Equity in health care confronting the confusion pdf download

Differences in medical specialist utilization among older people in need of longterm care results from german health claims data. Achieving equity in the australian healthcare system. Establishing equity of patient care hospital and health. Demographic changes in the united states bring diverse cultures, languages, and challenges to health care delivery, particularly for children. Health and health care improvement communities in the us are focusing on equity and racial disparities in some important new ways. Access to health care services, based on a common belief. Addressing equity of care remains an imperative for hospitals and health systems. References toward health equity and patientcenteredness. For instance, the idea of universal health coverage or access to health services appeals to horizontal equity, whereas provision of targeted health programs and services based on established needs may appeal to vertical equity principles. Elderly in need of longterm care tend to have worse health and have higher need of medical care than elderly without need for longterm care. Utilisation as a measure of equity by mooney, hall. To avoid confusion, the terms equity and inequity have been chosen by.

Despite general agreement that equity is part of the objective of the uk national health service as indeed it is in other health services, there is little consensus. Democrats, and even a few republicans, are in a populist mood, and fair enough. Pdf the ministers of health from chile, germany, greece, new zealand. H42,h51,i18 abstract this paper examines the efficiency and equity implications of alternative health care system financing strategies. This paper suggests seven possible definitions of equity not with the. Access is central to the performance of health care systems around the world. A primer for the health care system accessible, and acceptable to everyone in the population, while also maintaining a high degree of quality. Improving health and health care worldwide requires a focus on equity equity of access, treatments, and outcomes. In the transition from a planned economy to a marketoriented economy, chinas state funding for health care declined and traditional coverage plans collapsed, leaving chinas poor exposed to potentially ruinous health care costs. The hi method examines, quantifies, and explains inequity which is based on. Health economics research unit, discussion paper no. Measuring horizontal inequity in healthcare utilisation.

In the literal sense, disparity merely implies a difference or a lack of parity of some kind. Were in pursuit of transformational systems change. This greater likelihood of occurrence, severity, and adverse effects is compounded even further by multiple illnesses, multiple serious illnesses, and greater likelihood of adverse. Equity goals, such as equal treatment for equal need or equality of access, commonly take pride of place among the aims of health policy.

In reforming health care for the 21st century, equity in health care financing has become a major policy goal. Examining interactions between social factors of concern and need, or stratifying analyses according to different levels of need, can be used to identify horizontal and vertical equity. In collaboration with likeminded organizations, communities, and individuals, ihi applies improvement methods and tools to reduce unjust, costly, and persistent. However, while equity of access is widely accepted as a principle, measures of equity and the design of mechanisms to achieve this policy goal remain debated topics. In particular, firstlevel services may require strengthening in order to improve local access to basic primary health care. Our new crystalgraphics chart and diagram slides for powerpoint is a collection of over impressively designed datadriven chart and editable diagram s guaranteed to impress any audience.

Registered nurses have a responsibility to advocate for the elimination of social inequities. Evaluating healthcare equity challenges, solutions and. But do these conceptions, or others derived from more fundamental philosophical systems such as those of the utilitarians or john rawls, successfully capture the way in which the term equity is generally used. Improving health equity through data collection and use. Health care financing, efficiency, and equity nber working. International journal for equity in health articles. However, access to health care remains a complex notion as exemplified by the varying interpretations of the concept across authors. Frustrated by the slow progress of closing gaps despite decades of research and documentation of the problems, many are forging ahead to create more equitable access to care and better outcomes wherever and. Inequity, on the other hand, implies a state of being unfair. A conversation guide for health equity 2 what this conversation guide is and how to use it purpose the purpose of this guide is to provide a tool that anyone can use to convene, host, and facilitate a conversation with members of their community on how to collaborate and. Because of this, far too many start behind and stay behind.

Economics, medicine and health care wheatsheaf, brighton, uk. Empirical studies of equity in healthcare utilisation primarily rely on the horizontal inequity hi approach which measures unequal utilisation of healthcare services by socioeconomic status ses for equal medical need. Diseases are more likely to occur and to be more serious in socially disadvantaged people 2, 5. New evidence on financing equity in chinas health care. In fact, the importance of service delivery for people has resulted in measurement of utilisation and access having a prominent role in the health policy literature 1, 2. However, it has not always been clear what is meant by equity and health, and this. Understanding how health and equity issues affect racial, ethnic, and linguistic minorities in our state is important for both practical and policy purposes. Introduction a guide for hospital leaders a growing collection of resourcesin the form of guides, toolkits, research studies and other content is now available to assist hospital leaders in the development and execution of targeted interventions to. Comment utilisation as a measure of equity by mooney, hall. Resources document these overarching inequities as well as the social determinants of health. The evaluation of healthcare equity necessitates measuring both horizontal and vertical equity components to establish whether or not patients receive the health care across levels of need. Modernizing concepts of access and equity volume 4 issue 2 martin gulliford.

These strategic practices are rooted in a theory of change that to systematically dismantle the patterns of othering and exclusion in government practice, we must pursue a walltowall transformation. Despite general agreement that equity is part of the objective of the uk national health service as indeed it is in other health services, there is little consensus on what is meant by equity in health care. Equity some theory and its policy implications journal. Chart and diagram slides for powerpoint beautifully designed chart and diagram s for powerpoint with visually stunning graphics and animation effects. Other concepts of fair distribution of health such as equity of access to medical care may not be sufficient to equalise health outcomes but, nevertheless, they may be more practical and. Achieving equity in the australian healthcare system stephen r leeder the final in the mjas series of keynote addresses presented at the australian health care summit 2003. At the same time, faced with a growing demand for health care, governments. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Utilisation as a measure of equity by mooney, hall, donaldson.

