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Zhang S, Huang Y, Wang X, Wang H. Health Disparities Among Family Decision-Makers in China: An Ordered Probit Analysis of the China Family Panel Studies. Risk Manag Healthc Policy 2024; 17:635-647. [PMID: 38528941 PMCID: PMC10961237 DOI: 10.2147/rmhp.s443930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/15/2024] [Indexed: 03/27/2024] Open
Abstract
Purpose The family decision-makers serve as the backbone of the family, and their health status warrants consideration. This study aims to explore how the health status of this group of people, namely the family decision-making group, is affected, and to delve into the mechanisms of influence based on this. The goal is to provide reliable evidence and strategies for the health management of the family decision-makers group, contributing to the achievement of the "Healthy China 2030" Planning Outline. Patients and Methods Drawing on data from the China Family Panel Studies (CFPS), this study utilizes an Ordered Probit Model to analyze and compare the health status of family decision-makers and non-decision-makers. Results The findings indicate that decision-makers tend to experience poorer health outcomes than other family members, with increased pressure related to decision-making identified as a significant contributor to their declining health. Heterogeneity analysis reveals that the negative effect is less pronounced in households with higher net worth but more pronounced in those with more significant housing, education, and medical spending pressures. Moreover, this study analysis highlights that enhancing individual or family socioeconomic status can alleviate the adverse health effects experienced by family decision-makers. Conclusion The study reveals the presence of certain health adverse effects among family decision-makers. The implications drawn from this research hold significance for the health management of this demographic, underscoring the necessity for tailored interventions aimed at addressing the distinctive challenges confronted by this group.
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Affiliation(s)
- Songbiao Zhang
- School of Business, Hunan University of Science and Technology, Xiangtan, Hunan Province, People’s Republic of China
| | - Yuxuan Huang
- School of Business, Hunan University of Science and Technology, Xiangtan, Hunan Province, People’s Republic of China
| | - Xining Wang
- School of Business, Hunan University of Science and Technology, Xiangtan, Hunan Province, People’s Republic of China
| | - Huilin Wang
- School of Business, Hunan University of Science and Technology, Xiangtan, Hunan Province, People’s Republic of China
- Moray House School of Education and Sport, The University of Edinburgh, Edinburgh, Scotland, UK
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Charumbira MY, Conradie T, Berner K, Louw QA. Bridging the chasm between patients' needs and current rehabilitation care: perceptions of adults presenting for primary care in the Eastern Cape. BMC Health Serv Res 2024; 24:166. [PMID: 38317161 PMCID: PMC10840242 DOI: 10.1186/s12913-024-10564-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 01/05/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The need for rehabilitation in low-to-middle income countries (LMICs) is rapidly increasing as more people are living longer with chronic diseases. Primary health care (PHC) is ideally placed to provide the spectrum of care required to meet most of the complex and evolving population's health needs locally. This study aimed to describe the patient journeys of adults attending primary care in the Eastern Cape province of South Africa to understand the factors that affected their access to primary care rehabilitation services (or the lack thereof) and obtain suggestions on how rehabilitation may be enhanced at primary care. METHODS A maximum variation sampling approach was used to purposefully select persons with varied chronic health conditions and demographic characteristics to gain diverse perspectives regarding their rehabilitation needs and ways in which the current rehabilitation services at primary care may be enhanced. Data were collected via face-to-face semi-structured interviews between March and June 2022 which were electronically recorded. Inductive thematic analysis of transcribed data was done and coded in Atlas.ti.22®. RESULTS Twenty-five adult patients participated in the study. The patients had different experiences at their local PHC facilities that affected their access to rehabilitation at primary care. The study found that most patients were not able to access rehabilitation at primary care. There were several personal and contextual factors that resulted in the patients having a low perceived need to receive rehabilitation that potentially lowered patients' demand for and utilization of rehabilitation at primary care. Patients suggested increasing rehabilitation workforce at primary care, improving availability of assistive devices, increasing their knowledge regarding rehabilitation, and facilitating socio-economic integration into their communities. CONCLUSIONS Patients attending primary care are not guaranteed access to rehabilitation by virtue of having entered the PHC system. It is important to consider the patient perspectives regarding their health needs and suggestions for enhancing care.
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Affiliation(s)
- Maria Yvonne Charumbira
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7500, South Africa.
| | - Thandi Conradie
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7500, South Africa
| | - Karina Berner
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7500, South Africa
| | - Quinette Abegail Louw
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7500, South Africa
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Azizatunnisa L, Rotenberg S, Shakespeare T, Singh S, Smythe T. Health-worker education for disability inclusion in health. Lancet 2024; 403:11-13. [PMID: 38048789 DOI: 10.1016/s0140-6736(23)02707-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 11/30/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Luthfi Azizatunnisa
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Sara Rotenberg
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Tom Shakespeare
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
| | - Satendra Singh
- University College of Medical Sciences, University of Delhi, Delhi, India
| | - Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
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Douglas J, Winkler D, McLeod A, Oliver S, Gardner K, Supple J, Pearce C. Primary healthcare needs and service utilisation of people with disability: a data linkage protocol. BMJ Open 2023; 13:e068059. [PMID: 37076156 PMCID: PMC10124289 DOI: 10.1136/bmjopen-2022-068059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
INTRODUCTION General practitioners (GPs) play a crucial role in the early management and treatment of the comorbidities and complications experienced by people with disability. However, GPs experience multiple constraints, including limited time and disability-related expertise. Knowledge gaps around the health needs of people with disability as well as the frequency and extent of their engagement with GPs mean evidence to inform practice is limited. Using a linked dataset, this project aims to enhance the knowledge of the GP workforce by describing the health needs of people with disability. METHODS AND ANALYSIS This project is a retrospective cohort study using general practice health records from the eastern Melbourne region in Victoria, Australia. The research uses Eastern Melbourne Primary Health Network (EMPHN)-owned de-identified primary care data from Outcome Health's POpulation Level Analysis and Reporting Tool (POLAR). The EMPHN POLAR GP health records have been linked with National Disability Insurance Scheme (NDIS) data. Data analysis will involve comparisons across disability groups and the rest of the population to explore utilisation (eg, frequency of visits), clinical and preventative care (eg, cancer screening, blood pressure readings) and health needs (eg, health conditions, medications). Initial analyses will focus on NDIS participants as a whole and NDIS participants whose condition is either an acquired brain injury, stroke, spinal cord injury, multiple sclerosis or cerebral palsy, as classified by the NDIS. ETHICS AND DISSEMINATION Ethics approval was obtained from the Eastern Health Human Research Ethics Committee (E20/001/58261), and approval for the general collection, storage and transfer of data was from the Royal Australian College of General Practitioners National Research Ethics and Evaluation Committee (protocol ID: 17-088). Dissemination mechanisms will include the engagement of stakeholders through reference groups and steering committees, as well as the production of research translation resources in parallel with peer-reviewed publications and conference presentations.
