Journal articles: 'Minorities Medical care Australia'

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Ashing, Kimlin Tam, Lenna Dawkins-Moultin, Marshalee George, Gerard M. Antoine, Marcella Nunez-Smith, and Eliseo J. Pérez-Stable. "Across borders: thoughts and considerations about cultural preservation among immigrant clinicians." International Journal for Quality in Health Care 31, no. 8 (January 11, 2019): G103—G105. http://dx.doi.org/10.1093/intqhc/mzy256.

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Abstract Immigrant clinicians make up 20–28% of the health workforce in many high-income countries, including Australia, Britain, Canada and the USA. Yet, the preserved culture of immigrant clinicians remains largely invisible in the medical literature and discourse. Research on immigrant clinicians primarily attends to medical professional requirements for the adopted country (medical board examination eligibility, fellowship training and licensing). Cultural preservation among immigrant clinicians has not been adequately considered or studied. This paper highlights this notable gap in healthcare delivery and health services research relevant to immigrant clinicians. We propose it is worthwhile to explore possible relationships between immigrant clinicians’ preserved culture and clinical practices and outcomes since immigrant clinicians cross borders with their academic training as well as their culture. The sparse literature regarding immigrant clinicians suggests culture influences health beliefs, attitudes about the meaning of illness and clinical practice decisions. Additionally, immigrant clinicians are more likely to serve rural, low-income populations; communities with high density of ethnic minorities and immigrants; and areas with primary care shortage. Therefore, cultural preservation among immigrant clinicians may have important implications for public health and health disparities. This area of inquiry is important, if not urgent, in health services research.

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Pack, Margaret, and Peter Brown. "Educating on anti-oppressive practice with gender and sexual minority elders: Nursing and social work perspectives." Aotearoa New Zealand Social Work 29, no. 2 (July 26, 2017): 108–18. http://dx.doi.org/10.11157/anzswj-vol29iss2id279.

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INTRODUCTION: This article relates a common dilemma in professional education out of which developed a collaboration between two health disciplines at a regional Australian university. In a literature review across the two disciplines, the authors drew from social work’s teaching knowledge base in an attempt to strengthen the nursing skill base. The intention was to provide students working in the health sector with a consistent theoretical approach and practical tools when working with sexual and gender minorities.METHOD: As associate professors in social work and nursing, the authors argue on the basis of the teaching and the literature review, for an explicitly anti-oppressive approach to be applied to the education of professionals who work with elders identifying with gender and sexual minorities. Working within an anti-oppressive framework, beginning practitioners in social work and nursing in degree-level education programmes were encouraged to explore their own attitudes including taken-for-granted assumptions often unexplored in the prevailing medical models of care. How different demographics within the lesbian, gay, bisexual, transgender, intersex, queer (LGBTQIA) community experience the health industry is a current issue for educators. There have been increasing challenges expressed by transgender individuals and their concerns over their specific health needs/stigma in rest-home-care facilities, for example.CONCLUSION: By embedding anti-oppressive principles in our teaching practice, relating to gender and sexual minorities, we acknowledge and open the debate to some of the possibilities/practicalities/difficulties of advocating for this within a broader multi-disciplinary in small town, rural contexts. The implications for social work and nursing education are discussed.

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Moxham, Lorna, and Shane Pegg. "Delivering Health Services for Ethnic Minorities in Regional Australia." Australian Journal of Primary Health 4, no. 1 (1998): 72. http://dx.doi.org/10.1071/py98008.

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Recent articles in the print media have served to highlight the fact that health services in regional Australia are inadequately servicing the needs of ethnic minorities. Despite an increased awareness of the need for culturally appropriate services in more recent years, Australia, as one of the most ethno-culturally diverse nations in the world, still largely relies on the patriarchal biomedical model of health care, which has a pathogenic approach, focusing on why people fall sick and on treatment, rather than on communication between the client and the professional health care worker. Such practice, while well-intentioned, detracts from the ability of regional health services to adequately service the needs of a culturally diverse client group and, in turn, de-emphasises the clear link which has now been established between culture and health.

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Ramsey, G. "Minorities and Advance Care Planning." BMJ Supportive & Palliative Care 2, no. 2 (June 2012): 171.3–171. http://dx.doi.org/10.1136/bmjspcare-2012-000250.3.

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Blewett, Neal. "Financing Medical Care in Australia." Australian Quarterly 57, no. 3 (1985): 262. http://dx.doi.org/10.2307/20635332.

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Schlesinger, Mark. "Paying the Price: Medical Care, Minorities, and the Newly Competitive Health Care System." Milbank Quarterly 65 (1987): 270. http://dx.doi.org/10.2307/3349992.

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Navarro, Ronald A., Denise F. Greene, Raoul Burchette, Tadashi Funahashi, and Richard Dell. "Minimizing Disparities in Osteoporosis Care of Minorities With an Electronic Medical Record Care Plan." Clinical Orthopaedics and Related Research® 469, no. 7 (March 22, 2011): 1931–35. http://dx.doi.org/10.1007/s11999-011-1852-8.

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Seiden, Danielle, Jose Morillo, Juan P. Wisnivesky, and Cardinale B. Smith. "Disparities in supportive care needs among minority and non-minority patients with advanced lung cancer." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e21690-e21690. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e21690.

