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Showing results for tags 'Health inequalities'.
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Content ArticleEven before the Covid-19 pandemic, rural and remote health services in England faced long-standing workforce, financial and capacity issues. This report by the Nuffield Trust explores the impact the pandemic has had on the delivery of rural and remote health services, highlighting the underlying challenges faced by these services. It outlines how the challenges faced are different for rural areas when compared to more urban areas. The authors also discuss how performance could be monitored to signal the risk of any significant service pressures over the coming months.
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Content ArticleThis blog by Robert Otto Valdez, Director of the US Agency for Healthcare Research and Quality (AHRQ), outlines the setbacks to patient safety and the healthcare workforce caused by the Covid-19 pandemic. He highlights areas of concern including workforce burnout and an increase in healthcare associated infections (HAIs) since 2020. The issues faced by the US healthcare system are not felt equally, and Valdez draws attention to a report that demonstrates worsening health inequalities. The blog includes links to evidence-based research and initiatives developed by AHRQ aimed at improving current patient safety priorities. Toolkits to improve antibiotic use. These resources are based on a “Four Moments of Antibiotic Decision Making” model that has shown success in hospitals, long-term care facilities, and ambulatory care practices. Tools to engage patients and families in making healthcare safer. Patients and families are powerful partners in improving quality and safety in hospital settings, during primary care visits, or whenever a diagnosis is made. These resources help ensure that patients’ voices are heard. Surveys on patient safety culture. This family of surveys asks healthcare providers and staff about the extent to which their organisational culture supports patient safety. Each survey is designed to assess patient safety culture in a specific setting. Diagnostic Centers of Excellence. These grants establishing 10 centres of excellence are aimed at developing systems, measures, and new technology solutions to improve diagnostic safety and quality.
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Content ArticleA joint paper by Public Health Wales and Cardiff University has identified a worrying trend of depreciating health inequalities between Wales’ most and least deprived areas. This blog outlines the key findings of the paper, including how the gap in life expectancy increased amongst both men and women between 2002 and 2020. This was primarily caused by large drops in life expectancy in Wales’ most deprived areas, including a sharp decline for women between 2018 and 2020.
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Content ArticleThe Dahlgren-Whitehead rainbow model outlines determinants of health inequity on multiple hierarchical levels, and suggests that these determinants may interact both within and between levels. Since the model was developed, the involvement of digital technologies has come to have a much greater impact on health inequities. The authors of this article suggest adapting the Dahlgren-Whitehead model to reflect these developments, proposing a model that allows formulating testable hypotheses, interpreting research findings, and developing policy implications against the background of the global spread of digital technologies.
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Content ArticleThis briefing from the Centre of Mental Health summarises evidence from six studies on the use of digital and telephone technology to deliver mental health services. It finds that using remote technology can improve access to mental health support for rural communities, disabled people or people needing a specialist service far from home. It has the potential to increase access and choice in mental health care. But it also risks exacerbating inequalities for people who are digitally excluded.
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Content ArticleNHS England has published its planning guidance for 2023/2023. The 2023/24 priorities and operational planning guidance reconfirms the ongoing need to recover our core services and improve productivity, making progress in delivering the key NHS Long Term Plan ambitions and continuing to transform the NHS for the future.
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Content ArticleThis report commissioned by the NHS Confederation and written by the Centre for Mental Health sets out a vision for what mental health, autism and learning disability services in England should look like in ten years’ time. It brings together research and engagement with a wide range of stakeholders including people who bring personal and professional experience. The report identifies ten interconnecting themes that underpin the vision and three key requirements that would turn the vision into reality.
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Content ArticleThis article by the Betsy Lehman Center in Massachusetts draws attention to research by ECRI, a US non-profit research and risk management firm, which shows that efforts to address racial inequalities in medical care need to include an examination of the way in which patient safety events are reported. Research by ECRI shows that existing patient safety reporting systems may be undercounting events experienced by patients who are Black , Latino or from other ethnic groups. It also highlights that racial, ethnic and other demographic data about patients is missing in adverse event reports from most US healthcare organisations.
