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4.
PLoS One ; 15(2): e0229291, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32069309

RESUMEN

Changes in the United States federal-level political landscape have been felt within immigrant communities, and the public health clinics that serve them. We sought to document how HIV prevention and care clinics are reaching and retaining their immigrant community patients during a period of retrenchment of accessible public resources and immigrant rights. From May 2018 through January 2019, we conducted 20 in-depth interviews with clinicians, case workers, advocates, legal experts, and peer navigators in Northern and Central California. Interviews were recorded and transcribed. Several themes emerged which can be grouped into three primary areas: changes post-election, challenges meeting the needs of patients, and best practices for maintaining access to prevention and care services. Post-election, providers reported some of their patients skipping clinic appointments due to fear of Immigration and Customs Enforcement (ICE) raids and deportation while other patients had moved to locations that they felt were less policed. Challenges emerged around linguistic competency, meeting basic needs such as housing stability and employment, and treating mental health sequelae resulting from trauma experienced in home countries or during migration itself. Best practices included hiring bi-lingual and bi-cultural staff, linking to legal services to assist with immigration status, holding trainings around immigrant rights and responses to ICE raids, and building trust with immigrant patients by assuring them that their status would not be collected or reported. In light of adverse policy changes affecting immigrants, agencies have begun to institute best practices to mitigate the negative impact of those policies on their clients and patients.


Asunto(s)
Prestación de Atención de Salud/normas , Emigración e Inmigración/legislación & jurisprudencia , Infecciones por VIH/prevención & control , Accesibilidad a los Servicios de Salud/normas , Evaluación de Necesidades/normas , Aceptación de la Atención de Salud/estadística & datos numéricos , Guías de Práctica Clínica como Asunto/normas , Antirretrovirales/administración & dosificación , Prestación de Atención de Salud/legislación & jurisprudencia , VIH/aislamiento & purificación , Infecciones por VIH/psicología , Planificación en Salud , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Humanos , Política Pública , Encuestas y Cuestionarios
5.
Nurs Clin North Am ; 55(1): 11-20, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32005360

RESUMEN

Nurses need to actively embrace strategies to improve population health outcomes and reduce health and other disparities. Effective strategies include a focus on the broad range of factors and conditions that have a strong influence on health, advocacy directed at reducing barriers to improved population health, and engagement in policy making. Media engagement is an important tool for amplifying messages about societal problems amenable to public policy, educating stakeholders, bringing diverse stakeholders together for a common purpose, and promoting policy change.


Asunto(s)
Prestación de Atención de Salud/legislación & jurisprudencia , Prestación de Atención de Salud/normas , Política de Salud , Rol de la Enfermera , Defensa del Paciente/normas , Formulación de Políticas , Salud Poblacional , Medios de Comunicación Sociales , Adulto , Femenino , Promoción de la Salud/métodos , Humanos , Masculino , Guías de Práctica Clínica como Asunto
9.
Neurology ; 94(7): 306-310, 2020 02 18.
Artículo en Inglés | MEDLINE | ID: mdl-31969466

RESUMEN

Stroke is the second leading cause of death worldwide and a leading cause of adult disability worldwide. More than a third of individuals presenting with strokes are estimated to have a preexisting disability. Despite unprecedented advances in stroke research and clinical practice over the past decade, approaches to acute stroke care for persons with preexisting disability have received scant attention. Current standards of research and clinical practice are influenced by an underexplored range of biases that may hinder acute stroke care for persons with disability. These trends may exacerbate unequal health outcomes by rendering novel stroke therapies inaccessible to many persons with disabilities. Here, we explore the underpinnings and implications of biases involving persons with disability in stroke research and practice. Recent insights from bioethics, disability rights, and health law are explained and critically evaluated in the context of prevailing research and clinical practices. Allowing disability to drive decisions to withhold acute stroke interventions may perpetuate disparate health outcomes and undermine ethically resilient stroke care. Advocacy for inclusion of persons with disability in future stroke trials can improve equity in stroke care delivery.


Asunto(s)
Prestación de Atención de Salud/ética , Personas con Discapacidad , Accidente Cerebrovascular/terapia , Discusiones Bioéticas , Toma de Decisiones Clínicas/ética , Ensayos Clínicos como Asunto , Prestación de Atención de Salud/legislación & jurisprudencia , Personas con Discapacidad/legislación & jurisprudencia , Personas con Discapacidad/rehabilitación , Disparidades en Atención de Salud , Humanos , Derechos del Paciente/ética , Derechos del Paciente/legislación & jurisprudencia
12.
BMC Health Serv Res ; 19(1): 849, 2019 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-31747909