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e21690 Background: Significant racial and ethnic disparities exist in lung cancer care. Thus, minorities are diagnosed with late stage cancer and have inferior outcomes likely leading to increased suffering. Little is known, however, about disparities in supportive care needs among patients with advanced lung cancer. Methods: We performed a prospective cohort study of patients newly diagnosed with advanced lung cancer (stage III and IV). At baseline (within 3 months of diagnosis), patients completed a validated survey assessing needs among seven domains: medical communication and information, psychological and emotional support, daily living, financial concerns, physical symptoms, spiritual needs, and social needs. Univariate and multivariate regression analyses compared differences in supportive care needs among minority (Black and Hispanic) and non-minority patients with advanced lung cancer. Results: We have enrolled 95/160 patients (60%). To date, baseline surveys have been completed on 55 patients. Of those, 37 (67%) are minorities and 18 (33%) non-minorities. Minorities were less likely to be married (p = 0.01), had a lower annual income (p < 0.001), lower education attainment (p = .02) and more likely to have Medicaid (p < 0.001). There were no differences in gender (p = 0.35) or performance status (p = 0.13). Overall, 39% of minorities report having higher supportive care needs across all domains compared with 25% of non-minorities (p < 0.001). Similarly, minorities reported having significantly higher needs among each domain except medical communication and information (p = 0.06). Multivariate analysis, controlling for patient characteristics, found minorities had increased odds of overall supportive care needs (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.03-1.16). Conclusions: Minority patients with advanced lung cancer are more likely to have increased supportive care needs than non-minority patients. Ensuring minority patients have adequate supportive care evaluation and treatment is necessary to mitigating health disparities among patients with lung cancer. Future studies will be performed to evaluate how these needs change throughout the trajectory of lung cancer.

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FitzGerald, Gerry. "An emergency medical system for Australia." Emergency Medicine 6, no. 3 (August 26, 2009): 171–72. http://dx.doi.org/10.1111/j.1442-2026.1994.tb00160.x.

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Fish, Jessica N., Rodman E. Turpin, Natasha D. Williams, and Bradley O. Boekeloo. "Sexual Identity Differences in Access to and Satisfaction With Health Care: Findings From Nationally Representative Data." American Journal of Epidemiology 190, no. 7 (January 21, 2021): 1281–93. http://dx.doi.org/10.1093/aje/kwab012.

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Abstract Identification of barriers to adequate health care for sexual minority populations remains elusive given that they are complex and variable across sexual orientation subgroups (e.g., gay, lesbian, bisexual). To address these complexities, we used data from a US nationally representative sample of health-care consumers to assess sexual identity differences in health-care access and satisfaction. We conducted a secondary data analysis of 12 waves (2012–2018) of the biannual Consumer Survey of Health Care Access (n = 30,548) to assess sexual identity differences in 6 health-care access and 3 health-care satisfaction indicators. Despite parity in health insurance coverage, sexual minorities—with some variation across sexual minority subgroups and sex—reported more chronic health conditions alongside restricted health-care access and unmet health-care needs. Gay/lesbian women had the lowest prevalence of health-care utilization and higher prevalence rates of delaying needed health care and medical tests relative to heterosexual women. Gay/lesbian women and bisexual men were less likely than their heterosexual counterparts to be able to pay for needed health-care services. Sexual minorities also reported less satisfactory experiences with medical providers. Examining barriers to health care among sexual minorities is critical to eliminating health disparities that disproportionately burden this population.

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Kasmi, Yasir. "Characteristics of patients admitted to psychiatric intensive care units." Irish Journal of Psychological Medicine 24, no. 2 (June 2007): 75–78. http://dx.doi.org/10.1017/s0790966700010284.

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AbstractObjective: A paucity of research exists on the types of patients admitted to psychiatric intensive care units (PICUs), which is important in terms of identifying patient needs, training and service provision. Questions have also been raised as to whether or not ethnic minorities are overrepresented in these units.Method: A literature review using MeSH headings from a wealth of databases was performed to identify such studies. In addition studies on ethnic minority overrepresentation in psychiatric care were also identified.Results: Under a dozen studies were identified, mainly from the UK and Australia. Study designs tended to be basic and heterogeneous, but this was reflected in the nature of the study and the data gained. A typical PICU patient emerged, namely a young schizophrenic detained male, belonging to an ethnic minority (if in an inner city), known to mental health services with previous informal, detained and PICU admissions, admitted due to violence and often possessing a forensic history. If a complex need existed, it was usually substance misuse. The inpatient stay tended to be for less than two months and discharge was usually to an acute ward. Ethnic minorities were overrepresented in PICU care.Conclusions: The literature review highlighted a paucity of good-quality studies in this field. The establishment of a national association of intensive care units as well as national guidelines can only improve services. The reason for ethnic minority over-representation on these units is still far from clear.

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DeBord, Logan, Kali Ann Hopkins, and Padma Swamy. "Challenges in Caring for Linguistic Minorities in the Pediatric Population." Children 6, no. 8 (July 25, 2019): 87. http://dx.doi.org/10.3390/children6080087.

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Physicians in the United States (U.S.) face unique obstacles in providing care for persons with limited English proficiency (LEP), especially speakers of rare languages. Lack of professional resources is not a problem exclusive to health care delivery, with speakers of Mayan dialects receiving increasingly narrow representation in detention centers and immigration courts at the U.S.–Mexico border. Parent-child dynamics and other crucial information related to pediatric care may be lost in translation in the event of inadequate interpreter services. Several strategies could address disparities in medical care faced by persons with LEP, speaking rare as well as more common languages. These include increasing the availability of professional interpreters via expanded and/or incentivized training programs, providing focused education in interpreter services for medical students, and unifying interpretation services provided by local consulates and nonprofit agencies for both medical and legal purposes.

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Kirk, Julienne K., Ronny A. Bell, Alain G. Bertoni, Thomas A. Arcury, Sara A. Quandt, David C. Goff, and K. M. Venkat Narayan. "Ethnic Disparities: Control of Glycemia, Blood Pressure, and LDL Cholesterol Among US Adults with Type 2 Diabetes." Annals of Pharmacotherapy 39, no. 9 (September 2005): 1489–501. http://dx.doi.org/10.1345/aph.1e685.

