Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 174
Filtrar
1.
Lakartidningen ; 1162019 Oct 15.
Artigo em Sueco | MEDLINE | ID: mdl-31613375

RESUMO

This article highlights a special subtype of this dilemma, in which the patient requests a treatment that the physician judges to be substandard. Reasons for and against providing substandard treatment in the name of patient autonomy are presented and discussed. It is suggested that physicians carefully consider the risk of crowding out of other patients if substandard treatment is provided.


Assuntos
Necessidades e Demandas de Serviços de Saúde/ética , Preferência do Paciente , Qualidade da Assistência à Saúde/ética , Beneficência , Ética Médica , Prioridades em Saúde , Humanos , Participação do Paciente , Direitos do Paciente , Autonomia Pessoal , Papel do Médico
2.
Curr Opin Otolaryngol Head Neck Surg ; 27(3): 212-218, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30950835

RESUMO

PURPOSE OF REVIEW: The Indian healthcare industry, one of the largest in the world, caters for 1.3 billion people. The modern middle class addresses its needs by visiting private hospitals, which provide comprehensive services but at a high cost. The low socioeconomic individuals visit government hospitals where all basic services are available, but there is a struggle to provide advanced healthcare. In order to rectify this dichotomous approach, new initiatives are being implemented to provide uniform healthcare across the society. RECENT FINDINGS: Technological advancements have been rapid and modern methods have reached the shores of India at the same pace as in the western world. In otolaryngology, advanced services especially for restoration of hearing loss and multimodality treatments for head and neck cancers have been two areas where practical and ethical dilemmas have existed to provide the most optimal treatment at subsidized costs. This article explores these two areas as examples to understand the specific problems encountered in delivering advanced ENT care in a low-resource setting in a large populous country. SUMMARY: Introduction of government health insurance schemes have helped the poor to make use of advanced healthcare. The highlight of this scheme has been the inclusion of expensive interventions like cochlear and auditory brainstem implantation, whereby cost of the device, surgery and habilitation have all been delivered cost free for eligible children.


Assuntos
Assistência à Saúde/ética , Assistência à Saúde/organização & administração , Acesso aos Serviços de Saúde/ética , Necessidades e Demandas de Serviços de Saúde/ética , Otolaringologia/ética , Otolaringologia/organização & administração , Alocação de Recursos/ética , Alocação de Recursos/organização & administração , Países em Desenvolvimento , Humanos , Índia
3.
Am J Bioeth ; 19(4): 51-57, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30994422

RESUMO

Because the United States has failed to provide a pathway to citizenship for its long-term undocumented population, clinical ethicists have more than 20 years of addressing issues that arise in caring for this population. I illustrate that these challenges fall into two sets of issues. First-generation issues involve finding ethical ways to treat and discharge patients who are uninsured and ineligible for safety-net resources. More recently, ethicists have been invited to help address second-generation issues that involve facilitating the presentation for care of undocumented patients. In the current environment of widespread fear of deportation in the immigrant community, ethicists are working with health care providers to address patient concerns that prevent them from seeking care. I illustrate that in both generations of issues, values implicit within health care, namely, caring, efficiency, and promotion of public health, guide the strategies that are acceptable and recommended.


Assuntos
Acesso aos Serviços de Saúde/ética , Disparidades em Assistência à Saúde/ética , Discriminação Social/ética , Imigrantes Indocumentados/estatística & dados numéricos , Emigração e Imigração/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/ética , Humanos , Cobertura do Seguro/ética , Fatores Socioeconômicos , Estados Unidos
4.
Med Health Care Philos ; 22(1): 53-58, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29946900

RESUMO

Thirty years of debate have passed since the term "Rule of Rescue" has been introduced into medical ethics. Its main focus was on whether or why medical treatment for acute conditions should have priority over preventive measures irrespective of opportunity costs. Recent contributions, taking account of the widespread reluctance to accept purely efficiency-oriented prioritization approaches, advance another objection: Prioritizing treatment, they hold, discriminates against statistical lives. The reference to opportunity costs has also been renewed in a distinctly ethical fashion: It has been stipulated that favoring help for identifiable lives amounts to a lack of benevolence for one's fellow creatures. The present article argues against both objections. It suggests that the debate's focus on consequences (deaths or severe ill health) should be reoriented by asking which aspects of such states of affairs are actually attributable to a decision maker who judges within a specific situation of choice.