RESUMEN

BACKGROUND: Over the past two decades, we have seen a nationwide increase in the use of medical-legal partnerships (MLPs) to address health disparities affecting vulnerable populations. These partnerships increase medical teams' capacity to address social and environmental threats to patients' health, such as unsafe housing conditions, through partnership with legal professionals. Despite expansions in the use of MLP care models in health care settings, the health outcomes efficacy of MLPs has yet to be examined, particularly for complex chronic conditions such as HIV. METHODS: This on-going mixed-methods study utilizes institutional case study and intervention mapping methodologies to develop an HIV-specific medical legal partnership logic model. Up-to-date, the organizational qualitative data has been collected. The next steps of this study consists of: (1) recruitment of 100 MLP providers through a national survey of clinics, community-based organizations, and hospitals; (2) in-depth interviewing of 50 dyads of MLP service providers and clients living with HIV to gauge the potential large-scale impact of legal partnerships on addressing the unmet needs of this population; and, (3) the development of an MLP intervention model to improve HIV care continuum outcomes using intervention mapping. DISCUSSION: The proposed study is highly significant because it targets a vulnerable population, PLWHA, and consists of formative and developmental work to investigate the impact of MLPs on health, legal, and psychosocial outcomes within this population. MLPs offer an integrated approach to healthcare delivery that seems promising for meeting the needs of PLWHA, but has yet to be rigorously assessed within this population.


Asunto(s)
Continuidad de la Atención al Paciente/normas , Prestación de Atención de Salud/legislación & jurisprudencia , Infecciones por VIH/terapia , Relaciones Interprofesionales , Adolescente , Adulto , Anciano , Continuidad de la Atención al Paciente/legislación & jurisprudencia , Prestación de Atención de Salud/normas , Femenino , Disparidades en Atención de Salud/legislación & jurisprudencia , Vivienda/legislación & jurisprudencia , Vivienda/normas , Humanos , Servicios Legales , Masculino , Persona de Mediana Edad , Estados Unidos , Poblaciones Vulnerables/legislación & jurisprudencia , Adulto Joven
13.
Georgian Med News ; (294): 165-171, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31687971

RESUMEN

The article explores the issue of human rights protection in the field of health care by the Constitutional Court of Ukraine. The decisions of the Constitutional Court of Ukraine in the case of K. G. Ustimenko (1997), the case of paid medical services (1998), the case of free medical care (2002), the case of judicial control over the hospitalization of incapacitated persons into psychiatric institute are analyzed (2016), as well as the new legislation of Ukraine in the light of radical reform in the healthcare sector. Attention is drawn to the principle of friendly attitude to international law, constitutional complaint, legal positions of the Constitutional Court of Ukraine in the above-mentioned cases and the prospect of their application into the development of new legislation of Ukraine in the context of radical reform of the health care system of Ukraine. It is emphasized that the legal positions of the Constitutional Court of Ukraine, with regard of peculiarities of the national legislature, can serve as a source of inspiration for the courts of other countries. The purpose of the article is to specify the role and place of the Constitutional Court of Ukraine in the system of judicial protection of human and citizen rights, to determine the prospects of applying the legal positions of the Constitutional Court of Ukraine within the development of new legislation of Ukraine in the light of radical reform of the health care system. The object of the study is the social relations that arise during protection of human rights in the field of health care by the Constitutional Court of Ukraine. The methodological basis of the research are general and special methods of scientific knowledge (formal-logical method, comparative-legal, structural-logical). As a result of the conducted research, the role and place of the Constitutional Court of Ukraine in the system of judicial protection of human and citizen rights, the role of the decisions of the Constitutional Court of Ukraine in the case of K. G. Ustimenko, the case of paid medical services, the case of free medical care, the case of judicial control over hospitalization of incapacitated persons into psychiatric institution in the formation and development of domestic constitutional proceedings are defined. It is emphasized that the introduction of the constitutional complaint concept (institution) contributed to the improvement of the national mechanism of human rights protection in the field of health care. Conflicts of constitutional regulation of the human right to free medical care have been identified, and proposals have been worked out regarding possible ways and methods to eliminate them.