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OBJECTIVE: To examine ethnic disparities in the quality of diabetes care among adults with diabetes in the US through a systematic qualitative review. DATA SOURCES: Material published in the English language was searched from 1993 through June 2003 using PubMed, Web of Science, Cumulative Index to Nursing and Allied Health, the Cochrane Library, Combined Health Information Database, and Education Resources Information Center. STUDY SELECTION AND DATA EXTRACTION: Studies of patients with diabetes in which at least 50% of study participants were ethnic minorities and studies that made ethnic group comparisons were eligible. Research on individuals having prediabetes, those <18 years of age, or women with gestational diabetes were excluded. Reviewers used a reproducible search strategy. A standardized abstraction and grading of articles for publication source and content were used. Data on glycemia, blood pressure, and low-density lipoprotein cholesterol (LDL-C) were extracted in patients with diabetes. A total of 390 studies were reviewed, with 78 meeting inclusion criteria. DATA SYNTHESIS: Ethnic minorities had poorer outcomes of care than non-Hispanic whites. These disparities were most pronounced for glycemic control and least evident for LDL-C control. Most studies showed blood pressure to be poorly controlled among ethnic minorities. CONCLUSIONS: Control of risk factors for diabetes (glycemia, blood pressure, LDL-C) is challenging and requires routine assessment. These findings indicate that additional efforts are needed to promote diabetes quality of care among minority populations.

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LIAW, S. TENG. "Information Management in Primary Medical Care in South Australia." Family Practice 11, no. 1 (1994): 44–50. http://dx.doi.org/10.1093/fampra/11.1.44.

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Zhura, V. V., and A. P. Utesheva. "CROSS-CULTURAL COMMUNICATION IN MEDICAL SETTINGS." Bioethics 26, no. 2 (November 2, 2020): 14–17. http://dx.doi.org/10.19163/2070-1586-2020-2(26)-14-17.

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Tоday there is a strong tendency to incorporate the bioethical principle of social justice in healthcare in cross-cultural communication. Considering cultural differences makes it possible to ensure that the human right to medical care and wellbeing is fully respected. Several types of most vulnerable populations were identified – immigrants and social minorities. When seeking medical care they face a number of problems such as culture and language barriers, lower socio-economic status, lack of literacy, which impede effective communication and care provision. The most promising ways of coping with the problem are developing cultural competence and practicing a patient-centered approach. New curricula aiming at raising cultural awareness have been elaborated for practical use in medical schools.

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Gross, Paul F. "Technology Assessment in Health Care in Australia." International Journal of Technology Assessment in Health Care 5, no. 1 (January 1989): 137–44. http://dx.doi.org/10.1017/s0266462300006024.

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In 1977, in the middle of a protracted debate on the costs and methods of paying for health care, the federal minister for health established a Committee on Applications and Costs of Modern Technology in Medical Practice. In 1978, the committee produced its report, which reviewed a number of cost containment strategies, including the reduction or regulation of fees paid to medical practitioners for specific procedures. It recommended that a national panel be established to collect information on medical technology and advise on its introduction in Australia.In 1982, the National Health Technology Advisory Panel (NHTAP) was created to identify and examine existing and emerging medical technology, to determine methods and priorities for assessment, and to make recommendations to the minister for health with respect to assessment and funding of new technology.

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Benrimoj, Shalom I., and Alison S. Roberts. "Providing Patient Care in Community Pharmacies in Australia." Annals of Pharmacotherapy 39, no. 11 (November 2005): 1911–17. http://dx.doi.org/10.1345/aph.1g165.

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OBJECTIVE To describe Australia's community pharmacy network in the context of the health system and outline the provision of services. DATA SYNTHESIS The 5000 community pharmacies form a key component of the healthcare system for Australians, for whom health expenditures represent 9% of the Gross Domestic Product. A typical community pharmacy dispenses 880 prescriptions per week. Pharmacists are key partners in the Government's National Medicines Policy and contribute to its objectives through the provision of cognitive pharmaceutical services (CPS). The Third Community Pharmacy Agreement included funding for CPS including medication review and the provision of written drug information. Funding is also provided for a quality assurance platform with which the majority of pharmacies are accredited. Fifteen million dollars (Australian) have been allocated to research in community pharmacy, which has focused on achieving quality use of medicines (QUM), as well as developing new CPS and facilitating change. Elements of the Agreements have taken into account QUM principles and are now significant drivers of practice change. Although accounting for 10% of remuneration for community pharmacy, the provision of CPS represents a significant shift in focus to view pharmacy as a service provider. Delivery of CPS through the community pharmacy network provides sustainability for primary health care due to improvement in quality presumably associated with a reduction in healthcare costs. CONCLUSIONS Australian pharmacy practice is moving strongly in the direction of CPS provision; however, change does not occur easily. The development of a change management strategy is underway to improve the uptake of professional and business opportunities in community pharmacy.

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Cook, Benjamin L., Samuel H. Zuvekas, Jie Chen, Ana Progovac, and Alisa K. Lincoln. "Assessing the Individual, Neighborhood, and Policy Predictors of Disparities in Mental Health Care." Medical Care Research and Review 74, no. 4 (May 4, 2016): 404–30. http://dx.doi.org/10.1177/1077558716646898.

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This study assesses individual- and area-level predictors of racial/ethnic disparities in mental health care episodes for adults with psychiatric illness. Multilevel regression models are estimated using data from the Medical Expenditure Panel Surveys linked to area-level data sets. Compared with Whites, Blacks and Latinos live in neighborhoods with higher minority density, lower average education, and greater specialist mental health provider density, all of which predict lesser mental health care initiation. Neighborhood-level variables do not have differential effects on mental health care by race/ethnicity. Racial/ethnic disparities arise because minorities are more likely to live in neighborhoods where treatment initiation is low, rather than because of a differential influence of neighborhood disadvantage on treatment initiation for minorities compared with Whites. Low rates of initiation in neighborhoods with a high density of specialists suggest that interventions to increase mental health care specialists, without a focus on treating racial/ethnic minorities, may not reduce access disparities.

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Macdonald, John. "Primary Health Care or Primary Medical Care: In Reality." Australian Journal of Primary Health 13, no. 2 (2007): 18. http://dx.doi.org/10.1071/py07019.

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Despite considerable rhetoric, comprehensive primary health care remains largely a matter of a paper exercise. The theory promotes horizontal and vertical integration and the active participation of people in planning. Experience in Australia and elsewhere indicates that what is in place in health services is often primary medical care: the management of the needs of presenting individuals. The arguments for upstream interventions remain valid, bolstered by research on the social determinants of health. Two examples are given of primary health care that attempt to work upstream, before clinical interventions become necessary and illustrate the need for both horizontal and vertical integration. Consequences for policy and training are drawn.

