[Scientific Electronic Library Online Program, Scielo-Chile. A new way for accessing the national scientific literature].
Explore the source record for details and available documents.
Databases, Bibliographic↗
SEARCH · Search PubMed
Results for “Program Accessibility”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Access to health care in a rural area of the Philippines.
This study reports the results of a household survey requested by the mayor and community health officials in an under-served and understudied rural town in the Philippines. The study examines the extent and determinants of access to care. Results showed that 15% had a check-up in the previous year, despite 63% reporting a family history of chronic diseases. Multivariate regression analyses showed that having a usual source of care (P=.006) and education (P = .04) were predictors of having had a checkup the previous year. This study, which represents the first household survey assessing access to care in this rural Filipino population, provides empiric evidence supporting the need for health programs that will improve access to care and routine monitoring of chronic illness in this under-served, rural population.
Adult↗
Baby love and budget relief: some promising practices in prenatal managed care in Medicaid.
The provision of prenatal health care is one of the most important functions of Medicaid, as approximately three-quarters of program enrollees are poor women and children. A rapidly increasing number of states are seeking to address the dual crises of spiralling program costs and inadequate access to services through the use of managed care in Medicaid. Medicaid managed care is growing rapidly and now stands at more than 8 million enrollees, the overwhelming majority of whom are women and children. The focus on accessible preventive and primary care that is, in theory, the hallmark of managed care, should apply well to prenatal health services for Medicaid beneficiaries, though this is not always the case. The more successful managed prenatal care programs thus far have some common characteristics, which are examined here in the hope that they will be replicated by other states.
Centers for Medicare and Medicaid Services, U.S.↗
To participate or not to participate: that is the question.
Do I wish to participate or not to participate in this program? That is the question that young people ask themselves when considering a new opportunity. What can be done to increase the likelihood that they will choose to participate in out-of-school-time (OST) programs? This chapter describes a qualitative study that examined reasons for participating or not participating in OST programs. Some common reasons emerged, but the study also revealed differences among youth from different ethnic groups. It is clear that those who design and conduct programs must understand the processes through which diverse adolescents initiate their participation in programs and either persist or drop out. Given the apparent benefits of active participation in youth programs, it is important to remove barriers and increase access and, equally important, design programs that are of interest to youth in the contexts in which they live.
Adolescent↗
Mobile access: opening health care doors.
By combining traditional services and resources, the HealthQuest mobile van travels through six counties in northeast Indiana to reach those who have no easy access to health care. Existing programs that focus on meeting the needs of infants, children and adults living in rural communities via the use of mobile primary care vans are reviewed as well as this recently developed program.
Health Services Accessibility↗
A comprehensive refugee health screening program.
Nationally and internationally, there is a struggle to provide adequate health screening and assessment programs for refugees. The Department of Family Medicine at the University of Colorado Health Sciences Center in partnership with the Colorado Refugee Services Program has developed a comprehensive refugee health screening and assessment program. The program was designed to ensure access to screening and to provide better care for this vulnerable population. Key features of the program include a single point of access for all family members, full availability of appropriate interpreting services, comprehensive health assessments that include a thorough mental health screening, data collection and evaluation, and education of health care providers to deliver culturally responsive care. During the first 30 months of this program, comprehensive assessments were provided for more than 1600 refugees. Future directions include improving the efficiency of daily systems, seeking alternative sources of funding, improving follow-up and vaccination rates, expanding mental health services, and tracking health outcomes and refugees' utilization of health care services through longitudinal research.
Colorado↗
The impact of 1990 Medicaid drug rebates policy on access to prescriptions.
The U.S. Congress passed a new law (PL 101-508) in 1990 requiring the pharmaceutical manufacturers to grant rebates on prescription drugs sold at retail under the federal Medicaid program. The goals include containing Medicaid program costs and expanding access of the indigent to ethical drug treatments. This paper evaluates the impact of HCFA's mandatory federal upper limit (FUL) prices on the retail sales volume of prescription drugs during 1994. Data of the most frequently dispensed drugs, as measured by the National Prescription Audit of IMS America, are used. Regression model results suggest that the competing drug prices impact sales significantly, and Medicaid drug rebates expand access to drug interventions by stimulating retail transactions. Prescription sales are also own-price insensitive (inelastic) in Medicaid and non-Medicaid market segments. The implications of extending Medicaid prescription drug rebates policy to enrollees in the traditional Medicare program are examined.
Drug Industry↗
Cost-analysis of gym-based versus home-based cardiac rehabilitation programs.
A cost-analysis of an existing gym-based program was compared with a proposed home-based program for delivering cardiac rehabilitation services in West Moreton, Queensland. Cost and baseline data were collected on 95 cardiac rehabilitation patients living in Ipswich and West Moreton. Cost data included costs to the program funders and patients. The average cost per patient rehabilitated was $1,933 in the gym-based program and $1,169 in the home-based program. Adopting the lower cost home-based program would allow the services to be provided to many more patients. The relevance of home-based rehabilitation programs for rural patients facing barriers accessing traditional hospital- or gym-based programs is significant.
