Articles de revues : « Health services accessibility – Germany »

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Neumeier, Stefan. « Regional Distribution of Ambulant Nursing Services in Germany. A GIS Accessibility Analysis ». Raumforschung und Raumordnung 74, n^o 4 (31 août 2016) : 339–59. http://dx.doi.org/10.1007/s13147-016-0409-4.

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Abstract In many rural areas in Europe a spatial concentrating of basic services can be observed due to interacting socioeconomic and demographic processes. At the European level, territorial cohesion policy aims at mitigating the consequences of this development. Additionally, in Germany, this development is a greatly discussed topic. However, little data exists at the country level on the dimensions and consequences of this spatial concentration process. This limitation makes it difficult to realistically assess the situation and identify the regions and basic services where intervention may be required. As a contribution to bridging this knowledge gap, we used a GIS accessibility analysis to analyse the regional distribution of ambulant nursing services throughout Germany and to estimate the availability of such services near patients’ places of residence. Ambulant nursing care is an important basic service of the German health care system; such services allow disabled or elderly people who are not able to fully care for themselves to stay in their homes and living environments. The analysis results lead us to conclude that although ambulant nursing services must cover greater distances to reach customers in rural areas, at present such services are nationally available in rural areas as well as in urban areas.

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Stankunas, Mindaugas, Mark Avery, Jutta Lindert, Ian Edwards, Mirko Di Rosa, Francisco Torres-Gonzalez, Elisabeth Ioannidi-Kapolou, Henrique Barros et Joaquim Soares. « Healthcare and aging : do European Union countries differ ? » International Journal of Health Care Quality Assurance 29, n^o 8 (10 octobre 2016) : 895–906. http://dx.doi.org/10.1108/ijhcqa-09-2015-0110.

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Purpose The purpose of this paper is to evaluate socio-economic inequalities in the use, accessibility and satisfaction with health services amongst 60-84 year old people from seven European urban communities. Design/methodology/approach Data for this study were collected in 2009. The target population was people aged 60-84 years from Stuttgart (Germany), Athens (Greece), Ancona (Italy), Kaunas (Lithuania), Porto (Portugal), Granada (Spain) and Stockholm (Sweden). The total sample comprised 4,467 respondents with a mean response rate across these countries of 45.2 per cent. Findings The study demonstrated that the majority of respondents had contact with a health care provider within the last 12 months. The highest percentages were reported by respondents from Spain (97.8 per cent) and Portugal (97.7 per cent). The results suggest that 13.0 per cent of respondents had refrained from seeking care services. The highest rates were amongst seniors from Lithuania (24.0 per cent), Germany (16.2 per cent) and Portugal (15.4 per cent). Logistic regression suggests that seniors who refrained from seeking health care was statistically significant associated with those with higher levels of education (odds ratios (OR)=1.21; 95 per cent confidence intervals (CI)=1.01-1.25) and financial strain (OR=1.26; 95 per cent CI=1.16-1.37). Furthermore, the majority of respondents were satisfied with health care services. Originality/value The findings from the “Elder Abuse: a multinational prevalence survey” study indicate the existence of significant variations in use, accessibility and satisfaction with health services by country and for socio-economic factors related to organizing and financing of care systems.

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Sochinskaya, M. V. « Features of health insurance : an analysis of the German experience ». Collected Works of Uman National University of Horticulture 2, n^o 99 (22 décembre 2021) : 195–203. http://dx.doi.org/10.31395/2415-8240-2021-99-2-195-203.

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The article examines the models of health insurance in Western countries. A comparative analysis of forms of social insurance and sources of financing payments for four models of medical insurance is carried out. The practical aspects of the functioning of compulsory health insurance in Germany are investigated, its positive features are revealed. Attention is paid to medical insurance, which provides insurance in case of loss of health for any reason. It provides greater accessibility, quality and completeness to meet the diverse needs of the population in the provision of medical services, and is more effective than government funding of the health care system. In addition, the social and economic efficiency of health insurance related to reimbursement of citizens' expenses related to receiving medical care, as well as other expenses aimed at maintaining health, depends on how comprehensively the concept of developing insurance medicine in the country has been worked out. The positive and negative aspects of health insurance are analyzed. The forms of health insurance are considered: compulsory health insurance and voluntary health insurance. It was found that one of the first countries where health insurance was introduced was Germany. There are two types of health insurance in Germany: public and private. Germany's state health insurance is compulsory. That is, every employee, as well as persons trained in production (Auszubildende), are subject to compulsory state health insurance and must be members of one of their freely chosen state health insurance funds. At the same time, if a person wishes to receive medical services that are not included in the list of compulsory health insurance, he can conclude a supplementary health insurance contract with the insurance company. Voluntary health insurance allows you to choose an inpatient medical institution and the conditions of stay in it, special services of a personal physician.

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Biddle, Louise, Sandra Ziegler, Jenny Baron, Lea Flory et Kayvan Bozorgmehr. « The patient journey of newly arrived asylum seekers and responsiveness of care : A qualitative study in Germany ». PLOS ONE 17, n^o 6 (24 juin 2022) : e0270419. http://dx.doi.org/10.1371/journal.pone.0270419.

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Background Research on health and healthcare for asylum seekers and refugees (ASR) has focused strongly on accessibility and legal entitlements, with quality of care receiving little attention. This study aimed to assess responsiveness, as non-medical quality of care, in the narratives of ASR patients recently arrived in Germany. Methods 31 ASR with existing medical conditions were recruited in six refugee reception centres and three psychosocial centres. Semi-structured, qualitative interviews were conducted which reconstructed their patient journey after arrival in Germany. Interviews were recorded, transcribed verbatim and evaluated using thematic analysis. Results The experiences of participants throughout the patient journey provided a rich and varied description of the responsiveness of health services. Some dimensions of responsiveness, including respectful treatment, clear communication and trust, resurfaced throughout the narratives. These factors were prominent reasons for positive evaluations of the health system, and negative experiences were reported in their absence. Other dimensions, including cleanliness of facilities, autonomy of decision-making and choice of provider were raised seldomly. Positive experiences in Germany were often set in contrast to negative experiences in the participants’ countries of origin or during transit. Furthermore, many participants evaluated their experience with healthcare services in terms of the perceived technical quality of medical care rather than with reference to responsiveness. Conclusion This qualitative study among ASR analysed patient experiences to better understand responsiveness of care for this population. While our results show high overall satisfaction with health services in Germany, using the lens of responsiveness allowed us to identify particular policy areas where care can be strengthened further. These include in particular the expansion of high-quality interpreting services, provision of professional training to increase the competency of healthcare staff in caring for a diverse patient population, as well as an alignment between healthcare and asylum processes to promote continuity of care.

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Eickhoff, Christiane, Nina Griese-Mammen, Uta Mueller, André Said et Martin Schulz. « Primary healthcare policy and vision for community pharmacy and pharmacists in Germany ». Pharmacy Practice 19, n^o 1 (20 janvier 2021) : 2248. http://dx.doi.org/10.18549/pharmpract.2021.1.2248.

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Germany is the highest populated country in Europe with a population of 82.3 million in 2019. As in many other developed countries, it has an aging population. Approximately 10% of the gross domestic product is spent on healthcare. The healthcare system is characterized by its accessibility. Patients are generally free to choose their primary care physicians, both family doctors and specialists, pharmacy, dentist, or emergency service. Up to a certain income, health insurance is mandatory with the statutory health insurance (SHI) system, covering 88% of the population. Major challenges are the lack of cooperation and integration between the different sectors and healthcare providers. This is expected to change with the introduction of a telematic infrastructure that is currently being implemented. It will not only connect all providers in primary and secondary care in a secure network but will also enable access to patients’ electronic record/medical data and at the same time switch from paper to electronic prescriptions. Approximately 52,000 of the 67,000 pharmacists are working in approximately 19,000 community pharmacies. These pharmacies are owner-operated by a pharmacist. Pharmacists may own up to three subsidiaries nearby to their main pharmacy. Community pharmacy practice mainly consists of dispensing drugs, counselling patients on drug therapy and safety, and giving advice on lifestyle and healthy living. Many cognitive pharmaceutical services have been developed and evaluated in the past 20 years. Discussions within the profession and with stakeholders on the national level on the roles and responsibilities of pharmacists have resulted in nationally agreed guidelines, curricula, and services. However, cognitive services remunerated by the SHI funds on the national level remain to be negotiated and sustainably implemented. A law passed in November 2020 by parliament will regulate the remuneration of pharmaceutical services by the SHI funds with an annual budget of EUR 150 million. The type of services and their remuneration remain to be negotiated in 2021. The profession has to continue on all levels to advocate for a change in pharmacy practice by introducing pharmacy services into routine care.