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Content Article
In February 2022, we launched our Patient Safety Spotlight interview series to share stories and insight from people working on the frontline of patient safety—from patient campaigners and healthcare professionals to researchers and health and care leaders. For our final Patient Safety Spotlight of 2022, members of the Patient Safety Learning team share a personal patient safety reflection from the past 12 months and talk about their hopes for next year. -
Content ArticleThis guide by the Patient Information Forum (PIF) provides practical support for translating health information. It offers tips on overcoming key challenges and links to useful resources. It is mainly focused on foreign language translation, but the principles can also be applied to British Sign Language and Braille. Research shows that in the UK, up to a million people cannot speak English well or at all, and these people have a lower proportion of good health than English speakers. Providing culturally appropriate, translated health information can help people manage their own health and take part in shared decision making. Translation is consistently raised as a key challenge by health information producers. Please note, you will need to join PIF to view this content.
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Content ArticleFundamentals of Health Care Improvement: A Guide to Improving Your Patient’s Care, 4th edition, is intended to help health professional learners diagnose, measure, analyse, change and lead improvements in healthcare, with the aim to shape reliable, high-quality systems of care in partnership with patients. Copublished by Joint Commission Resources and the Institute of Healthcare Improvement, this fourth edition includes updated resources, including examples, figures, tables, and tools. New to this edition is a focus on health equity and disparities of care brought to light by the COVID-19 pandemic. This focus explores the relationship between social determinants of health and how improvement methods and skills can help identify and close disparity gaps in systems of care. Also new to this edition is an expanded discussion of effective teamwork and the importance of creating multidisciplinary health care teams that partner with patients and families.
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Content ArticleFor the 20th year, the Agency for Healthcare Research and Quality (AHRQ) is reporting on healthcare quality and disparities. The annual National Healthcare Quality and Disparities Report is mandated by Congress to provide a comprehensive overview of the quality of healthcare received by the general U.S. population and disparities in care experienced by different racial and socioeconomic groups. The report is produced with the help of an Interagency Work Group led by AHRQ.
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Content Article
NHS Atlas of Variation Series
Patient Safety Learning posted an article in Data and insight
The Atlases of Variation help to identify unwarranted variation and assess the value that healthcare provides to both populations and individuals. This is produced in collaboration with PHE, NHS England and RightCare and many other organisations. Products include Compendium atlases and themed atlases for areas such as Diagnostic Services and Liver Disease. A defining aspect of the atlases is that each of the indicator’s maps, column chart and box-and-whisker plot is accompanied by text which provides: the context for the indicator, a description of the variation and trend data, options for action and a list of evidence-based resources to support action. Interactive Atlases services can be accessed via the NHS England website. -
Content ArticleRacism, xenophobia, and discrimination exist in every modern society causing avoidable disease and premature death among groups who are often already disadvantaged. This Lancet series examines how the historic systems and structures of power and oppression, and discriminatory ideologies have shaped policy and practice today, and are root causes of racial health inequities. Furthermore, by applying a global lens and intersectional framework, overlapping forms of oppression such as age, gender, and socioeconomic status and their impact on discrimination are analysed. Interventions to address the spectrum of drivers of adverse health outcomes with a focus on the structural, societal, legal, human right, institutional and system level are reviewed. Research recommendations and key approaches for moving forward are proposed.
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Content ArticlePaul Batalden is the host of "The Power of Coproduction". Prepared as a pediatric physician, he has been an international architect, teacher, and advocate for the improvement of healthcare services for five decades. His current focus is the coproduction of healthcare services.
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Content ArticleOn 9 November 2022, The Professional Standards Authority hosted the Safer care for all conference to discuss questions and issues highlighted in the report Safer care for all – solutions from professional regulation and beyond. This webpage contains video summaries of the conference sessions. The conference provided an opportunity to hear experts’ views as well as consider and contest the themes raised in the report, including the PSA's main recommendation, the creation of a health and social care safety commissioner in all four UK countries. Speakers and delegates came from both professional and system regulators as well as patient organisations, the ombudsman, the NHS, health and care sector organisations and major healthcare inquiries.
