periods varied by race and Latino ethnicity...
July 21, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28738806/financial-crisis-and-income-related-inequalities-in-the-universal-provision-of-a-public-service-the-case-of-healthcare-in-spain
#4
Ignacio Abásolo, Marc Saez, Guillem López-Casasnovas
BACKGROUND: The objective of this paper is to analyse whether the recent recession has altered health care utilisation patterns of different income groups in Spain. METHODS: Based on information concerning individuals 'income and health care use, along with health need indicators and demographic characteristics (provided by the Spanish National Health Surveys from 2006/07 and 2011/12), econometric models are estimated in two parts (mixed logistic regressions and truncated negative binominal regressions) for each of the public health services studied (family doctor appointments, appointments with specialists, hospitalisations, emergencies and prescription drug use)...
July 24, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28738213/determinants-of-the-magnitude-of-socioeconomic-inequalities-in-mortality-a-study-of-17-european-countries
#5
Johan P Mackenbach, Matthias Bopp, Patrick Deboosere, Katalin Kovacs, Mall Leinsalu, Pekka Martikainen, Gwenn Menvielle, Enrique Regidor, Rianne de Gelder
The magnitude of socioeconomic inequalities in mortality differs importantly between countries, but these variations have not been satisfactorily explained. We explored the role of behavioral and structural determinants of these variations, by using a dataset covering 17 European countries in the period 1970-2010, and by conducting multilevel multivariate regression analyses. Our results suggest that between-country variations in inequalities in current mortality can partly be understood from variations in inequalities in smoking, excessive alcohol consumption, and poverty...
July 21, 2017: Health & Place
https://www.readbyqxmd.com/read/28736871/inequitable-health-service-use-in-a-canadian-paediatric-population-a-cross-sectional-study-of-individual-and-contextual-level-factors
#6
C Holtz, J Gilliland, A Thind, P Wilk, M K Campbell
BACKGROUND: Health service use may be influenced by multilevel predisposing, enabling, and need factors but is equitable when driven by need. The study's objectives were as follows: (a) to investigate residential context's effect on child health service use and (b) to examine inequity of child health service use by testing for effect measure modification of need factors. METHODS: The sample of 1,451 children was from a prenatal cohort recruited from London, Ontario, between 2002 and 2004, with follow-up until children were toddler/preschooler-aged...
July 23, 2017: Child: Care, Health and Development
https://www.readbyqxmd.com/read/28733459/advice-given-by-nhs-direct-in-wales-do-deprived-patients-get-more-urgent-decisions-study-of-routine-data
#7
Julie Peconi, Steven Macey, Sarah Rodgers, Ian Russell, Helen Snooks, Alan Watkins
BACKGROUND: In the UK, National Health Service Direct Wales (NHSDW) uses computerised decision support software to advise patients on appropriate care. However, the effect of deprivation on the advice given is not known. We aimed to estimate the effect of deprivation on advice given by nurses in NHSDW adjusting for confounding variables. METHODS: We included 400 000 calls to NHSDW between January 2002 and June 2004. We used logistic regression to model the effect of deprivation on advice given by nurses in response to calls seeking advice or information...
July 21, 2017: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/28729310/socioeconomic-inequalities-in-caries-experience-care-level-and-dental-attendance-in-primary-school-children-in-belgium-a-cross-sectional-survey
#8
Martijn J Lambert, Jacques S N Vanobbergen, Luc C Martens, Luc M J De Visschere
OBJECTIVES: Oral health inequality in children is a widespread and well-documented problem in oral healthcare. However, objective and reliable methods to determine these inequalities in all oral health aspects, including both dental attendance and oral health, are rather scarce. AIMS: To explore oral health inequalities and to assess the impact of socioeconomic factors on oral health, oral health behaviour and dental compliance of primary school children. METHODS: Data collection was executed in 2014 within a sample of 2216 children in 105 primary schools in Flanders, by means of an oral examination and a validated questionnaire...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728554/the-rise-and-fall-of-dental-therapy-in-canada-a-policy-analysis-and-assessment-of-equity-of-access-to-oral-health-care-for-inuit-and-first-nations-communities
#9
Victoria Leck, Glen E Randall
BACKGROUND: Inequality between most Canadians and those from Inuit and First Nations communities, in terms of both access to oral health care services and related health outcomes, has been a long-standing problem. Efforts to close this equity gap led to the creation of dental therapy training programs. These programs were designed to produce graduates who would provide services in rural and northern communities. The closure of the last dental therapy program in late 2011 has ended the supply of dental therapists and governments do not appear to have any alternative solutions to the growing gap in access to oral health care services between most Canadians and those from Inuit and First Nations communities...