Assuntos
Beneficência , Financiamento Governamental/economia , Prioridades em Saúde/economia , Recursos em Saúde/economia , Trabalho de Resgate/economia , Alocação de Recursos/economia , Tomada de Decisões , Ética Médica , Financiamento Governamental/ética , Prioridades em Saúde/ética , Recursos em Saúde/ética , Necessidades e Demandas de Serviços de Saúde/economia , Necessidades e Demandas de Serviços de Saúde/ética , Humanos , Programas Nacionais de Saúde/economia , Trabalho de Resgate/ética , Alocação de Recursos/ética
5.
Pediatrics ; 142(6)2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30401789

RESUMO

Transgender and gender-nonconforming (TGNC) youth who suffer from gender dysphoria are at a substantially elevated risk of numerous adverse physical and psychosocial outcomes compared with their cisgender peers. Innovative treatment options used to support and affirm an individual's preferred gender identity can help resolve gender dysphoria and avoid many negative sequelae of nontreatment. Yet, despite advances in these relatively novel treatment options, which appear to be highly effective in addressing gender dysphoria and mitigating associated adverse outcomes, ethical challenges abound in ensuring that young patients receive appropriate, safe, affordable treatment and that access to this treatment is fair and equitable. Ethical considerations in gender-affirming care for TGNC youth span concerns about meeting the obligations to maximize treatment benefit to patients (beneficence), minimizing harm (nonmaleficence), supporting autonomy for pediatric patients during a time of rapid development, and addressing justice, including equitable access to care for TGNC youth. Moreover, although available data describing the use of gender-affirming treatment options are encouraging, and the risks of not treating TGNC youth with gender dysphoria are evident, little is known about the long-term effects of both hormonal and surgical interventions in this population. To support ethical decision-making about treatment options, we encourage the development of a comprehensive registry in the United States to track long-term patient outcomes. In the meantime, providers who work with TGNC youth and their families should endeavor to offer ethically sound, patient-centered, gender-affirming care based on the best currently available evidence.


Assuntos
Disforia de Gênero/psicologia , Necessidades e Demandas de Serviços de Saúde/ética , Disparidades em Assistência à Saúde/ética , Atenção Primária à Saúde/ética , Pessoas Transgênero/psicologia , Adolescente , Feminino , Humanos , Masculino , Adulto Jovem
7.
Rev. bioét. derecho ; (44): 73-88, nov. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-176790

RESUMO

La escasez de órganos es un problema global constante, aun cuando se presentan diversas alternativas para superar ese problema que genera miles de muertes cada año. El presente artículo analiza los problemas éticos y jurídicos del mercado regulado de órganos, partiendo del modelo de donación recompensada de riñones en vida entre no parientes, implantado en Irán en 1988. Para ello, se realizarán algunos apuntes históricos, pasando por la presentación de los procedimientos y características de dicho modelo, concluyendo con sus principales resultados, aciertos y errores. Al final, adoptando una base empírica como punto de partida, se pretende contribuir con el debate teórico que existe en torno a esa polémica alternativa


Organ shortage is a constant, global problem, even though various alternatives are presented to overcome a problem that generates thousands of deaths every year. This article analyses the ethical and legal issues of the regulated organ market, based on the model of rewarded donation of living kidneys among non-relatives, introduced in Iran in 1988. To this purpose, some historical notes will be made, including a presentation of the procedures and characteristics of the Iranian model, concluding with its main results, successes and errors. In the end, adopting an empirical basis as a starting point, the aim is to contribute to the theoretical debate that exists around this controversial alternative


