scholarly journals Canadian Consensus on Medically Acceptable Wait Times for Digestive Health Care

2006 ◽  
Vol 20 (6) ◽  
pp. 411-423 ◽  
Author(s):  
William G Paterson ◽  
William T Depew ◽  
Pierre Paré ◽  
Denis Petrunia ◽  
Connie Switzer ◽  
...  
Keyword(s):  
Health Care ◽  
Digestive Disease ◽  
Access To Health Care ◽  
Colonic Polyps ◽  
Signs And Symptoms ◽  
Wait Times ◽  
Future Health ◽  
Specialist Consultation ◽  
Screening And Surveillance ◽  
Disease Specialist

BACKGROUND: Delays in access to health care in Canada have been reported, but standardized systems to manage and monitor wait lists and wait times, and benchmarks for appropriate wait times, are lacking. The objective of the present consensus was to develop evidence- and expertise-based recommendations for medically appropriate maximal wait times for consultation and procedures by a digestive disease specialist.METHODS: A steering committee drafted statements defining maximal wait times for specialist consultation and procedures based on the most common reasons for referral of adult patients to a digestive disease specialist. Statements were circulated in advance to a multidisciplinary group of 25 participants for comments and voting. At the consensus meeting, relevant data and the results of voting were presented and discussed; these formed the basis of the final wording and voting of statements.RESULTS: Twenty-four statements were produced regarding maximal medically appropriate wait times for specialist consultation and procedures based on presenting signs and symptoms of referred patients. Statements covered the areas of gastrointestinal bleeding; cancer confirmation and screening and surveillance of colon cancer and colonic polyps; liver, biliary and pancreatic disorders; dysphagia and dyspepsia; abdominal pain and bowel dysfunction; and suspected inflammatory bowel disease. Maximal wait times could be stratified into four possible acuity categories of 24 h, two weeks, two months and six months.FUTURE DIRECTIONS: Comparison of these benchmarks with actual wait times will identify limitations in access to digestive heath care in Canada. These recommendations should be considered targets for future health care improvements and are not clinical practice guidelines.

scholarly journals Measurement of surgical wait times in a universal health care system

2008 ◽  
Vol 2 (6) ◽  
pp. 597 ◽  
Author(s):  
Jun Kawakami ◽  
Wilma M. Hopman ◽  
Rachael Smith-Tryon ◽  
D. Robert Siemens
Keyword(s):  
Health Care ◽  
Multivariate Analysis ◽  
Real Time ◽  
Access To Health Care ◽  
A Priori ◽  
Wait Time ◽  
Administrative Databases ◽  
Wait Times ◽  
Data Set ◽  
Care Indicator

Introduction: Reported increases in surgical wait times for cancer have intensified the focus on this quality of health care indicator and have created a very public, concerted effort by providers to decrease wait times for cancer surgeryin Ontario. Delays in access to health care are multifactorial and their measurement from existing administrative databases can lack pertinent detail. The purpose of our study was to use a real-time surgery-booking software program to examine surgical wait times at a single centre.Methods: The real-time wait list management system Axcess.Rx has been used exclusively by the department of urology at the Kingston General Hospital to book all nonemergency surgery for 4 years. We reviewed the length of time from the decision to perform surgery to the actual date of surgery for patients in our group urological practice. Variables thought to be potentially important in predicting wait time were also collected, including the surgeon’s assessment of urgency, the type of procedure (i.e., diagnostic, minor cancer, major cancer, minor benign, major benign), age and sex of the patient, inpatient versus outpatient status and year of surgery. Analysis was planned a priori to determine factors that affected wait time by using multivariate analysis to analyze variables that were significant in univariate analysis.Results: There were 960 operations for cancer and 1654 for benign conditions performed during the evaluation period. The overall mean wait time was 36 days for cancer and 47 days for benign conditions, respectively. The mean wait time for cancer surgery reached a nadir in 2004 at 29.9 days and subsequently increased every year, reaching 56 days in 2007. In comparison, benign surgery reached a nadir wait time of 33.7 days in 2004 and in 2007 reached 74 days at our institution. Multivariate analysis revealed that the year of surgery was still a significant predictor of wait time. Urgency score, type of procedure and inpatient versus outpatient status were also predictive of wait time.Conclusion: The application of a prospectively collected data set is an effective and important tool to measure and subsequently examine surgical wait times. This tool has been essential to the accurate assessment of the effect of resource allocation on wait times for priority and nonpriority surgical programs within a discipline. Such tools are necessary to more fully assess and follow wait times at an institution or across a region.

