Displaying publications 1 - 20 of 55 in total

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  1. Allotey P, Verghis S, Alvarez-Castillo F, Reidpath DD
    BMC Public Health, 2012;12 Suppl 1(Suppl 1):S2.
    PMID: 22992314 DOI: 10.1186/1471-2458-12-S1-S2
    Matched MeSH terms: Healthcare Disparities*
  2. Reidpath DD, Olafsdottir AE, Pokhrel S, Allotey P
    BMC Public Health, 2012;12 Suppl 1:S3.
    PMID: 22992346 DOI: 10.1186/1471-2458-12-S1-S3
    In the health systems literature one can see discussions about the trade off between the equity achievable by the system and its efficiency. Essentially it is argued that as greater health equity is achieved, so the level of efficiency will diminish. This argument is borrowed from economics literature on market efficiency. In the application of the economic argument to health, however, serious errors have been made, because it is quite reasonable to talk of both health equity being a desirable output of a health system, and the efficient production of that output. In this article we discuss notions of efficiency, and the equity-efficiency trade off, before considering the implications of this for health systems.
    Matched MeSH terms: Healthcare Disparities*
  3. Cheong MWL, Allotey P, Reidpath DD
    Asia Pac J Public Health, 2020 07 25;32(6-7):379-380.
    PMID: 32715721 DOI: 10.1177/1010539520944726
    Matched MeSH terms: Healthcare Disparities*
  4. Dee EC, Paguio JA, Yao JS, Lim J, Lasco G
    Lancet Oncol, 2021 09;22(9):e381.
    PMID: 34478665 DOI: 10.1016/S1470-2045(21)00350-8
    Matched MeSH terms: Healthcare Disparities*
  5. Ahmadi K, Allotey P, Reidpath DD
    Acad Med, 2013 May;88(5):559.
    PMID: 23611970 DOI: 10.1097/ACM.0b013e31828a0d46
    Matched MeSH terms: Healthcare Disparities*
  6. Wong YL
    Asia Pac J Public Health, 2009 Oct;21(4):359-76.
    PMID: 19661102 DOI: 10.1177/1010539509337730
    Gender inequalities in health and gender bias in medicine are interrelated challenges facing health care providers and educators. Women and girls are disadvantaged in accessing health care because of their low social status and unequal treatment in medical care. Gender bias has long been inherent in clinical practice, medical research, and education. This can be traced to the medical curriculum that shapes the perceptions, attitudes, and behavior of the future doctor. The author advocates medical curricula change to address gender inequalities in health and gender bias in medicine. She analyses the reasons for integration of gender competencies in the medical curriculum, discusses what gender competencies are, and reviews ways to in-build gender competencies and their assessment. Efforts to change and gender sensitize medical curricula in developed and developing countries are also reviewed. The review hopes to contribute to strategic medical curriculum reform, which would lead to gender-sensitive health services and equity in health.
    Matched MeSH terms: Healthcare Disparities*
  7. Saw Chien G, Chee-Khoon C, Wai VH, Ng CW
    Asia Pac J Public Health, 2015 Nov;27(8 Suppl):79S-85S.
    PMID: 26116582 DOI: 10.1177/1010539515591847
    The goal of ensuring geographic equity of health care can be achieved if the geographic distribution of health care services is according to the health needs. This study aims to examine whether acute Ministry of Health hospital beds are distributed according to population health needs in various states within Peninsular Malaysia. The health needs of each state are indicated by the crude death rate. Comparisons of the share of hospital beds to that of population with differential health needs were assessed using concentration curve and index. In most years between 1995 and 2010, the distribution of hospital beds in Peninsular Malaysia were concentrated among states with higher health needs. This is in line with the principle of vertical equity and could be one advantage of a central federal government that can allocate health care resources to prioritize states with higher health care needs.
    Matched MeSH terms: Healthcare Disparities*
  8. Foster HE, Scott C, Tiderius CJ, Dobbs MB
    Pediatr Rheumatol Online J, 2020 Jul 14;18(1):60.
    PMID: 32664961 DOI: 10.1186/s12969-020-00451-8
    There is increasing concern about the emerging global non-communicable diseases (NCDs) burden. The focus has mainly been on NCDs in adults but it is important that MSK morbidity in both children and adults is included in strategic planning. There have been considerable advances in the understanding and treatment options for children and young people (CYP) and clinical outcomes are improving for those who can access such high quality care. However vast inequity exists and there are many CYP who live in areas of the world with high burden of health care challenges, compounded by paucity of specialist care and limited access to treatments. The Paediatric Global Musculoskeletal Task Force aims to raise awareness about unmet needs for CYP with MSK conditions, promotion of MSK health through lifestyle and the avoidance of injury. We aim to leverage change through 'working together better'.
