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Méndez A, Toffoletto C, Labra P, Hidalgo G, Pérez S. Barreras en acceso a control preventivo en padres migrantes de infantes en Santiago, Chile, 2018. Rev Salud Publica (Bogota) 2022. [DOI: 10.15446/rsap.v24n4.95206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objetivo Identificar barreras en el acceso a control preventivo de la Atención Primaria en padres migrantes de lactantes y preescolares en Santiago, Chile, en el año 2018.
Métodos Estudio observacional, descriptivo, transversal, en una muestra no probabilística de 108 padres migrantes de lactantes y preescolares entre 0-4 años, 11 meses, 29 días, que asisten a jardines infantiles de la comuna de Santiago, en quienes se autoaplicó un cuestionario en español y creole, diseñado y validado en contenido y traducción de forma piloto, previa autorización de Comité de Ética, entre julio y octubre de 2018. Se midieron variables de caracterización sociodemográfica, asistencia a control preventivo y barreras.
Resultados Un 7,8% de padres manifestó que su hijo no asistía a control, y 48,5% de los padres indicó que tenía dificultades para asistir. Las barreras para asistir a control fueron en un 63% horario y tiempos de espera, en un 39,8% desconocimiento del funcionamiento del sistema y en un 11,1% transporte.
Conclusiones Son necesarias estrategias para mejorar el acceso a salud con una mirada desde los determinantes sociales de la salud.
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Mourão S, Bernardes SF. What determines immigrant caregivers' adherence to health recommendations from child primary care services? A grounded theory approach. Prim Health Care Res Dev 2019; 20:e31. [PMID: 32799992 PMCID: PMC6476339 DOI: 10.1017/s1463423619000033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 10/24/2018] [Accepted: 01/03/2019] [Indexed: 11/10/2022] Open
Abstract
AIM To investigate the diversity and specificity of the determinants of immigrant caregivers' adherence to child primary care (CPC) health recommendations. BACKGROUND Immigrant caregiver's adherence to CPC health recommendations is of utmost importance to minimize their children's health-related vulnerabilities. Some research has been conducted on the determinants of immigrants' access to health services, but much less is known about the determinants of their adherence to health professionals' recommendations once they get there, especially in a primary health care context. This study contributes to bridge these gaps. METHODS Interviews and focus groups were conducted, with immigrant and non-immigrant caregivers living in Portugal (n=35), from heterogeneous socioeconomic backgrounds. Focus group and individual interview scripts were developed to explore caregivers' understanding and use of CPC services and, particularly, their adherence to CPC recommendations. A socio-demographic questionnaire was also administered. Qualitative data were analyzed using a grounded theory methodology. FINDINGS 'Adherence to CPC health recommendations' is a core and multidimensional concept. Several determinants were identified at individual, interpersonal, organizational and structural levels. Some determinants were highlighted both by immigrant and non-immigrant caregivers: valuing children's health, usefulness of recommendations, perceived health-care professionals' competence, central role of vaccination in CPC and caregivers' socio-economic conditions. Other determinants were specifically mentioned by immigrant caregivers: expectations about traditional versus pharmacological treatments, cultural mismatches in children's care practices, perceived quality of Portuguese CPC services versus CPC from countries of origin. These results provide innovative theoretical and empirical contributions to the field of primary health care and, particularly, to immigrant caregivers' adherence behaviors. Implications for research on treatment adherence in primary care contexts, the development of interventions that promote caregivers' adherence to CPC health recommendations and for child protection will be discussed.
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Affiliation(s)
- Susana Mourão
- Department of Social and Organizational Psychology, Instituto Universitário de Lisboa (ISCTE-IUL), Lisboa, Portugal
- Department of Social and Organizational Psychology, Centro de Investigação e Intervenção Social (CIS-IUL), Lisboa, Portugal
| | - Sónia F. Bernardes
- Department of Social and Organizational Psychology, Instituto Universitário de Lisboa (ISCTE-IUL), Lisboa, Portugal
- Department of Social and Organizational Psychology, Centro de Investigação e Intervenção Social (CIS-IUL), Lisboa, Portugal
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Effect of an mHealth Intervention to Improve Health Literacy in Immigrant Populations: A Quasi-experimental Study. Comput Inform Nurs 2019; 37:142-150. [PMID: 30531321 DOI: 10.1097/cin.0000000000000497] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Health literacy is a social determinant of the basic health of populations and is especially important to enhancing and developing the empowerment of migrant populations. To evaluate the effectiveness of an mHealth intervention to improve the cognitive and social skills that enable migrants to access and use health services, we developed a quasi-experimental design to encompass a single group of enrolled immigrants (N = 93). They completed preintervention and postintervention questionnaires of the European Health Literacy Survey Questionnaire, the self-created questionnaire HL-APP-Q14 (Health Literacy App Questionnaire), and a practical simulation test. Health literacy improved significantly after the intervention, increasing from a problematic level (mean, 9.55 [SD, 4.35]) to a sufficient level (mean, 14.03 [SD, 2.68]). Differences were statistically significant for males and females as well as for participants of all nationalities, except the Chinese group. The application e_SaludAble empowered the migrant participants through the improvement of their health literacy.