July 20, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28728533/lifestyle-inequalities-explaining-socioeconomic-differences-in-preventive-practices-of-clinically-overweight-women-after-menopause
#10
Mélisa Audet, Alex Dumas, Rachelle Binette, Isabelle J Dionne
Excess weight and menopause are two major factors increasing aging women's vulnerability to chronic diseases. However, social position and socioeconomic status have also been identified as major determinants influencing both health behaviors and the development of such diseases. This study focuses on the socioeconomic variations of behavioral risk factors of chronic diseases in aging women. By drawing on Bourdieu's sociocultural theory of practice, 40 semistructured interviews were conducted to investigate preventive health practices of clinically overweight, postmenopausal women from contrasting socioeconomic classes living in Canada...
August 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28726477/south-asian-ethnicity-socioeconomic-status-and-psychological-mediators-of-faecal-occult-blood-colorectal-screening-participation-a-prospective-test-of-a-process-model
#11
Sheina Orbell, Ala Szczepura, David Weller, Anil Gumber, Martin S Hagger
OBJECTIVE: Although ethnicity and socioeconomic status (SES) correlate with health inequality, efforts to explain variance in health behavior attributable to these factors are limited by difficulties in population sampling. We used ethnicity identification software to test effects of psychological beliefs about screening as mediators of ethnicity and SES on faecal occult blood colorectal screening behavior in a no-cost health care context. METHOD: Adults aged 50-67 years (N = 1,678), of whom 28% were from minority South Asian religiolinguistic ethnic groups (Hindu-Gujarati/Hindi, Muslim-Urdu and Sikh-Punjabi), participated in a prospective survey study...
July 20, 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28724420/legal-access-to-medications-a-threat-to-brazil-s-public-health-system
#12
Ana Luiza Chieffi, Rita De Cassia Barata Barradas, Moisés Golbaum
BACKGROUND: In Brazil, health is fundamental human right guaranteed by the Constitution of 1988, which created the Brazilian Universal Health System (Sistema Único de Saúde - SUS). The SUS provides medications for outpatient care via policy of pharmaceutical assistance (PA) programmes. Despite the advances in PA policies which include the improvement in access to medications, there has been a significant increase in lawsuits related to health products and services. This study aimed to characterize the medication processes filed between 2010 and 2014 against the Secretary of State for Health of São Paulo (State Health Department of São Paulo - SES/SP), in Brazil, following PA policies...
July 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28723997/access-to-health-care-as-a-human-right-in-international-policy-critical-reflections-and-contemporary-challenges
#13
Camilo Hernán Manchola Castillo, Volnei Garrafa, Thiago Cunha, Fernando Hellmann
Using the United Nations (UN) and its subordinate body, the World Health Organization (WHO), as a frame of reference, this article explores access to healthcare as a human right in international intergovernmental policies. First, we look at how the theme of health is treated within the UN, focusing on the concept of global health. We then discuss the concept of global health from a human rights perspective and go on to outline the debate surrounding universal coverage versus universal access as a human right, addressing some important ethical questions...
July 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28722561/the-quality-of-free-antenatal-and-delivery-services-in-northern-sierra-leone
#14
Manso M Koroma, Samuel S Kamara, Evelyn A Bangura, Mohamed A Kamara, Virgil Lokossou, Namoudou Keita
BACKGROUND: The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. METHODS: A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region...