L'escassetat d'òrgans és un problema global constant, tot i que es presenten diverses alternatives per superar aquest problema que genera milers de morts cada any. El present article analitza els problemes ètics i jurídics del mercat regulat d'òrgans, partint del model de donació recompensada de ronyons en vida entre no parents implantat a Iran en 1988. A tal fi, es realitzaran algunes anotacions històriques, passant per la presentació dels procediments i característiques d'aquest model i concloent amb els seus principals resultats, encerts i errors. Adoptant una base empírica com a punt de partida, el que es pretén és intervenir en el debat teòric que existeix a l’entorn d'aquesta polèmica alternativa


Assuntos
Humanos , Obtenção de Tecidos e Órgãos/ética , Obtenção de Tecidos e Órgãos/legislação & jurisprudência , Coleta de Tecidos e Órgãos/ética , Doação Dirigida de Tecido/ética , Doação Dirigida de Tecido/legislação & jurisprudência , Irã (Geográfico) , Necessidades e Demandas de Serviços de Saúde/ética , Necessidades e Demandas de Serviços de Saúde/legislação & jurisprudência , Diálise Renal/ética , Transplante de Rim/ética
8.
BMC Med Ethics ; 19(1): 79, 2018 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-30219106

RESUMO

BACKGROUND: The use of lengthy, detailed, and complex informed consent forms (ICFs) is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in biomedical research. METHODS: This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 (not important) to 5 (very important). RESULTS: Of the 2484 questionnaires distributed, 2113 (85.1%) were returned. The majority of respondents considered most elements required in the ICF to be 'moderately important' to 'very important' for their decision making (mean score, ranging from 3.58 to 4.47). Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF (mean score = 4.47, 4.47, and 4.45, respectively). CONCLUSIONS: Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF.


Assuntos
Termos de Consentimento/ética , Necessidades e Demandas de Serviços de Saúde/ética , Sujeitos da Pesquisa , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Tomada de Decisões , Ética em Pesquisa , Feminino , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Sujeitos da Pesquisa/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
9.
AMA J Ethics ; 20(7): E664-667, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30007027

RESUMO

Each work in this collection explores, from patients' or their loved ones' points of view, balance between patients' experiences and one or more of 4 well-known principles of ethics in health care.


Assuntos
Atitude do Pessoal de Saúde , Necessidades e Demandas de Serviços de Saúde/ética , Relações Profissional-Família/ética , Assistência Terminal/ética , Atitude Frente a Morte , Cuidadores , Compreensão , Família/psicologia , Humanos , Apoio Social
10.
Lakartidningen ; 1152018 06 11.
Artigo em Sueco | MEDLINE | ID: mdl-29893984

RESUMO

In relation to the Swedish ethical platform for priority setting in health-care it is debated what role cost-effectiveness should play. In the article an ethical analysis is presented showing that a limited role risks leading to unequal priorities between similar needs in conflict with the human dignity and need-solidarity principles of the platform. It is also argued that resulting problems with effect comparability over different conditions and resulting equality problems with the current praxis can be mitigated through strategies like explicitly considering outcome measure and by adjusting the cost-effectiveness threshold under specific conditions.