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Gea-Sánchez M, Alconada-Romero Á, Briones-Vozmediano E, Pastells R, Gastaldo D, Molina F. Undocumented Immigrant Women in Spain: A Scoping Review on Access to and Utilization of Health and Social Services. J Immigr Minor Health 2017; 19:194-204. [PMID: 26880030 DOI: 10.1007/s10903-016-0356-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This scoping review summarizes and analyzes relevant studies related to the evidence published on undocumented immigrant women's access to and utilization of health and social services in Spain. Scientific literature was identified by entering search terms in seven electronic databases which combined retrieved health sciences peer-reviewed articles (Pubmed, Embase, CINAHL Plus and Scopus) and grey literature databases (Europa OpenGrey, DART-Europe and Google Scholar) published between 2004 and 2014 and written in Spanish or in English presenting data about Spain. Those that fulfill the inclusion criteria were selected after a blind peer reviewed process when pertinence and quality was debated. A total of 16 publications were included, the main topics being socio-cultural differences in the access and utilization of social and health services and barriers faced by immigrant women. None of the studies focused exclusively on undocumented women, hence further research is needed in this area.
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Affiliation(s)
- Montserrat Gea-Sánchez
- Department of Nursing, Faculty of Nursing and Physiotherapy, GESEC, University of Lleida, Street Rovira Roure 44, 25198, Lleida, Spain. .,Research Group in Health Care (GRECS), IRB Lleida, Lleida, Spain.
| | - Álvaro Alconada-Romero
- Department of Nursing, Faculty of Nursing and Physiotherapy, GESEC, University of Lleida, Street Rovira Roure 44, 25198, Lleida, Spain.,Council of Nurses of Lleida, Lleida, Spain
| | - Erica Briones-Vozmediano
- Department of Nursing, Faculty of Nursing and Physiotherapy, GESEC, University of Lleida, Street Rovira Roure 44, 25198, Lleida, Spain.,Public Health Research Group, University of Alicante, Alicante, Spain
| | - Roland Pastells
- Department of Nursing, Faculty of Nursing and Physiotherapy, GESEC, University of Lleida, Street Rovira Roure 44, 25198, Lleida, Spain.,Research Group in Health Care (GRECS), IRB Lleida, Lleida, Spain
| | - Denise Gastaldo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Fidel Molina
- Department of Geography and Sociology, GESEC, University of Lleida, Lleida, Spain
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Porthé V, Vargas I, Ronda E, Malmusi D, Bosch L, Vázquez ML. Has the quality of health care for the immigrant population changed during the economic crisis in Catalonia (Spain)? Opinions of health professionals and immigrant users. GACETA SANITARIA 2017; 32:425-432. [PMID: 28583698 DOI: 10.1016/j.gaceta.2017.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/27/2017] [Accepted: 03/01/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To analyse changes in health professionals' and immigrant users' perceptions of the quality of care provided to the immigrant population during the crisis. METHODS A qualitative descriptive-interpretative and exploratory study was conducted in two areas of Catalonia. Semi-structured individual interviews were used with a theoretical sample of medical (n=24) and administrative (n=10) professionals in primary care (PC) and secondary care (SC), and immigrant users (n=20). Thematic analysis was conducted and the results were triangulated. RESULTS Problems related to technical and interpersonal quality emerged from the discourse of both professionals and immigrants. These problems were attributed to cutbacks during the economic crisis. Regarding technical quality, respondents reported an increase in erroneous or non-specific diagnoses, inappropriate use of diagnostic tests and non-specific treatments, due to reduction in consultation times as a result of cuts in human resources. With regard to interpersonal quality, professionals reported less empathy, and users also reported worse communication, due to changes in professionals' working conditions and users' attitudes. Finally, a reduction in the resolution capacity of the health services emerged: professionals described unnecessary repeated PC visits and limited responses in SC, while young immigrants reported an insufficient response to their health problems. CONCLUSION The results indicate a deterioration in perceived technical and interpersonal quality during the economic crisis, due to cutbacks mainly in human resources. These changes affect the whole population, but especially immigrants.
