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Barriers and Facilitators to Healthcare Service Access among Persons with Spinal Cord Injury (SCI)

BACKGROUND: Despite having a high healthcare need, persons with complex conditions are less likely to receive comprehensive care. Individuals with SCI experience difficulties accessing services 2-4 times more than the general population. There is little agreement concerning the factors that influenc...

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Autores principales: Bychkovska, O, Egen, C, Strøm, V, Juocevicius, A, Tederko, P, Arora, M, Rizzo Battistella, L, Engkasan, JP, Gemperli, A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9834962/
http://dx.doi.org/10.1093/eurpub/ckac129.475
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author Bychkovska, O
Egen, C
Strøm, V
Juocevicius, A
Tederko, P
Arora, M
Rizzo Battistella, L
Engkasan, JP
Gemperli, A
author_facet Bychkovska, O
Egen, C
Strøm, V
Juocevicius, A
Tederko, P
Arora, M
Rizzo Battistella, L
Engkasan, JP
Gemperli, A
author_sort Bychkovska, O
collection PubMed
description BACKGROUND: Despite having a high healthcare need, persons with complex conditions are less likely to receive comprehensive care. Individuals with SCI experience difficulties accessing services 2-4 times more than the general population. There is little agreement concerning the factors that influence these access restrictions. Few studies focus on health system impact on characteristics on access. OBJECTIVE: To outline barriers and facilitators to service access among persons with SCI across 22 countries in terms of health system characteristics METHODS: InSCI(2017): 1st community survey on experience of persons with SCI, 12591 participants, 22 countries (Australia, Brazil, China, France, Germany, Greece, Indonesia, Italy, Japan, Lithuania, Malaysia, Morocco, the Netherlands, Norway, Poland, Romania, South Africa, South Korea, Spain, Switzerland, Thailand, USA). DATA ANALYSIS: 1. Hierarchical cluster analysis based on Gower distance (to group systems by access restrictions: Acceptability, Approachability, Availability, Affordability, Appropriateness). 2. Generalized linear mixed-effects decision tree (to explore the association of system characteristics and access, including WHO and OECD system indicators (e.g. UHC index, expenditure, human resources). Missing values were imputed with missforest. RESULTS: 12% of persons with SCI reported having an access restriction, most of them (7%) with Availability. By country, the highest unmet needs were reported in Poland (25%), Germany, Lithuania, and Romania (13). 1. Cluster analysis: 7 health systems clusters (groups) were identified. 2. By June 2022, we will have the results of the second analysis: the association of system characteristics with access and how it is modified by socio-demographic and medical factors. EXPECTED CONCLUSIONS: The study identifies factors a country could modify in order to improve access and strengthen the system for persons with SCI/disability, that might be relevant to general population as well. KEY MESSAGES: • Persons with SCI often experience similar access restrictions across countries, incl. those with high-performing health systems. System strengthening in this area is further required in all countries. • Health systems are fragmented, e.g. healthcare quality and access inside a country differs by region, urban/rural setting etc., hence, the systems are challenging to classify.
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spelling pubmed-98349622023-01-12 Barriers and Facilitators to Healthcare Service Access among Persons with Spinal Cord Injury (SCI) Bychkovska, O Egen, C Strøm, V Juocevicius, A Tederko, P Arora, M Rizzo Battistella, L Engkasan, JP Gemperli, A Eur J Public Health Parallel Programme BACKGROUND: Despite having a high healthcare need, persons with complex conditions are less likely to receive comprehensive care. Individuals with SCI experience difficulties accessing services 2-4 times more than the general population. There is little agreement concerning the factors that influence these access restrictions. Few studies focus on health system impact on characteristics on access. OBJECTIVE: To outline barriers and facilitators to service access among persons with SCI across 22 countries in terms of health system characteristics METHODS: InSCI(2017): 1st community survey on experience of persons with SCI, 12591 participants, 22 countries (Australia, Brazil, China, France, Germany, Greece, Indonesia, Italy, Japan, Lithuania, Malaysia, Morocco, the Netherlands, Norway, Poland, Romania, South Africa, South Korea, Spain, Switzerland, Thailand, USA). DATA ANALYSIS: 1. Hierarchical cluster analysis based on Gower distance (to group systems by access restrictions: Acceptability, Approachability, Availability, Affordability, Appropriateness). 2. Generalized linear mixed-effects decision tree (to explore the association of system characteristics and access, including WHO and OECD system indicators (e.g. UHC index, expenditure, human resources). Missing values were imputed with missforest. RESULTS: 12% of persons with SCI reported having an access restriction, most of them (7%) with Availability. By country, the highest unmet needs were reported in Poland (25%), Germany, Lithuania, and Romania (13). 1. Cluster analysis: 7 health systems clusters (groups) were identified. 2. By June 2022, we will have the results of the second analysis: the association of system characteristics with access and how it is modified by socio-demographic and medical factors. EXPECTED CONCLUSIONS: The study identifies factors a country could modify in order to improve access and strengthen the system for persons with SCI/disability, that might be relevant to general population as well. KEY MESSAGES: • Persons with SCI often experience similar access restrictions across countries, incl. those with high-performing health systems. System strengthening in this area is further required in all countries. • Health systems are fragmented, e.g. healthcare quality and access inside a country differs by region, urban/rural setting etc., hence, the systems are challenging to classify. Oxford University Press 2022-10-25 /pmc/articles/PMC9834962/ http://dx.doi.org/10.1093/eurpub/ckac129.475 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Parallel Programme
Bychkovska, O
Egen, C
Strøm, V
Juocevicius, A
Tederko, P
Arora, M
Rizzo Battistella, L
Engkasan, JP
Gemperli, A
Barriers and Facilitators to Healthcare Service Access among Persons with Spinal Cord Injury (SCI)
title Barriers and Facilitators to Healthcare Service Access among Persons with Spinal Cord Injury (SCI)
title_full Barriers and Facilitators to Healthcare Service Access among Persons with Spinal Cord Injury (SCI)
title_fullStr Barriers and Facilitators to Healthcare Service Access among Persons with Spinal Cord Injury (SCI)
title_full_unstemmed Barriers and Facilitators to Healthcare Service Access among Persons with Spinal Cord Injury (SCI)
title_short Barriers and Facilitators to Healthcare Service Access among Persons with Spinal Cord Injury (SCI)
title_sort barriers and facilitators to healthcare service access among persons with spinal cord injury (sci)
topic Parallel Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9834962/
http://dx.doi.org/10.1093/eurpub/ckac129.475
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