Access to health care for persons with disabilities in rural South Africa

BMC Health Services Research, Год журнала: 2017, Номер 17(1)

Опубликована: Ноя. 17, 2017

Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts may present greater than urban contexts, but little known about access issues such contexts. There a paucity South Africa looking at "triple vulnerability" - poverty, disability rurality. This study explored to for an impoverished rural area Africa.

Язык: Английский

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Barreiras e facilitadores à comunicação no atendimento de pessoas com deficiência sensorial na atenção primária à saúde: estudo multinível

Revista Brasileira de Epidemiologia, Год журнала: 2020, Номер 23

Опубликована: Янв. 1, 2020

Communication barriers are the main obstacle for people with sensory disabilities (visual and hearing) to access health services. This study aims describe presence of facilitators communication basic units in Brazil verify its associated factors.Cross-sectional multilevel study, 38,811 5,543 municipalities between 2012 2013, collected National Program Improving Access Quality Primary Care (Programa Nacional de Melhoria do Acesso e da Qualidade Atenção Básica - PMAQ-AB). The outcome was defined by grouping (braille material; hearing resources; visual communication; accessible list service; professionals welcome users disabilities). two levels were structured, using variables: level I (contextual): macro region, population size, GDP per capita; II (service): extended professional team (psychologist/social worker); service shifts; welcoming room; publishing hours; physical facilitators. Multilevel Poisson regression hierarchical modeling used both stages.The is small Brazilian (32.1%). It more frequent a higher (RP = 1.02, 95%CI 0.92 1.12) size 1.25, 1.02 1.52).Welcoming facilitator should be focus initiatives improve care disabled persons. Universal adequate services, removal encouragement properly must promoted.

Язык: Английский

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Obstacles to access to community care in urban senior-only households: a qualitative study

BMC Geriatrics, Год журнала: 2022, Номер 22(1)

Опубликована: Фев. 14, 2022

Abstract Background The increased number of older adults living alone has created a substantial care need. However, the utilization rate services and facilities to meet these needs are surprisingly low. Many experience difficulties accessing services, although it remains unclear how obstacles impede access services. This study explored experienced by urban in seeking community care. Methods A phenomenological was carried out participatory observation in-depth interviews were employed investigate process communities. total 18 community-dwelling aged 75 years over included. Data collected analysed content analysis. Results We identified pathways which senior-only households sought encountered obstacles. (1) lack information: did not know where get even though institutions scattered throughout community; (2) limited mobility: often suffered from various chronic diseases, physically hindered their resources; (3) complex achieving care: functional fragmentation geographical dispersion made care-seeking challenging confusing for adults; (4) incomprehension expression: interaction time communication barriers between staff final obstacle. Only surmounting one can resources effectively. Conclusions When initiated calls help, they several Their physiological social disadvantages ability seek physically. Lack integration clear guidance providing exacerbated difficulties. Reform should focus on visibility accessibility adults.

Язык: Английский

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Death and long-term disability after gun injury: a cohort analysis

CMAJ Open, Год журнала: 2020, Номер 8(3), С. E469 - E478

Опубликована: Июль 1, 2020

Background:

Gun injury accounts for substantial acute mortality worldwide and many others survive with lingering disabilities. We investigated whether additional health losses beyond can also arise patients who long-term disability.

Methods:

conducted a population-based individual patient analysis of adults injured by firearms had received emergency medical care in Ontario, Canada, from Apr. 1, 2002, to 2019. Longitudinal cohort analyses were evaluated through deterministic linkages electronic files. The primary outcome was death or subsequent application disability the years after hospital discharge.

Results:

In total, 8313 firearms, which 3020 intentional incidents 5293 unintentional incidents. A total 2657 (88.0%) gun 5089 (96.1%) survived initial injuries. After mean 7.75 follow-up, surviving injuries rate twice as high (19.7% v. 10.1%, p < 0.001), equivalent hazard ratio 2.01 (95% confidence interval 1.80–2.25). higher risk survivors not explained demographic characteristics, extended treated released department, observed regardless incident self-inflicted interpersonal assault. Half cases identified first year. Additional predictors included lower socioeconomic status, an urban home location, arrival ambulance transport, history mental illness diagnosis substance use disorder.

Interpretation:

Our study shows that statistics underestimate extent disability, particularly those sustainable follow-up might improve outcomes.

Язык: Английский

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Unerfüllte Behandlungswünsche jüngerer und älterer Menschen mit geistiger, psychischer und mehrfacher Behinderung: eine Pilotstudie in einer Einrichtung im Ruhrgebiet

Zeitschrift für Evidenz Fortbildung und Qualität im Gesundheitswesen, Год журнала: 2025, Номер unknown

Опубликована: Янв. 1, 2025

Язык: Английский

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Oral health-related quality of life of Portuguese adults with mild intellectual disabilities

