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Creating inclusive health systems for people with intellectual disabilities: an international study
- Authors:
- McCONKEY Roy, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 17(4), 2020, pp.282-290.
- Publisher:
- Wiley
Background: Creating equitable access to mainstream health and healthcare service has been promoted as a means of addressing the health disparities experienced by people with intellectual disabilities (ID) globally. Specific Aims: This study addressed two questions: What strategic actions are most likely to bring about inclusive primary, secondary, and tertiary health systems for people ID? What are the system indicators that can be used to evidence a reduction in health disparities for this population? Method: A four‐phase study was undertaken involving an international expert advisory group, literature reviews, and individual interviews with 16 key informants from Special Olympics (SO). These led to an online international survey in which 61 respondents rated the relevance and feasibility of 30 strategic actions and system indicators to promote inclusive systems and reduce health disparities. Findings: All the strategic actions and system indicators were endorsed as relevant but less so for the feasibility of implementing them. Top‐rated strategic actions included the availability of policy statements and practice guidelines on making reasonable adjustments, mandatory training of health professionals on ID, and their involvement as cotrainers in staff training. Discussion: Implementing these strategic actions and system indicators will be a major undertaking and one that is unlikely to be speedily achieved given the many different policy and health systems that exist even within a locality as well as nationally and internationally. Nonetheless, the identified actions and indicators from this study can form the basis for improved access to health and for advancing the human rights of persons with ID. (Edited publisher abstract)
Learning disabilities: reducing inequalities
- Author:
- MARSHALL-TATE Karina
- Journal article citation:
- Nursing Times, 111(49), 2015, pp.12-13.
- Publisher:
- Nursing Times
Nurses without a learning disability qualification can feel unsure of how best to care for patients with a learning disability. This article outlines five small changes that nurses can make to improve healthcare and reduce avoidable, premature deaths of people with learning disabilities. These are: identifying people with learning disabilities, anticipating their needs and making adjustments; diagnosing and treating illness quickly; coordinating care; adhering to the Mental Capacity Act 2005, and listening to people with learning disabilities and their families. A case study shows how small changes can improve care. (Edited publisher abstract)
Determining unmet, adequately met, and overly met needs for health care and services for persons living with HIV/AIDS in Mississippi
- Authors:
- KRAUSE Denise D., MAY Warren L., BUTLER Kenneth R.
- Journal article citation:
- AIDS Care, 25(8), 2013, pp.973-979.
- Publisher:
- Taylor and Francis
A statewide needs assessment of persons living with HIV/AIDS (PLWHA) was conducted to determine what is known about access to care, utilization of services, and perceived barriers to receiving care and services to provide a better understanding of how effectively to allocate funding to provide for the needs of that group. In this cross-sectional study, a true random sample of PLWHA in Mississippi was interviewed in 2005–2006. Questions were asked to identify opinions about respondents' experiences with 23 health care services and 30 public or private assistance services. The kappa statistic was used to measure agreement between level of services needed and level of services provided. Services with the lowest kappa scores revealed which services were being either mostly unmet, or even overly met. Greatest service needs were HIV viral load test, Pap smear, CD4/T-cell count test, and medication for HIV/AIDS, which were reasonably well met. The most significantly unmet needs were dental care and dental exams, eye care and eye exams, help paying for housing, subsidized housing assistance, mental health therapy or counseling, access to emotional support groups, and job placement or employment. Overly met services included medical care at a physician's office or clinic and free condoms. This study identified needs perceived to be significantly unmet by PLWHA, as well as areas that were perceived to be adequately or overly met. This information may be used to target areas with the greatest impact for improvement and provide insight into how to effectively allocate health care resources and public/private assistance. (Edited publisher abstract)
Intellectual disability nursing – responding to health inequity
- Author:
- SHEERIN Fintan K.
- Journal article citation:
- British Journal of Learning Disabilities, 40(4), December 2012, pp.266-271.
- Publisher:
- Wiley
People with learning disabilities often have poorer health outcomes than the general population. It is recognised that improvements in health outcomes for people with learning disabilities is central to the role of learning disability nurses. This article argues that the continued enactment of the current role of learning disability nurses will fail to achieve improved outcomes and will prolong the marginalisation of people with learning disabilities. In identifying the basis of such outcomes to be social inequity, it proposes that nursing must act in two orientations: health-oriented service provision and social activism. It is argued that only when such an approach is adopted will there be a real opportunity for people with learning disabilities to achieve optimal health outcomes.
A specialist clinic for destitute asylum seekers and refugees in London
- Authors:
- NYIRI Polly, ELING Judith
- Journal article citation:
- British Journal of General Practice, 62(604), November 2012, pp.599-600.
