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Population Health > Lecture 19: Impact Of Access > Flashcards

Lecture 19: Impact Of Access Flashcards

1
Q

What is the working definition of “access”?

A

“Access is viewed as a set of more specific areas of fit between a patient and the health care system”

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2
Q

What are the 5 areas of access?

A
  1. Availability
  2. Accessibility
  3. Accommodation
  4. Affordability
  5. Acceptability
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3
Q

What is the definition of availability?

A

“The relationship of the volume and type of existing services (and resources) to the clients’ volume and type of need”

So supply and demand

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4
Q

How much confidence do you have in being able to get good medical care for you and your family when you need it?

A

Availability

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5
Q

How satisfied are you with being able to find one good doctor to treat the whole family?

A

Availability

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6
Q

How satisfied are you with your knowledge of where to get health care?

A

Availability

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7
Q

How satisfied are you with your ability to get medical care in an emergency?

A

Availability

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8
Q

What data suggests a (lack of) availability of health care?

A

Maori vs non-Maori ischaemic heart disease graph

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9
Q

Define accommodation

A

Aka organisational barriers

“The relationship between the manner in which supply resources are organised and the expectations of clients”

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10
Q

How satisfied are you with how long you have to wait to get an appointment?

A

Accommodation

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11
Q

How satisfied are you with how convenient physicians office hours are?

A

Accommodation

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12
Q

How satisfied are you with how long you have to wait in the waiting room?

A

Accommodation

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13
Q

How satisfied are you with how easy it is to get in touch with your physician?

A

Accommodation

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14
Q

Define acceptability

A

Aka psychological barriers

“The relationship between clients’ and providers’ attitudes to what constitutes appropriate care”

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15
Q

How satisfied are you with the appearance of the doctor’s office?

A

Acceptability

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16
Q

How satisfied are you with the neighbourhoods the doctor’s office is in?

A

Acceptability

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17
Q

How satisfied are you with the other patients you usually see in the doctor’s office?

A

Acceptability

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18
Q

Define accessibility

A

Aka geographical resources
“The relationship between the location of supply and the location of clients, taking into account client transportation resources and travel time, distance and cost”

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19
Q

How satisfied are you with how convenient your physician’s offices are to your home?

A

Accessibility

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20
Q

How difficult is it for you to get to your physician’s office?

A

Accessibility

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21
Q

Define affordability

A

Aka financial barriers

“The cost of provider services in relation to the client’s ability and willingness to pay for these services”

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22
Q

How satisfied are you with your health insurance?

A

Affordability

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23
Q

How satisfied are you with the doctor’s prices?

A

Affordability

24
Q

How satisfied are you with how soon you need to pay the bill?

A

Affordability

25
Q

What type of surveys were the youth2000 surveys?

A

Cross sectional, with random secondary school students

26
Q

“I don’t know how to”

A

Availability

27
Q

“I had no transport to get there”

A

Accessibility

28
Q

“I couldn’t get an appointment”

A

Accommodation

29
Q

“I couldn’t get in touch with the health care professional or person I usually see”

A

Accommodation

30
Q

“I didn’t feel comfortable with the person”

A

Acceptability

31
Q

“I couldn’t be bothered”

A

Acceptability

32
Q

“I was hoping the problem would go away or get better with time”

A

Acceptability

33
Q

“The staff were unfriendly”

A

Acceptability

34
Q

“Costs too much”

A

Affordability

35
Q

Is there are relationship between deprivation and barriers?

A

Yes

36
Q

What qualitative study investigated barriers to a health care service?

A

One that investigated the barriers experienced by Chinese when accessing ACC related services

37
Q

How many participants in the Chinese ACC study?

A

32: 3 focus groups and 8 interviews

38
Q

How is availability discussed in relation to Chinese and ACC use?

A
  • Types of health services available
  • Not all services are recognised and subsidised by ACC (eg Chinese medicine)
  • Lack of knowledge of the services and eligibility of ACC (potential and realised access)
39
Q

How is accessibility related to Chinese and ACC services?

A

Transportation for elderly

40
Q

Difference between qualitative and quantitative studies?

A

Quantitative tells the story, qualitative is just numbers

41
Q

What is potential access vs. realised access?

A

Potential access= you should be able to use the service as it is available
Realised access= knowing and actually utilising the access

42
Q

How is affordability related to Chinese and ACC?

A

Direct vs indirect costs
GP surcharge
Value of cost
Eg having to take time off work

43
Q

How is accommodation related to Chinese and ACC?

A

Opening hours of the service (eg after school? Links to affordability if costs more after hours)
Interpretation services

44
Q

How is acceptability related to Chinese and ACC?

A 
Use of an interpreter
Health beliefs (is it a serious injury?)
Cultural appropriate services vs. guidelines ie: you are told what entitlements are and they must be the same for everyone etc clashes with culturally appropriate services
45
Q

How many people had tuberculosis in 2014 and how many died?

A

9.6 million cases, 1.5 million dead

46
Q

How much has the tuberculosis death rate dropped since 1990?

A

47%

47
Q

How many lives were saved through tb diagnosis and treatment since 2000?

A

43 million

48
Q

What is FIDELIS?

A

A case-finding initiative to rapidly assess and implement innovative local TB control activities designed to find and cure smear positive patients

49
Q

What does FIDELIS stand for?

A

The fund for innovative DOTS expansion through local initiatives to stop TB

50
Q

Who funded FIDELIS?

A

CIDA (Canadian International Development Agency)

51
Q

Where was FIDELIS implemented in the study?

A

Anhui, China
(A pretty rural area and poor)
Around 62.6 million people

52
Q

Discuss how FIDELIS was implemented in Anhui

A

Family cough/symptoms card given to students to take home and return to school. Teachers trained to identify TB, GPs sent to homes with suspected cases. Health services integrated new cases into TB programme

53
Q

How does FIDELIS fit into the D&W model Socioeconomic, cultural and environmental level?

A
  1. Political environment: political and environmental commitment (eg DOTS)
  2. Rural and scattered housing in mountainous area (living/work conditions)
54
Q

How how does FIDELIS study fit into D&W model social and community networks level?

A

Family value towards children

Sputum smear test and anti-TB treatment (living/work conditions)

55
Q

Define DOTS?

A

Directly Observed Treatments

Population Health (15 decks)

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