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Non-communicable diseases (NCDs), account for a growing number of deaths worldwide. The English-speaking Caribbean has the highest per capita burden of NCDs in the region of the Americas . This paper presents an overview of availability and accessibility based on clinic hours and physician fulltime equivalents (FTE) on the island of Trinidad devoted to diabetes and wound care. The project integrates a Geographic Information System (GIS) with epidemiologic and bio-statistical data to provide a necessary spatial analysis not otherwise possible. It examines the island’s ability to effectively deliver treatment to residents with diabetes by providing a geographic perspective to data published on the internet by the Trinidad-Tobago Ministry of Health and the Central Statistical Office. Results indicate a significant regional variability in both numbers of physicians and office hours devoted to diabetes treatment.
Introduction: Studies on attitudes and practices are increasingly used but not specifically related to the motivations for the use of reproductive health care among women of fertile age, living in urban areas and in different social contexts. Objectives: The aim of this study was to estimate the associations between the variables of social status (degree of poverty in the studied groups) and the variables of fecundity (representations, tensions, practices and control of fertility) and, in addition, to compare access to health care in the different studied groups, assessing the association between use of maternal health care and poverty in urban areas. Design: A case-control study was conducted in the Municipality of Lisbon, Portugal, with a total sample of 1513 women of fertile age: 499 cases of women considered very poor were selected from the database of beneficiaries of RSI (Social Welfare Payment for Inclusion); 1014 controls (two controls for each selected case), divided as 507 poor women selected from the other beneficiaries of Santa Casa da Misericórdia in Lisbon and 507 non-poor women selected from four Health Centers from the Municipality of Lisbon, Portugal. A total of 1054 women answered the questionnaire: 304 cases (response rate of 61%) and 750 (response rate of 74%) controls. The statistical analysis involved descriptive analysis and multinomial logistic regression. Results: The analysis confirms the association between poverty and patterns and representations of fecun
dity regarding pregnancy planning. The results of this study thus show the existence of different distributions on several variables and the gradients of poverty. Regarding access to health care, the major impact of poverty on women
The aim of the current study is to examine the extent to which equity in the utilization of longterm care services has been achieved in the Republic of Korea (hereafter Korea), based on the Aday—Andersen Access Framework that takes into consideration a series of variables hypothesized as predictive of utilization. The current study used cross-sectional survey data collected and conducted by the Korea Labor Institute (KLI) between August 1 to December 22, 2006. The sample for this study was 5544 persons who are older than 60 years. The study was extracted from a larger nationally representative cross-sectional survey of 10,255 individuals. The stratified cluster sampling technique was used to draw the survey respondents. A self-administered questionnaire was used to collect the data from the sample. Descriptive and logistic regression analysis was performed examining the relationship between the dependent variable and the independent variables and the relative importance of factors. The results indicate that a universal health insurance system has not yielded a fully equitable distribution of services. The limitation of benefit coverage as well as disparities in consumer cost-sharing and associated patterns of utilization across plans high out-of-pocket payment can be a barrier to health care utilization, which results in inequity and differential long-term care utilization between sub-groups of older adults. Health policy reforms in Korea must continue to concentrate on expanding insurance coverage, reducing the inequities reflected in disparities in consumer cost-sharing and associated patterns of utilization across plans, and establishing a financially separate insurance system for poor older adults. The behavioral responses of physicians to the method of reimbursement, and the subsequent impact on overall rates of utilization and expenditures need to be more fully understood. In addition, further research is needed to identify the nonfinancial barriers that persist for certain demographic subgroups, i.e., those 70 and older, men, lacking social network members, those who have four or more family members, and those who have no schooling.
Demented persons in the process
of slowly becoming dependent have to rely on the assistance of others. These others
are health professionals (formal care), on the one hand and family carers (informal
care) on the other hand. The latter, whether or not they have chosen to play a role
which is hardly defined officially, have to face many difficult situations such
as complicated access to care due to lack of equal opportunities under the health
system, unable to support them efficiently. Taking care of a demented patient
is a life challenge often leading to burn out, having impact on physical and mental
health. Caregivers may thus even have no time or opportunity to take care of their
own health. So, is it not high time for the decision-makers to think it over and
take care of the carers by setting up programs and giving them the opportunity to
learn, to work as a team with the professionals so as to protect themselves and
their dignity as well as that of their patients. The difficulties/problems carers
of demented patients may encounter should be a major issue for public health care
because their role is a vital one and because the consequences which may have
on their own health can be negative.
The focus of this paper is to investigate the role self-employment conceptualized as a lifestyle factor on health, access to health care, and health behaviors. We analyze rich data on 13,435 working adults in the US, who are either selfemployed or salaried workers. Outcomes include physical and mental health perception, validated indexes of physical and mental health, and medical conditions; access-to-care measures such as a barrier to obtaining necessary health care; and health behaviors such as smoking, physical activity and body mass index. Instrumental variables methods are used to correct for selection into self-employment. We find that self-employment is positively associated with perceived physical health, and is negatively associated with having diabetes, high blood pressure, high cholesterol and arthritis. No mental health outcome is significantly associated with self-employment. There is no significant difference between self-employed and wage-earning individuals with regard to access to care. Self-employed individuals are less likely to smoke, and are more likely to participate in physical activity and have normal-weight. We conclude that despite lack of health insurance, self-employed persons in the US are as healthy as wage-earners, do not experience a greater barrier to access to care, and are more likely to engage in healthy behavior.