Asunto(s)
Prestación de Atención de Salud/legislación & jurisprudencia , Derechos Humanos , Derechos del Paciente , Instituciones de Salud , Hospitalización , Humanos , Ucrania
14.
Wiad Lek ; 72(9 cz 2): 1839-1843, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31622276

RESUMEN

OBJECTIVE: Introduction: It was identified that one of the priorities of medical reform in Ukraine is the establishment of an effective system of legal regulation of professional physician's obligations that meets European standards. However, the legal regulation of relations between actors in the field of health care lags behind the practice of their development. The aim to find out the status of legal regulation of the professional obligations of health workers, to identify the gaps in this regulation, to formulate proposals for improving the legal framework for the issue under investigation. PATIENTS AND METHODS: Materials and methods: Legislation of Ukraine and certain European countries, international declarations and conventions, scientific works, 28 judgments of the European Court of Human Rights, 96 sentences of the practice of the national courts of Ukraine. CONCLUSION: Conclusions: During the study, the stages of determining the professional physician's obligations were singled out, which would optimize the legislative process of regulation of obligations. One of the problems is the incorrect translation of protocols, which is assigned to a medical care institution. It was proposed to solve this problem by introducing a unified system of protocols and standards, the duty of translation and adaptation of which is entrusted to the central body of executive power in the field of health care. It is relevant to consolidate the duty of medical records management at the level of law, which will serve as a guarantee of ensuring the proper performance by the physician of a professional obligation to treat and diagnose a particular patient. In order to avoid cases of judgments, based on the results of the сommission's assessment of the actions of a physician and to eliminate the number of cases of unjustified attraction of physicians to liability, it is necessary to consolidate a clear list of general professional physician's obligations in a single regulatory act.


Asunto(s)
Prestación de Atención de Salud/legislación & jurisprudencia , Médicos/legislación & jurisprudencia , Derechos Humanos , Humanos , Rol Profesional , Ucrania
15.
Schmerz ; 33(5): 443-448, 2019 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-31478141

RESUMEN

BACKGROUND: Since March 2017 the law amending narcotics and other legal regulations has made it possible for doctors to prescribe cannabis and cannabis-derived medicines. The introduction of § 31 para 6 of the Social Code Book V (SGB V) allows that patients can be treated with cannabis-derived medicines at the expense of the statutory health insurance if they have a severe illness. COURT DECISIONS: The law requires the approval of a prescription of cannabis for medical purposes by the health insurance before the granting of benefits. Due to denied permission, numerous cases are pending before the social tribunals. The article presents which legal issues are decided and why there is still no case law from the Federal Social Court on the essential questions. OUTLOOK: The possibility of prescribing cannabis as medicine at the expense of the health insurance is an important advance in social law. The § 31 para 6 SGB V should be evaluated as soon as possible. The provisions of SGB V for the reimbursement of off-label treatment should be harmonized with § 31 para 6 SGB V.


Asunto(s)
Cannabis , Seguro de Salud , Médicos , Prescripciones , Prestación de Atención de Salud/legislación & jurisprudencia , Alemania , Humanos , Seguro de Salud/economía , Seguro de Salud/legislación & jurisprudencia , Médicos/legislación & jurisprudencia , Prescripciones/estadística & datos numéricos
16.
Georgian Med News ; (292-293): 134-139, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31560679

RESUMEN

The objective of the article is to determine the content and correlation of individual and joint interest within medical legal relations in Ukraine. To achieve this objective the authors have applied general scientific and special methods of cognition. The materials of research were statistical data on infectious diseases about the state of vaccinations in Ukraine, judicial practice, and national legislation. It has been concluded that individual and joint interest within medical legal relations are aimed at various objects: individual and public health. These objects are interconnected as general and special, since public health is a combination of individual health. It has been established that public and individual health does not have an economic content, cannot participate in the economic turnover, but have a social value. The prevalence of joint interest over the individual has been grounded. Individual interest within medical legal relations has been defined as the orientation of an individual to protect own health. It has been proved that joint (public) interest within medical legal relations is a set of individual (private) interests of individuals in the health care area. This interest is manifested in the formation of collective immunity, control over the spread of infectious diseases, the creation of conditions for affordable medical care, etc.


Asunto(s)
Prestación de Atención de Salud/legislación & jurisprudencia , Legislación Médica , Salud Pública/legislación & jurisprudencia , Humanos , Ucrania
17.
Infect Dis Poverty ; 8(1): 81, 2019 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-31514738

RESUMEN

BACKGROUND: Despite great medical advances and scientific progress over the past century, one billion people globally still lack access to basic health care services. In the context of the 2030 Agenda for Sustainable Development social innovation models aim to provide effective solutions that bridge the health care delivery gap, address equity and create social value. This commentary highlights the roles of multilateral organizations and governments in creating an enabling environment where social innovations can more effectively integrate into health systems to maximize their impact on beneficiaries. MAIN TEXT: The integration of social innovations into health systems is essential to ensure their sustainability and the wide dissemination of their impact. Effective partnerships, strong engagement with and endorsement by governments and communities, regulations, trust and sometimes willingness are key factors to enhance system integration, replication and dissemination of the models. Three examples of social innovations selected by the Social Innovation in Health Initiative illustrate the importance of engaging with governments and communities in order to link, integrate and synergize their efforts. Key challenges that they encountered, and lessons learnt are highlighted. Multilateral organizations and governments increasingly engage in promoting and supporting the development, testing and dissemination of social innovations to address the health care delivery gap. They play an important role in creating an enabling environment. This includes promoting the concept of social innovation in health care delivery, spreading social innovation approach and lessons learnt, fostering partnerships and leveraging resources, convening communities, health system actors and various stakeholders to work together across disciplines and sectors, and nurturing capacity in countries. CONCLUSIONS: Multilateral organizations and local and national governments have a critical role to play in creating an enabling environment where social innovations can flourish. In supporting and disseminating social innovation approach, multilateral organizations and governments have a great opportunity to accelerate Universal Health Coverage and the achievement of the Sustainable Development Goals.