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KARPYSHYN, Nataliia, et Iryna SYDOR. « Financing of medical services : experience of foreign countries and Ukraine ». Economics. Finances. Law, n^o 8 (28 août 2020) : 9–13. http://dx.doi.org/10.37634/efp.2020.8.2.

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Introduction. Research into the sources of health care funding is necessary to develop an effective policy to improve the domestic health care system and improve the accessibility and quality of medical care. The purpose of the article is to assess the sources of funding of medical services in foreign countries and in Ukraine in order to identify and analise current trends and prospects for financing the domestic health care system in the implementation of health care reform. Results. An analysis of trends in the financing of health services in foreign countries has shown that there is a certain imbalance between the country's economic growth and its health care expenditures. The share of health services expenditures in GDP averaged 8.8 % or almost $ 4,000 per OECD citizen in 2018 y . This cost figure is 24 times higher than the per capita health care costs in Ukraine and can be a guide to the amount of funding for medicine in the world community. Citizens of OECD countries, unlike Ukrainians, pay an average of 21 % of all health care costs. The priority sources of funding for one group of countries are budget funds (Norway, Denmark, Sweden, Great Britain, Canada), and for another – compulsory health insurance (Germany, Japan, France, etc.). Сonclusion. Funds of the population are the main source of funding for medical services in Ukraine – 53 %. This indicator is critical for the country, as low-income citizens are unable to pay for medical care and the number of chronic diseases, disability and mortality are increased. The transformational reform of the health care system in Ukraine was started in 2015 and according to international experts is successful and meets international practices of accessibility, quality and efficiency of medical services. Further consistent implementation of health care reform can provide financial protection for the population from excessive out-of-pocket spending, improve access to health care, and improve public health.

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Lee, Susan, Sophie E. Gross, Holger Pfaff et Antje Dresen. « Differences in Perceived Waiting Time by Health Insurance Type in the Inpatient Sector : An Analysis of Patients With Breast Cancer in Germany ». INQUIRY : The Journal of Health Care Organization, Provision, and Financing 56 (janvier 2019) : 004695801987589. http://dx.doi.org/10.1177/0046958019875897.

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Although the relationship between health insurance and waiting time has been established in the ambulatory sector in Germany, research in the inpatient sector is limited. This study aims to contribute to previous work through analyzing differences in perceived waiting time by health insurance type during the inpatient stays of patients with breast cancer in Germany. This study utilizes cross-sectional data from 2017 of patients with breast cancer (N = 4626) who underwent primary breast cancer surgery in a certified breast care center in Germany. Results from multilevel logistic regression models indicate a significant effect of health insurance status on perceived waiting time, net of other relevant factors (patient’s sociodemographic background, Union for International Cancer Control stage, grading, self-reported and classified health, type of surgery, and chemotherapy). Patients with statutory insurance were significantly more likely than privately insured patients to report long waiting times for examinations/procedures, discharge, and to speak with the physician. There were no significant differences in waiting time for nursing staff between private and statutory insurance holders. Results align with previous findings in the ambulatory sector and suggest a private health insurance advantage, with private patients receiving priority to some health care services. Disparities in health care accessibility and quality need to continue to be addressed and discussed, as well as the impact of health insurance type on other indicators of health.

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Fristedt, Sofi, Anna Wanka et Neil Charness. « User Involvement in Research on Aging and Health : Creating Knowledge and Technologies With Older Adults ». Innovation in Aging 4, Supplement_1 (1 décembre 2020) : 820. http://dx.doi.org/10.1093/geroni/igaa057.2989.

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Abstract Although, user involvement is largely recognized as instrumental when developing relevant knowledge, services as well as products - aging populations are still likely to be sparsely involved in such processes. Surprisingly, many gerontechnologies are still developed based on a technological perspective rather than a gerontological perspective. Consequently, age-related changes as well as needs, actual use or perceptions of older adults are disregarded or neglected. Similar problems apply to public and private environments with potentially negative implications on accessibility. The present symposium includes four presentations that address user involvement, by capturing older adults’ and aging populations’ use as well as perceptions of emerging technologies, successful development of gerontechnologies, and a multigenerational mass-experiment on housing accessibility in later life. The first study from Germany captures the everyday situation of smartphone use as well as aspects of user experience, affect and social context among older adults. The second study addresses perceptions and attitudes of three generations in Sweden related to continuous technological advancement of products intended to support active and healthy aging. The third presentation will describe the iterative development process of the 2020 mass-experiment – the Housing Experiment -- involving older adults, stakeholders in the housing sector, teachers and pupils in Sweden. The fourth presentation from Canada explores the benefits, challenges, and solutions to support older adult engagement in research that leads to the successful development of technologies for and with older adults. Finally, our discussant will further elaborate on the respective study findings and summarize the symposium.

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Apolinário-Hagen, Jennifer, Viktor Vehreschild et Ramez M. Alkoudmani. « Current Views and Perspectives on E-Mental Health : An Exploratory Survey Study for Understanding Public Attitudes Toward Internet-Based Psychotherapy in Germany ». JMIR Mental Health 4, n^o 1 (23 février 2017) : e8. http://dx.doi.org/10.2196/mental.6375.

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Background Despite the advanced development of evidence-based psychological treatment services, help-seeking persons with mental health problems often fail to receive appropriate professional help. Internet-delivered psychotherapy has thus been suggested as an efficient strategy to overcome barriers to access mental health care on a large scale. However, previous research indicated poor public acceptability as an issue for the dissemination of Internet-delivered therapies. Currently, little is known about the expectations and attitudes toward Internet-delivered therapies in the general population. This is especially the case for countries such as Germany where electronic mental health (e-mental health) treatment services are planned to be implemented in routine care. Objective This pilot study aimed to determine the expectations and attitudes toward Internet-based psychotherapy in the general population in Germany. Furthermore, it aimed to explore the associations between attitudes toward Internet-based therapies and perceived stress. Methods To assess public attitudes toward Internet-based psychotherapy, we conducted both Web-based and paper-and-pencil surveys using a self-developed 14-item questionnaire (Cronbach alpha=.89). Psychological distress was measured by employing a visual analogue scale (VAS) and the 20-item German version of the Perceived Stress Questionnaire (PSQ). In addition, we conducted explorative factor analysis (principal axis factor analysis with promax rotation). Spearman’s rank correlations were used to determine the associations between attitudes toward Internet-based therapies and perceived stress. Results Descriptive analyses revealed that most respondents (N=1558; female: 78.95%, 1230/1558) indicated being not aware of the existence of Internet-delivered therapies (83.46%, 1141/1367). The average age was 32 years (standard deviation, SD 10.9; range 16-76). Through exploratory factor analysis, we identified 3 dimensions of public attitudes toward Internet-based therapies, which we labeled “usefulness or helpfulness,” “relative advantage or comparability,” and “accessibility or access to health care.” Analyses revealed negative views about Internet-based therapies on most domains, such as perceived helpfulness. The study findings further indicated ambivalent attitudes: Although most respondents agreed to statements on expected improvements in health care (eg, expanded access), we observed low intentions to future use of Internet-delivered therapies in case of mental health problems. Conclusions This pilot study showed deficient “e-awareness” and rather negative or ambivalent attitudes toward Internet-delivered therapies in the German-speaking general population. However, research targeting determinants of the large-scale adoption of Internet-based psychotherapy is still in its infancy. Thus, further research is required to explore the “black box” of public attitudes toward Internet-delivered therapies with representative samples, validated measures, and longitudinal survey designs.

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Callander, Emily J., Lisa Corscadden et Jean-Frederic Levesque. « Out-of-pocket healthcare expenditure and chronic disease – do Australians forgo care because of the cost ? » Australian Journal of Primary Health 23, n^o 1 (2017) : 15. http://dx.doi.org/10.1071/py16005.

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Although we do know that out-of-pocket healthcare expenditure is relatively high in Australia, little is known about what health conditions are associated with the highest out-of-pocket expenditure, and whether the cost of healthcare acts as a barrier to care for people with different chronic conditions. Cross-sectional analysis using linear and logistic regression models applied to the Commonwealth Fund international health policy survey of adults aged 18 years and over was conducted in 2013. Adults with asthma, emphysema and chronic obstructive pulmonary disease (COPD) had 109% higher household out-of-pocket healthcare expenditure than did those with no health condition (95% CI: 50–193%); and adults with depression, anxiety and other mental health conditions had 95% higher household out-of-pocket expenditure (95% CI: 33–187%). People with a chronic condition were also more likely to forego care because of cost. People with depression, anxiety and other mental health conditions had 7.65 times higher odds of skipping healthcare (95% CI: 4.13–14.20), and people with asthma, emphysema and chronic obstructive pulmonary disease had 6.16 times higher odds of skipping healthcare (95% CI: 3.30–11.50) than did people with no health condition. People with chronic health conditions in Canada, the United Kingdom, Germany, France, Norway, Sweden and Switzerland were all significantly less likely to skip healthcare because of cost than were people with a condition in Australia. The out-of-pocket cost of healthcare in Australia acts as a barrier to accessing treatment for people with chronic health conditions, with people with mental health conditions being likely to skip care. Attention should be given to the accessibility and affordability of mental health services in Australia.

