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Equitable Access (equitable + access)
Selected AbstractsAddressing Minority Issues in Renal Transplantation: Is More Equitable Access an Achievable Goal?AMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2002Robert S. Gaston No abstract is available for this article. [source] Equitable access to dental care for an at-risk group: a review of services for Australian refugeesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2007Natasha Davidson Objective: Despite the poor dental health of refugees, few specific services are available. This review maps public dental services for refugees across Australian jurisdictions, identifies gaps in provision, identifies barriers to accessing dental care, and provides recommendations for improving access and oral health promotion for this group. Methods: Data were sought from the State and Territory services for: a) the survivors of torture; b) oral health care units; and c) auditors-general reports of dental services. Eligibility criteria and estimated waiting times for general dental services, criteria for access to emergency care and availability of interpreter services were reviewed. Results: Marked variation exists across Australian jurisdictions in available dental services and criteria for access to public dental care for refugees. There is limited priority access to general dental services for refugees. Waiting times for public dental treatment in most, if not all, jurisdictions are unacceptably long (range 13,58 months). Few interpreter services exist for refugees seeking to access dental services. Conclusions: Access to dental services for refugees across Australia remains fragmented and limited, particularly in rural and regional areas. Refugees are not using services because of several barriers, including long waiting times, variation in assessment criteria, different eligibility criteria and limited interpreter services. Consequently, their pattern of service use does not accurately reflect their needs. Implications: Australia needs better co-ordinated, more extensive dental services that are easily accessible for this very high risk group. Identification of refugees as a special needs group and provision of targeted interventions addressing barriers to care are needed to establish adequate dental care. [source] Role of medicines in malaria control and eliminationDRUG DEVELOPMENT RESEARCH, Issue 1 2010Marian Warsame Abstract Antimalarial medicines constitute important tools to cure and prevent malaria infections, thereby averting death and disability; their role in reducing the transmission of malaria is becoming increasingly important. Effective medicines that are currently available include artemisinin-based combination therapies (ACTs) for uncomplicated malaria, parenteral and rectal formulations of artemisinin derivatives and quinine injectables for severe malaria, and primaquine as an anti-relapse agent. These medicines are not optimal, however, owing to safety considerations in specific risk groups, complex regimens, and less than optimal formulations. The efficacy of antimalarial medicines including currently used ACTs is threatened by parasite resistance. Resistance to artemisinins has recently been identified at the Cambodia,Thailand border. Intermittent preventive treatment is constrained by the lack of a replacement for sulfadoxine-pyrimethamine. Despite increasing financial support to procure medicines, access to medicines by populations at risk of malaria, particularly in African countries, remains poor. This is largely due to weak health systems that are unable to deliver quality diagnostics and medicines through an efficient supply chain system, close at hand to the sick patient, especially in remote rural areas. Health systems are also challenged by incorrect prescribing practices in the informal and often unregulated private sector (an important provider of medicines for malaria) and the proliferation of counterfeit and substandard medicines. The provision of a more equitable access to life-saving medicines requires no less than a steady drug development pipeline for new medicines tailored to meet the challenging conditions in endemic countries, ideally single dose, highly effective against both disease and relapse-causing parasites and infective forms, extremely safe and with a long shelf life, and made available at affordable prices. Drug Dev Res 71: 4,11, 2010. © 2010 Wiley-Liss, Inc. [source] Older people and falls: health status, quality of life, lifestyle, care networks, prevention and views on service use following a recent fallJOURNAL OF CLINICAL NURSING, Issue 16 2009Brenda Roe Aim and objective., This study has investigated older people's experiences of a recent fall, its impact on their health, lifestyle, quality of life, care networks, prevention and their views on service use. Background., Falls are common in older people and prevalence increases with age. Falls prevention is a major policy and service initiative. Design., An exploratory, qualitative design involving two time points. Method., A convenience sample of 27 older people from two primary care trusts who had a recent fall. Taped semi structured qualitative interviews were conducted and repeated at follow up to detect change over time and repeat falls. Data were collected on their experience of falls, health, activities of living, lifestyle, quality of life, use of services, prevention of falls, informal care and social networks. Content analysis of transcribed interviews identified key themes. Results., The majority of people fell indoors (n = 23), were repeat fallers (n = 22) with more than half alone when they fell (n = 15). For five people it was their first ever fall. Participants in primary care trust 1 had a higher mean age than those in primary care trust 2 and had more injurious falls (n = 12, mean age 87 years vs. n = 15, mean age 81 years). The majority of non-injurious falls went unreported to formal services. Falls can result in a decline in health status, ability to undertake activities of living, lifestyle and quality of life. Conclusions., Local informal care and support networks are as important as formal care for older people at risk of falls or who have fallen. Access to falls prevention programmes and services is limited for people living in more rural communities. Relevance to practice., Falls prevention initiatives and services should work with local communities, agencies and informal carers to ensure equitable access and provision of information, resources and care to meet the needs of older people at risk or who have fallen. [source] Monitoring across Sectors: Examining the Effect of Nonprofit and For-Profit Contractor Ownership on Performance Monitoring in State and Local ContractsPUBLIC ADMINISTRATION REVIEW, Issue 5 2010Anna A. Amirkhanyan What is the effect of contractors' nonprofit and for-profit ownership on the scope and nature of performance measurement used by government agencies? Quantitative and qualitative data were generated through semistructured