Articles de revues : « Health services accessibility – Sweden »

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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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Westerlund, Tommy, et Bertil Marklund. « Community pharmacy and primary health care in Sweden - at a crossroads ». Pharmacy Practice 18, n^o 2 (2 mai 2020) : 1927. http://dx.doi.org/10.18549/10.18549/pharmpract.2020.2.1927.

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The overall goal of Swedish health care is good health and equitable care for the whole population. The responsibility for health is shared by the central government, the regions, and the municipalities. Primary care accounts for approximately 20 percent of all expenditures on health care. About 16% of all physicians work in primary health. The regions have also employed a large number of clinical pharmacists, usually hospital-based, but many perform a variety of different primary care services, the most common of which is patient medication reviews. Swedish primary health care is at a crossroads facing extensive challenges, due to changes in demography and demanding financial conditions. These changes necessitate large transformations in health services and delivery. Current Government inquiries have primarily focused on two ways to meet the challenges; a shift towards more local care requiring a transfer of resources from hospital care, and a further development of structured digi-physical care, that is both digital (“online doctors”) and physical accessibility of care. While primary care at present is undergoing processes of change, community pharmacy has done so during the past decade since the re-regulation of the Swedish pharmacy market. A monopoly was replaced by a competitive system, where five pharmacy chains now share most of the market, a competition that has made community pharmacy very commercialized. A number of different, promising primary care services are being offered, but they are usually delivered on a small scale due to a lack of remuneration and philosophy of providers. Priority is given to sales and fast dispensing of prescriptions, often with a minimum of counseling. Reflecting primary health care, community pharmacy in Sweden is at a crossroads but currently has a golden opportunity to choose a route of collaboration with primary health care in its current transformation into more local and digi-physical care. A major challenge is that primary health care inquires, strategic plans, and national policy documents usually do not include community pharmacy as a partner. Hence, community pharmacy have to be proactive and seize this chance of changes in primary health policy and organization in order to become an important link in the chain of health care delivery, or there is a significant risk that it will predominantly remain a retail business.

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Westerlund, Tommy, et Bertil Marklund. « Community pharmacy and primary health care in Sweden - at a crossroads ». Pharmacy Practice 18, n^o 2 (2 mai 2020) : 1927. http://dx.doi.org/10.18549/pharmpract.2020.2.1927.

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The overall goal of Swedish health care is good health and equitable care for the whole population. The responsibility for health is shared by the central government, the regions, and the municipalities. Primary care accounts for approximately 20 percent of all expenditures on health care. About 16% of all physicians work in primary health. The regions have also employed a large number of clinical pharmacists, usually hospital-based, but many perform a variety of different primary care services, the most common of which is patient medication reviews. Swedish primary health care is at a crossroads facing extensive challenges, due to changes in demography and demanding financial conditions. These changes necessitate large transformations in health services and delivery. Current Government inquiries have primarily focused on two ways to meet the challenges; a shift towards more local care requiring a transfer of resources from hospital care, and a further development of structured digi-physical care, that is both digital (“online doctors”) and physical accessibility of care. While primary care at present is undergoing processes of change, community pharmacy has done so during the past decade since the re-regulation of the Swedish pharmacy market. A monopoly was replaced by a competitive system, where five pharmacy chains now share most of the market, a competition that has made community pharmacy very commercialized. A number of different, promising primary care services are being offered, but they are usually delivered on a small scale due to a lack of remuneration and philosophy of providers. Priority is given to sales and fast dispensing of prescriptions, often with a minimum of counseling. Reflecting primary health care, community pharmacy in Sweden is at a crossroads but currently has a golden opportunity to choose a route of collaboration with primary health care in its current transformation into more local and digi-physical care. A major challenge is that primary health care inquires, strategic plans, and national policy documents usually do not include community pharmacy as a partner. Hence, community pharmacy have to be proactive and seize this chance of changes in primary health policy and organization in order to become an important link in the chain of health care delivery, or there is a significant risk that it will predominantly remain a retail business.