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Dern, Sebastian, et Tanja Sappok. « Barriers to healthcare for people on the autism spectrum ». Advances in Autism 2, n^o 1 (4 janvier 2016) : 2–11. http://dx.doi.org/10.1108/aia-10-2015-0020.

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Purpose – Adults on the autism spectrum experience difficulties in receiving health care, and health care providers face difficulties in offering health care to adults on the autism spectrum. The purpose of this paper is first, to assess the various difficulties and second, to provide strategies to overcome them. Design/methodology/approach – In this qualitative research project, current barriers and facilitators to health care services were sampled from a collaboration of autistic self-advocates and autism professionals in Berlin, Germany. The findings were complemented by a review of practical guidelines and research about the service accessibility of patients on the autism spectrum. Findings – A comprehensive list of barriers to health care was compiled and structured according to various aspects, such as “making appointments”, “waiting area”, “communication”, and “examination”. Strategies considering the perceptual and communicative peculiarities of autism were found to improve access to health care for autistic adults. Practical implications – Providing access to the health care system may improve the diagnosis and treatment of mental and somatic illnesses, and thereby, the health status and quality of life for people on the autism spectrum. This recognition of the needs of adults on the autism spectrum may serve as a model for other areas in society, such as education and employment. Originality/value – Data acquisition in this project is of special value because it resulted from collaboration between an autistic self-advocacy organization and professionals working in the field of intellectual developmental disabilities considering the experiences of autistic adults in the entire range of intellectual functioning.

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Bleyel, Caroline, Mariell Hoffmann, Michel Wensing, Mechthild Hartmann, Hans-Christoph Friederich et Markus W. Haun. « Patients’ Perspective on Mental Health Specialist Video Consultations in Primary Care : Qualitative Preimplementation Study of Anticipated Benefits and Barriers ». Journal of Medical Internet Research 22, n^o 4 (20 avril 2020) : e17330. http://dx.doi.org/10.2196/17330.

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Background Due to limited access to specialist services, most patients with common mental disorders (depression or anxiety, or both) usually receive treatment in primary care. More recently, innovative technology-based care models (eg, video consultations) have been proposed to facilitate access to specialist services. Against this background, the PROVIDE (Improving Cross-Sectoral Collaboration Between Primary and Psychosocial Care: An Implementation Study on Video Consultations) project aims to improve the provision of psychosocial care through implementing video consultations integrated into routine primary care. Objective From the patients’ perspective, this qualitative preimplementation study explored (1) anticipated benefits from and (2) barriers to implementing mental health specialist video consultations embedded in primary care services and (3) prerequisites for interacting with therapists via video consultations. Methods Using a purposive (ie, stratified) sampling strategy, we recruited 13 patients from primary care practices and a tertiary care hospital (psychosomatic outpatient clinic) for one-off semistructured interviews. In a computer-assisted thematic analysis, we inductively (bottom-up) derived key themes concerning the practicability of mental health specialist video consultations. To validate our results, we discussed our findings with the interviewees as part of a systematic member checking. Results Overall, we derived 3 key themes and 10 subthemes. Participants identified specific benefits in 2 areas: the accessibility of mental health specialist care (shorter waiting times: 11/13, 85%; lower threshold for seeking specialist mental health care: 6/13, 46%; shorter travel distances: 3/13, 23%); and the environment in primary care (familiar travel modalities, premises, and employees: 5/13, 38%). The main barriers to the implementation of mental health video consultations from the patients’ perspective were the lack of face-to-face contact (13/13, 100%) and technical challenges (12/13, 92%). Notably, participants’ prerequisites for interacting with therapists (12/13, 92%) did not seem to differ much from those concerning face-to-face contacts. Conclusions Mental health service users mostly welcomed mental health specialist video consultations in primary care. Taking a pragmatic stance, service users, who are often frustrated about uncoordinated care, particularly valued the embedment of the consultations in the familiar environment of the primary care practice. With respect to interventional studies and implementation, our findings underscore the need to minimize technical disruptions during video consultations and to ensure optimal resemblance to face-to-face settings (eg, by training therapists in consistently reacting to nonverbal cues). Trial Registration German Clinical Trials Register DRKS00012487; https://tinyurl.com/uhg2one

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Karbovska, L., I. Yakushik, E. Feshchenko, I. Kalina et A. Kozlova. « SUSTAINABLE DEVELOPMENT OF THE ECONOMY AND INCREASING ENERGY SECURITY BASED ON THE USE OF RES : PROBLEMS AND PROSPECTS ». Financial and credit activity : problems of theory and practice 2, n^o 37 (30 avril 2021) : 438–46. http://dx.doi.org/10.18371/fcaptp.v2i37.230338.

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Abstract. It is substantiated that the factor of economic growth, increase of economic and energy security, preservation of the environment from the detrimental impact of the consequences of consumption of hydrocarbon energy sources is the sustainable development of renewable energy. The state and prospects of using renewable energy sources in the world are considered (RES). The rating of countries by the share of electricity produced from renewable sources as a percentage of primary sources during 2015—2019 is presented, which shows that the largest share of RES is in countries such as: Iceland, Kenya and Latvia; Currently, the largest growth in renewable energy is observed in Ukraine, Great Britain, Turkey, Denmark, Japan, France, the USA and Germany. The generalized factors of growth of demand for renewable energy sources are: parity of the price and productivity owing to decrease in the price of RES; increasing the efficiency of energy production due to technological progress and the introduction of innovative technologies in foreign trade; integration of power grids and balancing the load on them; stimulating the demand for RES by large cities — the implementation of the strategy of «smart city» includes «smart» energy; development of public ownership of networks and sources of renewable energy; active participation of developing countries in the dissemination of renewable energy; growing participation of the corporate sector in the development of renewable energy. The relationship between the goals of energy development in terms of its accessibility, reliability, sustainability and goals in the field of sustainable development is determined. Thus, poverty reduction (goal 1) involves expanding access to basic resources and services and the availability of modern infrastructure, an element of which is RES; the use of clean renewable energy will help reduce health risks (disease prevention and pandemic control) (objective 3); creation of sustainable infrastructure, promotion of innovations (goal 9) involves the use of clean and environmentally friendly technologies and sustainable energy development; the use of RES activity has a synergistic connection with the implementation of goal 13 — urgent measures to combat climate change and its consequences. Keywords: sustainable development goals, economic growth, energy security, renewable energy sources, hydrocarbon fuel, decarbonization. JEL Classification F29, F43, L94, O10 Formulas: 0; fig.: 0; tabl.: 2; bibl.: 17.

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Lander, Jonas, Karin Drixler, Marie-Luise Dierks et Eva Maria Bitzer. « How Do Publicly Available Allergy-Specific Web-Based Training Programs Conform to the Established Criteria for the Reporting, Methods, and Content of Evidence-Based (Digital) Health Information and Education : Thematic Content Evaluation ». Interactive Journal of Medical Research 8, n^o 4 (24 octobre 2019) : e12225. http://dx.doi.org/10.2196/12225.

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Background Allergic diseases, such as allergic asthma, rhinitis, and atopic eczema, are widespread, and they are a considerable burden on the health care system. For patients and health care professionals, Web-based training programs may be helpful to foster self-management and provide allergy-specific information, given, for instance, their good accessibility. Objective This study aimed to assess an exploratory sample of publicly available allergy-specific Web-based training programs—that is, interactive, feedback-oriented Web-based training platforms promoting health behavior change and improvement of personal skills—with regard to (1) general characteristics, aims, and target groups and (2) the extent to which these tools meet established criteria for the reporting, methods, and content of evidence-based (digital) health information and education. Methods Web-based training programs were identified via an initial Google search and a search of English and German language websites of medical and public health services, such as the European Centre for Allergy Research Foundation (German), Asthma UK, and Anaphylaxis Canada. We developed a checklist from (1) established guidelines for Web-based health information (eg, the Journal of the American Medical Association benchmarks, DISCERN criteria, and Health On the Net code) and (2) a database search of related studies. The checklist contained 44 items covering 11 domains in 3 areas: (1) content (completeness, transparency, and evidence), (2) structure (data safety and qualification of trainers and authors), and (3) impact (effectiveness, user perspective, and integration into health care). We rated the Web-based training programs as completely, partly, or not satisfying each checklist item and calculated overall and domain-specific scores for each Web-based training program using SPSS 23.0 (SPSS Inc). Results The 15 identified Web-based training programs covered an average of 37% of the items (score 33 out of 88). A total of 7 Web-based training programs covered more than 40% (35/88; maximum: 49%; 43/88). A total of 5 covered 30% (26/88) to 40% (35/88) of all rated items and the rest covered fewer (n=3; lowest score 24%; 21/88). Items relating to intervention (58%; 10/18), content (49%; 9/18), and data safety (60%; 1/2) were more often considered, as opposed to user safety (10%; 0.4/4), qualification of staff (10%; 0.8/8), effectiveness (16%; 0.4/2), and user perspective (45%; 5/12). In addition, in 13 of 15 Web-based training programs, a minimum of 3 domains were not covered at all. Regarding evidence-based content, 46% of all Web-based training programs (7/15) scored on use of scientific research, 53% on regular information update (8/15), and 33% on provision of references (5/15). None of 15 provided details on the quality of references or the strength of evidence. Conclusions English and German language allergy-specific Web-based training programs, addressing lay audiences and health care professionals, conform only partly to established criteria for the reporting, methods, and content of evidence-based (digital) health information and education. Particularly, well-conducted studies on their effectiveness are missing.