scholarly journals Barriers to Access Health Care Services among Rural Adolescent Girls in Raina I Block, Purba Bardhaman, West Bengal

2021 ◽  
Vol 9 (3) ◽  
pp. 61-72
Author(s):  
Mousumi Dholey ◽  
Sumana Sarkar
Keyword(s):  
Health Care ◽  
Adolescent Girls ◽  
Rural Areas ◽  
Access To Health Care ◽  
Health Care Services ◽  
Future Health ◽  
Quality Health Care ◽  
Cross Sectional ◽  
Care Services ◽  
Rural Adolescent

Adolescence in girls is a crucial transition phase during which they experience biological and psychological changes along with changes in social outlook. This phase provides an opportunity to lay the foundation for their future health. But, in rural areas, adolescent girls are often deprived of better nutrition and proper health care guide, resulting in serious health issues like malnutrition, stunting, wasting, and anaemia. Moreover, their access to health care services is subjected to various constraints as infrastructural and societal barriers such as regressive norms, social stigma, gendered family structure, etc. Thus, the present study attempts to explore the perceived barriers that prevent rural adolescent girls from accessing health care services at the micro-level. A community-based cross-sectional study was carried out after randomly selecting 120 adolescent girls in the age cohort of 10-19 years in the Raina-I block of Purba Bardhaman district. The results suggested that societal barriers have a significant influence over health-related decision-making. Besides, lack of quality health care services and economic burden are some of the other significant obstacles observed here.

scholarly journals Acesso à saúde pela média complexidade: discurso coletivo de homens

2019 ◽  
Vol 13 ◽  
Author(s):  
Anderson Reis de Sousa ◽  
Raabe Moraes Pereira ◽  
Massila Silva Brito dos Anjos ◽  
Aiala de Sousa Cerqueira ◽  
Delmo de Carvalho Alencar ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Signs And Symptoms ◽  
Self Medication ◽  
Care Services ◽  
Primary Care Services ◽  
Qualitative Descriptive ◽  
Complicating Factors ◽  
Specific Care ◽  
La Red

