Week 4- Inequities in health care Flashcards
Define inequities
Unfair, unavoidable differences in health/ health care arising from poor governance, corruption or cultural exclusion
Define health inequalities
Uneven distribution ofhealth or healthcare result of genetic or other factors or lack of resources
What is equal access?
Providing same level or kind of services to everyone regardless of need
What is equitable access?
Providing services according to need
What are the two types of inequity?
Horizontal & Vertical
What is horizontal inequity?
People w/ same needs don’t have access to samere sources. Unequal treatment of equals
What is vertical inequity?
People w/ greater needs aren’t provided with greater resources to meet those needs
Why address health inequities?
- Social justice & fairness
- Evidence that equitable access to healthcare can contribute towards reduction in health inequalities
- Not addressing inequity inaccess to health care may widen in equalities
- Equality Act2010
What should inequities in health care consider? (3)
•Access to service: Facilities, tx & care
•Utilisation of primary & secondary services
•Availability of responsive services
What is the pro-poor bias?
generally those w/greatest health need have greatest access to GP
What are the horizontal & vertical inequities in primary care?
Difficulty accessing primary care for some groups
- Eg: asylum seekers
- Wait times
LGBTQ
- Less GP satisfaction
Under-utilisation of preventative services
- Colorectal cancer screening
- Low income households
What inequities are in secondary care?
Total hip arthroplasty
- Limited use in deprived areas and inappropriately high in affluent
Cancer care & survival
- Weekend tx provisions
- Bowl cancer in disadvantaged areas- > ED admission
- Lung cancer- survival
- Breast- <70yrs likely received better constructivesurgery
What ineqities are there is secondary care access?
EOL care
- More likely die in hosp
Access for older people
- Less hip & knee replacement 66-84yrs
Ethnic
- Cardiac & DM care
Disabled people
- Poorer access both primary & secondary
- Untreated ill-health & high numbers of avoidable deaths
List some supply and demand barriers
Supply: Funding, costs, services at wrong time/ place, culturally inappropriate, quality, clinician bias
Demand: Health literacy, geographic/physical barriers, community/cultural attitudes/norms
How can we address inequities? (3 +1)
- MDT
- Info from health impact assessments
- Action at organisational level
Complex & multifaceted