Asunto(s)
Prestación de Atención de Salud/métodos , Difusión de Innovaciones , Gobierno , Agencias Internacionales/estadística & datos numéricos , Prestación de Atención de Salud/legislación & jurisprudencia , Prestación de Atención de Salud/estadística & datos numéricos , Humanos
18.
Georgian Med News ; (291): 126-130, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31418745

RESUMEN

The article examines the issue of public procurement in the healthcare sector through the prism of the Association Agreement with the EU. The emphasis is on the ensuring mutual access to the markets of public procurement of the EU and Ukraine on the basis of planned and consistent approximation of Ukrainian legislation in the field of public procurement to the EU acquis in the field of public procurement. The purpose of this article is to identify the peculiarities of the reform in the field of public procurement in Ukraine, to search for drawbacks in the administrative legislation of Ukraine, which is governing public procurement in the healthcare sector in the context of Ukraine's implementation of the Association Agreement with the EU, and to justify its improvement. The subject of research is the social relations that arise in the implementation of public procurement in the field of health. The methodological basis of the conducted research is the general methods of scientific cognitivism as well as concerning those used in legal science: methods of analysis and synthesis, formal logic, comparative law, statistical methods etc The following main directions of reforming the system of public procurement were established. It has been proved that CPO functioning on the national level of government in the form of a state-owned enterprise under the control of one of the relevant ministries is non-feasibility. The advantages of the ProZorro electronic procurement system and the state of implementation of the provisions of the EU Directives on 2014/23/ EU, 2014/24/ EU, 2014/25/EU, 2014/55/EU into the administrative legislation of Ukraine have been identified. It has been found that in March, 2015 centralized procurement system for medicines and medical products was changed in Ukraine to use the funds of the State Budget of Ukraine for the purchase of medicines and medical products with the involvement of international specialized organizations. On December 21, 2018 the Verkhovna Rada (Supreme Council) of Ukraine put amendments into the Law of Ukraine "On Public Procurement". The attention is paid to the novelties of this Law. It has been found that the legislation of Ukraine has such shortcomings: 1) in Ukraine the issue of clear distribution of functions of the authorities authorized to carry out control in the field of public procurements remains unresolved; 2) the norms of the Law contradict each other; 3) the problems of creating effective mechanisms for the formation of the nomenclature of medicines still remain, as well as their supplies to healthcare institutions.


Asunto(s)
Prestación de Atención de Salud/legislación & jurisprudencia , Unión Europea , Sector de Atención de Salud/legislación & jurisprudencia , Prestación de Atención de Salud/economía , Sector de Atención de Salud/economía , Humanos , Ucrania
19.
Georgian Med News ; (291): 130-136, 2019 Jun.
Artículo en Ruso | MEDLINE | ID: mdl-31418746

RESUMEN

The objective of the article is a comparative and legal study of the models for the organization of public procurements in the healthcare field in the EU and Ukraine. Theoretical and empirical methods of cognition were used to achieve this goal, namely, methods of analysis, synthesis, generalization, as well as comparative and legal method in analyzing the experience of the EU countries in organizing public procurements. The conducted study suggests that the public procurement mechanism in the healthcare sector exists in most states. However, the legal regulation in this area differs significantly in different states. It has been established that a significant part of the states use centralized procurements. The shortcomings of the legal regulation of public procurements in Ukraine have been revealed and the ways to solve them have been offered. The authors have indicated the necessity of using international experience in organizing public procurements in the healthcare sector, in particular, with respect to: centralized procurements with the introduction of procurement groups or consortia (Great Britain, France, Germany, Italy); activities of specially created centralized organizations (Austria, Belgium, Spain, Hungary, Portugal) decentralized procurements (Sweden). In order to improve the legal regulation of public procurements in the healthcare field, the authors have proved the necessity of making amendments to the Law of Ukraine "On Public Procurements".


Asunto(s)
Prestación de Atención de Salud/economía , Prestación de Atención de Salud/legislación & jurisprudencia , Unión Europea , Humanos , Ucrania
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