Assuntos
Análise Custo-Benefício/ética , Prioridades em Saúde , Prioridades em Saúde/economia , Prioridades em Saúde/ética , Necessidades e Demandas de Serviços de Saúde/ética , Humanos , Pessoalidade , Anos de Vida Ajustados por Qualidade de Vida
11.
BMC Med Ethics ; 18(1): 75, 2017 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-29228939

RESUMO

BACKGROUND: Hospital-dependent patients are individuals who are repeatedly readmitted to the hospital because their acute medical needs cannot be met elsewhere. Unlike the chronically critically ill, these patients do not have a continuous need for life-sustaining equipment and can experience periods of relative stability where they have a good quality of life. However, some end up spending months or even years in the hospital receiving resource-intensive care because they are unable to be safely discharged, despite an initial optimistic prognosis. It is hard to reliably identify these patients on admission and more research is needed to better understand the unique medical needs of this population. But the inability to safely discharge these patients to their home or to a skilled nursing facility without rapid readmissions also creates ethical implications for the physicians who care for them. The aim of this paper is to clarify some of the ethical considerations involved in caring for hospital-dependent patients. MAIN BODY: Among physicians, the care of hospital-dependent patients is likely to disproportionately affect hospitalists and intensivists, whose care is often evaluated in terms of reducing patient length of stay and readmissions. Because hospital-dependent patients' medical needs thwart the traditional goal of safe discharge, both clinical ethics and physicians' professional obligations are implicated by their care. The inability to reliably identify these patients early can complicate discussions about treatment goals and informed consent. Similarly, the tremendous dedication of limited resources to these patients without safe discharge back to the community may raise concerns about the just allocation of healthcare resources. CONCLUSION: Our current acute care hospitals are not designed to provide long-term care for hospital-dependent patients. Unfortunately, safe discharge options remain elusive for these patients. Further research and support of this population is needed to more reliably identify hospital-dependent patients on admission, better inform the discussions of short- and long-term treatment goals, and more wisely allocate resources both within our acute care hospitals and larger healthcare system.


Assuntos
Doença Aguda/terapia , Continuidade da Assistência ao Paciente/ética , Necessidades e Demandas de Serviços de Saúde/ética , Tempo de Internação/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Relações Hospital-Paciente , Médicos Hospitalares/psicologia , Humanos , Papel do Médico , Guias de Prática Clínica como Assunto , Qualidade de Vida
13.
Soc Sci Med ; 178: 167-174, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28226302

RESUMO

Medicines are considered one of the main tools of western medicine to resolve health problems. Currently, medicines represent an important share of the countries' healthcare budget. In the Latin America region, access to essential medicines is still a challenge, although countries have established some measures in the last years in order to guarantee equitable access to medicines. A theoretical model is proposed for analysing the social, political, and economic factors that modulate the role of medicines as a health need and their influence on the accessibility and access to medicines. The model was built based on a narrative review about health needs, and followed the conceptual modelling methodology for theory-building. The theoretical model considers elements (stakeholders, policies) that modulate the perception towards medicines as a health need from two perspectives - health and market - at three levels: international, national and local levels. The perception towards medicines as a health need is described according to Bradshaw's categories: felt need, normative need, comparative need and expressed need. When those different categories applied to medicines coincide, the patients get access to the medicines they perceive as a need, but when the categories do not coincide, barriers to access to medicines are created. Our theoretical model, which holds a broader view about the access to medicines, emphasises how power structures, interests, interdependencies, values and principles of the stakeholders could influence the perception towards medicines as a health need and the access to medicines in Latin American countries.


Assuntos
Acesso aos Serviços de Saúde/ética , Necessidades e Demandas de Serviços de Saúde/ética , Sistemas de Medicação/economia , Modelos Teóricos , Ética Médica , Política de Saúde/economia , Acesso aos Serviços de Saúde/tendências , Humanos , América Latina , Sistemas de Medicação/ética
14.
Gesundheitswesen ; 79(10): 877-882, 2017 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-27144711

RESUMO

State of the debate: The "Rule of Rescue" refers to the practice that, in order to save people from immediate peril, societies incur high costs largely irrespective of the fact that many more lives could be saved under alternative uses of the resources. The practice has been found difficult to explain, let alone justify, and has often been criticized. In the early literature in the context of the Oregon rationing experiment, the irrationality objection dominated in view of the obvious lack to consider opportunity costs. More recent contributions, taking account of the declining support for purely efficiency-oriented prioritization approaches, advance an equity objection: The practice discriminates against statistical lives. Intent of the present contribution: This article provides a critical assessment of both objections. Results: The following contentions result from the analysis: 1. The equity objection is unfounded; 2. Following the rule of rescue is (in a certain sense) inefficient, but it is not irrational; 3. The criticized judgments result from deep-seated shortcomings in the action-theoretical concepts used (or rather, omitted) in the literature. These shortcomings are inherent in the consequentialist framework dominating the debate and deserve more attention.