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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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Baroudi, Mazen, Miguel San Sebastian, Anna-Karin Hurtig et Isabel Goicolea. « The perception of youth health centres’ friendliness : does it differ between immigrant and Swedish-Scandinavian youths ? » European Journal of Public Health 30, n^o 4 (17 mai 2020) : 780–85. http://dx.doi.org/10.1093/eurpub/ckaa077.

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Abstract Background Ensuring a good quality service and equal access according to need for all young people is a key objective of the Swedish health system. The aim of this study was to explore youths’ perception of youth health centres’ (YHCs’) friendliness and to assess the differences in perception between immigrant and Swedish-Scandinavian youths. Methods All YHCs in the four northern counties in Sweden were invited (22 centres), and 20 agreed to participate. Overall, 1089 youths aged 16–25 years answered the youth-friendly health services-Sweden questionnaire between September 2016 and February 2017. Thirteen sub-domains of friendliness were identified and their scores were calculated. Multilevel analysis was used to examine the differences in perception between immigrant and Swedish-Scandinavian youths. Results Our sample consisted of 971 Swedish-Scandinavian youths (89.2%) and 118 immigrants (10.8%). Generally, both groups perceived the services to be very friendly. All 13 sub-domains were rated more than three in a four-point scale except for fear of exposure and parental support of psychosocial services. However, immigrant youths perceived YHCs less friendly than their counterparts, particularly regarding the domains of equity, respect, quality and parental support. Conclusions Our study suggests that even though youths perceived YHCs as highly friendly, there is a space for improvement regarding access to health care. Our findings highlight the importance of an open and culturally sensitive attitude of the staff and the need to engage parents and community as a key to improve immigrant youths’ accessibility to health 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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Castor, Charlotte, Inger Kristensson Hallström, Kajsa Landgren et Helena Hansson. « Accessibility, utilisation and acceptability of a county‐based home care service for sick children in Sweden ». Scandinavian Journal of Caring Sciences 33, n^o 4 (13 mars 2019) : 824–32. http://dx.doi.org/10.1111/scs.12678.

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Kassa, Ann-Marie, Gunn Engvall, Michaela Dellenmark Blom et Helene Engstrand Lilja. « Understanding of the transition to adult healthcare services among individuals with VACTERL association in Sweden : A qualitative study ». PLOS ONE 17, n^o 5 (27 mai 2022) : e0269163. http://dx.doi.org/10.1371/journal.pone.0269163.

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Current knowledge of transitional care from the perspective of individuals with congenital malformations is scarce. Their viewpoints are required for the development of follow-up programs and transitional care corresponding to patients’ needs. The study aimed to describe expectations, concerns, and experiences in conjunction with transfer to adult health care among adolescents, young adults, and adults with VACTERL association, (i.e. vertebral defects, anorectal malformations (ARM), cardiac defects (CHD), esophageal atresia (EA), renal, and limb abnormalities). Semi-structured telephone interviews were performed and analyzed with qualitative content analysis. Of 47 invited individuals, 22 participated (12 males and 10 females). An overarching theme emerged: Leaving the safe nest of pediatric health care for an unfamiliar and uncertain follow up yet growing in responsibility and appreciating the adult health care. The participants described expectations of qualified adult health care but also concerns about the process and transfer to an unfamiliar setting. Individuals who were transferred described implemented or absence of preparations. Positive and negative experiences of adult health care were recounted including being treated as adults. The informants described increasing involvement in health care but were still supported by their parents. Ongoing follow up of health conditions was recounted but also uncertainty around the continuation, missing follow up and limited knowledge of how to contact health care. The participants recommended information ahead of transfer and expressed wishes for continued health care with regular follow up and accessibility to a contact person. Based on the participants’ perspective, a transitional plan is required including early information about transfer and follow up to prepare the adolescents and reduce uncertainty concerning future health care. Meetings with the pediatric and adult team together with the patient and the parents are essential before transfer. Follow up should be centralized to centers with multi-professional teams well-experienced with the condition. Further studies are warranted to evaluate the transition process for adolescents and young adults with complex congenital health conditions.