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Content ArticleIn this HSJ article, Gemma Dakin and George Croft from the Health Innovation Network share their reflections on the HSJ Patient Safety Congress. They highlight key themes that emerged including the need to listen to patients, service users, and carers stories, and encourage their involvement to bring about a cultural change. They argue that humanity will be central to making progress in quality improvement and patient safety.
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Content ArticleMaternal Mortality Review Committees (MMRCs) in the US are multidisciplinary committees that convene at the state or local level to comprehensively review deaths during or within a year of pregnancy. MMRCs have access to clinical and non-clinical information to more fully understand the circumstances surrounding each death, determine whether the death was pregnancy-related, and develop recommendations for action to prevent similar deaths in the future. This article summarises the data from MMRCs in 36 US states between 2017 and 2019, demonstrating variations in prevalence and cause of death according to race, ethnicity and geographical area. The data suggests that over 80% of pregnancy-related deaths examined were determined to be preventable.
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Content ArticleReducing socioeconomic inequalities in cancer is a priority for the public health agenda. In this study, cancer-specific mortality data by socioeconomic status, as measured by educational level, were collected and harmonised across 18 countries in Europe and for multiple points in time over the period 1990–2015. The study found that everywhere in Europe, lower-educated individuals have higher mortality rates for nearly all cancer-types relative to their more highly educated counterparts, particularly for tobacco/infection-related cancers. However, the magnitude of inequalities varies greatly by country and over time, predominantly due to differences in cancer mortality among lower-educated groups, as for many cancer-types higher-educated have more similar (and lower) rates, irrespective of the country. Inequalities were generally greater in Baltic/Central/East-Europe and smaller in South-Europe, although among women large and rising inequalities were found in North-Europe. These results call for a systematic measurement, monitoring and action upon the remarkable socioeconomic inequalities in cancer existing in Europe.
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Content ArticleThis report by LCP Health Analytics, looks at how inequalities across the medicine life cycle impact patients and populations. It paints a vision of what success could look like, and proposes specific, feasible calls to action across industry, health technology assessment (HTA) bodies and players that could transform the role of the life science sector in reducing inequalities and fostering healthy populations. The report identifies two key challenges in addressing health inequalities that are tractable, and where the life science sector is most likely to make commitments and contributions: Multimorbidity is increasing and embedding inequalities in health Financial incentives across health systems are not aligned with patient and population health
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Content ArticleThe Health Equity Network will launch in January 2023 and aims to build momentum for health equity across the UK. It will provide an opportunity for public and private sector organisations, community and voluntary groups and individuals to share their work on health equity and to engage across the country with others with the same interests. This article describes how the Network will work and offers the opportunity to register interest in joining.
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Content ArticleCore20PLUS5 is NHS England's approach to reducing health inequalities at both national and system level. The approach defines a target population cohort and identifies five focus clinical areas that require accelerated improvement. This infographic outlines the specific Core20PLUS5 approach to reducing health inequalities for children and young people.