    Matched MeSH terms: Healthcare Disparities/organization & administration*
  9. Poudel A, Kc B, Shrestha S, Nissen L
    J Glob Health, 2019 12;9(2):020309.
    PMID: 31656599 DOI: 10.7189/jogh.09.020309
    Matched MeSH terms: Healthcare Disparities/statistics & numerical data*
  10. Lee KS, Ming LC, Lean QY, Yee SM, Patel R, Taha NA, et al.
    J Epidemiol Glob Health, 2019 06;9(2):93-97.
    PMID: 31241865 DOI: 10.2991/jegh.k.190506.001
    Matched MeSH terms: Healthcare Disparities*
  11. Miyasaki JM, Lim TT, Bhidayasiri R
    Parkinsonism Relat Disord, 2021 04;85:114-116.
    PMID: 33840573 DOI: 10.1016/j.parkreldis.2021.03.022
    Matched MeSH terms: Healthcare Disparities*
  12. Palagyi A, Balane C, Shanthosh J, Jun M, Bhoo-Pathy N, Gadsden T, et al.
    Int J Cancer, 2021 02 15;148(4):895-904.
    PMID: 32875569 DOI: 10.1002/ijc.33279
    In this systematic review and meta-analyses, we sought to determine sex-disparities in treatment abandonment in children with cancer in low- and middle-income countries (LMICs) and identify the characteristics of children and their families most disadvantaged by such abandonment. Sex-disaggregated data on treatment abandonment were collated from the available literature and a random-effects meta-analysis was conducted to compare the rates in girls with those in boys. Subgroup analyses were conducted in which studies were stratified by design, cancer type and the Gender Inequality Index of the country of study. Eighteen studies were included in the systematic review and of these studies, 16 qualified for the meta-analysis, representing 10 754 children. The pooled rate of treatment abandonment overall was 30%. We observed no difference in the proportion of treatment abandonment in girls relative to estimates observed in boys (rate ratio [RR] 0.95, 95% CI: 0.79-1.15; P = .61). There was significant heterogeneity across the included studies and in the pooled estimate of RR for girls vs boys (both I2 > 98%). Subgroup analyses did not reveal any effect on abandonment risk. Risk factors for abandonment observed fell into three main categories: socio-demographic; geographic; and travel-related. In conclusion, a high rate of treatment abandonment (30%) was observed overall for children with cancer in included studies in LMICs, although this was variable and context specific. No evidence of gender bias in childhood cancer treatment abandonment rates across LMICs was found. Given that the risk factors for abandonment are context specific, in-depth country-level analyses may provide further insights into the role of a child's gender in treatment abandonment decisions.
    Matched MeSH terms: Healthcare Disparities/economics; Healthcare Disparities/statistics & numerical data*
  13. Mohamad Nasaruddin Mahdzir, Izwan Effendy Zainuddin, Sharifa Ezat Wan Puteh
    Int J Public Health Res, 2012;2(2):177-183.
    MyJurnal
    The relationship between healthcare services and inequalities is more likely when a group that shares a salient identity faces severe inequalities of various kinds. Such inequalities may be catalyzed by economic, social, political or concern cultural status. The objectives of this review are to identify the issues and challenges involve in healthcare inequalities, to compare factors contributes to healthcare inequalities and to purpose suggestions and recommendations for improvement based on issues and challenges between United States and India. Comparing annual year healthcare report, documentation of healthcare institutional, Ministry of Health's report and circular, official institutional website, scientific healthcare journals, articles and reports published in 1994 until 2011 regarding healthcare inequalities between United States and India. Health inequalities in the healthcare system contributed by the different in socioeconomic status and accessibility to the healthcare facility due to high cost of treatment has been common risk 'Catastrophic' factors to the inequalities in both countries. Health financing system and resource allocation that benefit only the upper class social spectrum of the population. Disparities occur due to the imbalance in distribution of wealth, discrimination and change in the world economy. Adapting healthcare system that provides care to all classes of people need improvement as no healthcare system is perfect. This matter must be tackle urgently as it's a matter of national concern.
    Matched MeSH terms: Healthcare Disparities
  14. Yom S, Lor M
    J Racial Ethn Health Disparities, 2022 Dec;9(6):2248-2282.
    PMID: 34791615 DOI: 10.1007/s40615-021-01164-8
    BACKGROUND: Despite recognition that the health outcomes of Asian American subgroups are heterogeneous, research has mainly focused on the six largest subgroups. There is limited knowledge of smaller subgroups and their health outcomes. This scoping review identifies trends in the health outcomes, reveals those which are under-researched, and provide recommendations on data collection with 24 Asian American subgroups.

