Health care, access

Dustan H, Francis C, Allen H, et al. Principles of access to health care. Access to Health Care Task Force, American Heart Association. Circulation 1993 87 657-8. 

An extensive literature documents persistent differences in health outcomes between ethnic minorities and white Americans. These disparities include differences in health care access and utilization as well as health status and outcomes. Wolinsky showed that differences in access and use of health services by various ethnic groups stems in part from their varying cultural traditions. Pharmacists can assist in closing this gap in health outcomes by providing culturally sensitive patient care. Information about patients cultural health care beliefs and practices is essential for devising interven-... 

Asgary, R., and Segar, N. (2011) Barriers to Health Care Access among Refugee Asylum Seekers. Journal of Health Care for the Poor and Underserved 22(2) 506-22. 

The National Health Policy (NHP) launched in 1993 includes as core elements the development of preventive, promotive and curative health care assurance of health care accessibility for all segments of the population and the promotion of private sector and NGO participation... 

Clinical Practice Guideline, Cancer Pain Management. United States Department of Health and Human Services, Agency for Health Care Policy and Research. AHCPR Pub. Rockville, MD 1994. Available at http //www.ncbi.nlm.nih.gov/books/bookres.fcgi/ hstat6/07 capcf4.gif.Accessed January 10, 2006. 

VRE) may colonize hospitalized patients or patients who access the health care system frequently. It is key to know which patients have acquired these organisms because patients generally become colonized prior to developing infection, and colonized patients should be placed in isolation (per infection-control policies) to minimize transmission to other patients. 

A cancer patient may encounter many different health care professionals phlebotomists, pathologists, surgeons, medical and radiation oncologists, physician assistants, pharmacists, nurses, counselors, dieticians, social workers, and chaplains all may be involved with a single patient. Each one plays an important role in care of the cancer patient. The pharmacist s role may include education of patients and family members, education of staff about new agents and safety issues, preparation of therapies, resolution of reimbursement issues, development of order sets, and participation in clinical trials. Each patient should have access to an interdisciplinary team to assist him or her during treatment. 

There are gradients of health status across income and education (referred to as socioecomic status or SES ) that are not explained by access to health care or other simple explanations [40]. Therefore, it may be of great relevance in the future to understand the role of such factors as sense of control, helplessness, persistent fear and anxiety, diet, exercise, and the impact of the living and social (e.g. family and work) environments in regulating the allostatic systems these factors could cause allostatic systems to operate inefficiently and lead to an acceleration of genetic predispositions towards disease. 

In light of recent experience with biotechnology-derived products, it is reasonable to expect that pharmacogenomics-based drugs will be expensive relative to traditional modes of treatment (Richmond et al., 1999). If the price of these innovations is viewed out of context from the consumption of other health care goods and services, the response may well be to reduce or deny access to these products. In an era of escalating health care cost, "inputs" to the production of health care, such as pharmaceuticals, physician visits, lab-... 

Pharmacogenomics represents a true paradigm shift for health care. The potential to effectively treat or cure most diseases will come at a price. These therapeutic advances will create economic and ethical dilemmas at all levels of the economy. At the individual level, there will be economic barriers to access, particularly for disadvantaged or disenfranchised populations. The costs of diagnostic tests and treatments may be prohibitive, and mechanisms (e.g., insurance, income subsidies, rationing) to distribute and pay for care must be devised. With limited health care resources, trade-offs between cost, access, and quality are inevitable. 

Access to health care can be defined in many ways, including by insurance status, number of physician visits in the last year, and treatment interventions once an individual is in the health care system. Furthermore, access can relate to whether the patient s health care is satisfactory, comprehensive, and meeting the overall needs of the patient from a social, cultural, spiritual, or other perspective. 

What impact will pharmacogenomics have on promoting health, preventing and curing disease, and delivering appropriate care in communities of color What are the implications for differential health status, access to care, and disparate treatment for pharmacogenomic research and the delivery of pharmacogenomics-based medicine to communities of color ... 

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