- Publisher:
- Royal College of General Practitioners
This descriptive analysis is based on the last 122 patients seen at a refugee health clinic. The majority were survivors of torture or rape. The aim of this study was to examine the challenges they faced, in particular the difficulties they experienced in accessing health care. This south London specialist clinic runs two days a week. Patients are referred in a number of ways; by support organisations, solicitors, or word of mouth. They are offered 30 minute appointments with telephone access to an interpreter. Fifty four percent of those included in the study had been turned away by main stream GP surgeries. Overall 81% were homeless or in temporary, unstable accommodation; 65% had not eaten on the day of consultation. Half the group showed symptoms of depression and a quarter of PTSD. Suicide was assessed as a risk in 35%. However, only eight patients had a history of substance abuse. Eighteen percent had at least one serious communicable disease. By the end of the study period, more than half of the patients were in contact with mainstream general practice. The authors conclude that the clinic serves an important function in helping this vulnerable group negotiate the process of rebuilding their lives in the country of asylum.
Improving healthcare access for people with visual impairment and blindness
- Authors:
- CUPPLES M.E., et al
- Journal article citation:
- British Medical Journal, 4.2.11, 2011, pp.42-46.
- Publisher:
- British Medical Association
The difficulties facing visually impaired patients when accessing health care are discussed. The article also looks at how effective communication and anticipation of difficulties can help to avoid and resolve problems. Examples are given in the areas of: improving delivery of information about appointments and treatment; helping patients to navigate unfamiliar environments; and communication and consultation skills.
Good intentions, increased inequities: developing social care services in Emergency Departments in the UK
- Authors:
- BYWATERS Paul, et al
- Journal article citation:
- Health and Social Care in the Community, 19(5), September 2011, pp.460-467.
- Publisher:
- Wiley
Assessing the quality of services provided in Emergency Departments (EDs) has been a central area of development for UK policy. EDs constitute a critical boundary between the community and the hospital and a key point for the identification of social care needs. As such, EDs have become the focus for a variety of service developments such as the establishment of multidisciplinary teams aimed at preventing re-attendance or admission, re-directing patients to other services, or speeding patients through EDs to provide improved quality of care. This survey of social care initiatives based in EDs determined the objectives, organisation, extent, functions, funding and evidence of outcomes of such interventions. Approximately, one-third of EDs had embedded social care teams, with two-thirds relying on referrals to external social care services. These teams varied in their focus, size and composition, leadership, availability, funding and permanence. As a result, the effect has been to increase inequities in access to social care services provided through EDs. In conclusion, this research adds to international evidence pointing to the benefits of a variety of social care interventions based in EDs.
False economy in health cuts
- Author:
- MOONEY Helen
- Journal article citation:
- Community Care, 9.6.11, 2011, pp.22-23.
- Publisher:
- Reed Business Information
Although the government has stated that improving the health of homeless people is a priority, survey results from Homeless Link’s annual survey of needs and provision (SNAP) found that many services are facing cuts. A short case study describes the impact of the closure of a Nottingham substance misuse day centre on the health of the homeless and an increase in A&E attendance. The Centre helped homeless people access primary healthcare.
Access to health care for disabled people: a systematic review
- Authors:
- GIBSON Jeremy C., O'CONNOR Rory J.
- Journal article citation:
- Social Care and Neurodisability, 1(3), 2010, pp.21-31.
- Publisher:
- Emerald
Published studies were systematically reviewed to determine if disability limits access to health care and to identify what body functions, structures and activities, participation and contextual factors interact with the health condition to limit this access. Online database searches were carried out for original study articles in English from 1974 to 2008. Studies identified were critically appraised and 60 studies were selected for inclusion in the review. Studies broadly fell into 3 categories (database studies, quantitative surveys, and qualitative interviews); no randomised controlled trials were identified. The authors concluded that disabled people are restricted in accessing health care and report less satisfaction with their medical care than non-disabled people, while noting that many of the identified studies centred on subjective opinions rather than objective assessments. They assert that more objective evidence is needed, especially in the UK, to clarify the true level of access to health care in people with disabilities.
Fighting for a better life
- Author:
- DAVIS Rowenna
- Journal article citation:
- Community Care, 24.9.09, 2009, pp.26-27.
- Publisher:
- Reed Business Information
A recent report from a committee of MPs found that services for people with muscular dystrophy are so poor they "compromise patient survival". The difficulties faced by those with muscular dystrophy to secure adequate services are highlighted by reporting on the battle of the fight of one man, Sulaiman Kahn, to obtain a care package. He believes that offering the option of direct payments would provide people with more control over their care.