scholarly journals Access and Quality of Care by Insurance Type for Low-Income Adults Before the Affordable Care Act

2016 ◽  
Vol 106 (8) ◽  
pp. 1409-1415 ◽  
Author(s):  
Kevin H. Nguyen ◽  
Benjamin D. Sommers
Keyword(s):  
Quality Of Care ◽  
Affordable Care Act ◽  
Low Income ◽  
Insurance Type ◽  
The Affordable Care Act ◽  
Access And Quality

scholarly journals Association of the Affordable Care Act Medicaid Expansion With Access to and Quality of Care for Surgical Conditions

JAMA Surgery ◽  
2018 ◽  
Vol 153 (3) ◽  
pp. e175568 ◽  
Author(s):  
Andrew P. Loehrer ◽  
David C. Chang ◽  
John W. Scott ◽  
Matthew M. Hutter ◽  
Virendra I. Patel ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Affordable Care Act ◽  
Medicaid Expansion ◽  
The Affordable Care Act ◽  
Surgical Conditions

Neoliberal Reforms in Swedish Primary Health Care: For Whom and for What Purpose?

2008 ◽  
Vol 38 (4) ◽  
pp. 697-715 ◽  
Author(s):  
Göran Dahlgren
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Low Income ◽  
Health Sector ◽  
High Income ◽  
Public Hospitals ◽  
Primary Health ◽  
Access And Quality

The conservative government that came to power in Sweden in 2006 has initiated major market-oriented reforms in the health sector. Its first health care policy bill changed the health legislation to make it possible to sell/transfer public hospitals to commercial providers while maintaining public funding. Far-reaching market-oriented primary health care reforms are also initiated, for example in Stockholm County. They are typically presented as “free choice models” in which “the money follows the patient.” The actual and likely effects of these reforms in terms of access and quality of care are discussed in this article. One main finding is that existing social inequities in geographic access to care not only are reinforced but also become very difficult to change by democratic political decisions. Furthermore, dynamic market forces will gradually reduce the quality of care in low-income areas while both access and quality of care will be even better in high-income areas. Public funds are thus transferred from people living in low-income areas to people living in high-income areas, even though the need for good health services is much greater in the low-income areas. Certain policy options for reversing the inverse law of care are also presented.

School-Based Health Centers: Improving Access and Quality of Care for Low-Income Adolescents

PEDIATRICS ◽  
2007 ◽  
Vol 120 (4) ◽  
pp. e887-e894 ◽  
Author(s):  
M. A. Allison ◽  
L. A. Crane ◽  
B. L. Beaty ◽  
A. J. Davidson ◽  
P. Melinkovich ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Low Income ◽  
Health Centers ◽  
School Based ◽  
Access And Quality ◽  
School Based Health Centers

Building research capacity and capabilities in Fiji: are we there yet?

2020 ◽  
Vol 21 (5) ◽  
pp. 265-271
Author(s):  
Jyotishna Mudaliar ◽  
Bridget Kool ◽  
Janice Natasha ◽  
Judith McCool
Keyword(s):  
Low Income ◽  
Research Capacity ◽  
Research Knowledge ◽  
Research Skills ◽  
Research Findings ◽  
Access And Quality ◽  
The University ◽  
Local Investigator ◽  
Research Capacity Development

Introduction: A barrier to local investigator-led research in low income settings, is the limited availability of personnel with appropriate research skills or qualifications to conduct the type of research required for evidence-informed policy making to improve access and quality of health care. In response to this, Fiji National University’s College of Medicine, Nursing and Health Sciences in Fiji, collaborated with academics based at the University of Auckland, New Zealand to deliver a series of research capacity development workshops in Fiji. Methods: Participants who attended any of the nine workshops (n=123) were contacted via email to take part in a brief survey regarding their perceptions of the effectiveness of the research capacity building workshops. Of the possible 123 participants, 80% (n=76) completed the questionnaire.  Results: Findings demonstrate that the majority of participants reported that they had gained research skills from the workshops (75%) including proposal development skills (68%) and knowledge of appropriate research methods (59%). Furthermore, 70% agreed that the workshops built their research confidence.  Since attending a workshop, 18% of respondents had successfully applied and received funding for research grants and/or fellowships.  Barriers to conduct research included workload (75%), lack of research knowledge, experience or skills (51%), and lack of institutional support (41%). Suggestions for future workshops included: more focus on data analysis, regular courses rather than ‘one offs’, and preparation of research findings (e.g. publications). Conclusion: Our findings indicate that research workshops of this nature may increase individual research capabilities but sustained, locally led initiatives, backed by institutional and supplementary technical support are essential.

