This study aimed to analyze the prevalence of indicators of use of healthcare services according to sex, income and race/skin color, in adolescents (aged 10-19 years old) based on data from the Health Survey of the Municipality of Campinas (ISACamp), carried out in 2014/2015 in Campinas, São Paulo, Brazil. The chi-square test was used to evaluate the differences between the outcome variables (indicators of use of healthcare service) and sex, income and race/skin color. Adjusted prevalence ratios (PR) were estimated using Poisson multiple regression models. The demand for medical care was high in the last year of the interview (79.2%), mostly attended by the Brazilian Unified National Health System (65.2%), with routine consultations being more prevalent for females (PR = 1.17; 95%CI: 1.01-1.34) and injury for the male population (PR = 0.47; 95%CI: 0.26-0.84). Economic and racial differences were found in the evaluation of the last medical consultation, with a higher prevalence of worse care among those with lower income (PR = 1.46; 95%CI: 1.14-1.87) and black people (PR = 1.27; 95%CI: 1.01-1.61). Inequalities remained for delay or failure to carry out exams (PR = 1.64; 95%CI: 1.02-2.64) and worse quality of dental care (PR = 2.10; 95%CI: 1.38-3.21) in those with lower income. Also, black people had fewer appointments with dentists (PR = 0.90; 95%CI: 0.82-0.99).
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http://dx.doi.org/10.1590/0102-311XEN146523 | DOI Listing |
J Wound Care
January 2025
Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, US.
Objective: The Veterans Health Administration (VHA) recently piloted the implementation of the TeleWound Practice Program (TWP), which provides interprofessional wound care to Veterans remotely. We assessed the perceptions of Veterans and healthcare team members (HCTMs), and their experiences with the TWP.
Method: We surveyed Veterans from four VHA medical centres who had received at least one TWP visit between 1 May 2020 and 31 May 2021, and HCTMs associated with any TWP encounter between 1 September 2019 and 31 March 2021.
Disabil Rehabil Assist Technol
January 2025
School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA.
The wheelchair service delivery process (SDP) is a large complex system and therefore has many potential points of failure; determining priorities for improvement is challenging. The complexities introduce several barriers to accessing and maintaining wheelchairs for individuals with mobility impairments. Given the breadth and depth of the barriers, it is important to know in which areas to focus future policy reform efforts.
View Article and Find Full Text PDFBMJ Open Qual
December 2024
Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
Background: Driven by rising retirement age and increasing prevalence of chronic diseases impacting work participation, there is an increasing need for quality and efficiency improvement in social insurance medicine (SIM). SIM provides guidance to individuals facing long-term work disability, assess their functional abilities and eligibility for long-term disability benefits. Value-based healthcare (VBHC) targets quality and efficiency improvements in healthcare by placing a priority on improving patient value.
View Article and Find Full Text PDFBMJ Open Gastroenterol
December 2024
Florence Nightingale Faculty of Nursing Midwifery & Palliative Care, King's College London, London, UK
Objective: Many people with inflammatory bowel disease (IBD) experience fatigue, pain and faecal incontinence that some feel are inadequately addressed. It is unknown how many have potentially reversible medical issues underlying these symptoms.
Methods: We conducted a study testing the feasibility of a patient-reported symptom checklist and nurse-administered management algorithm ('Optimise') to manage common medical causes of IBD-related fatigue, pain and faecal incontinence.
BMJ Open Gastroenterol
December 2024
Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
Objective: Non-alcoholic fatty liver disease (NAFLD) is estimated to affect a third of Australian adults, and its prevalence is predicted to rise, increasing the burden on the healthcare system. The LOCal Assessment and Triage Evaluation of Non-Alcoholic Fatty Liver Disease (LOCATE-NAFLD) trialled a community-based fibrosis assessment service using FibroScan to reduce the time to diagnosis of high-risk NAFLD and improve patient outcomes.
Methods: We conducted a 1:1 parallel randomised trial to compare two alternative models of care for NAFLD diagnosis and assessment.
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