July 12, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28720632/improving-efficiency-while-improving-patient-care-in-a-student-run-free-clinic
#15
Jason S Lee, Kristen Combs, Magdalena Pasarica
INTRODUCTION: Student-run free clinics (SRFCs) have the capacity to decrease health care inequity in underserved populations. These facilities can benefit from improved patient experience and outcomes. We implemented a series of quality improvement interventions with the objectives to decrease patient wait times and to increase the variety of services provided. METHODS: A needs assessment was performed. Problems related to time management, communication between staff and providers, clinic resources, and methods for assessing clinic performance were identified as targets to reduce wait times and improve the variety of services provided...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28720105/decomposing-the-causes-of-socioeconomic-related-health-inequality-among-urban-and-rural-populations-in-china-a-new-decomposition-approach
#16
Jiaoli Cai, Peter C Coyte, Hongzhong Zhao
BACKGROUND: In recent decades, China has experienced tremendous economic growth and also witnessed growing socioeconomic-related health inequality. The study aims to explore the potential causes of socioeconomic-related health inequality in urban and rural areas of China over the past two decades. METHODS: This study used six waves of the China Health and Nutrition Survey (CHNS) from 1991 to 2006. The recentered influence function (RIF) regression decomposition method was employed to decompose socioeconomic-related health inequality in China...
July 18, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28719772/inequalities-in-household-catastrophic-health-expenditure-and-impoverishment-associated-with-noncommunicable-diseases-in-chi-linh-hai-duong-vietnam
#17
Vu Duy Kien, Hoang Van Minh, Nguyen Bao Ngoc, Tran Bich Phuong, Tran Thu Ngan, Mikkel B Quam
A costly modern-day double burden, the expenses of noncommunicable diseases (NCDs) are becoming a devastating epidemic. The World Health Organization estimates $7 trillion in economic losses from NCDs in 2011-2025. Although regarded as affluent diseases, the burden of NCDs is shifting into poorer groups. In this study, we assessed the socioeconomic inequalities in catastrophic health expenditure and impoverishment associated with NCDs in Northern Vietnam. We also identified associated factors for catastrophic health expenditure and impoverishment...
July 2017: Asia-Pacific Journal of Public Health
https://www.readbyqxmd.com/read/28717769/end-of-life-care-in-latin-america
#18
REVIEW
Enrique Soto-Perez-de-Celis, Yanin Chavarri-Guerra, Tania Pastrana, Rossana Ruiz-Mendoza, Alexandra Bukowski, Paul E Goss
Cancer has become a global pandemic with disproportionately higher mortality rates in low- and middle- income countries, where a large fraction of patients present in advanced stages and in need of end-of-life care. Globally, the number of adults needing end-of-life care is greater than 19 million, and up to 78% of these patients are living in low- and middle- income countries. In the Americas alone, more than one million people are in need of end-of-life care, placing an enormous burden on local health systems, which are often unprepared to meet the challenge presented by this complex patient population...
June 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28716350/progress-and-priorities-for-reproductive-maternal-newborn-and-child-health-in-kenya-a-countdown-to-2015-country-case-study
#19
Emily C Keats, Anthony Ngugi, William Macharia, Nadia Akseer, Emma Nelima Khaemba, Zaid Bhatti, Arjumand Rizvi, John Tole, Zulfiqar A Bhutta
BACKGROUND: Progress in reproductive, maternal, newborn, and child health (RMNCH) in Kenya has been inconsistent over the past two decades, despite the global push to foster accountability, reduce child mortality, and improve maternal health in an equitable manner. Although several cross-sectional assessments have been done, a systematic analysis of RMNCH in Kenya was needed to better understand the push and pull factors that govern intervention coverage and influence mortality trends...
August 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28714334/-regional-inequalities-of-health-status-of-pregnant-women-in-hungary-long-term-series-analysis
#20
Ágota Moravcsik-Kornyicki, Zsigmond Kósa, Anikó Gyulai, Renáta Jávorné Erdei, Karolina Kósa
INTRODUCTION: Monitoring the health status of populations is essential for good health policy decisions. This is particularly true in maternal and child health where targeted and timely interventions may have long-term consequences. AIM: Our objective was to describe changes in the health status of pregnant women at the national and county level during the period of 1997-2012. METHOD: Data were extracted from the mandatory annual reports of district nurses responsible for primary maternal care...
July 2017: Orvosi Hetilap
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