Documents access to care 89 results

"Durant la période de récession (2008-2009), les dépenses publiques de santé ont joué leur rôle de stabilisation économique ; une rupture, historique par son ampleur dans les pays « périphériques » s'est toutefois opérée à partir de 2010 ou 2011 dans l'Union européenne. La limitation, voire la réduction des dépenses publiques de santé a surtout été obtenue par une compression des revenus et des emplois, en particulier dans le secteur public de santé, ce qui a eu pour conséquence de dégrader les conditions de travail. Certaines réformes dites structurelles ont également été amplifiées ou accélérées. Or, le choix de diminuer les dépenses de santé, en particulier sa composante publique, est inefficace au regard même de l'objectif économique de réduction des déficits publics, tant les multiplicateurs budgétaires sont élevés pour les dépenses de santé. De plus, les conséquences de ces réformes sur l'accès aux soins et sur la santé sont inquiétantes, ce dont atteste la dégradation de nombreux indicateurs dans les pays les plus frappés."

"The Millennium Development Goals (MDGs) mobilized global commitments to promote health, socioeconomic, and sustainable development. Trends indicate that the health MDGs may not be achieved by 2015, in part because of insufficient coordination across related health, socioeconomic, and environmental initiatives. Explicitly acknowledging the need for such collaboration, the Meikirch Model of Health posits that: Health is a state of wellbeing emergent from conducive interactions between individuals' potentials, life's demands, and social and environmental determinants. Health results throughout the life course when individuals' potentials – and social and environmental determinants – suffice to respond satisfactorily to the demands of life. Life's demands can be physiological, psychosocial, or environmental, and vary across contexts, but in every case unsatisfactory responses lead to disease. This conceptualization of the integrative nature of health could contribute to ongoing efforts to strengthen cooperation across actors and sectors to improve individual and population health – leading up to 2015 and beyond."

"Background: We compare disparities in health status between first-generation immigrants and others in the United States (US) and Canada. Methods: We used data from the Joint Canada–US Survey of Health. The regression models adjusted for demographics, socioeconomic status, and health insurance (the US). Results: In both countries, the health advantage belonged to immigrants. Fewer disparities between immigrants and those native-born were seen in Canada versus the US. Canadians of every immigrant/race group fared better than US native-born Whites. Discussion: Fewer disparities in Canada and better overall health of all Canadians suggest that societal context may create differences in access to the resources, environments, and experiences that shape health and health behaviors."

"This article provides a critical analysis of the role of transnational migrant workers providing care and household services in an age of globalization. On the demand side, the feminization of migration is linked to the increase in women's labour force participation, falling birth rates, increasing life expectancy, changes in family structure, and the shortage of public care. On the supply side, it is argued that remittances are key for the survival of households and communities in a number of developing countries and that exporting workers is one means by which governments address the problems of unemployment and foreign debt. The concept of the global care chain serves to cast light on the social processes associated with the transnational transfer of domestic labour."

"This article examines associations of socio-demographic and health-care indicators, and the statistic ‘mortality amenable to health care' (amenable mortality) across the US states. There is over two-fold variation in amenable mortality, strongly associated with the percentages of state populations that are poor or black. Controlling for poverty and race with bi- and multi-variate analyses, several indicators of health system performance, such as hospital readmission rates and preventive care for diabetics, are significantly associated with amenable mortality. A significant crude association of ‘uninsurance' and amenable mortality rates is no longer statistically significant when poverty and race are controlled. Overall, there appear to be opportunities for states to focus on specific modifiable health system performance indicators. Comparative rates of amenable mortality should be useful for estimating potential gains in population health from delivering more timely and effective care and for tracking the health outcomes of efforts to improve health system performance."

"The present study examines how growing socio-economic inequalities in transitional countries that have followed different health policy paths affect women's access to reproductive health care. I conducted surveys in Kazakhstan and Belarus and used logistic regression analyses to determine accessibility to and satisfaction with reproductive health services, reproductive status, and reproductive history based on country of residence. By all measures, access to reproductive health services was most problematic for the low-income women in Kazakhstan but to a significantly lesser extent for economically disadvantaged respondents in Belarus. Differences in education had a significant effect on women's access to reproductive health services in Kazakhstan but were not present in Belarus. Household income was the most powerful predictor of self-perceived health in Kazakhstan, but not in Belarus. The unreformed health-care system in Belarus appears to be more accessible for all women than Kazakhstan's health-care system that underwent significant market-oriented reform."

"Achieving equitable universal health coverage requires the provision of accessible, necessary services for the entire population without imposing an unaffordable burden on individuals or households. In South Africa, little is known about access barriers to health care for the general population. We explore affordability, availability, and acceptability of services through a nationally representative household survey (n=4668), covering utilization, health status, reasons for delaying care, perceptions and experiences of services, and health-care expenditure. Socio-economic status, race, insurance status, and urban-rural location were associated with access to care, with black Africans, poor, uninsured and rural respondents, experiencing greatest barriers. Understanding access barriers from the user perspective is important for expanding health-care coverage, both in South Africa and in other low- and middle-income countries."

"L'article propose une lecture transversale du numéro qui porte sur les mobilisations sanitaires de neuf États et de l'Union européenne face à la « première vague » de l'épidémie de Covid-19. En s'intéressant aux interventions publiques sur l'accès aux soins, les services de santé et l'industrie médicale, il montre que la plupart des États ont recours à des recettes similaires (confinement, mobilisation des hôpitaux, etc.) qui s'inscrivent cependant dans des logiques nationales liées aux configurations institutionnelles et économiques des systèmes de santé."

"C'est aux États-Unis que l'épidémie de Covid-19 s'est montrée la plus meurtrière, bien que les dépenses de santé par habitant y soient les plus élevées au monde. Elle aura ainsi mis au jour de manière flagrante les apories chroniques du système de santé et de l'assurance santé (coût exorbitant, fortes inégalités d'accès, sous-financement de la santé publique, système hospitalier gouverné par des logiques de marché). Elle aura aussi révélé les revers du fédéralisme américain sous l'administration Trump, notamment sa capacité à gérer une crise sanitaire d'une telle ampleur, qui se sont illustrés tout particulièrement dans l'impéritie du leadership présidentiel."