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Bogataj, David, Valerija Rogelj, Marija Bogataj et Eneja Drobež. « Housing equity withdrawal for development of assisted-living facilities ». Facilities 38, n^o 9/10 (15 juillet 2020) : 651–90. http://dx.doi.org/10.1108/f-10-2018-0125.

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Purpose The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent on the help of others is a crucial question in the European Union (EU). The housing stock in Europe is not fit to support a shift from institutional care to the home-based independent living. Some 90% of houses in the UK and 70%–80% in Germany are not adequately built, as they contain accessibility barriers for people with emerging functional impairments. The available reverse mortgage contracts do not allow for relocation to their own adapted facilities. How to finance the adaptation from housing equity is discussed. Design/methodology/approach The authors have extended the existing loan reverse mortgage model. Actuarial methods based on the equivalence of the actuarial present values and the multiple decrement approach are used to evaluate premiums for flexible longevity and lifetime long-term care (LTC) insurance for financing adequate facilities. Findings The adequate, age-friendly housing provision that is appropriate to support the independence and autonomy of seniors with declining functional capacities can lower the cost of health care and improve the well-being of older adults. For financing the development of this kind of facilities for seniors, the authors developed the reverse mortgage scheme with embedded longevity and LTC insurance as a possible financial instrument for better LTC services and housing with care in assisted-living facilities. This kind of facilities should be available for the rapid growth of older cohorts. Research limitations/implications The numerical example is based on rather crude numbers, because of lack of data, as the developed reverse mortgage product with LTC insurance is a novelty. Intensity of care and probabilities of care in certain category of care will change after the introduction of this product. Practical implications The model results indicate that it is possible to successfully tie an insurance product to the insured and not to the object. Social implications The introduction of this insurance option will allow many older adult with low pension benefits and a substantial home equity to safely opt for a reverse mortgage and benefit from better social care. Originality/value While currently available reverse mortgage contracts lapse when the homeowner moves to assisted-living facilities in any EU Member State, in the paper a new method is developed where multiple adjustments of housing to the functional capacities with relocation is possible, under the same insurance and reverse mortgage contract. The case of Slovenia is presented as a numerical example. These insurance products, as a novelty, are portable, so the homeowner can move in own specialised housing unit in assisted-living facilities and keep the existing reverse mortgage contract with no additional costs, which is not possible in the current insurance products. With some small modifications, the method is useful for any EU Member State.

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Fernández-Mayoralas, Gloria, Vicente Rodrı́guez et Fermina Rojo. « Health services accessibility among Spanish elderly ». Social Science & ; Medicine 50, n^o 1 (janvier 2000) : 17–26. http://dx.doi.org/10.1016/s0277-9536(99)00247-6.

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Tyrie, Christine M. « Mental health services in Germany ». Psychiatric Bulletin 16, n^o 01 (janvier 1992) : 40–42. http://dx.doi.org/10.1192/s0955603600106658.

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On a recent study trip I was able to examine approaches to health care, in particular, mental health services in what was West Germany. I visited a range of facilities and met a wide range of professional workers.

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Froneberg, Brigitte. « Occupational Health Services in Germany ». Policy and Practice in Health and Safety 5, sup1 (janvier 2007) : 73–86. http://dx.doi.org/10.1080/14774003.2007.11667703.

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Ozkiran, Umit. « Examination of health services for citizens ». LAPLAGE EM REVISTA 7, n^o 2 (7 janvier 2021) : 139–44. http://dx.doi.org/10.24115/s2446-6220202172696p.139-144.

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The aim of the study is to reveal the health services for disabled citizens upon accessibility and automation. The study relies on qualitative research which documentary analysis and self-report reflection of authorities form upon themes were employed. Automation and accessibility models and practice of social and health services from literature and workshop results revealed and compared with the results. System and welfare for the developing country needs automation and accessible services for disabled citizens. Physical and web accessibility create a big dilemma to reach services that needs to be considered urgently by governmental and institutional authorities.

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Zartaloudi, A. « Accessibility of migrants to mental health services ». European Psychiatry 65, S1 (juin 2022) : S138. http://dx.doi.org/10.1192/j.eurpsy.2022.374.

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Introduction Cultural barriers and prejudices of mental healthcare professionals may promote inequalities in the provision of care to immigrant population and have a negative impact in provided service quality. Objectives To identify barriers and facilitators of immigrants’ accessibility to mental health services. Methods A literature review has been made through PubMed database. Results Immigrants’ accessibility to mental health services may be related to social insurance problems, inadequate knowledge about their health rights, inadequate knowledge of the local language, as well as the bureaucracy of Greek State which may complicate mental health examination and treatment. The challenges faced by mental healthcare professionals in terms of diagnosis and treatment of migrants include communication difficulties due to linguistic and cultural differences as far as verbal presentation of symptoms and illness behavior is concerned. Culturally competent mental health professionals should work to erase racism and prejudice, to be familiar with cultural issues and have adequate knowledge related to cultural groups, to learn the life story of each patient separately and encourage patients to explain how their illness affects their lives, promoting a trustful communication environment in the context of healthcare provision. Conclusions Exploring the specific needs of migrants as well as assessing the degree of satisfaction from their access to healthcare services are essential to providing integrated mental health care for people from different culture. Disclosure No significant relationships.

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KANOWNIK, GRETA. « Patient Safety And Accessibility To Health Services ». Zeszyty Naukowe Uniwersytetu Szczecińskiego Finanse Rynki Finansowe Ubezpieczenia 85 (2017) : 609–20. http://dx.doi.org/10.18276/frfu.2017.1.85-49.

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Plomp, HN. « Accessibility and utilization of occupational health services ». Scandinavian Journal of Work, Environment & ; Health 22, n^o 3 (juin 1996) : 216–22. http://dx.doi.org/10.5271/sjweh.134.

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Forjanič, Miran, Valerij Dermol et Valentina Prevolnik Rupel. « Factors affecting dental services accessibility ». Obzornik zdravstvene nege 53, n^o 4 (16 décembre 2019) : 269–79. http://dx.doi.org/10.14528/snr.2019.53.4.2984.

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Introduction: Access to dental services is a basic right included in the compulsory health insurance for patients and thus an important part of the healthcare system in Slovenia. The purpose of this research was to identify and explore the factors that have the greatest impact on the accessibility of dental services from the perspective of the system stakeholders in Slovenia.Methods: A qualitative study was conducted based on the focus group method. The focus group consisted of relevant system stakeholders, namely two representatives of the regulator, provider and payer, a total of six participants. A thematic analysis was carried out in order to identify the patterns and themes within thequalitative data obtained.Results: The results of the focus group revealed the views of system stakeholder on the accessibility of dental services in Slovenia. According to the system stakeholders' perspective, accessibility of dental services in Slovenia is not optimal and significant changes in terms of financing and organisation are required.Discussion and conclusion: We found that the lack of adequate human resources, insufficient health insurance and payment for services are the crucial factors in providing adequate access to dental health in Slovenia. In order to increase its accessibility, the dental programme needs to be expanded and the number of teams for its implementation increased.

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Chen, Yuehong, Yuyu Li, Guohao Wu, Fengyan Zhang, Kaixin Zhu, Zelong Xia et Yu Chen. « Exploring Spatiotemporal Accessibility of Urban Fire Services Using Real-Time Travel Time ». International Journal of Environmental Research and Public Health 18, n^o 8 (15 avril 2021) : 4200. http://dx.doi.org/10.3390/ijerph18084200.