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Yogesan, K., C. Henderson, C. J. Barry, and I. J. Constable. "Online eye care in prisons in Western Australia." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 63–64. http://dx.doi.org/10.1258/1357633011937173.

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In prisons, prison medical officers provide general medical care. However, if specialist care is needed then the prisoner is transported to a specialist medical centre. This is a costly procedure and prison escapes occur during transportation. We have tested our Internet-based eye care system in prisons in Western Australia. Medical and ophthalmic history, visual acuity and intraocular pressure were stored in a browser-based multimedia database. Digital images of the retina and the external eye were recorded and transmitted to a central server. Based on the medical data and the digital images, the specialist ophthalmologist could provide a diagnosis within 24 h. Eleven patients (mean age 48, range 30–82 years) were reviewed during two separate visits to a maximum-security prison in Western Australia. Our main aim was to train prison medical officers and nurses to operate the portable ophthalmic imaging instruments and to use the Internet-based eye care system. The outcome of the pilot study indicated that considerable savings could be made in transport costs and the security risk could be reduced. The Ministry of Justice in Western Australia has decided to implement telemedicine services to provide regular ophthalmic consultation to its prisons.

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Tekian, A., and R. P. Foley. "Why do medical students from underrepresented minorities choose–or not choose–primary care careers?" Academic Medicine 72, no. 2 (February 1997): 94–5. http://dx.doi.org/10.1097/00001888-199702000-00008.

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O’Loughlin, Mary, Caryn West, and Jane Mills. "Medical homes and chronic care: consumer lessons for regional Australia." Australian Journal of Primary Health 28, no. 2 (February 1, 2022): 97–103. http://dx.doi.org/10.1071/py21020.

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Medical home models of care, including Australia’s Health Care Homes, have the potential to improve health service delivery. This qualitative study explored the primary healthcare experience of people living with chronic conditions in a regional community. The study aim was to use consumer perspectives to inform the further development of a medical home-type model for regional Australia. Participants were recruited from the emergency department of a north Queensland hospital. Twenty-one adults (aged ≥18 years) participated in interviews, using a semi-structured schedule. Inductive, deductive and abductive analyses were guided by grounded theory methods. Participants were committed to an individual GP, rather than a practice organisation. This finding has implications for medical homes, as individuals may choose not to access team-based practice care. Most participants perceived they currently received high-quality GP care, although challenges were identified. These challenges included disconnected after-hours care and uncertainty around the cost of care. Those living with complex, uncommon, chronic conditions felt the most disenfranchised from existing care models, and could benefit from increased engagement with a medical home-type model. Strengthening the continuity of care between GPs both within and outside the practice may enhance service delivery. Involving consumers in the design of care models supports health services that are fit-for-purpose.

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Ikeme, Shelly, Emilie Kottenmeier, Goldfield Uzochukwu, and Waleed Brinjikji. "Evidence-Based Disparities in Stroke Care Metrics and Outcomes in the United States: A Systematic Review." Stroke 53, no. 3 (March 2022): 670–79. http://dx.doi.org/10.1161/strokeaha.121.036263.

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Stroke disproportionately affects racial minorities, and the level to which stroke treatment practices differ across races is understudied. Here, we performed a systematic review of disparities in stroke treatment between racial minorities and White patients. A systematic literature search was performed on PubMed to identify studies published from January 1, 2010, to April 5, 2021 that investigated disparities in access to stroke treatment between racial minorities and White patients. A total of 30 studies were included in the systematic review. White patients were estimated to use emergency medical services at a greater rate (59.8%) than African American (55.6%), Asian (54.7%), and Hispanic patients (53.2%). A greater proportion of White patients (37.4%) were estimated to arrive within 3 hours from onset of stroke symptoms than African American (26.0%) and Hispanic (28.9%) patients. A greater proportion of White patients (2.8%) were estimated to receive tPA (tissue-type plasminogen activator) as compared with African American (2.3%), Hispanic (2.6%), and Asian (2.3%) patients. Rates of utilization of mechanical thrombectomy were also lower in minorities than in the White population. As shown in this review, racial disparities exist at key points along the continuum of stroke care from onset of stroke symptoms to treatment. Beyond patient level factors, these disparities may be attributed to other provider and system level factors within the health care ecosystem.

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Bill-Harvey, Dee, Robert M. Rippey, Micha Abeles, and Carol A. Pfeiffer. "Methods used by Urban, low-income minorities to care for their arthritis." Arthritis Care & Research 2, no. 2 (June 1989): 60–64. http://dx.doi.org/10.1002/anr.1790020207.

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Westbury, J. L., S. Jackson, and G. M. Peterson. "Psycholeptic use in aged care homes in Tasmania, Australia." Journal of Clinical Pharmacy and Therapeutics 35, no. 2 (October 11, 2009): 189–93. http://dx.doi.org/10.1111/j.1365-2710.2009.01079.x.

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Noah, Barbara A. "The Participation of Underrepresented Minorities in Clinical Research." American Journal of Law & Medicine 29, no. 2-3 (2003): 221–45. http://dx.doi.org/10.1017/s0098858800002823.

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The past decade witnessed unprecedented growth in medical research involving human subjects, promising the development of new treatments that extend and improve the quality of life, as well as prevent disease. Recent biomedical breakthroughs such as the mapping of the human genome, improved understanding of pharmacokinetics and molecular biology, and novel theories about the mechanisms of diseases such as cancer have led to a proliferation of clinical trials. Such research provides the necessary bridge from scientific theory to practical medical application, and it is essential that these efforts benefit all persons who suffer from the studied diseases.In addition to the potential long-term pay-offs, clinical trials may offer immediate dividends to enrolled subjects. The opportunity to participate in medical research carries with it a variety of potential risks and benefits. Because clinical trial participation potentially results in significant individual benefits, including access to state-of-the-art care and improved disease monitoring, fairness demands equal opportunity for inclusion whenever scientifically appropriate.

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Soror, Noha, and Amany Keruakous. "Racial disparities and medical care accessibility in cancer statistics." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e18510-e18510. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e18510.