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Franzén, Cecilia, et Eva-Lotta Nilsson. « Middle Managers’ Views on Participation in a Home Visiting Program for First-Time Parents in Scania, Sweden ». International Journal of Social Science Studies 9, n^o 6 (27 septembre 2021) : 12. http://dx.doi.org/10.11114/ijsss.v9i6.5281.

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Family home visiting programs delivering early childhood services are supported by politicians and policy makers in many countries. This study focuses on a home visiting program for first-time parents in a county in Sweden. The program comprises six home visits conducted by interprofessional teams, including child healthcare nurses, midwives, social workers and dental hygienists, with the aim to increase accessibility to child healthcare and to promote more equal health in young children. Child healthcare, maternal care, social services and dental care organisations participated voluntarily in the program. This study explores how middle managers of the participating organisations view the program. Data were collected from semi-structured interviews with ten middle managers. The interviews were analysed using qualitative content analysis as a method. The results show that the middle managers saw the home visiting program as beneficial for society, parents and children, and the participating organisations and professionals. In other words, they expressed both altruistic goals and a self-interest in participating. The study is of importance as middle managers’ decision to participate in a home visiting program might be grounded on their perceptions of the program.

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Persson, Stefan, Curt Hagquist et Daniel Michelson. « Young voices in mental health care : Exploring children’s and adolescents’ service experiences and preferences ». Clinical Child Psychology and Psychiatry 22, n^o 1 (26 juillet 2016) : 140–51. http://dx.doi.org/10.1177/1359104516656722.

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The development of ‘youth-friendly’ services has become a priority across a wide range of health-care contexts. However, relatively few studies have specifically examined users’ experiences of, and preferences for, child and adolescent mental health care. The current study investigated young service users’ views of outpatient and community mental health clinics in Sweden, based on two data sources. First, focus group interviews were conducted with seven children and adolescents (aged 10–18 years) to explore both positive and negative experiences of mental health care. Second, written suggestions about specific service improvements were obtained from 106 children and adolescents. Qualitative content analysis revealed three overarching themes: ‘Accessibility’, ‘Being heard and seen’ and ‘Usefulness of sessions’. Young people’s recommendations for improving practice included more convenient appointment times, offered in welcoming settings; opportunities to communicate more openly with clinical staff, enabling sensitive discussion of mental health and wider personal issues; and more structured treatments that offer greater credibility and relevance to young people’s mental health and developmental needs. Young people also discussed being compelled by parents and school professionals to engage in treatment. Attending to young people’s preferences must be a priority in order to overcome ambivalence about session attendance, and enhance treatment participation and outcomes.

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Berbyuk Lindström, Nataliya, et Rocío Rodríguez Pozo. « Perspectives of Nurses and Doulas on the Use of Information and Communication Technology in Intercultural Pediatric Care : Qualitative Pilot Study ». JMIR Pediatrics and Parenting 3, n^o 1 (17 mars 2020) : e16545. http://dx.doi.org/10.2196/16545.

