Barriers to Health Care
Respond to the following questions concerning the identified disparities to health within the Healthy People 2020
- Are there tools to help identify these gaps in care?
- If you could develop a screening tool to address a barrier to healthcare, what would it look like?
- Who would administer this and what resources would you need to coordinate with to solve this problem?
- Is this feasible for a clinic setting? Why or why not?
Barrier to Health Care Sample Answer
Health disparities are regarded as unjust or avoidable differences in vulnerability and exposure to health risk aspects, health-care results, and the economic and social penalties of these results. It can also be regarded as specific population variations in the presence of healthcare access, health outcomes, or diseases. Health disparities are ethnic or racial variations in the healthcare quality, which are not as a result of clinical needs, intervention appropriateness, preferences, and access-related factors (Abu-Saad, Avni & Kalter-Leibovici, 2018).
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Health disparity according to Health People 2020 refers to a specific form of health variation that is closely associated to environmental, social, or economic disadvantage. It adversely impact groups of individuals who have analytically experienced greater economic or social obstacles to health, due to their ethnic or racial group, gender, age, socioeconomic status, gender identity or sexual orientation, mental health, geographical location, physical, sensory or cognitive disability or other traits that are historically connected to exclusion or discrimination (Braveman, 2014).
Tools to Help in Identifying these Gaps in Care
There are various developed gaps analysis tools to assist in identification of healthcare needs and gaps in care, but mostly customized to cater for individual healthcare organization’s needs and not that of the entire population. For instance, Golden et al. (2017), developed gap analysis tool that was more inclined to specific disease and how to eliminate health disparity gap in that particular disease; diabetes. The tool focused more on health organization internal factors influencing health disparity. However, a few aspects can be borrowed from this tool. Golden et al. (2017) tool employed data-driven and systematic approach to identify the needs. The tool is also said to assess automated access of data, order sets and policies, protocols, program infrastructure, as well as health care and patient professional education. Gap analysis assisted in identifying areas of priority so as to synergize and integrate diabetes care efforts and resources to reduce disparities and to enhance quality in care, across the hospital system. This can act as guidance to the development of a universal health disparities assessment tool, which can help in keeping track of health disparity in the entire American population and which can be used in any healthcare facility.
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According to Dye et al. (2019) there has
been ongoing research on evaluation of health disparities that incorporate
unique components that include sociocultural context, population traits, and
lack of common metrics and indicators to health disparity. The research focuses
on three components of evaluation strategies. The first component is formative
which comprises of process and needs assessment. The second component is
methodology and design, which comprises of multilevel designs employed in
real-world environments. The last component is summative which focuses on the
cost, impacts, and outcomes. Every component in the ongoing research
deliberates on the unique aspects of health disparity, and offer strategies to
advance the health disparities research evaluation. Although the research has
not come up with a specific tool that can be used to enhance assessment and
identification of gaps, it has clearly demonstrated procedures that can be
employed to ensure effective assessment of health disparities in the American
society. According to Dye et al. (2019), needs’ assessments offer a
fact-founded way, to establish gaps and to evade requirement assumptions, as
per the mainstream values. They also assist in capitalization and
identification of the health disparity population strength. Strength-founded
assessments permit communities to be perceived in light of their hopes,
abilities, values, talents, visions, competences, and possibilities. They
presume communities have the aptitude to do their best, change, and grow. In Dye
et al. (2019) views, both strengths- and needs-founded health disparity
assessments in the population should be aware of physical environments and
multilevel social context that include level of crime, system policies, lack of
green space or resources, laws, existence of environmental toxins or food
deserts, and geographic locations. All these external factors can have
considerable impact on the participants’ involvement and in the health
disparity interventions success, though they are never considered in evaluation
program that is currently being researched.
Developing a Screening Tool to Address Barriers to Healthcare
According to Health People 2020 health disparities are mostly based on social, economic and environmental obstacles and mostly affect individuals who experienced ethnic, racial, cultural, sexual, or mental health discriminations among other forms of discrimination (Braveman, 2014). In this regard, if I were to develop a screening tool, I would focus on those aspects that initiate health disparities. The screening tool will be automated analytical tool that focuses on collecting population personal information with intention of capturing data on individual ethnicity, gender, sexuality, socioeconomic status, race, culture, disabilities, mental health and geographical location among other things. The identified population will also go through comprehensive medical assessment to determine their state of health. This will be followed by interview questions regarding their accessibility to quality health care services, most discouraging factors to acquire healthcare services, if they have health cover, and their level of health satisfaction (Abu_saad, Avni & Kalter-Leibovici, 2018).
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This information will also integrate with individual treatment information which will include diagnosis, classification of the diagnosed disease as preventable or unpreventable, chronic or terminal. More information will be taken on measures that diagnosed individuals have taken in the past to enhance treatment and recovery. If no measures taken, reason should be stated. This assessment will help in classifying patients based on the aspects that bring about health disparities to them over the rest of the population. All the collected data will be stored in this particular tool. The analytical tool will then be used to determine the main factors result to health disparities among the marginalized or discriminated population. With this information, strategic measures can be put in place to address disparities especially on preventable diseases. Therefore, the tool will be more like a questionnaire with different sections to be filled in. The questionnaire will be digitalized to ensure that the data is stored in an electronic database for ease of analysis. The respondents will thus have to answer a structured questionnaire, which will be orally administered ,but responses keyed in in the digital questionnaire.
Administration of the Screening Tool and Needed Resources to Coordinate with to address the Problem
The tool will be administered by a team
of public health workers and medical team. The team will be aided by volunteers
and NGOs focused on fighting for rights of discriminated people in the society,
especially in general data collection. The tool will be administered in the
community, especially in areas where most of minority groups reside. This will
help to have enough information to understand health disparities and define the
most viable measure to address them. To address this problem, the researcher
will need to coordinate with healthcare workers, policy makers, and leaders of
the community. Medical professional will center on conducting the technical
part of the interview that concerns health issues. Policy member will assist in
developing laws and policies that will eliminate health discrimination among
the marginalized, based on what will be established as the main cause of health
disparities. Community leaders will play a great role of mobilizing people to
take part in the research.
Is the Tool Feasible in Clinical Setting?
The tool will be highly feasible in clinical setting. However, it may require a lot of time to complete all the aspects of the assessment. The best way to approach it will be integrating the questionnaire in the patient assessment, prior to diagnosis as part of gathering patient’s health history and other relevant health information. The tool can be used as a continuous assessment where some parts will be answered during assessment, and the remaining part will be done after the diagnosis, when the physician has all the required patient information on the disease, cause, whether preventable or not and whether cultivated by discriminative aspects enhancing health disparity among the minority groups. The physician will then decide on the best measures to address specific patient condition to reduce health disparity, either based on defined measures after research or based on individual personal knowledge, for patients who are treated during the research stage of the process. For successful implementation in healthcare organization, a collaborative effort can be used. In this case, nurses involved in patients’ assessment should open patient account in a digital system and gather personal and medical history data. The physician can answer the remaining part after patient diagnosis.
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