RESUMO Objetivo: analisar o discurso de homens sobre o acesso à saúde em unidades de média complexidade. Método: trata-se de estudo qualitativo, descritivo, com 56 homens, atendidos em duas unidades de saúde média complexidade, com um roteiro semiestruturado, que guiou a entrevista, analisada sob a ótica do Discurso do Sujeito Coletivo. Resultados: revelou-se que as necessidades e os motivos expressados por homens foram motivados pela apresentação de sinais e sintomas de agravos já instalados, em situações de pequena gravidade, influenciados por fatores como a automedicação, sendo observado o afastamento dos serviços de Atenção Básica, mediante fatores dificultadores, como a demora no atendimento e no acesso aos exames e medicamentos, além da ausência de acolhimento, desconhecimento das necessidades de saúde e ausência de atendimento específico, apontando limitações na resolubilidade às suas demandas. Conclusão: tornam-se indispensáveis a estruturação e a reorganização dos serviços e da rede de atenção com a ampliação do acesso e da oferta de programas ao público masculino e a sensibilização do exercício do autocuidado como superação da problemática. Descritores: Saúde do Homem; Atenção Básica; Sinais e Sintomas; Masculinidades; Acesso aos Serviços de Saúde; Assistência Ambulatorial. ABSTRACT Objective: to analyze the speech of men on the access to health care at mid-complexity units. Method: this is a qualitative, descriptive study, with 56 men, attended to at two mid-complexity health units, with a structured guide, which guided the interview, analyzed from the perspective of the Discourse of the Collective Subject. Results: the needs and reasons expressed by men were motivated by the presentation of signs and symptoms of diseases already installed, in situations of low severity, influenced by factors such as self-medication, observing the remoteness of Primary Care services, through complicating factors, such as delay in service and access to examinations and medicines, besides the absence of reception, unknown health needs and absence of specific care, pointing out limitations in solving their demands. Conclusion: the structuring and reorganization of services become indispensable, as well as of the care network, with the expansion of access and the provision of programs to the male public and awareness of the exercise of self-care as a way to overcome the problem. Descriptors: Men’s Health; Primary Health Care; Signs and Symptoms; Masculinity; Health Services Accessibility; Ambulatory Care.RESUMEN Objetivo: analizar el discurso de los hombres en el acceso a los servicios de salud en unidades de media complejidad. Método: este es un estudio cualitativo, descriptivo, con 56 hombres, atendidos en dos unidades de salud de complejidad media, con un guión estructurado, que guió la entrevista, analizada a partir de la perspectiva del discurso de los sujetos colectivos. Resultados: se puso de manifiesto que las necesidades y las razones expresadas por los hombres fueron motivados por la presentación de signos y síntomas de enfermedades ya instaladas, en situaciones de baja gravedad, influenciados por factores tales como la auto-medicación, observando la lejanía de los servicios de atención primaria, por diversos factores, tales como la demora en el servicio y el acceso a los exámenes y medicamentos, además de la ausencia de la acogida, las necesidades de salud desconocidas y falta de cuidados específicos, señalando limitaciones en la solución de sus demandas. Conclusión: se vuelven indispensables la estructuración y reorganización de los servicios y de la red de atención con la ampliación del acceso y la prestación de los programas de alfabetización y sensibilización pública del ejercicio de auto-cuidado para superar el problema. Descriptores: Salud del Hombre; Atención Primaria de Salud; Signos y Sintomas; Masculinidad; Accesibilidad a los Servicios de Salud; Atención Ambulatoria.

scholarly journals Women’s access to health care: Gaps that the future health care reform in Chile must solve

Medwave ◽  
2021 ◽  
Vol 21 (10) ◽  
pp. e8490-e8490
Author(s):  
Daniela Paredes-Fernández ◽  
Rony Lenz-Alcayaga ◽  
Camila Rojas-Cáceres ◽  
María Begoña Carroza Escobar
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Care Providers ◽  
Snowball Sampling ◽  
Future Health ◽  
Eligibility Criteria ◽  
Access To Health ◽  
Care Gaps

Introduction In the Chilean health system, difficulties complicate women’s access to health care and aggravate the complexity of health-illness processes in their interaction as users or caregivers. Objective In the national and international literature, we aimed to identify gaps in women’s access to health care derived from gender disparities and the exercise of gender roles in a prioritized set of health problems. These problems exacerbate gender gaps and should be considered in health reform. Methods We made a literature review through algorithms, snowball sampling, and reference lists from November 2020 to March 2021. The population included were women of all ages, including women users of the health system and women caregivers of specific pathologies. The search was conducted in parallel by four investigators divided into two groups. It was cross-validated to ensure inter-investigator reliability by standardizing evidence eligibility criteria. The analysis showed women users' and caregivers' dimensions for a set of pathologies prioritized by the extent of the disease burden. The pathologies analyzed included stroke, obesity, depression, musculoskeletal pain, and breast cancer. Results Among women users of the health system, problems of access, rates of use, experience, and outcome for the whole group of prioritized pathologies were observed. In the women caregiver dimension, we found that women are the primary health care providers. There is a knowledge gap concerning obesity and musculoskeletal conditions. However, both were reported as health consequences of women’s caregiving roles.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

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