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Background Sweden is rapidly becoming an increasingly multicultural and digitalized society. Encounters between pediatric nurses and migrant mothers, who are often primary caregivers, are impeded by language problems and cultural differences. To support mothers, doulas, who are women having the same linguistic and cultural backgrounds, serve as cultural bridges in interactions with health care professionals. In addition, information and communication technology (ICT) can potentially be used to manage interactions owing to its accessibility. Objective The objective of this study was to investigate the role of ICT in managing communicative challenges related to language problems and cultural differences in encounters with migrant mothers from the perspectives of Swedish pediatric nurses and doulas. Methods Deep semistructured interviews with five pediatric nurses and four doulas from a migrant-dense urban area in western Sweden were audio recorded, transcribed, and analyzed using thematic content analysis. Results The results showed that ICT contributes to mitigating communicative challenges in interactions by providing opportunities for nurses and migrant mothers to receive distance interpreting via telephones and to themselves interpret using language translation apps. Using images and films from the internet is especially beneficial while discussing complex and culturally sensitive issues to complement or substitute verbal messages. These findings suggest that ICT helps enable migrant mothers to play a more active role in interactions with health care professionals. This has important implications for their involvement in other areas, such as child care, language learning, and integration in Sweden. Conclusions The findings of this study suggest that ICT can be a bridging tool between health care professionals and migrants. The advantages and disadvantages of translation tools should be discussed to ensure that quality communication occurs in health care interactions and that health information is accessible. This study also suggests the development of targeted multimodal digital support, including pictorial and video resources, for pediatric care services.

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Rasti, Reza, Johanna Brännström, Andreas Mårtensson, Ingela Zenk, Jesper Gantelius, Giulia Gaudenzi, Helle Mölsted Alvesson et Tobias Alfvén. « Point-of-care testing in a high-income country paediatric emergency department : a qualitative study in Sweden ». BMJ Open 11, n^o 11 (novembre 2021) : e054234. http://dx.doi.org/10.1136/bmjopen-2021-054234.

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ObjectivesIn many resource-limited health systems, point-of-care tests (POCTs) are the only means for clinical patient sample analyses. However, the speed and simplicity of POCTs also makes their use appealing to clinicians in high-income countries (HICs), despite greater laboratory accessibility. Although also part of the clinical routine in HICs, clinician perceptions of the utility of POCTs are relatively unknown in such settings as compared with others. In a Swedish paediatric emergency department (PED) where POCT use is routine, we aimed to characterise healthcare providers’ perspectives on the clinical utility of POCTs and explore their implementation in the local setting; to discuss and compare such perspectives, to those reported in other settings; and finally, to gather requests for ideal novel POCTs.DesignQualitative focus group discussions study. A data-driven content analysis approach was used for analysis.SettingThe PED of a secondary paediatric hospital in Stockholm, Sweden.ParticipantsTwenty-four healthcare providers clinically active at the PED were enrolled in six focus groups.ResultsA range of POCTs was routinely used. The emerging theme Utility of our POCT use is double-edged illustrated the perceived utility of POCTs. While POCT services were considered to have clinical and social value, the local routine for their use was named to distract clinicians from the care for patients. Requests were made for ideal POCTs and their implementation.ConclusionDespite their clinical integration, deficient implementation routines limit the benefits of POCT services to this well-resourced paediatric clinic. As such deficiencies are shared with other settings, it is suggested that some characteristics of POCTs and of their utility are less related to resource level and more to policy deficiency. To address this, we propose the appointment of skilled laboratory personnel as ambassadors to hospital clinics offering POCT services, to ensure higher utility of such services.

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Grandahl, Maria, Margareta Larsson et Björn Herrmann. « ‘To be on the safe side’ : a qualitative study regarding users’ beliefs and experiences of internet-based self-sampling for Chlamydia trachomatis and Neisseria gonorrhoeae testing ». BMJ Open 10, n^o 12 (décembre 2020) : e041340. http://dx.doi.org/10.1136/bmjopen-2020-041340.