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Affiliation(s)
- Victoria Porthé
- Grup de Recerca en Polítiques de Salut i Serveis Sanitaris (GRPSS), Servei d'Estudis i Prospectives en Polítiques de Salut, Consorci de Salut i Social de Catalunya, Barcelona, Spain
| | - Ingrid Vargas
- Grup de Recerca en Polítiques de Salut i Serveis Sanitaris (GRPSS), Servei d'Estudis i Prospectives en Polítiques de Salut, Consorci de Salut i Social de Catalunya, Barcelona, Spain
| | - Elena Ronda
- Departamento de Salud Pública, Universidad de Alicante, Alicante, Spain
| | - Davide Malmusi
- Direcció de Serveis de Salut, Ajuntament de Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Spain
| | - Lola Bosch
- Unitat de Atenció al Ciutadà i Comunicació, Serveis de Salut Integrats del Baix Empordà, Palamós, Girona, Spain
| | - M Luisa Vázquez
- Grup de Recerca en Polítiques de Salut i Serveis Sanitaris (GRPSS), Servei d'Estudis i Prospectives en Polítiques de Salut, Consorci de Salut i Social de Catalunya, Barcelona, Spain.
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Changes in access to health care for immigrants in Catalonia during the economic crisis: Opinions of health professionals and immigrant users. Health Policy 2016; 120:1293-1303. [PMID: 27743703 DOI: 10.1016/j.healthpol.2016.09.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/31/2016] [Accepted: 09/11/2016] [Indexed: 01/06/2023]
Abstract
Policy measures introduced in Spain during the economic crisis included a reduction in public health expenditure and in healthcare entitlements (RDL16/2012), which affected the general population as a whole, but especially immigrants. This paper analyzes changes in immigrants' access to health care during the economic crisis from the perspective of health professionals (medical and administrative) and immigrants. A qualitative descriptive-interpretative study was conducted in Catalonia through individual interviews with a theoretical sample of health professionals (n=34) and immigrant users (n=20). Thematic analysis was conducted and data quality was ensured through triangulation. Informants described barriers to enter the health system related to reduced healthcare entitlements and a stricter enforcement of administrative requirements: while medical professionals highlighted restrictions to accessing the healthcare continuum, immigrants accentuated barriers to obtaining the individual health card. With regard to use of services, an increase in waiting times due to cutbacks in human resources dominated the informants' discourse. Health professionals pointed out organizational changes to increase efficiency that may improve access to primary care. Informants related lower health services utilization to a deterioration in immigrants' living and working conditions. According to health professionals, these conditions limited the use of services during working hours and led to delays in seeking care and treatment interruptions. Results show an aggravation of pre-existing barriers to health services utilization and, simultaneously, the appearance of new barriers to enter the system. These changes in the healthcare services contradict the equity principles of the national health system (NHS), thus policy decisions are needed to address this problem.