    METHODS: Our literature search of peer-reviewed English language primary source articles published between 1991 and 2018 was conducted across six databases (Embase, PubMed, Web of Sciences, CINAHL, PsychINFO, Academic Search Complete) and Google Scholar, yielding 3844 articles. After duplicate removal, we independently screened 3413 studies to determine whether they met inclusion criteria. Seventy-six studies were identified for inclusion in this review. Data were extracted on study characteristics, content, and findings.

    FINDINGS: Seventy-six studies met the inclusion criteria. The most represented subgroups were Chinese (n = 74), Japanese (n = 60), and Filipino (n = 60), while Indonesian (n = 1), Malaysian (n = 1), and Burmese (n = 1) were included in only one or two studies. Several Asian American subgroups listed in the 2010 U.S. Census were not represented in any of the studies. Overall, the most studied health conditions were cancer (n = 29), diabetes (n = 13), maternal and infant health (n = 10), and cardiovascular disease (n = 9). Studies showed that health outcomes varied greatly across subgroups.

    CONCLUSIONS: More research is required to focus on smaller-sized subgroup populations to obtain accurate results and address health disparities for all groups.

    Matched MeSH terms: Healthcare Disparities
  15. Kamal SM, Hassan CH, Kabir MA
    Asia Pac J Public Health, 2015 Mar;27(2):NP1321-32.
    PMID: 23572376 DOI: 10.1177/1010539513483823
    This study examines the inequality of the use of skilled delivery assistance by the rural women of Bangladesh using the 2007 Bangladesh Demographic and Health Survey data. Simple cross-tabulation and univariate and multivariate statistical analyses were employed in the study. Overall, 56.1% of the women received at least one antenatal care visit, whereas only 13.2% births were assisted by skilled personnel. Findings revealed apparent inequality in using skilled delivery assistance by socioeconomic strata. Birth order, women's education, religion, wealth index, region and antenatal care are important determinants of seeking skilled assistance. To ensure safe motherhood initiative, government should pay special attention to reduce inequality in seeking skilled delivery assistance. A strong focus on community-based and regional interventions is important in order to increase the utilization of safe maternal health care services in rural Bangladesh.
    Matched MeSH terms: Healthcare Disparities/statistics & numerical data*
  16. Lim KK, Sivasampu S, Mahmud F
    Aust J Rural Health, 2017 Apr;25(2):102-109.
    PMID: 27377781 DOI: 10.1111/ajr.12298
    OBJECTIVE: To examine the extent of equity in access to health care, their determinants and reasons of unmet need of a rural population in Malaysia.