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ObjectivesIn Sweden, an increasing number of tests for sexually transmitted infections are conducted. Self-sampling services are provided free of charge at the national eHealth website. Our aim was to obtain a deeper understanding of users’ beliefs and experiences of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) self-sampling services.MethodsThis qualitative study is part of the national project ‘Internet-based chlamydia and gonorrhoea self-sampling test’, conducted in Sweden. Individuals ordering a CT/NG self-sampling test at home from the eHealth website were invited to participate. Of the 114 individuals who agreed, a purposeful sample including 20 women and men aged 18–49 years (mean, 30.8 years) participated in a telephone interview in 2019.ResultsThe test service for CT/NG was highly appreciated by men and women of different ages. Round-the-clock accessibility, avoiding clinical visits, ease of use, confidentiality and a rapid test result were reasons for this appreciation. Language, uncertainty about the correct sampling procedure, unreliable postal services and concerns about handling of personal data were mentioned as barriers. Reasons for testing were checking after unprotected sex, symptoms, checking a partner’s fidelity or a regular routine—‘to be on the safe side’. Knowledge about the infections and their consequences was limited; some considered them severe, especially if they could threaten fertility, and others were less concerned. Disclosing an infection was described as emotionally stressful. Participants had high self-efficacy in relation to the test and would not hesitate to use the service again, even if it involved a cost.ConclusionsInternet-based CT/NG self-sampling at home was highly appreciated and was used for individual health reasons, but also out of concern for others’ health and for society as a whole. The benefits seem to outweigh the barriers, and the service may therefore continue to be widely offered.

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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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Nielsen, Anna, Ayesha de Costa, Kristina Gemzell-Danielsson, Jens Boman et M. Salazar. « ‘Repeat testing without having ‘the talk’ is not meaningful’—healthcare providers’ perceptions on finding a balance between Chlamydia trachomatis testing and primary prevention strategies. A qualitative study in Stockholm, Sweden ». BMJ Open 10, n^o 8 (août 2020) : e034179. http://dx.doi.org/10.1136/bmjopen-2019-034179.

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ObjectivesChlamydia trachomatis is a public health problem. Widespread testing and re-testing after a sexually transmitted infection (STI) is recommended to contain the epidemic and has been adopted by many countries. A recent study in Stockholm found that serial testing was used as a substitute for condom use by youth presenting at the Youth Health Clinics (YHC). The objectives of this study are to explore frontline healthcare provider’s perception of youth testing repeatedly for C. trachomatis as a substitute for condom use and their views on how this might be addressed.DesignQualitative study, in-depth interviews and analysed using content analysis.SettingYHC in Stockholm County, Sweden.ParticipantsHealthcare providers (HCPs) working at the YHC.FindingsTesting used as a method of prevention of STIs by youth has been a well-known phenomenon observed by HCPs at the YHC. Despite frustration regarding this behaviour, attitudes towards youth visiting the clinics repeatedly were overall positive. It is seen as an opportunity to reach youth with primary prevention strategies. Time for in-depth conversations with the youth is considered essential to understand the various reasons behind sexual risk-taking and to tailor counselling accordingly. Introducing concepts of self-compassion and self-respect in relation to sex is thought of as an effective intervention to improve sexual health among youth.ConclusionHCPs’ views on testing repeatedly for C. trachomatis as means of prevention, range widely from seeing this as ‘a positive strategy for C. trachomatis prevention’ to ‘a waste of healthcare resources’. There was a more unified view on how this should be addressed. Testing without having time to problematise sexual risk-taking was seen as meaningless. In depth, one-on-one counselling was deemed important. While scaling up accessibility to testing services, primary prevention strategies must not be neglected.

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Wallin, Emma Emmett Karolina, Susanne Mattsson et Erik Martin Gustaf Olsson. « The Preference for Internet-Based Psychological Interventions by Individuals Without Past or Current Use of Mental Health Treatment Delivered Online : A Survey Study With Mixed-Methods Analysis ». JMIR Mental Health 3, n^o 2 (14 juin 2016) : e25. http://dx.doi.org/10.2196/mental.5324.