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The accessibility of urban fire services is a critical indicator in evaluating fire services and optimizing fire resource allocation. However, previous studies have mainly concentrated on measuring the spatial accessibility of fire services, and little, if any, consideration has been paid to exploring the spatiotemporal dynamics of the accessibility of urban fire services. Therefore, we used real-time travel time to extend an existing spatial accessibility method to measure the spatiotemporal accessibility of fire services in a case study of Nanjing, China. The results show that (1) the overall accessibility of fire incidents and fire stations in Nanjing, China, is uneven, with relatively high accessibility in the southwest and northeast of the city center; (2) the number of fire incidents with low-level accessibility apparently increases in rush hours (i.e., 07:00–09:00 and 17:00–19:00 h) in the southeast and north of the city center, and the fire incidents with medium-level and high-level accessibility easily change to lower levels under the influence of traffic congestion, with fire incidents with medium-level accessibility being affected the most; (3) the accessibility of fire stations changes over time with an obvious W pattern, with lower accessibility during rush hours than at other times, and several fire stations in the city center present an asymmetric W pattern; (4) the accessibility decline ratio for fire stations in rush hours is greater in the city center than in urban suburbs, and the decline ratios are strongly related to the travel time increase and the percent increase in uncovered fire incidents during rush hours. The results and findings demonstrate that our method can be used to explore the spatiotemporal dynamics of the accessibility of fire services, and so can guide policymakers in improving fire services.

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Arca, Muhammed, et Günay Saka. « Health Services Accessibility And Expectations of Disabled People ». Eurasian Journal of Family Medicine 8, n^o 2 (26 juin 2019) : 69–77. http://dx.doi.org/10.33880/ejfm.2019080203.

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Aim: In this study, it was aimed to investigate the distribution of disability types, treatment and rehabilitation needs, utilization of the basic services provided, and determination of expectations of disabled persons. Methods: This descriptive study was carried out in Hazro district of Diyarbakır. Of the 1069 individuals screened by a cross-sectional study, 148 disabled individuals were identified. A face-to-face meeting was provided with the families of these disabled individuals. The demographic characteristics of the disabled person, information on the types of disability, the use of health services and the questionnaire form which asks the expectation status were used. Results: The prevalence of disability was 13.8%. 51.3% of the disabled were male, 48.2% were not literate and 16.7% did not have any social security. It was determined that 37.8% of people with disabilities did not receive treatment for their disability and 98.0% did not benefit from rehabilitation services. It was found that 70.9% of the disabled did not receive education, 60.1% of them did not know about vocational and skill courses and 51.4% of them could not benefit from public transportation services. Families stated that, the disabled people do not go to any institution or rehabilitation center with 44.8% because of absence in the close environment; 26.9% stated that they do not know if there is any. It was found that the most important expectation of 50% of disabled people and their families from institutions and organizations is to provide health services easily. Conclusion: Disabled persons have difficulty in accessing health services and cannot benefit from rehabilitation services. Basic services such as education, vocational courses and public transport are also insufficient. In this sense, health and social service institutions have important duties.

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Martin, Emma, et Gay Rabie. « Looking at the accessibility of sexual health services ». British Journal of School Nursing 5, n^o 10 (10 décembre 2010) : 508–11. http://dx.doi.org/10.12968/bjsn.2010.5.10.508.

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Ferreira, Rita, Nuno Marques da Costa et Eduarda Marques da Costa. « Accessibility to urgent and emergency care services in low-density territories : the case of Baixo Alentejo, Portugal ». Ciência & ; Saúde Coletiva 26, suppl 1 (juin 2021) : 2483–96. http://dx.doi.org/10.1590/1413-81232021266.1.40882020.

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Abstract Access to health care is a sensitive issue in low population density territories, as these areas tend to have a lower level of service provision. One dimension of access is accessibility. This paper focuses on measuring the accessibility to urgent and emergency care services in the Portuguese region of Baixo Alentejo, a territory characterized by low population density. Data for the calculation of accessibility is the road network, and the methodology considers the application of a two-level network analyst method: time-distance by own mean (car or taxi) to the urgent care services and the time distance to emergency services as a way to get assistance and to go to urgent care services. While urgent care accessibility meets the requirements stipulated in the Integrated Medical Emergency System’s current legislative framework, the simulation of different scenarios of potential accessibility shows intra-regional disparities. Some territories have a low level of accessibility. Older adults, the poorly educated, and low-income population, also have the lowest levels of accessibility, which translates into dually disadvantageous situation since the potential users of emergency services are most likely to belong to this group of citizens.

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Hu, Jinrong, Yuyuan Zhang, Le Wang et Victor Shi. « An Evaluation Index System of Basic Elderly Care Services Based on the Perspective of Accessibility ». International Journal of Environmental Research and Public Health 19, n^o 7 (2 avril 2022) : 4256. http://dx.doi.org/10.3390/ijerph19074256.

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Population aging has become more and more severe in many countries. As a result, the demand for basic elderly care services has risen. The establishment of an evaluation index system for basic elderly care services can provide guidelines for governments to improve the quality of such services. Based on the “5A” theoretical analysis framework of Penchansky and Thomas, this paper introduces the concept of “accessibility” into evaluation. The “accessibility” model of services, through a literature review, field research, and three rounds of expert correspondence, consists of three first-level indicators, including the accessibility of home-based community elderly care services, the accessibility of institutional elderly care services, and the accessibility of administrative services. The evaluation index system of 15 s-level indicators and 70 third-level indicators, using AHP to determine the weight value of each indicator, provides a quantitative basis for the quality evaluation and improvement of basic elderly care services. Based on our quantitative results, policy recommendations are put forward: strengthen the support for the human and financial resources of community home-based elderly care services; improve the affordability of basic elderly care services; increase the types and numbers of institutional elderly care service projects; improve the availability and adaptability of institutional elderly care services; improve the accessibility of administrative services so that elderly care service institutions and elderly care administrative agencies can establish an effective communication and feedback mechanism.

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Sandre, Anthony Robert, et K. Bruce Newbold. « Telemedicine : Bridging the Gap between Refugee Health and Health Services Accessibility in Hamilton, Ontario ». Refuge : Canada's Journal on Refugees 32, n^o 3 (23 novembre 2016) : 108–18. http://dx.doi.org/10.25071/1920-7336.40396.

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Refugees face considerable challenges upon seeking asylum in Canada, and accessing health care services remains a prominent issue. Recurrent themes in the literature outlining barriers to health-services accessibility include geographic, economic, and cultural barriers. Drawing on the experiences of service providers in Hamilton, Ontario, we explored the efficacy of telemedicine services in bridging the gap between refugee health and health services accessibility. Research methodology included structured interviews with clinicians who provide health-care services to refugees, complemented by a scoping literature review. The results of this exploratory study demonstrate the efficacy of telemedicine in encouraging dialogue and policy change in the greater health-care setting, and its potential to increase access to specialist health-care services.

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Edelman, Debra. « University Health Services Sponsoring Lesbian Health Workshops : Implications and Accessibility ». Journal of American College Health 35, n^o 1 (juillet 1986) : 44–45. http://dx.doi.org/10.1080/07448481.1986.9938964.

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Baumeister, Sebastian E., Christian Meyer, Daisy Carreon, Jennis Freyer, Hans-Jürgen Rumpf, Ulfert Hapke, Ulrich John et Dietrich Alte. « Alcohol Consumption and Health-Services Utilizationin Germany ». Journal of Studies on Alcohol 67, n^o 3 (mai 2006) : 429–35. http://dx.doi.org/10.15288/jsa.2006.67.429.

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Lee, Sangwan. « Spatial and Socioeconomic Inequalities in Accessibility to Healthcare Services in South Korea ». Healthcare 10, n^o 10 (17 octobre 2022) : 2049. http://dx.doi.org/10.3390/healthcare10102049.

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This study explored questions of (1) whether certain areas of South Korea experienced inequal accessibility to public health centers, private hospitals/clinics, and general hospitals by car and public transportation using gaussian mixture models (GMM) and (2) whether socially disadvantaged socioeconomic groups faced disproportionate burdens on accessibility to the multi-tier healthcare services employing ordinary least square regression models (OLS). This study used nationwide accessibility indicators in South Korea measured by Korea Transport Institute in 2019. The main findings were as follows: First, the results of the GMM indicate that the degree of accessibility to healthcare services was significantly lower in rural, mountainous, and seaside locations compared to metropolitan areas. Second, there was more considerable inequality in public transportation accessibility than car accessibility. Third, the findings of the OLS reveal a significant relationship between accessibility indicators and socioeconomic variables, such as age, gender, disability, and residential location, which indicates socioeconomic inequality in accessibility in South Korea. This study contributes to shedding light on understanding the spatial and socioeconomic inequality in accessibility across the nation and offering policy implications.