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7
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Was access to health care easy for immigrants in Spain? The perspectives of health personnel in Catalonia and Andalusia. Health Policy 2016; 120:396-405. [DOI: 10.1016/j.healthpol.2016.01.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 01/07/2016] [Accepted: 01/08/2016] [Indexed: 11/19/2022]
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Bas-Sarmiento P, Fernández-Gutiérrez M, Albar-Marín MJ, García-Ramírez M. Percepción y experiencias en el acceso y el uso de los servicios sanitarios en población inmigrante. GACETA SANITARIA 2015; 29:244-51. [DOI: 10.1016/j.gaceta.2015.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/22/2015] [Accepted: 03/24/2015] [Indexed: 10/23/2022]
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Roura M, Domingo A, Leyva-Moral JM, Pool R. Hispano-Americans in Europe: what do we know about their health status and determinants? A scoping review. BMC Public Health 2015; 15:472. [PMID: 25948239 PMCID: PMC4430018 DOI: 10.1186/s12889-015-1799-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 04/24/2015] [Indexed: 12/19/2022] Open
Abstract
Background Policy makers and health practitioners are in need of guidance to respond to the growing geographic mobility of Hispano-American migrants in Europe. Drawing from contributions from epidemiology, social sciences, demography, psychology, psychiatry and economy, this scoping review provides an up-to-date and comprehensive synthesis of studies addressing the health status and determinants of this population. We describe major research gaps and suggest specific avenues of further inquiry. Methods We identified systematically papers that addressed the concepts “health” and “Hispano Americans” indexed in five data bases from Jan 1990 to May 2014 with no language restrictions. We screened the 4,464 citations retrieved against exclusion criteria and classified 193 selected references in 12 thematic folders with the aid of the reference management software ENDNOTE X6. After reviewing the full text of all papers we extracted relevant data systematically into a table template to facilitate the synthesising process. Results Most studies focused on a particular disease, leaving unexplored the interlinkages between different health conditions and how these relate to legislative, health services, environmental, occupational, and other health determinants. We elucidated some consistent results but there were many heterogeneous findings and several popular beliefs were not fully supported by empirical evidence. Few studies adopted a trans-national perspective and many consisted of cross-sectional descriptions that considered “Hispano-Americans” as a homogeneous category, limiting our analysis. Our results are also constrained by the availability and varying quality of studies reviewed. Conclusions Burgeoning research has produced some consistent findings but there are huge gaps in knowledge. To prevent unhelpful generalisations we need a more holistic and nuanced understanding of how mobility, ethnicity, income, gender, legislative status, employment status, working conditions, neighbourhood characteristics and social status intersect with demographic variables and policy contexts to influence the health of the diverse Hispano-American populations present in Europe. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1799-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria Roura
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB) Hospital Clínic, Universitat de Barcelona, Rosselló 132, 4th floor, 08036, Barcelona, Spain.
| | - Andreu Domingo
- Centre for Demographic Studies, Autonomous University of Barcelona, Carrer de Ca n'Altayó. Edifici E2, Bellaterra, Barcelona, 08193, Spain.
| | - Juan M Leyva-Moral
- Escola Superior d'Infemeria del Mar, University Pompeu Fabra, Doctor Aiguader, 80, Barcelona, Spain.
| | - Robert Pool
- Social Science and Global Health, Centre for Social Science and Global Health, University of Amsterdam, Postbus 15718, 1001, NE, Amsterdam, The Netherlands.
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Garcia-Subirats I, Vargas I, Sanz B, Malmusi D, Ronda E, Ballesta M, Luisa Vázquez M, I M. Changes in access to health services of the immigrant and native-born population in Spain in the context of economic crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:10182-201. [PMID: 25272078 PMCID: PMC4210974 DOI: 10.3390/ijerph111010182] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 09/17/2014] [Accepted: 09/18/2014] [Indexed: 11/17/2022]
Abstract
AIM To analyze changes in access to health care and its determinants in the immigrant and native-born populations in Spain, before and during the economic crisis. METHODS Comparative analysis of two iterations of the Spanish National Health Survey (2006 and 2012). Outcome variables were: unmet need and use of different healthcare levels; explanatory variables: need, predisposing and enabling factors. Multivariate models were performed (1) to compare outcome variables in each group between years, (2) to compare outcome variables between both groups within each year, and (3) to determine the factors associated with health service use for each group and year. RESULTS unmet healthcare needs decreased in 2012 compared to 2006; the use of health services remained constant, with some changes worth highlighting, such as the decline in general practitioner visits among autochthons and a narrowed gap in specialist visits between the two populations. The factors associated with health service use in 2006 remained constant in 2012. CONCLUSION Access to healthcare did not worsen, possibly due to the fact that, until 2012, the national health system may have cushioned the deterioration of social determinants as a consequence of the financial crisis. Further studies are necessary to evaluate the effects of health policy responses to the crisis after 2012.
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Affiliation(s)
- Irene Garcia-Subirats
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consorci de Salut i Social de Catalunya, Avenida Tibidabo, 21, Barcelona 08022, Spain.
| | - Ingrid Vargas
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consorci de Salut i Social de Catalunya, Avenida Tibidabo, 21, Barcelona 08022, Spain.
| | - Belén Sanz
- National School of Public Health, Instituto de Salud Carlos III, Avda Monforte de Lemos 5, Pabellón 7, Madrid 28029, Spain.
| | - Davide Malmusi
- Sub-Program on Immigration and Health of the CIBERESP, Melchor Fernández Almagro, 3-5, Madrid 28029, Spain.
| | - Elena Ronda
- Sub-Program on Immigration and Health of the CIBERESP, Melchor Fernández Almagro, 3-5, Madrid 28029, Spain.
| | - Mónica Ballesta
- Sub-Program on Immigration and Health of the CIBERESP, Melchor Fernández Almagro, 3-5, Madrid 28029, Spain.
| | - María Luisa Vázquez
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consorci de Salut i Social de Catalunya, Avenida Tibidabo, 21, Barcelona 08022, Spain.