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Affiliation(s)
- Jacinta Douglas
- Research and Innovation, Summer Foundation, Melbourne, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Di Winkler
- Research and Innovation, Summer Foundation, Melbourne, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Adam McLeod
- Department of Primary Care Research, Outcome Health, Melbourne, Victoria, Australia
| | - Stacey Oliver
- Research and Innovation, Summer Foundation, Melbourne, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Karina Gardner
- Department of Primary Care Research, Outcome Health, Melbourne, Victoria, Australia
| | - Jamie Supple
- Department of Primary Care Research, Outcome Health, Melbourne, Victoria, Australia
| | - Christopher Pearce
- Department of Primary Care Research, Outcome Health, Melbourne, Victoria, Australia
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Tshaka B, Visagie S, Ned LY. Non-use of healthcare services among persons with mobility impairments in Cofimvaba, South Africa. Afr J Disabil 2023; 12:1112. [PMID: 36756459 PMCID: PMC9900281 DOI: 10.4102/ajod.v12i0.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/29/2022] [Indexed: 02/05/2023] Open
Abstract
Background Access to primary health care is a fundamental right for all. However, persons with disabilities are experiencing difficulties when accessing healthcare because of various environmental and personal barriers which may lead to nonuse of such services. Objectives This study aimed to identify the challenges leading to non-use of healthcare services among persons with mobility impairments in Cofimvaba. Method A descriptive qualitative design using snowball sampling was implemented. Semistructured interviews were conducted in isiXhosa with five participants who stopped accessing healthcare, using a self-developed interview guide. Inductive thematic analysis was used to develop codes and themes from the data. Results Study findings revealed major challenges experienced by persons with mobility impairments in accessing healthcare. These included inaccessible roads, geographic inaccessibility, financial accessibility and indirect cost of care, having little or not many health problems, physical infrastructure difficulties within facilities, and attitudinal barriers. Conclusion The findings indicated that persons with disabilities are experiencing a combination of structural and environmental challenges which make them stop accessing healthcare. Contribution The article shares insights on access challenges that influence non-use of the often-needed healthcare services within the context of rural areas.
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Affiliation(s)
- Babalwa Tshaka
- Centre for Disability and Rehabilitation Studies, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Surona Visagie
- Centre for Disability and Rehabilitation Studies, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lieketseng Y. Ned
- Centre for Disability and Rehabilitation Studies, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Skuban-Eiseler T, Orzechowski M, Steger F. Access to healthcare for disabled individuals: An analysis of judgments of the European Court of Human Rights from an ethical perspective. Front Public Health 2023; 10:1015401. [PMID: 36703847 PMCID: PMC9871461 DOI: 10.3389/fpubh.2022.1015401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Individuals with disabilities (ID) suffer from restricted access to healthcare. This contributes to their poorer health status and constitutes an ethical challenge. The aim of this research was to systematically analyze judgments of the European Court of Human Rights (ECtHR) to illustrate examples of restricted access to healthcare for ID. Methods Through a search in the ECtHR's database we identified judgments dealing with access to healthcare for ID. The search resulted in n = 329 judgments, of which n = 55 were included in the analysis. A descriptive statistic was performed on Articles of the European Convention on Human Rights and violation of these articles. Qualitative thematic analysis was conducted to group the judgments in thematic categories. Results Most applications were filed against Russia (n = 23), followed by Poland (n = 8) and Ukraine (n = 7). The youngest applicant was 18, the oldest 72 years old. An overwhelming majority of cases dealt with disabled prisoners. Most of the judgments involved Article 14 and Article 8. We identified seven partially overlapping categories representing thematic patterns in the analyzed judgments. Discussion Any restriction of access to healthcare can be considered a violation of human rights. However, the results show a relatively low total number of judgments dealing with limited access to healthcare for ID. This could be a further confirmation of the fact that ID still experience too little attention in our societies. Especially in the context of detention, ID is restricted from receiving the healthcare they require. Indirect ways of a restricted access to healthcare should not be overseen.
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Affiliation(s)
- Tobias Skuban-Eiseler
- Faculty of Medicine, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany,kbo-Isar-Amper-Klinikum Region München, München-Haar, Germany,*Correspondence: Tobias Skuban-Eiseler ✉
| | - Marcin Orzechowski
- Faculty of Medicine, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Florian Steger
- Faculty of Medicine, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
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