scholarly journals Health, psychosocial, and economic impacts of the COVID-19 pandemic on people with chronic conditions in India: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kavita Singh ◽  
Dimple Kondal ◽  
Sailesh Mohan ◽  
Suganthi Jaganathan ◽  
Mohan Deepa ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Access To Health Care ◽  
Vegetable Consumption ◽  
Economic Impacts ◽  
Economic Status ◽  
Qualitative Interviews ◽  
Multivariable Logistic Regression Analysis ◽  
Limited Data ◽  
Access To Health ◽  
Health Care Treatment

Abstract Background People with chronic conditions are disproportionately prone to be affected by the COVID-19 pandemic but there are limited data documenting this. We aimed to assess the health, psychosocial and economic impacts of the COVID-19 pandemic on people with chronic conditions in India. Methods Between July 29, to September 12, 2020, we telephonically surveyed adults (n = 2335) with chronic conditions across four sites in India. Data on participants’ demographic, socio-economic status, comorbidities, access to health care, treatment satisfaction, self-care behaviors, employment, and income were collected using pre-tested questionnaires. We performed multivariable logistic regression analysis to examine the factors associated with difficulty in accessing medicines and worsening of diabetes or hypertension symptoms. Further, a diverse sample of 40 participants completed qualitative interviews that focused on eliciting patient’s experiences during the COVID-19 lockdowns and data analyzed using thematic analysis. Results One thousand seven hundred thirty-four individuals completed the survey (response rate = 74%). The mean (SD) age of respondents was 57.8 years (11.3) and 50% were men. During the COVID-19 lockdowns in India, 83% of participants reported difficulty in accessing healthcare, 17% faced difficulties in accessing medicines, 59% reported loss of income, 38% lost jobs, and 28% reduced fruit and vegetable consumption. In the final-adjusted regression model, rural residence (OR, 95%CI: 4.01,2.90–5.53), having diabetes (2.42, 1.81–3.25) and hypertension (1.70,1.27–2.27), and loss of income (2.30,1.62–3.26) were significantly associated with difficulty in accessing medicines. Further, difficulties in accessing medicines (3.67,2.52–5.35), and job loss (1.90,1.25–2.89) were associated with worsening of diabetes or hypertension symptoms. Qualitative data suggest most participants experienced psychosocial distress due to loss of job or income and had difficulties in accessing in-patient services. Conclusion People with chronic conditions, particularly among poor, rural, and marginalized populations, have experienced difficulties in accessing healthcare and been severely affected both socially and financially by the COVID-19 pandemic.

scholarly journals Proposing an Ecosystem of Digital Health Solutions for Teens With Chronic Conditions Transitioning to Self-Management and Independence: Exploratory Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Emre Sezgin ◽  
Monica Weiler ◽  
Anthony Weiler ◽  
Simon Lin
Keyword(s):  
Health Care Providers ◽  
Chronic Conditions ◽  
Access To Health Care ◽  
Environmental Changes ◽  
Digital Health ◽  
Chronically Ill ◽  
Care Providers ◽  
Component Solution ◽  
Access To Health ◽  
Transition To Independence

BACKGROUND Chronic disease management is critical to quality of life for both teen patients with chronic conditions and their caregivers. However, current literature is largely limited to a specific digital health tool, method, or approach to manage a specific disease. Guiding principles on how to use digital tools to support the transition to independence are rare. Considering the physiological, psychological, and environmental changes that teens experience, the issues surrounding the transition to independence are worth investigating to develop a deeper understanding to inform future strategies for digital interventions. OBJECTIVE The purpose of this study was to inform the design of digital health solutions by systematically identifying common challenges among teens and caregivers living with chronic diseases. METHODS Chronically ill teens (n=13) and their caregivers (n=13) were interviewed individually and together as a team. Verbal and projective techniques were used to examine teens’ and caregivers’ concerns in-depth. The recorded and transcribed responses were thematically analyzed to identify and organize the identified patterns. RESULTS Teens and their caregivers identified 10 challenges and suggested technological solutions. Recognized needs for social support, access to medical education, symptom monitoring, access to health care providers, and medical supply management were the predominant issues. The envisioned ideal transition included a 5-component solution ecosystem in the transition to independence for teens. CONCLUSIONS This novel study systematically summarizes the challenges, barriers, and technological solutions for teens with chronic conditions and their caregivers as teens transition to independence. A new solution ecosystem based on the 10 identified challenges would guide the design of future implementations to test and validate the effectiveness of the proposed 5-component ecosystem.