    DESIGN: Exploratory cross-sectional survey administered by trained interviewers among participants of a health screening program.

    SETTING: A rural plantation estate in the West Coast of Peninsular Malaysia.

    PARTICIPANTS: One hundred and thirty out of 142 adults above 18 years old who attended the program.

    MAIN OUTCOME MEASURE: Percentages of respondents reporting realised access and unmet need to health care, determinants of both access indicators and reasons for unmet need. Realised access associated with need but not predisposing or enabling factors and unmet need not associated with any variables were considered equitable.

    RESULTS: A total of 88 (67.7%) respondents had visited a doctor (realised access) in the past 6 months and 24.8% (n = 31) experienced unmet need in the past 12 months. Using logistic regression, realised access was associated with presence of chronic disease (OR 6.97, P  RM 2000 per month) (OR 51.27, P 

    Matched MeSH terms: Healthcare Disparities*
  17. Kong YC, Bhoo-Pathy N, Subramaniam S, Bhoo-Pathy N, Taib NA, Jamaris S, et al.
    PMID: 28420149 DOI: 10.3390/ijerph14040427
    Background: Survival disparities in cancer are known to occur between public and private hospitals. We compared breast cancer presentation, treatment and survival between a public academic hospital and a private hospital in a middle-income country. Methods: The demographics, clinical characteristics, treatment and overall survival (OS) of 2767 patients with invasive breast carcinoma diagnosed between 2001 and 2011 in the public hospital were compared with 1199 patients from the private hospital. Results: Compared to patients in the private hospital, patients from the public hospital were older at presentation, and had more advanced cancer stages. They were also more likely to receive mastectomy and chemotherapy but less radiotherapy. The five-year OS in public patients was significantly lower than in private patients (71.6% vs. 86.8%). This difference was largely attributed to discrepancies in stage at diagnosis and, although to a much smaller extent, to demographic differences and treatment disparities. Even following adjustment for these factors, patients in the public hospital remained at increased risk of mortality compared to their counterparts in the private hospital (Hazard Ratio: 1.59; 95% Confidence Interval: 1.36-1.85). Conclusion: Late stage at diagnosis appears to be a major contributing factor explaining the breast cancer survival disparity between public and private patients in this middle-income setting.
    Matched MeSH terms: Healthcare Disparities*
  18. Shahar S, Lau H, Puteh SEW, Amara S, Razak NA
    BMC Public Health, 2019 Jun 13;19(Suppl 4):552.
    PMID: 31196021 DOI: 10.1186/s12889-019-6852-8
    The current issue of BMC Public Health presents work by the Consortium of Low Income Population Research (CB40R), highlighting a comprehensive aspect of health, i.e., physical health, mental health, health behaviour and health financing; and also nutrition involving all stages of lifespan of the socioeconomic deprived group in Malaysia.Consortium of B40 Research (CB40R) reposited and harmonised shared, non-identifiable data from epidemiological studies involving low income population (B40) in Malaysia. CB40R also performed joint or mega-analyses using combined, harmonised data sets that yield collated results with enhanced statistical power, more variabilities (study population, geographical regions, ethnicities and sociocultural groups) to better understand the needs, characteristics and issues of B40 groups in Malaysia. It also aimed to develope a system/framework of minimum/standard variables to be collected in research involving B40 in future. For this special issues, members of the consortium have been invited to contribute an original article involving analysis of the health aspects, access to health and nutritional issues of the B40 samples.All the papers in this special issue have successfully highlighted the health and nutritional issues (i.e., non-communicable disease (NCD), inflammatory bowel disease (IBD), knowledge towards sexually transmitted disease (STD), low birth weight, Motoric Cognitive Risk (MCR) syndrome, urinary incontinence), mental health, oral health and inequalities among the low-income group in Malaysia, including the rural population and also the urban poor. The low-income population in Malaysia is also at risk of both under- and over nutrition, of which specific cost effective strategies are indeed needed to improve their quality of life.The low income population in Malaysia is facing various health challenges, particularly related to NCD and poor mental health, nutritional and physical function. There is a need for a sustainable intervention model to tackle the issues. It is also important to highlight that reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health.
    Matched MeSH terms: Healthcare Disparities/trends*
  19. Yip CH, Taib NA
    Climacteric, 2014 Dec;17 Suppl 2:54-9.
    PMID: 25131779 DOI: 10.3109/13697137.2014.947255
    Breast cancer is one of the leading cancers world-wide. While the incidence in developing countries is lower than in developed countries, the mortality is much higher. Of the estimated 1 600 000 new cases of breast cancer globally in 2012, 794 000 were in the more developed world compared to 883 000 in the less developed world; however, there were 198 000 deaths in the more developed world compared to 324 000 in the less developed world (data from Globocan 2012, IARC). Survival from breast cancer depends on two main factors--early detection and optimal treatment. In developing countries, women present with late stages of disease. The barriers to early detection are physical, such as geographical isolation, financial as well as psychosocial, including lack of education, belief in traditional medicine and lack of autonomous decision-making in the male-dominated societies that prevail in the developing world. There are virtually no population-based breast cancer screening programs in developing countries. However, before any screening program can be implemented, there must be facilities to treat the cancers that are detected. Inadequate access to optimal treatment of breast cancer remains a problem. Lack of specialist manpower, facilities and anticancer drugs contribute to the suboptimal care that a woman with breast cancer in a low-income country receives. International groups such as the Breast Health Global Initiative were set up to develop economically feasible, clinical practice guidelines for breast cancer management to improve breast health outcomes in countries with limited resources.
    Matched MeSH terms: Healthcare Disparities/economics; Healthcare Disparities/trends
  20. O'Hara CA, Foon XL, Ng JC, Wong CS, Wang FY, Tan CY, et al.
    Med Educ Online, 2023 Dec;28(1):2172744.
    PMID: 36744296 DOI: 10.1080/10872981.2023.2172744
    PURPOSE: International studies document that lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI+) patients face significant health disparities. Studies exploring the attitudes, knowledge, preparedness and comfort levels of healthcare students towards LGBTQI+ health have been conducted in the United States, United Kingdom and Malaysia. This study aims to investigate stigma in healthcare for LGBTQI+ patients in Singapore, and possible upstream factors within medical education.