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e18510 Background: Cancer is one of the leading causes of death worldwide. It continues to be the second leading cause of death in the United States despite all national efforts aiming to reduce cancer burden and mortality. Delays in medical care and subsequently age-appropriate screening leads to increased cancer burden which reflect on the overall prognosis. Medical care accessibility has been a challenge that is reported by approximately one third of the USA adult population. We aimed to identify health care disparities and its correlation with prevalence of cancer as well as delays in medical care due to financial challenges among Texas residents. Methods: We analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) 2017. We measured specific health care disparities including patient’s gender, age, race/ethnicity, body mass index (BMI), annual income, alcohol consumption, history of cancer, and delays in medical care due to financial burden, among respondents to the 2017 BRFSS survey from Texas. We computed the difference between our comparison groups using chi-square test for categorical variables and t-test for continuous variables. Results: We analyzed the differences in health care disparities among respondents with and without history of cancer. We report results from 11,165 adult respondents who reside in Texas, among which nine percent were diagnosed with cancer. We noticed a higher proportion of females than males among participants with a history of cancer (64% females p < 0.0001). Age did differ between both groups, with the majority of participants with cancer are aged 50 years and older. Interestingly, BMI did not differ between both groups (p-value = 0.6930). Although annual income did not differ between both groups, twelve percent of participants with cancer diagnosis suffered from delays in medical care due to financial burden. Racial disparities were statistically different between participants with or without cancer (p < .0001). Seventy seven percent of patients with cancer diagnosis were White and non-Hispanic with a cancer prevalence rate of 12% in that racial group. On a stratified analysis to compute the relationship between delayed medical care due to financial burden and cancer diagnosis among all ethnic groups, it was not statistically different (p-value = 0.1063). We showed that prevalence of cancer among multiracial participants and other racial minorities was higher in the group of participants who reported delays in medical care due to financial burden (11% versus 7%). Conclusions: Racial and ethnic disparities could affect accessibility to medical services. Race is a significant variable that is associated with cancer, with higher prevalence of cancer in White and non-Hispanic. Delayed medical care due to financial burden is more pronounced in multiracial population and racial minorities and should be targeted in future quality improvement projects.

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Clark, Peter A. "Prejudice and the Medical Profession: A Five-Year Update." Journal of Law, Medicine & Ethics 37, no. 1 (2009): 118–33. http://dx.doi.org/10.1111/j.1748-720x.2009.00356.x.

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Over the past decades the mortality rate in the United States has decreased and life expectancy has increased. Yet a number of recent studies have drawn Americans attention to the fact that racial and ethnic disparities persist in health care. It is clear that the U.S. health care system is not only flawed for many reasons including basic injustices, but may be the cause of both injury and death for members of racial and ethnic minorities.In 2002, an Institute of Medicine (IOM) report requested by Congress listed more than 100 studies documenting a wide range of disparities in the United States health care system. This report found that people belonging to racial and ethnic minorities often receive lower quality of health care than do people of European descent, even when their medical insurance coverage and income levels are the same as that of the latter.

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Richardson, Jeffrey. "Medical Technology and its Diffusion in Australia." International Journal of Technology Assessment in Health Care 4, no. 3 (July 1988): 407–31. http://dx.doi.org/10.1017/s0266462300000362.

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AbstractThe author examines the Australian health care system by surveying the financing techniques, physical organization, and government activity. He explains the impact of the public and private sectors and comments on the effectiveness of current evaluation procedures. While the author believes that the system is relatively healthy and cost effective, he recognizes a need for more comprehensive and scientific oversight. Using regression analysis and focusing on the installation of medical technology in hospitals, the author attempts to determine the specific factors that influence technology diffusion. He concludes by stressing that further studies analyzing the actual use of specific technologies are vital.

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Krzyżaniak, Natalia, Iga Pawłowska, and Beata Bajorek. "Pharmacist perspectives towards pharmaceutical care services in neonatal intensive care units in Australia and Poland." Drugs & Therapy Perspectives 34, no. 12 (September 18, 2018): 573–82. http://dx.doi.org/10.1007/s40267-018-0556-5.

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Lasser, Karen E., David U. Himmelstein, Steffie J. Woolhandler, Danny McCormick, and David H. Bor. "Do Minorities in the United States Receive Fewer Mental Health Services Than Whites?" International Journal of Health Services 32, no. 3 (July 2002): 567–78. http://dx.doi.org/10.2190/uexw-rarl-u46v-fu4p.

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Older studies have found that minorities in the United States receive fewer mental health services than whites. This analysis compares rates of outpatient mental health treatment according to race and ethnicity using more recent, population-based data, from the 1997 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. The authors calculated visit rates per 1,000 population to either primary care or psychiatric providers for mental health counseling, psychotherapy, and psychiatric drug therapy. In the primary care setting, Hispanics and blacks had lower visit rates (per 1,000 population) for drug therapy than whites (48.3 and 73.7 vs. 109.0; P < .0001 and P < .01, respectively). Blacks also had a lower visit rate for talk therapy (mental health counseling or psychotherapy) than whites (23.6 vs. 42.5; P < .01). In the psychiatric setting, Hispanics and blacks had lower visit rates than whites for talk therapy (38.4 and 33.6 vs. 85.1; P < .0001 for both comparisons) and drug therapy (38.3 and 29.1 vs. 71.8; P < .0001 for both comparisons). These results indicate that minorities receive about half as much outpatient mental health care as whites.

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Jones, P. Eugene, and Karen E. Mulitalo. "Physician Assistant Distribution in Texas-Mexico Border Counties: Public Health Implications." Journal of Environmental and Public Health 2010 (2010): 1–4. http://dx.doi.org/10.1155/2010/975016.

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Purpose. Texas Medical Board physician assistant (PA) data were assessed to assist workforce education and planning strategies for PA programs in regions with high percentages of Hispanic populations.Methods. Data were assessed for gender, ethnicity, program attended and current employment addresses within the 14 Texas-Mexico border counties.Results. Of the 329 border county PAs, 227 self-reported as Hispanic (69%), and 53% were female. Remarkably, 72% of all Hispanic PAs attended two of the six public Texas PA Programs.Conclusions. The Sullivan Commission report of 2004 concluded that the primary cause of poor public health care for minorities resulted from unequal representation of minorities in the health care professions. Two public Texas PA programs have made substantial contributions to public health care access in poverty-stricken border areas by educating and placing Hispanic PAs within medically underserved communities.