Cardiac Rehabilitation↗
Developing Membership in the Education of Deaf and Hard-of-Hearing Students in Inclusive Settings.
This article discusses the importance of membership in the inclusive education of deaf/hard-of-hearing (D/HH) students. Membership refers to being an integral part of the classroom and school communities. Membership is a key philosophical concept in inclusion that may influence how classroom teachers and teachers of D/HH students share their expertise and how they work with students and each other. Membership can be contrasted with "visitorship." When programs treat D/HH students as visitors, these students face greater barriers to obtaining a quality education in classes with hearing students. A social constructivist perspective of learning and teaching that requires students in the classroom to interact with one another and the teacher may best promote learning and is consistent with a focus on membership. We suggest that inclusion is possible, but to sustain students as full members of their classes and school, programs must go beyond placement and communication access issues. To facilitate membership, inclusive programs must carefully address teacher attitudes, teacher roles and relationships, student knowledge and curriculum, structural barriers, extracurricular activities, community relationships, and parental support.
Journal Article↗
Three decades of the Ceylon Medical Journal--analysis using MEDLINE (PubMed).
INTRODUCTION: The Ceylon Medical Journal (CMJ) is the only Sri Lankan medical journal that is indexed in MEDLINE (PubMed). Publications in the CMJ from 1965 March to 2001 December were analysed using the PubMed interface of MEDLINE. METHOD: Using PubMed we downloaded the CMJ bibliography in MEDLINE format. Important tagged fields were written to a Microsoft-Access database using a PubMed Grabber/Analyser program. The analysis was done using Access-SQL and PubMed queries. RESULTS: There were 1472 citations by 1373 authors. 944 authors had only one and 176 had two articles. The top 10 authors contributed 8% and the top 25, 15.4% of the articles. Publications types were: 68.5% 'journal articles', 10.4% letters, 4.2% historical articles and 4.1% reviews. Controlled clinical trials, randomised controlled trials and clinical trials together totalled only 39 (2.1%). Articles were classified using 2 to 44 medical subject headings (MeSH; average 11.4, mode 9) from the MeSH vocabulary. CMJ articles classified using broad MeSH categories were (top five): infections 370(15 %), pathological conditions signs and symptoms 266( 10.8%), haemic, lymphatic and immunologic 199 (7.7%), endocrine, nutritional and metabolic 189 (7.7%), neoplasms 179(7.3%). DISCUSSION: For 938 (68%) authors, publishing in the CMJ was a one time affair. The top 50 authors contributed nearly a quarter (23.2%). A product of this research is an off-line CMJ searching system from 1965 to 2001 with menu driven search facilities which will be a useful tool for researchers.
Abstracting and Indexing↗
A totally implanted injection port system for blood sampling and chemotherapy administration.
We evaluated a totally implanted system consisting of a subcutaneous injection port connected to a silicone elastomer central venous catheter for vascular access, including blood drawing, in 35 patients with cancer. All patients lacked peripheral venous access sites and were undergoing aggressive chemotherapy programs. The cumulative duration of successful access exceeded 2,900 days (for individual patients: range, five to 203 days; median, 61 days). In no instance were infusions or injections unsuccessful. Blood-sampling attempts were successful 90% of the time. The system did not require flushing between uses, being filled with heparinized saline after each entry. There were no instances of irreversible catheter occlusion or shear and no system-related infections. Thus, this device appears to have advantages over other central venous catheters in terms of patient acceptance and lack of maintenance between uses.
Adolescent↗
[Vascular accesses for chronic hemodialysis in children].
BACKGROUND: The success of a chronic hemodialysis program depends on a good vascular access. AIM: To evaluate the experience with vascular accesses for chronic hemodialysis in pediatric patients. PATIENTS AND METHODS: One hundred fifty-one vascular accesses used in 60 pediatric patients (33 female) coming from 2 hemodialysis (HD) centers were analyzed. RESULTS: The average age of admission to the hemodialysis program was 10 years old (range 1.8-15). Forty percent of accesses were internal arterio-venous fistulae (AVF), 58% were central venous catheters and 2% were grafts. Twenty four patients required a central venous catheter from the beginning since they required immediate dialysis. Twenty patients began dialysis with a permeable AVF and never required another vascular access. Eight small children used a central catheter as the only vascular access and 32 patients required both types of vascular accesses. Eighty-seven catheters were used in 34 patients, of which 77 were temporary and 10 permanent. Seventeen patients needed only one catheter and one girl required 15 catheters. The average life span for AVF was 524 days (20-1277), for temporary catheters 34 days (1-76) and for permanent catheters 73 days (9-147). Two years survival of AVF was 95%. One month survival for subclavian and jugular catheters was 50%. Fifty-six percent of AVF had no complications, 12 failed due to insufficient flow and 24% had a complication. Of the 87 catheters placed, 75% had complications and 22 were electively removed. CONCLUSIONS: Arteriovenous fistula is the vascular access of choice for hemodialysis in pediatric patients. Central venous catheters can become an essential access, specially in small children.
Adolescent↗
Feasibility and use of school-based condom availability programs in Tijuana, Mexico.