    METHODS: This mixed-methods study adopts a convergent parallel design. The Health Stigma and Discrimination Framework was referenced to devise in-depth interviews with representatives from 13 LGBTQI-affirming non-governmental organisations, analysed through thematic analysis. 320 clinical medical students were surveyed about attitudes, knowledge, comfort, preparedness, and perceived importance of/towards LGBTQI+ health, analysed via descriptive statistics and multivariate regression.

    RESULTS: Prevailing stigma in Singaporean society against LGBTQI+ individuals is exacerbated in healthcare settings. Doctors were cited as unfamiliar or uncomfortable with LGBTQI+ health, possibly from lack of training. Among medical students surveyed, the median composite attitudes, comfort and preparedness index was 3.30 (Interquartile Range (IQR) = 0.50), 3.17 (IQR = 0.83), 2.50 (IQR = 1.00) respectively. Only 12.19% of students answered all 11 true-false questions about LGBTQI+ health correctly.

    CONCLUSION: Medical students in Singapore have scored sub-optimally in their knowledge and preparedness towards LGBTQI+ health, while interpersonal and structural stigma in healthcare towards LGBTQI+ people in Singapore negatively affects health and wellbeing. These findings are an impetus to improve medical training in this area. High scores among medical students in attitudes, comfort and perceived importance of LGBTQI+ topics demonstrate that there is space for LGBTQI+ health in the local medical education curriculum. Curricular interventions can prioritise content knowledge, communication skills and sensitivity.

    Matched MeSH terms: Healthcare Disparities
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