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Islam, Md Ziaul, Farhana Zaman, Sharmin Farjana et Sharmin Khanam. « Accessibility to Health Care Services of Upazila Health Complex : Experience of Rural People ». Journal of Preventive and Social Medicine 38, n^o 2 (28 juin 2020) : 30–37. http://dx.doi.org/10.3329/jopsom.v38i2.47862.

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Background: Upazila health complex (UHC) is the first referral health facility at primary level of health care delivery system in the country. Rural people attend the UHCs to meet their health care needs and demands. But accessibility of the rural people to the UHCs is still not up to the mark. Objective: This study was conducted to assess accessibility of rural people to health care services of UHC. Methods: The study was a cross-sectional study, which was conducted at the Kaliakair UHC of Gazipur district in Bangladesh during the period from January to December 2016. The study included 300 rural adults, who were selected systemically. Data were collected by face-to-face interview with the help of a semi-structured questionnaire. Prior to data collection, informed written consent was taken from each participant. Results: The study revealed that males (51.3%) and females (48.7%) were very close in proportion with mean age of 35.73(±11.74) years. More than three fourth (77.3%) were married and 31.3% had primary education while 28.7% were illiterate. One third was housewives; average family size was 5.43 (±2.54) and average monthly family income was Tk.13920 (±10290.75). Around half of the participants choose the UHC for effective treatment and due to close distance from their residence while one third for low cost treatment and free of cost treatment. Around half of them didn‟t find any display board at the UHC. More than three fourth (82.0%) regarded doctor‟s behavior as „Good‟ while behavior of supporting staff was regarded „Good‟ by 66.0% participants. About half of the participants went to the UHC by rickshaw and 32.0% on foot. Average waiting time was 23.99 (±15.07) minutes to get access to treatment. Off all, 62.0% got full course of prescribed drugs but majority (71.3%) didn‟t get access to advised laboratory facility. Most (82.7%) could not be admitted in the hospital due to insufficient bed (24.2%) and inadequate treatment facility (22.6%), manpower (62.8%) and drug supply. Overall accessibility to UHC was „good‟ (21.3%) followed by „average‟ (31.3%) and „poor‟ (47.3%). It was found that females (53.3%) had significantly (p<0.05) poor accessibility to the UHC services than their counterpart males (41.1%). On the contrary, young adults, elderly, illiterate and primary education groups had significantly (p<0.05) „poor‟ accessibility to UHC services. Higher education (42.9% Masters and 36.4% Graduates) group had significantly „good‟ accessibility. More than half (53.1%) of the service holders and majority (60.0%) of higher income (Tk.30001-50000) group had had „average‟ and „good‟ accessibility respectively, which is statistically significant (p<0.05). Barriers to accessibility included long waiting time (67.0%), inadequate drug supply (62.0%), limited laboratory facility (40.0%), inadequate manpower (37.9%) and poor cooperation of the staff (32.0%) and communication (18.4%). Conclusion: To improve accessibility of the rural people to the health care services of the UHC, associated problems must be overcome by effective measures and program interventions. JOPSOM 2019; 38(2): 30-37

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Jankowski, Piotr, et Blake Brown. « Health Care Accessibility Modeling : Effects of Change in Spatial Representation of Demand for Primary Health Care Services ». Quaestiones Geographicae 33, n^o 3 (1 septembre 2014) : 39–53. http://dx.doi.org/10.2478/quageo-2013-0028.

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Abstract Health care accessibility can be measured by the number of prospective patients who could reach a medical facility within a prescribed time limit. The representation of health care demand in estimating accessibility is an important consideration since different spatial aggregations of demand have different consequences with regard to accessibility estimates. This article examines the effects of aggregating population demand for primary health care, ranging from census tract to aggregated census block, on estimates of primary health care accessibility. Spatial representations of aggregated demand were incorporated into a location-allocation model in order to determine a measure of accessibility represented by the unmet demand for primary health care services. The model was implemented for the U.S. State of Idaho, based on the allocation of Idaho residents’ demand for primary health care to the state’s existing primary health care facilities. The results confirm a relationship between the level of demand aggregation and the level of potential accessibility. In case of a rural state such as Idaho the relationship is positive; higher levels of aggregation result in higher measures of accessibility.

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Tuczyńska, Magdalena, Maja Matthews-Kozanecka, Arkadiusz Nowak et Ewa Baum. « How the COVID-19 Pandemic Affected the Accessibility and Quality of Health Services in Poland ». Studies in Logic, Grammar and Rhetoric 66, n^o 3 (1 décembre 2021) : 561–72. http://dx.doi.org/10.2478/slgr-2021-0032.

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Abstract The outbreak of the COVID-19 pandemic had an impact on the global economy, including the provision of health services, with medical facilities and patients cancelling or postponing medical appointments. An alternative to in-person appointments was through the available forms of telemedicine. Scientific reports around the world have suggested that the accessibility and quality of health services declined. The aim of this study was to investigate the accessibility and quality of health services in Poland and to verify whether there were differences between men and women in this respect. The study was based on the authors’ own survey questionnaire filled in by 265 respondents, including 181 women, 82 men, and 2 persons without a defined gender. The study revealed that during the COVID-19 pandemic, the accessibility and quality of health services declined. Additionally, women were more likely to use general and specialist health services than men, but a comparison of changes in the assessment of accessibility and quality of services by gender revealed no differences in the assessment of accessibility and quality.

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Heinz, A., S. Krieg, C. Hunner et S. Penka. « Accessibility of drug treatment institutions for migrants in Germany ». European Psychiatry 17 (mai 2002) : 218. http://dx.doi.org/10.1016/s0924-9338(02)80931-2.

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Mokhethi, Maluke, et Cheryl M. E. McCrindle. « The accessibility to oral health services in Lesotho’s public health sector ». South African Dental Journal 77, n^o 05 (11 août 2022) : 264–69. http://dx.doi.org/10.17159/2519-0105/2022/v77no5a2.

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Lesotho is a land-locked mountainous country in Southern Africa. Both geography and poverty impact on dental health in low-income patients. Information on the number and function of dentists and dental therapists in public hospitals, are lacking. The aim was to investigate accessibility to oral health services. Objectives were to investigate the number and geographical distribution of oral health personnel and document the availability of dental services in Lesotho. A cross-sectional mixed methods study design was used. Four dental therapists of the six employed by the government, participated in in-depth interviews. Questionnaires about access to oral health services were administered to government employed dentists. The Lesotho National Department of Oral Health provided information regarding dental patient statistics between 2017 and 2019. It was found that 20 dentists and 10 dental therapists provided limited dental services in public facilities. In 2017, 2018 and 2019; the annual numbers of dental patients were 85 776, 75 148 and 97 425 respectively. Approximately 40% of patients visited two hospitals in Maseru. It was concluded that there was a shortage of oral health personnel, resulting in inadequate access to dental services, particularly in rural areas.

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Ayandiji, A. « Accessibility of youths to health care in Nigeria ». Journal of Agriculture, Forestry and the Social Sciences 11, n^o 2 (17 février 2015) : 92–97. http://dx.doi.org/10.4314/joafss.v11i2.9.

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The youths of Nigeria cover up to 60% of the entire Nigeria population. Youths are a symbol of a town or village with potentials to perform strenuous work and constitute essential human resources for development. Youths are not excluded from health issues facing the generality of the human population. This study examines the accessibility of youths to the various health facilities available, the cost of services provided and also the relationship between the health facilities available and the cost of services provided. The National baseline survey report of 2012 was used. Three States were randomly selected from each of the six geopolitical zones of the country. Majority of the respondents patronized public hospitals than other health institutions. Most youths claimed that the cost of services provided were moderate. There is a significant relationship between health care alternatives available and cost of services. There should be more sensitization for the youth to take their health seriously and patronize health facilities where adequate examination can be carried out.Key words: Youth, Accessibility, Nigeria.

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Al-Taiar, Abdullah, Allan Clark, Joseph C. Longenecker et Christopher JM Whitty. « Physical accessibility and utilization of health services in Yemen ». International Journal of Health Geographics 9, n^o 1 (2010) : 38. http://dx.doi.org/10.1186/1476-072x-9-38.

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Naing, Sa Hlyan Htet, Sang-Arun Isaramalai et Phen Sukmag. « Policy Literacy, Barriers, and Gender Impact on Accessibility to Healthcare Services under Compulsory Migrant Health Insurance among Myanmar Migrant Workers in Thailand ». Journal of Environmental and Public Health 2020 (29 décembre 2020) : 1–8. http://dx.doi.org/10.1155/2020/8165492.