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Background The use of the Internet has the potential to increase access to evidence-based mental health services for a far-reaching population at a low cost. However, low take-up rates in routine care indicate that barriers for implementing Internet-based interventions have not yet been fully identified. Objective The aim of this study was to evaluate the preference for Internet-based psychological interventions as compared to treatment delivered face to face among individuals without past or current use of mental health treatment delivered online. A further aim was to investigate predictors of treatment preference and to complement the quantitative analyses with qualitative data about the perceived advantages and disadvantages of Internet-based interventions. Methods Two convenience samples were used. Sample 1 was recruited in an occupational setting (n=231) and Sample 2 consisted of individuals previously treated for cancer (n=208). Data were collected using a paper-and-pencil survey and analyzed using mixed methods. Results The preference for Internet-based psychological interventions was low in both Sample 1 (6.5%) and Sample 2 (2.6%). Most participants preferred psychological interventions delivered face to face. Use of the Internet to search for and read health-related information was a significant predictor of treatment preference in both Sample 1 (odds ratio [OR] 2.82, 95% CI 1.18-6.75) and Sample 2 (OR 3.52, 95% CI 1.33-9.29). Being born outside of Sweden was a significant predictor of preference for Internet-based interventions, but only in Sample 2 (OR 6.24, 95% CI 1.29-30.16). Similar advantages and disadvantages were mentioned in both samples. Perceived advantages of Internet-based interventions included flexibility regarding time and location, low effort, accessibility, anonymity, credibility, user empowerment, and improved communication between therapist and client. Perceived disadvantages included anonymity, low credibility, impoverished communication between therapist and client, fear of negative side effects, requirements of computer literacy, and concerns about confidentiality. Conclusions Internet-based interventions were reported as the preferred choice by a minority of participants. The results suggest that Internet-based interventions have specific advantages that may facilitate help-seeking among some individuals and some disadvantages that may restrict its use. Initiatives to increase treatment acceptability may benefit from addressing the advantages and disadvantages reported in this study.

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Bohlin, Lars, et Lars Hjalmarson. « Occupational Health Services in Sweden ». Policy and Practice in Health and Safety 5, sup1 (janvier 2007) : 113–23. http://dx.doi.org/10.1080/14774003.2007.11667706.

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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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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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Woolf, P. Grahame. « Subnormality Services in Sweden ». Developmental Medicine & ; Child Neurology 12, n^o 4 (12 novembre 2008) : 525–30. http://dx.doi.org/10.1111/j.1469-8749.1970.tb01955.x.

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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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Van Steijvoort, Eva, Davit Chokoshvili, Jeffrey W Cannon, Hilde Peeters, Karen Peeraer, Gert Matthijs et Pascal Borry. « Interest in expanded carrier screening among individuals and couples in the general population : systematic review of the literature ». Human Reproduction Update 26, n^o 3 (25 février 2020) : 335–55. http://dx.doi.org/10.1093/humupd/dmaa001.

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Abstract BACKGROUND Through carrier screening, prospective parents can acquire information about whether they have an increased risk of conceiving a child affected with an autosomal recessive or X-linked condition. Within the last decade, advances in genomic technologies have facilitated a shift from condition-directed carrier screening to expanded carrier screening (ECS). Following the introduction of ECS, several studies have been performed to gauge the interest in this new technology among individuals and couples in the general population. OBJECTIVE AND RATIONALE The aim of this systematic review was to synthesize evidence from empirical studies that assess the interest in ECS among individuals and couples in the general population. As the availability and accessibility of ECS grow, more couples who are a priori not at risk based on their personal or family history will be presented with the choice to accept or decline such an offer. Their attitudes and beliefs, as well as the perceived usefulness of this screening modality, will likely determine whether ECS is to become a widespread reproductive genetic test. SEARCH METHODS Four databases (Pubmed, Web of Science, CINAHL, Cochrane Library) were systematically searched to identify English language studies performed between January 2009 and January 2019 using the following search terms: carrier screening, carrier testing, attitudes, intention, interest, views, opinions, perspectives and uptake. Studies were eligible for inclusion if they reported on intentions to undergo a (hypothetical) ECS test, uptake of an actual ECS offer or both. Two researchers performed a multistep selection process independently for validation purposes. OUTCOMES Twelve empirical studies performed between 2015 and 2019 were included for analysis. The studies originated from the USA (n = 6), the Netherlands (n = 3), Belgium (n = 1), Sweden (n = 1) and Australia (n = 1). The sample size of the studies varied from 80 to 1669. In the included studies, 32%–76% of respondents were interested in a (hypothetical) ECS test, while uptake rates for actual ECS offers ranged from 8% to 50%. The highest overall uptake was observed when ECS was offered to pregnant women (50%). By contrast, studies focusing on the preconception population reported lower overall uptake rates (8–34%) with the exception of one study where women were counseled preconception in preparation for IVF (68.7%). WIDER IMPLICATIONS Our findings suggest that there may be discrepancies between prospective parents’ reported intentions to undergo ECS and their actual uptake, particularly during the preconception period. As ECS is a new and relatively unknown test for most future parents, the awareness and comprehension within the general population could be rather limited. Adequate pre- and post-test counseling services should be made available to couples offered ECS to ensure informed reproductive decision-making, together with guidelines for primary health care professionals. Due to restricted nature of the samples and methods of the underlying primary studies, some of the reported results might not be transferable to a broader population. More research is needed to see if the observed trends also apply to a broader and more diverse population.