PLoS ONE, Год журнала: 2018, Номер 13(3), С. e0193953 - e0193953

Опубликована: Март 21, 2018

Individuals with disabilities are regarded as a highly vulnerable population group, particularly far oral health is concern. However, few studies have assessed the impact of condition on quality life these individuals. Therefore, aim this study to expand knowledge status Portuguese adults mild intellectual disability, and assess how patient's related their life. A sample 240 linked Federation for Intellectual Disability, were interviewed using previously validated version Oral Health Impact Profile. An examination was also conducted three indexes: Clinical Index (COHI); Care Needs (COCNI) Prevention (COPI). Sociodemographic characteristics dental factors collected, following statistical analysis. More than half individuals (54,9%) presented one or more problems major severe (COHI level 2); only 4,6% do not need treatment (COCNI 0) 85% needs measures educational preventive action (COPI 1). In 76,9% participants, had The most affected dimensions physical pain 61,9%, followed by psychological discomfort disability 45,1% 45%, respectively. With relation sociodemographic variables it verified that fewer teeth higher self-perception negative On other hand, institutionalization an increase in at least category positive Given high burden disease considerable found study, establishment guidelines improve should be imperative.

Язык: Английский

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Unmet health care needs and inequality: A cross‐country comparison of the situation of people with spinal cord injury

Health Services Research, Год журнала: 2021, Номер 56(S3), С. 1429 - 1440

Опубликована: Авг. 12, 2021

Abstract Objective To estimate and compare unmet health care needs of persons with spinal cord injury (SCI) across countries, the causes these shortfalls, role income. Data Sources We analyzed cross‐sectional data 20 countries from International Spinal Cord Injury (InSCI) survey, a compendium comparable on living situation SCI. included information high‐, middle‐, low‐income countries. The survey comprises 12,095 participants. Study Design used logit regressions to probability SCI its causes. adjusted results by individuals' characteristics countries' fixed effects. disaggregated income decile individuals in each country. Collection/Extraction Methods inclusion criteria for InSCI were adults aged 18 years older community, who able respond provided informed consent. Principal Findings Unmet are significant people long‐term conditions like SCI, where groups tend be more affected. Among barriers meeting needs, foremost is cost (in 11 countries), followed transportation service availability. Persons Morocco reported highest sample, 0.54 (CI: 047–0.59), well behind South Africa, 0.27 0.20–0.33), Brazil, 0.26 0.20–0.33). In contrast, Spain, 0.06 0.04–0.08), lowest closely Norway, 0.07 0.05–0.09), Thailand, 0.08 0.05–0.11), France, 0.06–0.11), Switzerland, 0.09 0.07–0.10). Conclusions long‐term, irreversible condition characterized physical impairment series chronic illness. This makes high‐need, high‐cost group that faces which mainly explained costs services, transportation, services prevalent low‐, high‐income lower disproportionately improve situation, combination measures social systems required.

Язык: Английский

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Self-Reported Barriers to Care Among Sexual and Gender Minority People With Disabilities: Findings From The PRIDE Study, 2019–2020

American Journal of Public Health, Год журнала: 2023, Номер 113(9), С. 1009 - 1018

Опубликована: Сен. 1, 2023

Objectives. To examine the associations of self-reported disability status with health care access barriers for sexual and gender minority (SGM) people. Methods. The Population Research in Identity Disparities Equality (PRIDE) Study participants lived United States or its territories, completed 2019 annual questionnaire (n = 4961), their experiences, including whether they had a primary provider, were uninsured, delayed care, unable to obtain care. We classified disabilities as physical, mental, intellectual, other; compared those without disabilities; performed logistic regression determine barriers. Results. SGM people less likely have usual place seek (69.0% vs 75.3%; P ≤ .001) more often reported being mistreated disrespected reasons delay (29.0% 10.2%; .001). (adjusted odds ratio [AOR] 3.28; 95% confidence interval [CI] 2.83, 3.81) be (AOR 3.10; CI 2.59, 3.71). Conclusions. Future work should address culturally competent ameliorate disparities community. (Am J Public Health. 2023;113(9):1009–1018. https://doi.org/10.2105/AJPH.2023.307333 )

Язык: Английский

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Discrimination reported by older adults living with mental health conditions: types, contexts and association with healthcare barriers

Social Psychiatry and Psychiatric Epidemiology, Год журнала: 2020, Номер 56(6), С. 1003 - 1014

Опубликована: Июль 21, 2020

Язык: Английский

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Understanding the Unmet Needs among Community-Dwelling Disabled Older People from a Linkage Perspective

International Journal of Environmental Research and Public Health, Год журнала: 2021, Номер 18(2), С. 389 - 389

Опубликована: Янв. 6, 2021

One of the challenges in response to population aging is meet needs for elderly care among older people especially those who want age their homes or communities. However, disabled have more due restricted mobility access resources than non-disabled ones. We propose a new framework based on changing relationship between and environment, which resource linkage utilization emphasized. conducted survey with 139 participants (i.e., 60 years over different level disabilities) three types neighborhoods Beijing, China. By conducting decision tree analysis under Person-Environment Link (P-E Link) model, we (1) characterized unmet (activities daily living (ADL) instrumental activities (IADL) assistance) community-dwelling people; (2) found had both ADL IADL assistance because lack linkages ones; (3) better supporting place, including family support, social connection, spatial environment. Our findings help improve Anderson behavioral model by characterizing enabling environments, highlights that not only availability but also these play an important role meeting people. can inform improvements policy design are targeted reduce inequalities.

Язык: Английский

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