Focus on health equity and action health services research. Unfortunately, many areas have experienced generations of isolation from opportunity. Introduction in a recent note in this journal, mooney, hall, donaldson and gerard 1991 hereafter mhdg argue that almost all empirical work by economists on equity in the delivery of health care is misguided, because it is based on an inappropriate notion of equity. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Integrating literacy, culture, and language to improve health care quality for diverse populations. The concepts and principles of equity and health citeseerx. The evaluation of health care equity necessitates measuring both horizontal and vertical equity components to establish whether or not patients receive the health care across levels of need.

How health care organizations can create equity in. Accessibility of services refers to the extent to which the health care system is designed to meet the needs of its users. This essay seeks to characterise the essential features of an equitable health care system in terms of the classical aristotelian concepts of horizontal and vertical equity, the common but illdefined language of need and the economic notion of costeffectiveness as a prelude to identifying some of the more important issues of value that policymakers will have to decide for themselves. Introduction a guide for hospital leaders fulfill reporting requirements and are unsure of how to mine the data for trends in their patient population and develop interventions to address inequities identified in care. This essay seeks to characterise the essential features of an equitable health care system in terms of the classical aristotelian concepts of horizontal and vertical equity, the common but illdefined language of need and the economic notion of costeffectiveness as a prelude to identifying some of the more important issues of value that policymakers will have to decide for. Metrics for the determinants of health provides a framework for understanding how disparities in health outcomes are produced and how health equity can be achieved, particularly by addressing the determinants of health. The ministers intend to form a network to share thinking and evidence on. A conversation guide for health equity 2 what this conversation guide is and how to use it purpose the purpose of this guide is to provide a tool that anyone can use to convene, host, and facilitate a conversation with members of their community on how to collaborate and act to achieve health equity. Like many complex efforts, it is not only what you are doing i. A wholepatient oriented view of disease is more accurate than a disease oriented view. Thats why planned parenthood advocacy and political organizations fight to protect reproductive health care for everyone. This paper explores four definitions of equity in health care. Confusion over health policies and outofpocket costs have led many people to delay seeking medical treatment. Health care costs, confusion have many avoiding the doctor.

The aim of this paper is to suggest a conceptualisation of access to health care describing broad dimensions and determinants that integrate demand and supplysidefactors and. In the context of health care, these two concepts may have distinct implications for practice and policy. Access to healthcare is central in the performance of health care systems around the world. Mooney, g, 1983, equity m health care confronting the confusion, effective. But if they really want the tax code to be more progressive i. Confronting racial and ethnic disparities in health care.

Policymakers should be concerned about health equity, as research shows that health disparities actually lower overall health care quality and increase overall health care costs. Health sector reform in developing countries, including the decentralization of management and the provision of primary health care, is expected to produce changes in the pattern of health service delivery and improvements in the equity of provision 1 4. Equity and equality in health and health care sciencedirect. Identify all potential conflicts of interest that might be relevant to your comment. Equality of health status is the health equity goal being pursued in developed countries and advocated by development agencies such as who and the rockefeller foundation for developing countries also. Thats the finding of a new report by connecticutbased scio health analytics and. By 2050, the census bureau projects that 54 percent of the population will comprise minorities. Jan 22, 2015 confusion over health policies and outofpocket costs have led many people to delay seeking medical treatment.

Article information, pdf download for the concepts and principles of equity and health open. Challanges in health equity and community engagement the following topical themes emerged throughout the bay area focus group data and highlighted the. Health care financing, efficiency, and equity sherry a. A conversation guide for health equity reos partners. Health equity is realized when each individual has a fair opportunity to achieve their full health potential. Northholland equity and equality in health and health care at culyer department of economics and related studies, university of york, heslington, york, uk adam wagstaff school of social sciences, university of sussex, fulmer, brighton, uk received august 1992, final version received march 1993 this paper explores four definitions of equity in. Advancing health equity in health care communityview. Across the western world, equity of access to primary health care phc services is a fundamental goal of rural health policies and planning 1.

Challanges in health equity and community engagement the following topical themes emerged throughout the bay area focus group data and highlighted the subtle nuances of each of these strategic concepts. Equity some theory and its policy implications journal of. Improving equity in the provision of primary health care. Therefore, nursing research needs to help us better understand the role of nursing in population health, health care and health care systems. The hidden inequity in health care international journal. The ministers of health from chile, germany, greece, new zealand, slovenia, sweden, and the united kingdom recently established the international forum on common access to health care services, based on a common belief that their citizens should enjoy universal and equitable access to good quality health care. In australia, national and state strategic plans and frameworks are committed to providing equitable access to phc, regardless of where people live 2. H42,h51,i18 abstract this paper examines the efficiency and equity implications of alternative health care system financing. Despite general agreement that equity is part of the. The veteran affairs health system is one example of horizontal equity in access, as military veterans. A pre scription to end confusion iom, 2004 highlighted the importance of health literacy to health outcomes and the provision of highquality health care and illustrated the need for communication in the health care context that is clear and effective. Health equity ihi institute for healthcare improvement. Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers bureaus, stock ownership or options, expert testimony, royalties, donation of medical.

Introduction disparity and inequity are two interdependent, yet distinct concepts. The concepts and principles of equity and health margaret. Stephen leeder was director of the divsion of public health and community medicine at westmead hospital and professor of public health and community medicine 19851997. Providing highquality health care that is patient centered and equitable requires tailored care and a focus on both health care disparities and health literacy. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. Equity in healthcare is an overarching goal of many healthcare systems around the world. These acceptable reasons should not be confused with unacceptable. Advancing health equity in health care what is health equity. Health care equity the unrelenting and unprecedented wave of attacks on reproductive health and rights has a devastating effect on the lives of people seeking health care. Confronting bias and discrimination in health carewhen.