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News Article
More than a million Americans ration insulin due to the high cost of the drug
Patient Safety Learning posted a news article in News
Insulin rights activists and those who live with diabetes are calling for meaningful action to address the high costs of insulin in the United States as a new study shows the widespread habit of rationing the life-saving medicine. A study published on 18 October in the Annals of Internal Medicine by researchers at Harvard Medical School, the City University of New York’s Hunter College and Public Citizen, found that 1.3 million Americans rationed insulin due to the high costs of insulin in 2021. The staggering number represents an estimated 16.5% of the US population with diabetes. The study found insulin rationing was most commonly reported by those without health insurance coverage and individuals under the age of 65 not eligible for Medicare. Black insulin users were more likely to report rationing insulin, at 23.2%. The impact of the practice can be terrible. Janelle Lutgen of Dubuque county, Iowa, lost her 32-year-old son Jesse, a type 1 diabetic, after he started rationing his insulin because he lost his job and with it his health insurance and died in early 2018 from diabetic ketoacidosis. Without health insurance, Lutgen said over-the-counter insulin costs more than $1,000 (£865) a month, and that her son couldn’t afford the high cost of healthcare coverage in the marketplace without a job and wasn’t eligible for Medicaid coverage because his income from when he was working was too high. “It would probably be impossible to really know exactly all the harm that’s been done with high insulin prices,” said Lutgen, who explained that individuals who ration insulin because of the cost, if they do survive, can still experience other health impacts such as neuropathy, or losing toes or feet. “It seems like we can’t get it through legislators’ heads that we have to make sure everyone who needs insulin can get it, not just people who have insurance or people on Medicare – everybody. The only way to do that is to go to the root of the problem, big pharma.” Read full story Source: The Guardian, 1 November 2022 -
News Article
‘Alarming’ rise in type 2 diabetes among UK under-40s
Patient Safety Learning posted a news article in News
The number of people under 40 in the UK being diagnosed with type 2 diabetes is rising at a faster pace than the over-40s, according to “shocking” and “incredibly troubling” data that experts say exposes the impact of soaring obesity levels. The UK ranks among the worst in Europe with the most overweight and obese adults, according to the World Health Organization. On obesity rates alone, the UK is third after Turkey and Malta. The growing numbers of overweight and obese children and young adults across the UK is now translating into an “alarming acceleration” in type 2 diabetes cases among those aged 18 to 39, analysis by Diabetes UK suggests. There is a close association between obesity and type 2 diabetes. There is a seven times greater risk of type 2 diabetes in obese people compared with those of healthy weight, and a threefold increase in risk for those just overweight. “This analysis confirms an incredibly troubling growing trend, underlining how serious health conditions related to obesity are becoming more and more prevalent in a younger demographic,” Chris Askew, the chief executive of Diabetes UK, said. He added: “While it’s important to remember that type 2 diabetes is a complex condition with multiple other risk factors, such as genetics, family history and ethnicity, these statistics should serve as a serious warning to policymakers and our NHS. “They mark a shift from what we’ve seen historically with type 2 diabetes and underline why we’ve been calling on the government to press ahead with evidence-based policies aimed at improving the health of our nation and addressing the stark health inequalities that exist in parts of the UK.” Read full story Source: The Guardian, 1 November 2022 -
News ArticlePatients from minority groups are facing longer wait times for potentially life-saving lung cancer treatment compared to their white counterparts, according to a study. Experts warn that disparities can have real consequences – the earlier treatment is initiated, the better the health outcomes for patients. Researchers at the University of Virginia (UVA) Cancer Centre reviewed data from more than 222,700 patients with non-small cell lung cancer across the US. The findings, published in the scientific journal Health Equity, showed that the mean time for radiation initiation was 61.7 days. Broken down by ethnicity, white patients had to wait only 60.9 days, while Black patients had a wait time of 65.9 days, meanwhile for Asian patients, it was 71.9 days. A single-week delay in treatment could lead to a 3.2% and 1.6% increase in the risk of death for patients with stage I and stage II non-small cell lung cancer, respectively. “Our results suggest that non-white lung cancer patients have delayed time to cancer treatment compared with white patients, and this is not limited to a particular type of treatment facility,” said senior researcher Rajesh Balkrishnan, PhD, of UVA Cancer Center and the University of Virginia School of Medicine’s Department of Public Health Sciences. “Collaboration among providers and community stakeholders and organisations is much needed to increase accessibility and patient knowledge of cancer and to overcome existing disparities in timely care for lung cancer patients.” Scientists cite multiple reasons for the racial disparities, including health insurance – non-white patients are more likely to be uninsured, face greater socioeconomic barriers to care and may be perceived by doctors as being at risk for not following through with treatment plans. Read full story Source: The Independent, 26 October 2022