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Alonazi WB, Thomas SA. Quality of care and quality of life: convergence or divergence? Health Serv Insights 2014; 7:1-12. [PMID: 25114568 PMCID: PMC4122532 DOI: 10.4137/hsi.s13283] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 11/12/2013] [Accepted: 11/22/2013] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to explore the impact of quality of care (QoC) on patients' quality of life (QoL). In a cross-sectional study, two domains of QoC and the World Health Organization Quality of Life-Bref questionnaire were combined to collect data from 1,059 pre-discharge patients in four accredited hospitals (ACCHs) and four non-accredited hospitals (NACCHs) in Saudi Arabia. Health and well-being are often restricted to the characterization of sensory qualities in certain settings such as unrestricted access to healthcare, effective treatment, and social welfare. The patients admitted to tertiary health care facilities are generally able to present themselves with a holistic approach as to how they experience the impact of health policy. The statistical results indicated that patients reported a very limited correlation between QoC and QoL in both settings. The model established a positive, but ultimately weak and insignificant, association between QoC (access and effective treatment) and QoL (r = 0.349, P = 0.000; r = 0.161, P = 0.000, respectively). Even though the two settings are theoretically different in terms of being able to conceptualize, adopt, and implement QoC, the outcomes from both settings demonstrated insignificant relationships with QoL as the results were quite similar. Though modern medicine has substantially improved QoL around the world, this paper proposes that health accreditation has a very limited impact on improving QoL. This paper raises awareness of this topic with multiple healthcare professionals who are interested in correlating QoC and QoL. Hopefully, it will stimulate further research from other professional groups that have new and different perspectives. Addressing a transitional health care system that is in the process of endorsing accreditation, investigating the experience of tertiary cases, and analyzing deviated data may limit the generalization of this study. Global interest in applying public health policy underlines the impact of such process on patients' outcomes. As QoC accreditation does not automatically produce improved QoL outcomes, the proposed study encourages further investigation of the value of health accreditation on personal and social well-being.
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Affiliation(s)
- Wadi B Alonazi
- Department of Health and Hospital Administration, Faculty of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | - Shane A Thomas
- Deputy Dean (International), Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
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Vázquez ML, Vargas I, Aller MB. Reflexiones sobre el impacto de la crisis en la salud y la atención sanitaria de la población inmigrante. Informe SESPAS 2014. GACETA SANITARIA 2014; 28 Suppl 1:142-6. [DOI: 10.1016/j.gaceta.2014.02.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 02/11/2014] [Accepted: 02/13/2014] [Indexed: 10/25/2022]
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Ostrach B. "Yo no sabía..."-immigrant women's use of national health systems for reproductive and abortion care. J Immigr Minor Health 2014; 15:262-72. [PMID: 22825462 DOI: 10.1007/s10903-012-9680-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Half of pregnancies worldwide are unintended; half of these end in abortion. Immigrant women encounter more obstacles to reproductive healthcare than non-immigrant women, and access to national healthcare is a particularly important factor in abortion access. Spain's government recently liberalized abortion laws, including abortion services in the national health system available to immigrants. Evidence suggests that immigrant women in Spain experience difficulties navigating the health system-the impact of the changed abortion laws on immigrant's women's access to care is not yet clear. Through a literature review and analysis, this paper examines the experiences of immigrant women with national health systems, and their use of such systems for reproductive and abortion care, in order to explore what could be expected in Spain as the national health system expands to include abortion care, and to illuminate immigrant women's experiences with using national health systems for reproductive healthcare more broadly.
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Affiliation(s)
- Bayla Ostrach
- Department of Anthropology, University of Connecticut, 354 Mansfield Rd., U-2176, Storrs-Mansfield, CT 06269, USA.