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Accessibility to health service and experience of healthcare are important factors for public health policymaking. The current study aimed to describe the status of accessibility and barriers to getting care as well as policy literacy among Myanmar migrant workers and ultimately to identify the predictors of accessibility to healthcare services among this population through Thailand’s Compulsory Migrant Health Insurance (CMHI). A cross-sectional survey was used to collect data from 240 Myanmar migrant workers who were 18 years or older, resided in Songkhla Province, and had Compulsory Migrant Health Insurance. The instrument was a set of questionnaires consisting of a Personal Data Form, Policy Literacy Questionnaire, Barriers to Get Care Questionnaire, and Accessibility to Healthcare Services Questionnaire. Descriptive statistics, correlation analysis, and multiple regression analysis were used to analyze data. The majority of participants had a high level of policy literacy (36.3%), barriers to get care (34.2%), and accessibility to health care services (35.8%). Policy literacy (β = 0.35, p < 0.001 ), barriers to get care (β = −0.32, p < 0.001 ), and gender ( p < 0.001 ) were significant predictors of accessibility to healthcare services and could explain 43.2% of the total variance. To increase the accessibility to healthcare services among migrant workers with Compulsory Migrant Health Insurance, public health policymakers are recommended to cooperate more with healthcare staff and the workers’ employers to enhance the distribution of information about the health insurance to decrease barriers to get care.

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Arrivillaga, Marcela. « Assesing Health Services in Colombia : Development of a Conceptual Framework and Measurement tools based on primary data ». SAGE Open 11, n^o 2 (avril 2021) : 215824402110168. http://dx.doi.org/10.1177/21582440211016844.

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Colombia has a mixed public-private health care system, and although official data indicate more than 95% of health coverage, research in this field has demonstrated the persistence of barriers to accessing health care services. This study aimed to analyze the conceptual framework of health services accessibility and develop measurement tools for its assessment using primary data and also to propose a method for ascertaining health services accessibility and availability using a territory-based approach. A mixed method study with concurrent design was carried out in four phases between 2014 and 2017. The starting points were a review of the literature and a documentary research that identified five conceptual frameworks for health services accessibility published between 1970 and 2013. It was found that the theoretical concept of health services availability has not been clear; the literature does not define it explicitly and does not differentiate it from the concept of health coverage. As a result, two measurement tools were developed: a Health Care Services Accessibility Household Survey and a Health Care Services Availability Questionnaire. These tools and the proposed method for ascertaining health services accessibility can be useful for government, institutions, and social and scientific organizations to monitor progress in guaranteeing the fundamental human right to health, declared in the Health Organic Law issued in 2015 in Colombia.

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Hailemeskal, Meklit Berhan, Yuliia Sereda, Alisher Latypov, Tetiana Kiriazova et Nata Avaliani. « Perceived quality of HIV care and client satisfaction across different service providers in Ukraine ». European Journal of Public Health 30, n^o 1 (3 juillet 2019) : 23–30. http://dx.doi.org/10.1093/eurpub/ckz124.

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Abstract Background Prior studies have shown that high client satisfaction and quality of services are important drivers of uptake and retention in human immunodeficiency virus (HIV) care. Study objectives were to assess the perceived quality of HIV services, satisfaction and associated factors across different types of health facilities in Ukraine. Methods We conducted a cross-sectional study among 649 individuals receiving HIV services across 47 health facilities in three regions of Ukraine. Primary outcomes were satisfaction and perceived quality of services measured along five dimensions: accessibility, user-friendliness, privacy and confidentiality, comprehensiveness (separately for testing and treatment services). Quality dimensions were constructed by confirmatory factor analysis. Links between quality dimensions, satisfaction and related factors were measured by structural equation modelling. Results Median scores for accessibility, user-friendliness, privacy and confidentiality, comprehensiveness of services and overall satisfaction ranged from 0.75 to 1 out of 1. User-friendliness was the main determinant associated with satisfaction (total effect: β = 0.515, P < 0.001). Satisfaction was higher at primary healthcare centres (direct effect: β = 0.145, P < 0.001; indirect effect through accessibility: β = 0.060, P < 0.001), narcological/tuberculosis dispensaries (direct effect: β = 0.105, P = 0.006; indirect effect through accessibility: β = 0.060, P < 0.001) and hospitals (indirect effects through user-friendliness and accessibility: β = 0.180, P < 0.001) when compared to acquired immune deficiency syndrome centres. Conclusions User-friendliness is a key driver of client satisfaction with HIV services in Ukraine. Decentralization of services, together with improved training and supervision for provider–client interactions may provide important levers to improve client satisfaction with HIV services and enrolment and retention in the cascade of HIV services.

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Sutan, Rosnah, et Pinta Pudiyanti Siregar. « Reproductive health practices and use of health services among immigrant Indonesian women working in Malaysia ». Revista de Saúde Pública 56 (24 juin 2022) : 55. http://dx.doi.org/10.11606/s1518-8787.2022056003811.

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OBJECTIVE To describe the reproductive health practices of immigrant Indonesian women working in Malaysia and their accessibility to health services. METHODS A cross-sectional study using a validated self-administered questionnaire was conducted with 593 immigrant Indonesian workers who stayed in Malaysia for at least six months and within the reproductive age group. RESULTS About 13.5% of the respondents have used health facilities for reproductive health-related problems. Less than half of the respondents preferred to use public health facilities. Only 15% used treatment available in health facilities related to irregular menstrual cycles (34.6%), severe dysmenorrhea (58.7%) and nonspecific symptoms related to menstruation (31.7%). Family planning services were the most required health service. However, only 31.5% met the needs for family planning services. One-third of the respondents had sexual reproductive health problems and required treatment, but only 9.9% sought reproductive health services when needed. CONCLUSIONS Strategies to improve the accessibility to sexual reproductive health services requires a collaboration between the Indonesian government representatives in Malaysia and non-governmental organizations to address the reproductive health issues among immigrant Indonesian women in Malaysia. Health policy related to immigrant workers is needed in order to enhance the accessibility to women’s health needs for universal health coverage.

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Delva, Nicholas, Simon Patry, Peter Chan, Murray Enns, Jeanne Ferguson, Ian Gilron, Caroline Gosselin et al. « Geographic Accessibility of ECT Services in Canada ». Journal of ECT 25, n^o 2 (juin 2009) : 149. http://dx.doi.org/10.1097/01.yct.0000344114.66628.b5.

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Fauk, Nelsensius Klau, Maria Silvia Merry, Theodorus Asa Siri, Fabiola Tazrina Tazir, Mitra Andhini Sigilipoe, Kristin Oktanita Tarigan et Lillian Mwanri. « Facilitators to Accessibility of HIV/AIDS-Related Health Services among Transgender Women Living with HIV in Yogyakarta, Indonesia ». AIDS Research and Treatment 2019 (1 juillet 2019) : 1–10. http://dx.doi.org/10.1155/2019/6045726.

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The study aimed to explore facilitators or enabling factors that enhance accessibility (defined as the opportunity to be able to use) to HIV/AIDS-related health services among HIV positive transgender women, also known as Waria in Yogyakarta, Indonesia. A qualitative study employing one-on-one in-depth interviews was conducted from December 2017 to February 2018. Participants were HIV positive Waria recruited using purposive and snowball sampling techniques. Data were analysed using the framework analysis for qualitative research. The findings showed that participants’ knowledge of HIV/AIDS and the availability of HIV/AIDS-related health services were enablers to the services accessibility. Emotional support from fellow Waria displayed in various ways, such as kind and caring attention, attentive listening, and encouraging words, was an important social support that played a role in supporting Waria’s accessibility to the services. HIV/AIDS-related health service information shared personally or jointly by fellow Waria and instrumental support including helping each other to collect antiretroviral (ARV) from hospitals or community health centres, contacting ambulance in emergency situations, accompanying each other to health service facilities, and helping those without the health insurance to receive free health services were also the social support enabling accessibility to the services among the study participants. Appraisal support such as providing constructive feedback and affirmation was another enabling factor to Waria’s accessibility to the services. The findings indicate the needs to broadly disseminate information and educate Waria populations and their significant others about HIV/AIDS and related health services to raise their awareness of HIV/AIDS and acceptance of HIV/AIDS positive individuals. Educating and broadly disseminating this information in other settings in the country will also increase accessibility to the HIV/AIDS services among Waria, their families, and communities addressing the currently existing inequities in health. The findings also reinforce the importance of the establishment of Waria peer-support groups within Waria communities and the involvement of Waria in HIV/AIDS activities and programs, which may increase their awareness of HIV/AIDS, and accessibility to HIV/AIDS-related health services.

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Gutting, Robin, Maria Gerhold et Stefanie Rößler. « Spatial Accessibility in Urban Regeneration Areas : A Population-Weighted Method Assessing the Social Amenity Provision ». Urban Planning 6, n^o 4 (17 novembre 2021) : 189–201. http://dx.doi.org/10.17645/up.v6i4.4425.