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Spurgeon, Peter, Paul Long, John Clark, and Frank Daly. "Do we need medical leadership or medical engagement?" Leadership in Health Services 28, no. 3 (July 6, 2015): 173–84. http://dx.doi.org/10.1108/lhs-03-2014-0029.

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Purpose – The purpose of this paper is to address issues of medical leadership within health systems and to clarify the associated conceptual issues, for example, leadership versus management and medical versus clinical leadership. However, its principle contribution is to raise the issue of the purpose or outcome of medical leadership, and, in this respect, it argues that it is to promote medical engagement. Design/methodology/approach – The approach is to provide evidence, both from the literature and empirically, to suggest that enhanced medical engagement leads to improved organisational performance and, in doing so, to review the associated concepts. Findings – Building on current evidence from the UK and Australia, the authors strengthen previous findings that effective medical leadership underpins the effective organisational performance. Research limitations/implications – There is a current imbalance between the size of the databases on medical engagement between the UK (very large) and Australia (small but developing). Practical implications – The authors aim to equip medical leaders with the appropriate skill set to promote and enhance greater medical engagement. The focus of leaders in organisations should be in creating a culture that fosters and supports medical engagement. Social implications – This paper provides empowerment of medical professionals to have greater influence in the running of the organisation in which they deliver care. Originality/value – The paper contains, for the first time, linked performance data from the Care Quality Commission in the UK and from Australia with the new set of medical engagement findings.

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Samander, Laura J., and Jeffrey Harman. "Disparities in Offered Anxiety Treatments Among Minorities." Journal of Primary Care & Community Health 13 (January 2022): 215013192110658. http://dx.doi.org/10.1177/21501319211065807.

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Purpose The primary purpose of this article was to determine if race and ethnicity played a role in if primary care physicians offered anxiety treatment in office visits by adult patients who were diagnosed with an anxiety disorder(s). Methods This study pooled data from the 2011 to 2018 National Ambulatory Medical Care Survey (NAMCS) that included adult patients with an anxiety disorder and the type of treatment offered to them. Logistic regressions were performed to examine the odds of offered anxiety treatment in office visits by non-Hispanic Black, Hispanic, and other race/ethnicity patients compared to office visits by non-Hispanic White patients. Results Physicians offered anxiety treatment in more than half of office visits where the patient was diagnosed with an anxiety disorder. Providers offered counseling or talk therapy in less than 13% of all office visits. Office visits by non-Hispanic Black patients had half the odds of being offered counseling/talk therapy ( P = .068) compared to those by non-Hispanic White patients. Conclusions These findings suggest that statistically significant differences in the offering of any anxiety treatments in office visits to minorities compared to non-Hispanic White patients do not exist; however, there are still differences in the rates of counseling/talk therapy offered in office visits by minorities versus non-minorities. Future studies may want to examine reasons for lower rates of counseling/talk therapy offered to minority and majority patients and the specific pharmacological or therapeutic treatments offered to different races.

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Figueroa-Moseley, C. D., G. R. Morrow, P. Jean-Pierre, and J. Purnell. "Ethnic minority participation in Community Clinical Oncology Program (CCOP) research studies." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): 1550. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.1550.

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1550 Background: Low minority participation in clinical research is concerning for both research and for the public health. Objective: The aim of this project was to investigate barriers and successes in minority participation in cancer medical research and cancer clinical trials. More specifically to: (1) determine major environmental, cultural, and economic barriers confronted by minority patients with cancer; and (2) determine the components of an environment that supports greater recruitment and retention of minorities to Clinical Community Oncology Practice (CCOP) cancer studies. Methods: Six focus groups consisting of 8 to 12 current or former minority cancer patients and 18 health care practitioners, from geographically diverse areas, were recruited to participate in this qualitative study. Focus group participants were asked questions about their attitudes and beliefs concerning their cancer and medical research. Health care practitioners were questioned on site recruitment and retention practices. Results: Two major thematic areas emerged for providers: barriers minority recommendation to trials and reasons for why minorities are underrepresented in trials. The three thematic areas for focus group participants were perceptions of medical research, reasons for participation or nonparticipation, and effects of Tuskegee Syphilis Study on participation. Conclusions: The Tuskegee Syphilis Study may have been a major impetus for why many Blacks and other minorities in this sample do not participate in medical research. Providers seem to state what was obviously important in connecting with the community, however, their actions in the community varied. This qualitative study gives voice to communities which mistrust the medical community in general and medical research in particular, and highlights the need for interventions bridging the community and research. No significant financial relationships to disclose.

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Jackson-Triche, M. "Depression and health-related quality of life in ethnic minorities seeking care in general medical settings." Journal of Affective Disorders 58, no. 2 (May 2000): 89–97. http://dx.doi.org/10.1016/s0165-0327(99)00069-5.

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Oyarvide Tuthill, Zelma, and Bridget Gorman. "Medical Comfort at the Intersection of Sexual Orientation and Gender Identity." Social Currents 6, no. 5 (June 6, 2019): 464–86. http://dx.doi.org/10.1177/2329496519852580.

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Effective and comfortable provider-patient communication is associated with engagement in health-promoting behavior. Although research on medical experiences among sexual minorities has increased, work has not examined how gender intersects with sexual identity to shape medical experiences. Using an intercategorical intersectional approach, we examine whether sexual minorities perceive their medical provider as knowledgeable and comfortable with their sexual identity, and how these relationships differ for cisgender men, cisgender women, and multigendered transgender adults. Drawing on data from 3,050 adults included in the 2010 Social Justice Sexuality Project, logistic regression models show three main findings. First, compared with heterosexual cisgender women, bisexual cisgender women are less likely to perceive that their provider knew their sexual identity—and if they did perceive knowledge, they were less likely to perceive that their provider was comfortable with their sexual identity. Second, gay transgender adults have significantly lower odds of perceiving provider comfort with their sexual identity relative to heterosexual transgender adults. Finally, for each gender group, our models demonstrated the importance of medical and social relationships for perceiving both knowledge and comfort with sexual identity from medical care providers.