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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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Popescu Ljungholm, Doina. « PUBLIC HEALTH SISTEM IN SWEDEN ». Agora International Journal of Juridical Sciences 8, n^o 1 (4 février 2014) : 141–47. http://dx.doi.org/10.15837/aijjs.v8i1.939.

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The Swedish health care system is a socially responsible system with an explicit publiccommitment to ensure the health of all citizens. Quality health care for all is a cornerstone ofthe Swedish welfare state. The 1982 Health and Medical Services Act not only incorporatedequal access to services on the basis of need, but also emphasizes a vision of equal health forall. Three basic principles areintended to apply to health care in Sweden. The principle ofhuman dignity means that all human beings have an equal entitlement to dignity, and shouldhave the same rights, regardless of their status in the community. The principle of need andsolidarity means that those in greatest need take precedence in medical care. The principle ofcost–effectiveness means that when a choice has to be made between different health careoptions, there should be a reasonable relationship between the costs and the effects, measuredin terms of improved health and improved quality of life.

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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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Friman, Margareta, Katrin Lättman et Lars E. Olsson. « Carpoolers’ Perceived Accessibility of Carpooling ». Sustainability 12, n^o 21 (29 octobre 2020) : 8976. http://dx.doi.org/10.3390/su12218976.

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In order to constitute a realistic option to existing travel modes, carpooling needs to be able to offer adequate levels of accessibility. Insights into how carpooling services affect perceived accessibility up until now remain unexplored. In this study we explore carpooling experiences of 122 users in Sweden and examine a number of possible determinants of the perceived accessibility of carpooling. Results show that carpooling is not perceived by the users as particularly accessible with low levels across the sample. Moreover, multiple linear hierarchical regression analyses show that simplicity of travel, population density, years of education, and school and work-trips appear to affect perceptions of accessibility of carpooling, whereas travel time and cost appear not to. The final model explains a third of the variance in perceived accessibility of carpooling, thus nearly two thirds of the variation is still unaccounted for. Future research should explore further possible determinants of perceived accessibility of carpooling in order to explain, understand, and counteract the low levels of accessibility that appear to be linked to this specific travel mode.

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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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Hjern, Anders, et Peter Allebeck. « Health examinations and health services for asylum seekers in Sweden ». Scandinavian Journal of Social Medicine 25, n^o 3 (septembre 1997) : 207–9. http://dx.doi.org/10.1177/140349489702500310.

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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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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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Örtenstrand, Annica, et Ulla Waldenström. « Mothers' experiences of child health clinic services in Sweden ». Acta Paediatrica 94, n^o 9 (2 janvier 2007) : 1285–94. http://dx.doi.org/10.1111/j.1651-2227.2005.tb02090.x.

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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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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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