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Principles of social sustainability serve to guide urban regeneration programmes around the world. Increasingly, the upholding of these principles is subject to qualified evaluation and monitoring. One of the cornerstones of social sustainability is access to basic services. This is also a strategic and operational objective in urban regeneration measures. While indicator-based evaluations of accessibility do exist, hitherto they have tended to apply descriptive statistics or density parameters only. Therefore, there is a need for small-scale, regularly updated information on accessibility, such as the nearest facility based on street networks and population density. This deficit can often be attributed to the complex methodological requirements. To meet this need, our article presents a method for determining the spatial accessibility of basic services with low data requirements. Accessibility is measured in walking time and linked to the local population distribution. More specifically, GIS tools in connection with land survey data are used to estimate the number of inhabitants per building; the walking time needed to reach four types of social amenity along the street network is then determined for each building; finally, a population-weighted accessibility index is derived and mapped in a 50-m grid. To test this method, we investigated four urban regeneration areas in Dresden, Germany. The results show that with freely available geodata, it is possible to identify neighbourhoods and buildings with both high population densities and poor accessibility to basic services. Corresponding maps can be used to monitor urban regeneration measures or form a basis for further action.

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Zhang, Jiawei, Peien Han, Yan Sun, Jingyu Zhao et Li Yang. « Assessing Spatial Accessibility to Primary Health Care Services in Beijing, China ». International Journal of Environmental Research and Public Health 18, n^o 24 (14 décembre 2021) : 13182. http://dx.doi.org/10.3390/ijerph182413182.

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Primary health care has been emphasized as a pillar of China’s current round of health reforms throughout the previous decade. The purpose of this study is to analyze the accessibility of primary health care services in Beijing and to identify locations with a relative scarcity of health personnel. Seven ecological conservation districts, which are relatively underdeveloped, were selected in the study. The Gini coefficient and Lorenz curve, as well as the shortest trip time and modified two-step floating catchment area (M2SFCA) approach, are used to quantify inequalities in primary health care resources and spatial accessibility. The Gini coefficient of primary medical services was calculated as high as 0.705, showing a significant disparity in primary care services. A total of 81.22% of communities reached the nearest primary care institution within 15 min. The average accessibility of primary healthcare services, as measured by the number of health professionals per 1000 population, was 2.34 in the 1715 communities of seven ecological conservation districts. Three hundred and ninety-one communities (22.80%) were identified with relatively low accessibility. More primary health professionals should be allocated to Miyun, Mentougou, and Changping Districts. Overall, the primary healthcare resources were distributed unevenly in most districts. According to our study, expanding primary healthcare institutions, increasing the number of competent health professionals, and enhancing road networks will all be effective ways to increase spatial accessibility and reduce primary healthcare service disparity in Beijing.

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Krafft, V., et E. Rösch. « OP0329-PARE IN SHORT : EASY-TO-UNDERSTAND INFORMATION FOR VULNERABLE GROUPS ». Annals of the Rheumatic Diseases 79, Suppl 1 (juin 2020) : 202.1–202. http://dx.doi.org/10.1136/annrheumdis-2020-eular.4240.

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Background:Some 800,000 people in Switzerland have trouble reading (1). For people with reading or learning difficulties, many texts are too complex or simply too long. People with a migrant background likewise often lack access to health information, in their case due to language barriers.Objectives:One of the top priorities set out in Switzerland’s “National Strategy on Musculoskeletal Diseases (2017–2022) is to develop low-threshold services for vulnerable groups. In keeping with this strategy, the Swiss League against Rheumatism (SLR) wants to reach out to people with a migrant background as well as those with reading difficulties by making available to them helpful and readily understandable information material on rheumatic diseases.Methods:During the planning phase, the SLR collaborated with migesplus, the portal for equal health opportunities operated by the Swiss Red Cross. Their input flowed into the conception of the new publication series “kurz & knapp” (in short).The texts for the new series are written in accordance with the rules for Easy Language, with the help of an expert committee from Pro Infirmis, the Swiss professional organisation for people with disabilities (www.buero-leichte-sprache.ch). After being evaluated, the final texts then receive a seal of approval. Easy Language is a key component of accessibility, because it makes complex content accessible to a wider audience.For the benefit of people with a migrant background, the SLR has the texts translated not only into the three Swiss national languages German, French and Italian but also into Albanian, Bosnian/Croatian/Montenegrin/Serbian, Portuguese, Spanish and Turkish.Brochures on “Gout” and “Arthrosis” have already been published in the “kurz & knapp” series. In 2020, a publication on the subject of “Back Pain” will follow.In order to make the publications known to the intended target groups, the SLR wrote to various multipliers, such as immigration offices and foreign media.The publications are available free of charge in the online shop.Results:The new series “kurz & knapp” has been commended in particular by migration experts. Within the last ten months, the SLR has already distributed over 1,000 copies.Conclusion:To reach people with reading difficulties or a migrant background – groups that make up a large part of the Swiss population – specially designed communication tools are needed. An interdisciplinary network is indispensable for the development and dissemination of such tools.References:[1]Notter, P. & Arnold, C (2006). Lesen und Rechnen im Alltag: Grundkompetenzen von Erwachsenen in der Schweiz. Swiss Federal Statistical Office (BFS). Accessed on 28 January 2020:https://www.lesen-schreiben-schweiz.ch/myUploadData/files/ALL-StudieD.pdfDisclosure of Interests:Valérie Krafft Grant/research support from: Yes, Menarini AG (for gout brochure), Eva Rösch: None declared

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Valladares-garrido, Mario J., Laura M. Ccosco-blas, Paula Gutiérrez, Paola J. Ramos-rupay, Alix X. Rivera-pinto, Andrea S. Velarde-Tello, Deyanira Vertiz-cuadra et Fiorella Inga-berrospi. « Factors Associated with Accessibility in Seven Peruvian Primary Health Care Facilities ». Pakistan Journal of Medical and Health Sciences 15, n^o 8 (30 août 2021) : 2301–6. http://dx.doi.org/10.53350/pjmhs211582301.

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Introduction: There is limited evidence on factors associated with access to health primary health care services in users of marginal urban areas of Lima, Peru. Objective: To determine factors associated with access to primary health care services in Lima, Peru. Material and Methods: Cross-sectional study in users treated at seven primary health care facilities in a marginal urban area of Lima, Peru in 2019. A questionnaire was used to measure accessibility to health services; demographic and socioeconomic factors and characteristics of health services were investigated as well. Simple and multiple regression analyses were performed, estimating prevalence ratios. Results: Out of a total of 150 participants, 85.2% had access to health services. Female gender was positively associated with access to health services (aPR:1.17, 95% CI:1.11-1.23). Secondary education (aPR:0.65, 95% CI:0.44-0.98) and higher technical education or armed forces (aPR:0.64, 95%CI:0.46-0.89) were negatively associated with access to health services. On the other hand, we found that waiting time for care reduces the possibility of accessing health care; in case wait time is more than 30 minutes (aPR:0.83, 95% CI: 0.77-0.95), more than one hour (RPa:0.85, CI95%:0.75-0.95) and more than two hours (RPa:0.84, CI95%:0.75-0.93). Conclusions: The majority of users treated at the Primary Health Care facilities had access to health services. Having a higher educational level and reporting a longer waiting time for care were associated with a lower frequency of accessibility, while being a woman was associated with a higher frequency of accessibility. Key words: Health services, primary health care, health services accessibility, delivery of health care, public health.

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Tao, Zhuolin, et Qi Wang. « Facility or Transport Inequality ? Decomposing Healthcare Accessibility Inequality in Shenzhen, China ». International Journal of Environmental Research and Public Health 19, n^o 11 (4 juin 2022) : 6897. http://dx.doi.org/10.3390/ijerph19116897.

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Accessibility to healthcare services is crucial for residents’ wellbeing. Numerous studies have revealed significant spatial inequality in healthcare accessibility across various contexts. However, it still remains unclear whether the inequality is caused by the unbalanced spatial distribution of healthcare facilities or by unequal transport access to them. This study decomposes inequality in healthcare accessibility into facility- and transport-driven inequality by comparing scenarios of healthcare accessibility, which consider various combinations of multidimensional components of accessibility using different distance measures. Using a case study in Shenzhen, this study reveals that both facility distribution and transport access substantially contribute to spatial inequality in healthcare accessibility. Facility distribution accounts for 61.3% and 50.8% of the overall accessibility inequality for driving and transit modes, respectively. The remaining inequality is induced by imbalanced mobility provided by transport networks. Furthermore, the impact of transport component on healthcare accessibility is unevenly distributed. This study highlights that both facility- and transport-related countermeasures should be considered to improve the accessibility and equality of healthcare services. It provides transferable methods for quantitatively decomposing facility- and transport-driven inequality in accessibility to healthcare or other facilities.

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