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Shin, Tiffany M., Pilar Ortega, and Karol Hardin. "Educating Clinicians to Improve Telemedicine Access for Patients with Limited English Proficiency." Challenges 12, no. 2 (December 15, 2021): 34. http://dx.doi.org/10.3390/challe12020034.

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The COVID-19 pandemic prompted the rapid incorporation of telemedicine into healthcare systems, resulting in increased access challenges for patients in the United States with limited English proficiency (LEP). Non-English-language speakers face challenges with telemedicine that magnify pre-existing barriers to language-appropriate care, such as difficulty accessing professional medical interpreters and navigating both electronic health information and online patient portals. Improved medical education on telehealth would increase equitable care for linguistic minorities. Medical education targeting telehealth care delivery should include clinician instruction on working with interpreters in telehealth contexts, increasing patient access to telehealth resources, and addressing patients’ language needs for telemedicine.

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Adams, Diana, and Gavin Marx. "Daily Life As an Australian Medical Oncologist." Journal of Oncology Practice 6, no. 3 (May 2010): 146–48. http://dx.doi.org/10.1200/jop.878901.

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Helfrich, Christian D., Christine W. Hartmann, Toral J. Parikh, and David H. Au. "Promoting Health Equity through De-Implementation Research." Ethnicity & Disease 29, Suppl 1 (February 21, 2019): 93–96. http://dx.doi.org/10.18865//ed.29.s1.93.

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Ensuring equitable access to quality health care historically has focused on gaps in care, where patients fail to receive the high-value care that will benefit them, something termed underuse. But providing high-quality health care sometimes requires reducing low-value care that delivers no benefit or where known harms outweigh expected benefits. These situations represent health care overuse. The process involved in reducing low-value care is known as de-implementation. In this article, we argue that de-implementation is critical for advancing equity for several reasons. First, medical overuse is associated with patient race, ethnicity, and socioeconomic status. In some cases, the result is even double jeopardy, where racial and ethnic minorities are at higher risk of both overuse and underuse. In these cases, more traditional efforts focused exclusively on underuse ignore half of the problem. Second, overuse of preventive care and screening is often greater for more socioeconomically advantaged patients. Within insured populations, this means more socioeconomically disadvantaged patients subsidize overuse. Finally, racial and ethnic minorities may have different experiences of overuse than Whites in the United States. This may make efforts to de-implement overuse particularly fraught. We therefore provide several actions for closing current research gaps, including: adding subgroup analyses in studies of medical overuse; specifying and measuring potential mechanisms related to equity (eg, double jeopardy vs thermostat models of overuse); and testing de-implementation strategies that may mitigate bias.Ethn Dis. 2019;29(Suppl 1):93-96; doi:10.18865/ed.29.S1.93.

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Helfrich, Christian D., Christine W. Hartmann, Toral J. Parikh, and David H. Au. "Promoting Health Equity through De-Implementation Research." Ethnicity & Disease 29, Suppl 1 (February 21, 2019): 93–96. http://dx.doi.org/10.18865/ed.29.s1.93.

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Ensuring equitable access to quality health care historically has focused on gaps in care, where patients fail to receive the high-value care that will benefit them, something termed underuse. But providing high-quality health care sometimes requires reducing low-value care that delivers no benefit or where known harms outweigh expected benefits. These situations represent health care overuse. The process involved in reducing low-value care is known as de-implementation. In this article, we argue that de-implementation is critical for advancing equity for several reasons. First, medical overuse is associated with patient race, ethnicity, and socioeconomic status. In some cases, the result is even double jeopardy, where racial and ethnic minorities are at higher risk of both overuse and underuse. In these cases, more traditional efforts focused exclusively on underuse ignore half of the problem. Second, overuse of preventive care and screening is often greater for more socioeconomically advantaged patients. Within insured populations, this means more socioeconomically disadvantaged patients subsidize overuse. Finally, racial and ethnic minorities may have different experiences of overuse than Whites in the United States. This may make efforts to de-implement overuse particularly fraught. We therefore provide several actions for closing current research gaps, including: adding subgroup analyses in studies of medical overuse; specifying and measuring potential mechanisms related to equity (eg, double jeopardy vs thermostat models of overuse); and testing de-implementation strategies that may mitigate bias.Ethn Dis. 2019;29(Suppl 1):93-96; doi:10.18865/ed.29.S1.93.

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Gray, Gwen. "Access to Medical Care under Strain: New Pressures in Canada and Australia." Journal of Health Politics, Policy and Law 23, no. 6 (January 1, 1998): 905–47. http://dx.doi.org/10.1215/03616878-23-6-905.

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Tran, Don Quang, Andrew G. Ryder, and G. Eric Jarvis. "Reported immigration and medical coercion among immigrants referred to a cultural consultation service." Transcultural Psychiatry 56, no. 5 (June 6, 2019): 807–26. http://dx.doi.org/10.1177/1363461519847811.

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Members of visible minorities are commonly targets of social coercion related to immigration and medical measures. Social coercion is associated with poor mental health outcomes and mistrust of medical services. This study will determine if Afro-Canadian immigrants referred to a Cultural Consultation Service (CCS) in Montreal report more or less medical and immigration coercion compared with other ethnic minorities. We reviewed the charts of 729 referrals to the CCS and gathered data on the 401 patients included in the study. Chi-square statistics examined the relation between minority group and self-reported coercion. Binary logistic regression models controlled for standard sociodemographic variables in addition to ethnicity, language barrier, length of stay in Canada since immigration, refugee claimant status, referral source, presence of psychosis in the main diagnosis, and presence of legal history. Patients were diverse and included 105 Afro-Canadians, 40 Latin Americans, 73 Arab and West Asians, 149 South Asians, and 34 East and Southeast Asians. Being Afro-Canadian was significantly and positively associated with medical coercion (p = .02, 95% CI = 1.15-4.57), while being South Asian was negatively and significantly associated with immigration coercion (p = .03, 95% CI = .29–.93). Members of visible minority communities are not equal in their reported experience of social coercion after arriving to Canada. Future research clarifying pathways to mental health care for immigrants and the experience of new Canadians in immigration and health care settings would give needed context to the findings of this study.