Impact of low economic status, low screening coverage and access to health care on cancer management in a cohort in Mexico.

2020 ◽  
Vol 46 (2) ◽  
pp. e154
Author(s):  
Alethia Alvarez-Cano ◽  
Dorian Yarih Garcia-Ortega ◽  
Hector Hugo Romero-Garza ◽  
Edson Rene Marcos-Ramirez ◽  
Edelmiro Perez-Rodriguez ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Economic Status ◽  
Cancer Management ◽  
Access To Health ◽  
Screening Coverage

2-1-1 Toronto: Lessons Learnt About Newcomers’ Access to Health Information

2013 ◽  
Author(s):  
Andrea Cortinois ◽  
Richard Glazier ◽  
Nadia Caidi ◽  
Gavin Andrews ◽  
Mary Herbert-Copley ◽  
...  
Keyword(s):  
Health Care ◽  
Health Information ◽  
Access To Health Care ◽  
Qualitative Interviews ◽  
Access To Information ◽  
Face To Face ◽  
Soins De Santé ◽  
Phone Survey ◽  
Access To Health ◽  
Nouveaux Arrivants

This study examines the importance of access to information as an enabler of access to health care by newcomers to Canada. Specifically, we focus on the role played by the 2-1-1 Toronto service through a 2005 phone survey and face-to-face qualitative interviews with 2-1-1 Toronto callers in 2006-2007.Cette étude examine l’importance de l’accès à l’information comme moteur de l’accès aux soins de santé par les nouveaux arrivants au Canada. Plus précisément, nous nous attardons sur le rôle que joue le service 2-1-1 Toronto au moyen d’entrevues téléphoniques effectuées en 2005 et d’entrevues qualitatives en personne avec des appelants du service 2-1-1 Toronto en 2006-2007.

scholarly journals Inequality and inequity in access to health care and treatment for chronic conditions in China: the Guangzhou Biobank Cohort Study

2012 ◽  
Vol 28 (5) ◽  
pp. 467-479 ◽  
Author(s):  
T. M. Elwell-Sutton ◽  
C. Q. Jiang ◽  
W. S. Zhang ◽  
K. K. Cheng ◽  
T. H. Lam ◽  
...  
Keyword(s):  
Health Care ◽  
Cohort Study ◽  
Chronic Conditions ◽  
Access To Health Care ◽  
Access To Health ◽  
Care And Treatment

scholarly journals Improving access to health care in a rural regional hospital in South Africa: Why do patients miss their appointments?

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Lucy Frost ◽  
Louis S. Jenkins ◽  
Benjamin Emmink
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Economic Status ◽  
Missed Appointments ◽  
Access To Health Services ◽  
Targeted Interventions ◽  
Access To Health ◽  
Hospital Systems ◽  
Underlying Causes ◽  
People First

Background: Access to health services is one of the Batho Pele (‘people first’) values and principles of the South African government since 1997. This necessitated some changes around public service systems, procedures, attitudes and behaviour. The challenges of providing health care to rural geographically spread populations include variations in socio-economic status, transport opportunities, access to appointment information and patient perceptions of costs and benefits of seeking health care. George hospital, situated in a rural area, serves 5000 outpatient visits monthly, with non-attendance rates of up to 40%. Objectives: The aim of this research was to gain a greater understanding of the reasons behind non-attendance of outpatient department clinics to allow locally driven, targeted interventions. Methods: This was a descriptive study. We attempted to phone all patients who missed appointments over a 1-month period (n = 574). Only 20% were contactable with one person declining consent. Twenty-nine percent had no telephone number on hospital systems, 7% had incorrect numbers, 2% had died and 42% did not respond to three attempts. Results: The main reasons for non-attendance included unaware of appointment date (16%), out of area (11%), confusion over date (11%), sick or admitted to hospital (10%), family member sick or died (7%), appointment should have been cancelled by clerical staff (6%) and transport (6%). Only 9% chose to miss their appointment. The other 24% had various reasons. Conclusions: Improved patient awareness of appointments, adjustments in referral systems and enabling appointment cancellation if indicated would directly improve over two-thirds of reasons for non-attendance. Understanding the underlying causes will help appointment planning, reduce wasted costs and have a significant impact on patient care.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

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