Assuntos
Financiamento Governamental/economia , Prioridades em Saúde/economia , Recursos em Saúde/economia , Programas Nacionais de Saúde/economia , Trabalho de Resgate/economia , Alocação de Recursos/economia , Discriminação Social , Análise Custo-Benefício , Ética Médica , Financiamento Governamental/ética , Alemanha , Prioridades em Saúde/ética , Recursos em Saúde/ética , Necessidades e Demandas de Serviços de Saúde/economia , Necessidades e Demandas de Serviços de Saúde/ética , Humanos , Trabalho de Resgate/ética , Alocação de Recursos/ética , Discriminação Social/ética
15.
Early Interv Psychiatry ; 11(2): 104-112, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27027848

RESUMO

AIM: Early intervention and prevention of serious mental disorders such as bipolar disorder has the promise of decreasing the burden associated with these disorders. With increasing early and preventive intervention efforts among cohorts such as those with a familial risk for bipolar disorder, there is a need to examine the associated ethical concerns. The aim of this review was to examine the ethical issues underpinning the clinical research on pre-onset identification and preventive interventions for bipolar disorder. METHODS: We undertook a PubMed search updated to November 2014 incorporating search terms such as bipolar, mania, hypomania, ethic*(truncated), early intervention, prevention, genetic and family. RESULTS: Fifty-six articles that were identified by this method as well as other relevant articles were examined within a framework of ethical principles including beneficence, non-maleficence, respect for autonomy and justice. The primary risks associated with research and clinical interventions include stigma and labelling, especially among familial high-risk youth. Side effects from interventions are another concern. The benefits of preventive or early interventions were in the amelioration of symptoms as well as the possibility of minimizing disability, cognitive impairment and progression of the illness. Supporting the autonomy of individuals and improving access to stigma-free care may help moderate the potential challenges associated with the risks of interventions. CONCLUSIONS: Concerns about the risks of early identification and pre-onset interventions should be balanced against the potential benefits, the individuals' right to choice and by improving availability of services that balance such dilemmas.


Assuntos
Transtorno Bipolar/psicologia , Transtorno Bipolar/terapia , Intervenção Médica Precoce/ética , Ética Médica , Suicídio/ética , Suicídio/prevenção & controle , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/prevenção & controle , Tomada de Decisões/ética , Necessidades e Demandas de Serviços de Saúde/ética , Humanos , Intenção , Autonomia Pessoal , Medição de Risco/ética , Medição de Risco/métodos , Resultado do Tratamento
17.
J Bioeth Inq ; 13(2): 193-202, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27251402

RESUMO

Adverse developmental exposures and pathologies of the social environment make vastly greater contributions to the leading health burdens in society than currently known genotypic information. Yet, while patients now commonly bring information on single alleles to the attention of their healthcare team, the former conditions are only rarely considered with respect to future health outcomes. This manuscript aims to integrate social environmental influences in genetic predictive models of disease risk. Healthcare providers must be educated to better understand genetic risks for complex diseases and the specific health consequences of societal adversities, to facilitate patient education, disease prevention, and the optimal care in order to achieve positive health outcomes for those with early trauma or other social disadvantage.