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P Sturmberg, Joachim, and Geoff M McDonnell. "How Modelling could Contribute to Reforming Primary Care—Tweaking “the Ecology of Medical Care” in Australia." AIMS Medical Science 3, no. 3 (2016): 298–311. http://dx.doi.org/10.3934/medsci.2016.3.298.

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Albsoul, Rania Ali, Gerard FitzGerald, and Muhammad Ahmed Alshyyab. "Missed nursing care: a snapshot case study in a medical ward in Australia." British Journal of Nursing 31, no. 13 (July 7, 2022): 710–16. http://dx.doi.org/10.12968/bjon.2022.31.13.710.

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Background: Missed nursing care is a global issue in acute healthcare settings. It is a complex phenomenon that refers to nursing care that is required by patients but left undone or significantly delayed. Aim: To investigate the nature of missed nursing care and influencing factors in a general medical ward in an acute care hospital in Brisbane, Australia. Method: This is a descriptive case study. The study was carried out in a 29-bed inpatient general medical/cardiology/telemetry ward in an acute care tertiary hospital. Results: The study ward has been identified as a high complexity unit. The survey data found that the most frequent nursing care elements missed, as reported by the patients, were oral care, response to machine beep, and response to call light. The most frequent nurse-reported missed care items were ambulation, monitoring fluid intake/output and attendance at interdisciplinary conferences. Conclusion: Despite mandating nurse-to-patient ratios in the study ward, inadequate staffing was still perceived as being problematic and one of the most frequent reasons leading to missed nursing care. This possible disconnect between mandated staffing ratios and the persistence of perceived missed care suggests a more complex relationship than can be managed by macro (large-scale) resourcing formulas alone.

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Shephard, Mark. "Abnormal laboratory results: Point-of-care testing comes of age in Australia." Australian Prescriber 33, no. 1 (February 1, 2010): 6–9. http://dx.doi.org/10.18773/austprescr.2010.003.

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Roughead, Elizabeth E., Susan J. Semple, and Andrew L. Gilbert. "Quality Use of Medicines in Aged-Care Facilities in Australia." Drugs & Aging 20, no. 9 (2003): 643–53. http://dx.doi.org/10.2165/00002512-200320090-00002.

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Loucks, Vernon R. "Home Health Care." International Journal of Technology Assessment in Health Care 1, no. 2 (April 1985): 301–4. http://dx.doi.org/10.1017/s0266462300000076.

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Throughout the industrialized world—from the United States to Japan, from Scandinavia to Australia—the theme of cost containment dominates the discourse on health care. This issue is the offspring of successful past efforts to ensure all patients effective medical care. While many countries have groups with special health disadvantages, the great majority of people in the industrialized nations have access to modern medical care and make ready use of it. The problem now is its cost, as aging populations, increasing in number as the result of advanced techniques that are more effective in prolonging life, place considerable strains on health care budgets.

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Tran, David Minh, and Malcolm P. Forbes. "Addressing cost of unwarranted medical care in the medical curriculum." Australian Health Review 41, no. 2 (2017): 151. http://dx.doi.org/10.1071/ah15172.

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Within the past decade, there has been a significant increase in Australia’s health expenditure, with a concurrent rise in overdiagnosis. Australia has introduced the Choosing Wisely campaign in a bid to identify and reduce commonly used investigations, treatments and procedures that add little benefit to patient care. By catalysing a discussion regarding evidence-based use of medications and medical testing, the Choosing Wisely campaign can minimise risk of harm to patients, as well as reduce expenditure. Internationally, several institutions are considering introducing training regarding cost-effective medical investigations into medical school curricula. The American College of Radiology has found positive results when conducting small-group teaching sessions with medical students regarding appropriate imaging modalities. These results are reflected in a US study that used an educational intervention to improve students’ understanding of investigation costs. In addition, the Academy of Clinical Laboratory Physicians and Scientists has developed a proposed curriculum to further medical students’ training in appropriate ordering of laboratory investigations. Australian medical educators must consider whether introducing evidence-based testing into Australian medical curricula should be part of a wider strategy to prevent unnecessary testing and health expenditure now and into the future.

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Robertson, A. G., M. G. Leclercq, and S. Poke. "(A235) Australian Medical Assistance Teams in Australia." Prehospital and Disaster Medicine 26, S1 (May 2011): s64. http://dx.doi.org/10.1017/s1049023x11002214.

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Western Australia (WA) was one of the first states in Australia to deploy medical team members to the tsunami-stricken regions of the Maldives and Banda Aceh in 2004. This early experience led the WA Department of Health to develop and pilot these teams locally and to progress a national model for their future development, which could be implemented further by other Australian jurisdictions. Further experience with these teams in Yogyakarta after the 2006 Java earthquake, Karratha after Tropical Cyclone George in 2007, Ashmore Reef after the 2009 boat explosion, Samoa after the 2009 tsunami, and during the Pakistan floods in 2010 have signaled both the utility of the Australian Medical Assistance Teams (AUSMATs) and the commitment by the Australian Commonwealth and State Governments to utilize these teams in both domestic and international settings. This presentation will examine the implementation of the AUSMAT model in Australia over the last five years, the modifications to the original model to suit the unique geographical and resource challenges faced by Australian teams, both within and outside Australia, and the lessons learned from recent team deployments. The challenges of delivering health care over vast, sparsely populated distances, and the inherent and increasing natural and industrial disaster threats in the Asia-Pacific region, have contributed to the modification of the model to ensure that the AUSMATs are flexible, modular, and capable of responding to a variety of major incidents. The national model continues to evolve to ensure that well prepared, equipped and trained civilian AUSMATS remain able to effectively deploy to a mass casualty situation in Australia's area of interest.

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Journal articles on the topic 'Minorities Medical care Australia'

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