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14
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Are migrants health policies aimed at improving access to quality healthcare? An analysis of Spanish policies. Health Policy 2013; 113:236-46. [DOI: 10.1016/j.healthpol.2013.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 06/07/2013] [Accepted: 06/12/2013] [Indexed: 11/19/2022]
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A first approach to differences in continuity of care perceived by immigrants and natives in the Catalan public healthcare system. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:1474-88. [PMID: 23571452 PMCID: PMC3709329 DOI: 10.3390/ijerph10041474] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 03/11/2013] [Accepted: 03/27/2013] [Indexed: 12/04/2022]
Abstract
Objective: To compare immigrants’ and natives’ perceptions of relational, managerial and informational continuity of care and to explore the influence of the length of stay on immigrants’ perceptions of continuity. Methods: Cross-sectional study based on a survey of a random sample of 1,500 patients, of which 22% (331) were immigrants. The study area was made up by three healthcare areas of the Catalan healthcare system. To collect data, the CCAENA questionnaire was applied. Multivariate logistic regression models were conducted. Results: Like natives, immigrants perceive high levels of managerial continuity (88.5%) and relational continuity with primary and secondary care physicians (86.7 and 81.8%), and lower levels of informational continuity (59.1%). There were no statistically significant differences in managerial and informational continuity between immigrants and natives. However, immigrants perceive a worse relational continuity with primary care physicians in terms of trust, communication and clinical responsibility. Conversely, immigrants perceive higher relational continuity with secondary care physicians in terms of effective communication and clinical responsibility. Discussion: Similar managerial and informational continuity perceptions seem to point towards a similar treatment of patients, regardless of their immigrant status. However, differences in relational continuity highlight the need for improvements in professionals’ skills in treating immigrants’ patients.
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Aller MB, Vargas I, Waibel S, Coderch J, Sánchez-Pérez I, Colomés L, Llopart JR, Ferran M, Vázquez ML. A comprehensive analysis of patients' perceptions of continuity of care and their associated factors. Int J Qual Health Care 2013; 25:291-9. [PMID: 23425531 DOI: 10.1093/intqhc/mzt010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To determine the patients' perceived degree of continuity of care between primary and secondary care and to identify contextual and individual factors that influence patients' perceptions of continuity of care. DESIGN Cross-sectional study by means of a survey of patients attended to in primary and secondary care. SETTING Three health-care areas of the Catalonian public health-care system. PARTICIPANTS A random sample of 1500 patients. MAIN OUTCOME MEASURES Relational, informational and managerial continuity of care measured by means of Likert scales, using the CCAENA questionnaire. RESULTS Overall, 93.8 and 83.8% of patients perceived an ongoing relationship with primary and secondary care physicians, respectively (relational continuity), 71.2% perceived high levels of information transfer (informational continuity) and 90.7% perceived high levels of consistency of care (managerial continuity). Patients from health-care areas where primary and secondary care were managed by a single organization and the elderly tended to perceive higher levels of all three types of continuity. Foreign-born patients were less likely to perceive relational continuity with primary care physicians; those with higher educational levels were less likely to perceive high levels of informational continuity and patients with worse health status were less likely to report high levels of managerial and relational continuity with secondary care physicians. CONCLUSIONS Study results suggest high levels of perceived continuity of care, especially for relational and managerial continuity. The adopted comprehensive approach proves to be useful to properly understand the phenomenon because perceptions and associated factors vary according to the type of continuity.
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Affiliation(s)
- Marta-Beatriz Aller
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Barcelona, Spain.
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Agudelo-Suárez AA, Gil-González D, Vives-Cases C, Love JG, Wimpenny P, Ronda-Pérez E. A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services' accessibility in economic migrants. BMC Health Serv Res 2012; 12:461. [PMID: 23245431 PMCID: PMC3565901 DOI: 10.1186/1472-6963-12-461] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 11/23/2012] [Indexed: 11/30/2022] Open
Abstract
Background Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011). Methods A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.
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Affiliation(s)
- Andrés A Agudelo-Suárez
- Faculty of Dentistry, University of Antioquia, Calle 64 N° 52-59, Medellín, Antioquia, Colombia.
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Welbel M, Matanov A, Moskalewicz J, Barros H, Canavan R, Gabor E, Gaddini A, Greacen T, Kluge U, Lorant V, Esteban Peña M, Schene AH, Soares JJ, Straßmayr C, Vondráčková P, Priebe S. Addiction treatment in deprived urban areas in EU countries: Accessibility of care for people from socially marginalized groups. DRUGS-EDUCATION PREVENTION AND POLICY 2012. [DOI: 10.3109/09687637.2012.706757] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Health professional perceptions regarding healthcare provision to immigrants in Catalonia. Int J Public Health 2010; 56:549-57. [DOI: 10.1007/s00038-010-0223-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 11/22/2010] [Accepted: 11/22/2010] [Indexed: 10/18/2022] Open
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