Assuntos
Assistência à Saúde/normas , Exposição Ambiental/efeitos adversos , Epigenômica/ética , Aconselhamento Genético/ética , Pesquisa em Genética/ética , Testes Genéticos/ética , Necessidades e Demandas de Serviços de Saúde/ética , Predisposição Genética para Doença , Disparidades nos Níveis de Saúde , Humanos , Vigilância da População , Medição de Risco , Meio Social
18.
Rev Lat Am Enfermagem ; 24: e2694, 2016.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-27192418

RESUMO

OBJECTIVES: describe care needs and demands that mark the discursive practices of ostomized clients and family members and discuss guidelines for a comprehensive care program to ostomized clients and their families, organized by macrosociological categories. METHOD: Creative and Sensitive, involving 17 ostomized subjects and family members at a municipal outpatient clinic. The ethical aspects were complied with. A characterization form was used, as well as Creativity and Sensitivity Dynamics: "speaking map", "body-knowledge" and "calendar". Critical Discourse Analysis was applied. RESULTS: the health needs and care demands of the ostomized patients and their family members, in their multiple dimensions, were constituted in the home and community, outpatient and social context, implying new orientations for nursing care. The unveiling of the data brought elements that constituted guidelines, in a macrosociological approach, to achieve the expanded integrality of nursing care. CONCLUSION: the ostomized clients are unique in their genre/peculiar from Latin sui generis, calling for strategies that respond to and distinguish their specificities. Elaborating a Public Health Policy that improves and reorganizes the care demands, taking into account these individual biopsychosocial and spiritual aspects, is a possible and irrevocable target in the attempt to achieve better conditions of health and wellbeing.


Assuntos
Família , Necessidades e Demandas de Serviços de Saúde , Estomia/enfermagem , Adulto , Idoso , Feminino , Guias como Assunto , Necessidades e Demandas de Serviços de Saúde/ética , Humanos , Masculino , Pessoa de Meia-Idade , Estomia/psicologia , Pesquisa Qualitativa
19.
Bioethics ; 30(8): 588-96, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27196999

RESUMO

Many hold that distributing healthcare according to medical need is a requirement of equality. Most egalitarians believe, however, that people ought to be equal on the whole, by some overall measure of well-being or life-prospects; it would be a massive coincidence if distributing healthcare according to medical need turned out to be an effective way of promoting equality overall. I argue that distributing healthcare according to medical need is important for reducing individuals' uncertainty surrounding their future medical needs. In other words, distributing healthcare according to medical need is a natural feature of healthcare insurance; it is about indemnity, not equality.


Assuntos
Assistência à Saúde/ética , Necessidades e Demandas de Serviços de Saúde/ética , Disparidades em Assistência à Saúde , Incerteza , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde/ética , Humanos
20.
N Y State Dent J ; 82(2): 38-42, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27209718

RESUMO

The ADA Principles of Ethics and Code of Professional Conduct is an expression of the obligation occurring between the profession and society to meet the oral health needs of the public. At a time of economic concerns for the profession, suggestions are made to bring together the ethics of the profession and the need to expand services to underserved populations, including individuals with disabilities and the poor. The profession's effort to secure economic support for such an effort is possible with increased legislative awareness of the magnitude of the problem. To this end, the number of individuals with disabilities was developed for each Congressional district in New York State in an effort to challenge members of Congress to recognize the need in terms of their constituents, rather than in terms of the tens of millions with disabilities in the United States-which become "just numbers," not actual people.


Assuntos
Assistência Odontológica para Pessoas com Deficiências/ética , Economia em Odontologia , Ética Odontológica , Acesso aos Serviços de Saúde/ética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Assistência Odontológica para Pessoas com Deficiências/economia , Organização do Financiamento , Gastos em Saúde , Acesso aos Serviços de Saúde/economia , Necessidades e Demandas de Serviços de Saúde/economia , Necessidades e Demandas de Serviços de Saúde/ética , Humanos , Medicaid/economia , Área Carente de Assistência Médica , Pessoa de Meia-Idade , New York , Dinâmica Populacional , Pobreza , Estados Unidos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA