Darbo tikslas. Įvertinti Kauno miesto bedarbių nuomonę apie prieinamumą sveikatos priežiūros paslaugoms ir pasitenkinimą jomis. Tyrimo metodika. Tyrimas buvo atliekamas Kauno mieste 2012 m. kovo – balandžio mėnesį. Tiriamąjį kontingentą sudarė tuo laikotarpiu Kauno teritorinėje darbo biržoje besilankantys darbo neturintys, darbingo amžiaus asmenys. Iš viso gautos 448 tinkamai užpildytos anketos (atsako dažnis – 58,0 proc.). Statistinė duomenų analizė buvo atlikta naudojant SPSS programos 17.0 versiją. Rezultatai. Dauguma (61,1 proc.) bedarbių savo sveikatą vertino teigiamai, tačiau ilgalaikiai bedarbiai vertino ženkliai blogiau, negu trumpalaikiai. 45,1 proc. bedarbių neoficialiai mokėjo už sveikatos priežiūros paslaugas. Ilgalaikiai bedarbiai statistiškai reikšmingai dažniau turėjo finansinių sunkumų perkant reikiamus vaistus, lyginant su trumpalaikiais. Ketvirtadalis respondentų teigė patyrę diskriminaciją iš sveikatos priežiūros personalo. Dauguma pacientų palankiai vertino (58,2 proc.) paslaugų teikimą pirminėje sveikatos priežiūros gydymo įstaigose Ilgalaikiai bedarbiai kritiškiau vertino pasitenkinimą sveikatos priežiūros paslaugomis nei trumpalaikiai. Privačioje sveikatos priežiūros įstaigoje prisiregistravę respondentai, buvo labiau patenkinti suteiktomis paslaugomis, negu valstybinėje įstaigoje. Išvados. Dauguma darbo neturinčių asmenų, teigiamai atsiliepė apie sveikatos priežiūros paslaugų prieinamumą ir gydytojo – paciento bendravimo apsektus, tačiau pasitenkinimas... [toliau žr. visą tekstą] / Aim of the study. To evaluate satisfaction and accessibility to health care services among unemployed population in Kaunas city. Methods. The data was collected in cross – sectional study, in 2012. We received 448 filled-in questionnaires (response rate – 58.0%) from unemployed persons, who were attending the Kaunas labor market office (Lithuania). The statistical analysis of data was performed using statistical package SPSS Statistics 17.0. Results. The majority (61.1 %) of unemployed evaluated their health positively. However, long–term unemployed persons rated their health status more negatively, then short term unemployed ones. 45.1% of unemployed made non–official payments to health care providers. Long-term unemployed has experienced more financial difficulties in purchasing the necessary medication, compared with short–term ones. One quarter of respondents reported episodes of discrimination from health care staff. The majority of unemployed (58.2 %) were satisfied with health care services. Short–term unemployed were more satisfied with health care, then long–term ones. Clients of private medical health care facilities were more satisfied with the quality and accessibility of health care service, comparing with those from public health units. Conclusions. The majority of respondents were satisfied with quality of health care services. Higher satisfaction has been observed among short-term unemployed, comparing with long–term ones. The results showed that short–term... [to full text]

SUMMARY Assessment of health care services quality and accessibility for tick-borne encephalitis patients in Kaunas region Liucijus Ambraška Supervisor Janina Petkevičienė, Dr.Sc.Assoc. Prof., Department of Social Medicine. Faculty of Public Health, Kaunas University of Medicine.- Kaunas, 2005.-P.68 Key words: tick-borne encephalitis, quality and accessibility of health care services Incidence of tick-borne encephalitis (TBE) is increasing by data of Lithuanian health information center. Aim of the study – to assess accessibility and quality of health care services for TBE patients in Kaunas region. Objectives: to establish peculiarities of transmission TBE infection and opinion about TBE prophylaxis of reconvalescents; to evaluate duration of admission period of TBE patients to specialized hospital and peculiarities of monitoring after discharging and satisfaction with health care services; to determine standpoint of general practitioners (GP) on TBE prophylaxis and reconvalescents monitoring problems. Methods. Case histories of TBE patients treated in Kaunas Clinical Hospital of Infectious Diseases in years 2001-2002 (n=187) analyzed. Questionnaires about state of health and assessment of quality of health care services during period of illness and reconvalescence were posted. 104 answers received. Questionnaires about standpoint on TBE control problems handed to 150 GP and returned by 101. Original questionnaires used. Differences between groups assessed using Mann-Whitney... [to full text]

Magistro baigiamajame darbe išanalizuoti LR egzistuojančių viešų ir privačių sveikatos priežiūros įstaigų veiklos skirtumai bei jų sąveiką. Ištirti tokie viešųjų ir privačių sveikatos priežiūros sektorių aspektai: sveikatos priežiūros sektoriai patys savaime, šių įstaigų institucinis išsidėstymas, teisinis reglamentavimas, finansavimas, konkurencingumas, prieinamumas pacientui. Pirmojoje darbo dalyje yra aptarta Lietuvos nacionalinės sveikatos sistema, kaip turinti vienyti viešąsias ir privačiąsias sveikatos priežiūros įstaigas, aptarta jos bendroji charakteristika. Antrojoje dalyje išsamiai išnagrinėtos, suklasifikuotos sveikatos priežiūros įstaigos, aptarta jų priklausomybė viena nuo kitos. Trečiojoje darbo dalyje kaip atskiros grupės išskirtos privačios ir viešosios sveikatos priežiūros: aptarta jų sąveika, pagrindiniai skirtumai, pamatiniai teisinio reglamentavimo ypatumai. Paskutinė ketvirta lyginamoji darbo dalis leido surasti tuos taškus, per kuriuos viešasis sveikatos priežiūros sektorius galėtų bendradarbiauti su privačiu. Palyginta šių sektorių finansavimo bazė, surasta papildoma alternatyva papildomojo sveikatos draudimo pavidalu. Kadangi sveiktos priežiūros sektoriuje centrinė figūra vis tik turi būti pacientas, pateiktas ir jo požiūris į privatų ir viešąjį sveikatos priežiūros sektorius, šių sektorių vertinimas. / The distinction and interface of health care institutions of Lithuania Republic are analyzed in this final master’s work Such public ant private health care institutions aspects are analyzed: health care institutions by themselves, deployment of these institutions, their legal regulation, sponsorship, competitive ability, accessibility for the patients. The first part of the work is concerned about national health care system of Lithuania, which must unify public and private health care institutions. The common characteristics of this system are discussed. The second part thoroughly reveals and classifies health care institutions; knock about their dependence on each other. In the third part as separate groups are divided private and public health care institutions: their interaction, main differences and basic legal regulation principles are discussed. The last fourth comparative part enabled to find those points, which could help for private health care sector to collaborate with public one. The comparison of financial basis of those sectors, allowed to found an additional assurance alternative. Since the patient is the central figure in a health care sector, his attitude towards the private and public health care institutions, and those sectors valuation is represented.

Background: Accessibility to health care in rural areas is globally impeded by physical, material, human, financial and managerial resources and societal barriers in the health care system. The Systems Model formed the backbone to developing a strategic action plan to address the challenges experienced by all stakeholders involved. Purpose: The purpose of this study was to describe accessibility to health care in rural areas to develop a strategic action plan to enhance accessibility to health care in these areas of Zimbabwe. Methods: A multiple methods approach combining qualitative and quantitative components during 4 phases. Phase 1 collected quantitative data with questionnaires from professional nurses and health care users who were conveniently sampled. Phase 2 collected qualitative data with a nominal group from national health directors who were conveniently sampled. Phase 3 was based on the findings from Phases 1 and 2 with a literature control to develop a draft strategic action plan. During phase 4 the strategic plan was amended and validated with a validation tool by members of the parliamentary portfolio committee on health in Zimbabwe with all-inclusive sampling. Framework: The Systems Model Framework was adopted for this study as outcomes and impact on people’s health is determined by inputs, processes and outputs. This model was relevant and applicable to accessibility to health care. Research findings: Accessibility to health care in rural areas of Zimbabwe is affected by inadequate distribution of physical resources, shortage of material and human resources, and a lack of financial resources. The strategies identified contributed to the strategic action plan which was amended and validated. The strategic action plan includes improving the health infrastructure, providing appropriate medical drugs, training and retention of health workers, providing medical equipment at the rural health facilities, reviewing the health worker workload and addressing staff shortages, providing free health care services in rural areas, and improving the capacity of the health care system. Conclusion: The strategic action plan was developed based on the inputs of the relevant stakeholders and the System Model. The inclusion of the parliamentary portfolio committee on health (members of parliament of Zimbabwe) might enhance the possibility for implementation which can enhance the accessibility to health care in rural areas of Zimbabwe. / Health Studies / D. Litt. et. Phil. (Health Studies)

Les iniquités de santé vécues par les communautés autochtones sont des conséquences visibles des déterminants structurels de la santé, tels que le racisme systémique et le colonialisme. En 2021, une enquête auprès des Inuit du Nunavik, a révélé un manque de confiance envers les professionnels de la santé et des services non culturellement sécuritaires. Les infirmières en première ligne sont les piliers du système de soins nordiques. Cette étude avait pour but d’explorer la perspective d’infirmières de première ligne sur la prestation de soins et services promouvant l’équité exerçant auprès des communautés Inuit du Nunavik. Une perspective critique postcoloniale ainsi qu’un devis descriptif interprétatif (Thorne, 2016) ont été utilisés. Le cadre théorique développé par Browne et al. (2018) s’intitulant Key Dimensions of Equity-Oriented Health Care and Strategies to Guide Implementation a guidé cette étude. Au total, 10 infirmières et infirmiers de première ligne exerçant au Nunavik ont participé à des entrevues individuelles semi-structurées. Une analyse thématique des données (Braun et Clarke, 2006) a été effectuée. Les résultats ont permis d’identifier une conception fluide des soins et services promouvant l'équité, passant d’une perspective égalitaire à critique. Cette conception façonne de manière significative la perception du contexte nordique colonial, du système de santé et de l’approche de soins infirmiers. L'un des principaux défis exprimés par les infirmières concerne l'indifférence des systèmes de santé aux priorités des communautés. Des actions locales sont priorisées pour surmonter ce défi. Des pistes d’améliorations, telles que le développement d’une conscience critique sont décrites. / Health inequities experienced by Indigenous communities are visible consequences of structural determinants of health, such as systemic racism and colonialism. In 2021, a survey of Inuit in Nunavik revealed a lack of trust in health care professionals and culturally unsafe services. Primary care nurses (RNs) are the backbone of the northern health care system. The purpose of this study was to explore equity-oriented care and services from the perspectives of primary care RNs working in Nunavik Inuit communities. A critical postcolonial perspective (Anderson et al., 2009) and an interpretive descriptive design (Thorne, 2016) were used. The Key Dimensions of Equity-Oriented Health Care and Strategies to Guide Implementation (Browne et al., 2018) theoretical framework guided the study. Semi-structured interviews were conducted with ten primary care RNs working in Nunavik. The data was analyzed thematically (Braun & Clarke, 2006). The findings identified a fluid conceptualization of equity-oriented care and services, ranging from egalitarian to critical perspectives. This conception significantly shapes nurses' perceptions of the northern colonial context, the health system, and the nursing care approach. One of the main challenges expressed by nurses is the indifference of health systems to community priorities. Local actions are prioritized to overcome this challenge. Pathways of change, such as the development of critical consciousness, are described.