scholarly journals Care-seeking and managing diabetes in rural Bangladesh: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Maria Jennings ◽  
Joanna Morrison ◽  
Kohenour Akter ◽  
Hassan Haghparast-Bidgoli ◽  
Carina King ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Care Providers ◽  
Low Income ◽  
Diabetes Management ◽  
Local Health ◽  
Care Seeking ◽  
Care Providers ◽  
Structured Interviews ◽  
Rural Bangladesh

Abstract Background Type 2 diabetes mellitus poses a major health challenge worldwide and in low-income countries such as Bangladesh, however little is known about the care-seeking of people with diabetes. We sought to understand the factors that affect care-seeking and diabetes management in rural Bangladesh in order to make recommendations as to how care could be better delivered. Methods Survey data from a community-based random sample of 12,047 adults aged 30 years and above identified 292 individuals with a self-reported prior diagnosis of diabetes. Data on health seeking practices regarding testing, medical advice, medication and use of non-allopathic medicine were gathered from these 292 individuals. Qualitative semi-structured interviews and focus group discussions with people with diabetes and semi-structured interviews with health workers explored care-seeking behaviour, management of diabetes and perceptions on quality of care. We explore quality of care using the WHO model with the following domains: safe, effective, patient-centred, timely, equitable and efficient. Results People with diabetes who are aware of their diabetic status do seek care but access, particularly to specialist diabetes services, is hindered by costs, time, crowded conditions and distance. Locally available services, while more accessible, lack infrastructure and expertise. Women are less likely to be diagnosed with diabetes and attend specialist services. Furthermore costs of care and dissatisfaction with health care providers affect medication adherence. Conclusion People with diabetes often make a trade-off between seeking locally available accessible care and specialised care which is more difficult to access. It is vital that health services respond to the needs of patients by building the capacity of local health providers and consider practical ways of supporting diabetes care. Trial registration ISRCTN41083256. Registered on 30/03/2016.

Telepsychiatry Use in Rural Areas in the United States

2020 ◽  
Vol 13 (4) ◽  
pp. 1-13
Author(s):  
Alberto Coustasse ◽  
Morgan Ruley ◽  
Tonnie C. Mike ◽  
Briana M. Washington ◽  
Anna Robinson
Keyword(s):  
Mental Health ◽  
United States ◽  
Quality Of Care ◽  
Rural Areas ◽  
Care Delivery ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
The United States ◽  
Access And Quality

Rural areas have experienced a higher than average shortage of healthcare professionals. Numerous challenges have limited access to mental health services. Some of these barriers have included transportation, number of providers, poverty, and lack of insurance. Recently, the utilization of telepsychiatry has increased in rural areas. The purpose of this review was to identify and coalesce the benefits of telepsychiatry for adults living in rural communities in the United States to determine if telepsychiatry has improved access and quality of care. The methodology for this study was a literature review that followed a systematic approach. References and sources were written in English and were taken from studies in the United States between 2004 and 2018 to keep this review current. Fifty-nine references were selected from five databases. It was found that several studies supported that telepsychiatry has improved access and quality of care available in rural environments. At the same time, telepsychiatry in mental healthcare has not been utilized as it should in rural adult populations due to lack of access, an overall shortage of providers, and poor distribution of psychiatrists. There are numerous benefits to implementing telepsychiatry in rural areas. While there are still barriers that prevent widespread utilization, telepsychiatry can improve mental health outcomes by linking rural patients to high-quality mental healthcare services that follow evidence-based care and best practices. Telepsychiatry utilization in rural areas in the United States has demonstrated to have a significant ability to transform mental health care delivery and clinician productivity. As technology continues to advance access, telepsychiatry will also advance, making access more readily available.

scholarly journals The Affordable Care Act Medicaid Expansion and Smoking Cessation Among Low-Income Smokers

2019 ◽  
Vol 57 (6) ◽  
pp. e203-e210 ◽  
Author(s):  
J. Travis Donahoe ◽  
Edward C. Norton ◽  
Michael R. Elliott ◽  
Andrea R. Titus ◽  
Lucie Kalousová ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Affordable Care Act ◽  
Low Income ◽  
Medicaid Expansion ◽  
The Affordable Care Act
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