Condom availability programs (CAPs) may increase access to condoms and contribute to increased condom use among youth. This study describes the characteristics, degree of satisfaction, and gender differences among users of a CAP implemented in two high schools in Tijuana (Baja California, Mexico). A kiosk distributing free male condoms was set up in two high schools in Tijuana. Kiosk users (N=570) were more likely to be male, young, and/or enrolled in a lower SES school. Most kiosk users were either sexually active or planning to have sex. Females were less likely to request condoms and to continue using the kiosk, but more likely to request information on other contraceptive methods. Results demonstrate the feasibility of implementing CAPs in Mexican schools and suggest that these programs can improve adolescents' condom access.
Adolescent↗
Immunization among African American children: implications for social work.
Although childhood immunizations have proved to be one of the most effective means of preventing and controlling the spread of infectious and communicable diseases, thousands of preschool children, particularly children from urban African American poor families, are not being immunized. This article discusses the critical problem of low rates of immunization for this population and identifies ways social workers can play an active role in ensuring that more children are immunized. Immunization of preschool children is a function of the interrelationship among health-seeking behavior of parents, financial and nonfinancial barriers to health care, and provider practices that inhibit appropriate immunization. Improving access to existing public programs, facilitating community organization efforts, assisting communities through self-help and mutual-aid initiatives, and supporting national efforts can improve immunization status among poor children.
Black or African American↗
The impact of public insurance expansions on children's access and use of care.
OBJECTIVE: Our goal was to examine the impact of the State Children's Health Insurance Program nationally on children's access and use of health care. OBJECTIVE: Our data source was the National Health Interview Survey, using 1997 as a baseline, which predates the implementation of the State Children's Health Insurance Program, and 2003 as the end point of the analysis. We analyzed 25,734 children aged 0 to 18 years (1997 and 2003 combined) to examine changes in health insurance coverage rates, health care access, and utilization for children in the State Children's Health Insurance Program target population, defined here as those living in families with incomes between 100% and 199% of the federal poverty level. RESULTS: Children in the State Children's Health Insurance Program target income group showed the largest reduction in rates of uninsurance among 3 income groups (< 100%, 100%-199%, and > or = 200% of the federal poverty level) between 1997 and 2003 (15.1%-8.7%). Significant reductions occurred in the proportion of children without a usual source of care in the target income group (9.4%-7.3%) and in the proportion of children without a provider visit in the past year (10.8%-9.8%). Other measures (unmet needs, delayed care, volume of provider visits, receipt of well-child care, and dental care) showed no significant changes over this time period. A separate multivariate analysis restricted to the State Children's Health Insurance Program target population in 2003 showed that children with continuous public coverage had significantly better access and utilization on all measures studied when compared with uninsured children and performed as well or better than children with continuous private coverage. CONCLUSIONS: Implementation of the State Children's Health Insurance Program is associated with substantial gains in public coverage for children in the target income group. Although some of these gains were offset by losses in private coverage, our findings demonstrate that public health insurance provides significant benefits in terms of access and utilization for children living in the target income group.
Adolescent↗
Change in obstetrician advice following a two-year community educational program on alcohol use and pregnancy.
A professional education program about the risks of drinking during pregnancy was conducted from 1979 to 1981 in King County, Washington. Advice of obstetricians to patients was measured both before and after the program. There was a significant increase in the proportion of obstetricians asking about current alcohol use of patients and in the proportion routinely recommending that alcohol be limited during pregnancy. When asked by their patients about the possible effects of alcohol on the fetus, obstetricians were more likely to mention fetal alcohol syndrome as a specific risk after the educational program. Patients of these obstetricians also reported similar, although somewhat more conservative attitudes. While no control group without access to the educational program was available, sources of information about drinking and pregnancy cited by obstetricians indicated that the program was influential in the change that occurred in the 2-year period.
Adolescent↗
Motivation and fertility control behaviour in Pakistan.
Using data from the Population, Labor Force, and Migration (PLM) Survey of 1979-80, this paper examines the component of potential motivation for fertility limitation among Pakistani married women and then determines what factor are important in explaining the contraceptive use differentials among the potentially motivated subgroup of women. The analysis is conducted using logit regression models. The findings show that, among women wanting no additional children, a substantial proportion is reluctant to adopt fertility control behavior, confirming the existence of latent demand for contraception in all strata. A majority of those women report no exposure to the program or no contact with a family planning worker, and a large majority of those who have had exposure or have been contacted do not report contraceptive use, indicating a considerable shortfall of the program. Among the urban women wanting no more children, the important factors affecting contracepting use positively are education (both primary and secondary), household income, living in a nuclear family, exposure to the program, and contact with a family planning worker, for rural women, only nuclear family living and the program factors are significant in promoting contraceptive use. The suggestions likely to increase contraceptive prevalence are, first, to reach those women who have the potential motivation for contraception, and, second, to increase the quality and sources of the motivation efforts of the program to crystallize the latent demand among those who need it.
Age Factors↗
Program helps immigrants navigate health system.
Explore the source record for details and available documents.
Delivery of Health Care↗