interviews administered to a sample of state and local public agencies and private contractors across five jurisdictions. The findings of this study suggest that monitoring officers working with nonprofit rather than for-profit contractors are more likely to rely on qualitative performance data and examine equitable access to services, contractors' reputation, and compliance with industry rules and regulations. Although organizational ownership may not be well understood by practitioners, performance appears to be conceptualized differently across sectors. The author calls for a better understanding of the impact of the identified differences in performance measurement on the effectiveness of contract monitoring. [source] Neighborhood Poverty, Racial Composition and Renal Transplant WaitlistAMERICAN JOURNAL OF TRANSPLANTATION, Issue 8 2010M. R. Saunders To date, no study has characterized the association between neighborhood poverty, racial composition and deceased donor kidney waitlist. Using the United States Renal Data System data linked to 2000 U.S. Census Data, we examined Whites (n = 152 788) and Blacks (n = 130 300) initiating dialysis between January 2000 and December 2006. Subjects' neighborhoods were divided into nine strata based on the percent of Black residents and percent poverty. Cox proportional hazards were used to determine the association between time to waitlist and neighborhood characteristics after adjusting for demographics and comorbid conditions. Individuals from poorer neighborhoods had a consistently lower likelihood of being waitlisted. This association was synergistic with neighborhood racial composition for Blacks, but not for Whites. Blacks in poor, predominantly Black neighborhoods (adjusted hazard ratio [HR] 0.57, 95% confidence intervals [CI] 0.53,0.62) were less likely to appear on transplant waitlist than those in wealthy, predominantly Black neighborhoods (HR 0.80, CI 0.67,0.96) and poor, predominantly White neighborhoods (HR 0.79, CI 0.70,0.89). All were all less likely to be waitlisted than their Black counterparts in wealthy, predominantly White or mixed neighborhoods (p < 0.05). Interventions targeted at individuals in poor and minority neighborhoods may represent an opportunity to improve equitable access to the deceased donor kidney waitlist. [source] Race and Ethnicity in Access to and Outcomes of Liver Transplantation: A Critical Literature ReviewAMERICAN JOURNAL OF TRANSPLANTATION, Issue 12 2009A. K. Mathur Racial/ethnic disparities in access to and outcomes of liver transplantation are an important topic given the increasing diversity in the United States. Most reports on this topic predate the advent of allocation based on the model for end-stage liver disease (MELD). For many patients with a variety of lethal conditions, liver transplantation is the only effective therapy, signifying the importance of equitable access to care. Racial/ethnic disparities have been described at various steps of the liver transplant process, including liver disease prevalence and treatment, access to a transplant center and its waitlist, receipt of a liver transplant and posttransplant outcomes. The purpose of this minireview is to critically evaluate the published literature on racial/ethnicity-based disparities in liver disease prevalence and treatment, transplant center referral, transplant rates and posttransplant outcomes. We identify the shortcomings of previous reports and detail the barriers to completing properly constructed analyses, particularly emphasizing deficits in requisite data and the need for improved study design. Understanding the nature of race/ethnicity-based disparities in liver transplantation is necessary to improve research initiatives, policy design and serves the broader responsibility of providing the highest quality care to all patients with liver disease. [source] Social Identity and the Yup'ik Eskimo Village Tunnel System in Precolonial and Colonial Western Coastal AlaskaARCHEOLOGICAL PAPERS OF THE AMERICAN ANTHROPOLOGICAL ASSOCIATION, Issue 1 2006Lisa Frink Some western Alaskan coastal prehistoric and protohistoric village sites had intrasite semisubterranean passageways that connected the village men's house(s) and the smaller family houses. These tunnels acted as an interstitial and negotiated space that connected the gendered spatial spheres of Yup'ik Eskimo women and men. Instead of examining a newly constructed space that may have transformed relationships, this work examines the historically contingent consequence of the loss of these tunnels as a built medium, both between women and men and among women. It is my contention that the dismantling of the multipurpose village tunnels insulated women from one another, from their established methods for learning and means for building influence and authority, and from intimate engagement with the expanding mercantilist economy and equitable access to social and economic resources. [source] Do women have equitable access to quality breast prosthesis services?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2000P LIVINGSTON Although up to 90% of women who have had a mastectomy use breast prostheses, significant gaps exist around current breast prosthesis services for Australian women. These gaps include the timeliness and quality of information provision, the disparity in financial assistance, and the lack of knowledge regarding the determinants of what constitutes a "quality" breast prosthesis. Revised policy initiatives are central to addressing these gaps to ensure equitable access to quality breast prosthesis services. [source] Welfarism Versus ,Free Enterprise': Considerations Of Power And Justice In The Philippine Healthcare SystemBIOETHICS, Issue 5-6 2003Peter A. Sy ABSTRACT The just distribution of benefits and burdens of healthcare, at least in the contemporary Philippine context, is an issue that gravitates towards two opposing doctrines of welfarism and ,free enterprise.' Supported largely by popular opinion, welfarism maintains that social welfare and healthcare are primarily the responsibility of the government. Free enterprise (FE) doctrine, on the other hand, maintains that social welfare is basically a market function and that healthcare should be a private industry that operates under competitive conditions with minimal government control. I will examine the ethical implications of these two doctrines as they inform healthcare programmes by business and government, namely: (a) the Devolution of Health Services and (b) the Philippine Health Maintenance Organization (HMO). I will argue that these doctrines and the health programmes they inform are deficient in following respects: (1) equitable access to healthcare, (2) individual needs for premium healthcare, (3) optimal utilisation of health resources, and (4) the equitable assignment of burdens that healthcare entails. These respects, as considerations of justice, are consistent with an operational definition of ,power' proposed here as ,access to and control of resources.' [source] | |||||||||||||