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Special Issue "Inequalities in Health Care"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (30 June 2021).

Special Issue Editors

Prof. Dr. Milena Pavlova
E-Mail Website
Chief Guest Editor
Department of Health Services Research; CAPHRI; Maastricht University Medical Center; Faculty of Health, Medicine and Life Sciences, Maastricht University, 6211 LK Maastricht, The Netherlands
Interests: health economics; health systems; health policy; out-of-pocket payments; access; affordability; consumer preferences; equity
Dr. Tetiana Stepurko
E-Mail Website1 Website2
Guest Editor
(a) School of Public Health, National University of Kyiv-Mohyla Academy, Kyiv 04655, Ukraine
(b) Ukrainian-Swiss Project “Medical educaiton development” of the Swiss Tropical and Public Health Institute
Interests: informal patient payments; informality; integrity in medical education; mother and child health; healthcare governance; corruption in healthcare; medical education; social science and healthcare
Dr. Marzena Tambor
E-Mail Website
Guest Editor
Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Kraków, Poland
Interests: health economics; health and social policy; health care financing; financial protection; equity; out-of-pocket payments

Special Issue Information

Dear Colleagues,

Poverty, deprived living conditions, low literacy, and unhealthy lifestyles commonly go hand in hand and jointly worsen one’s health status, which makes recovery from an illness prolonged and sometimes incomplete or even impossible. In low-resource settings, access to care is also challenging. Healthcare facilities might be difficult to reach because of a lack of transportation, inadequate communication, and poor road conditions. Those who can reach the facilities might be confronted with unaffordable out-of-pocket payments, a lack of skilled care providers, as well as a lack of equipment or inability to use the equipment available at the facilities due to staff shortage or technical problems. Limited facility capacity might even prevent the necessary basic isolation of patients with a contagious disease, resulting in further spread of the disease, and some patients might not even have the chance to receive adequate care or even any care at all, which can increase morbidity and mortality outcomes.

All these factors threaten the achievement of the universal health coverage goal, i.e., equal access to health services of sufficient quality to be effective, without suffering financial hardship. Strengthening the resilience and flexibility of the health system is an important future strategy. Thus, politicians, medical practitioners, public health experts, scientists, and industry should come together to establish effective mechanisms for continuous monitoring of health systems to promptly detect acute system gaps.

This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on the inequalities in the distribution of health resources and barriers to access to adequate healthcare services. We welcome research papers, reviews, case reports, and commentaries, especially those dealing with new approaches and insights. We will accept manuscripts from different disciplines, including but not limited to public health, health economics, health systems research, and healthcare management.


Prof. Dr. Milena Pavlova
Dr. Marzena Tambor
Dr. Tetiana Stepurko
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • equity
  • health resources
  • healthcare services
  • out-of-pocket payments
  • access
  • affordability
  • vulnerable groups
  • financial protection

Published Papers (2 papers)

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Research

Article
Self-Reported Waiting Times for Outpatient Health Care Services in Hungary: Results of a Cross-Sectional Survey on a National Representative Sample
Int. J. Environ. Res. Public Health 2021, 18(5), 2213; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052213 - 24 Feb 2021
Viewed by 770
Abstract
(1) Background: System-level data on waiting time in the outpatient setting in Hungary is scarce. The objective of the study was to explore self-reported waiting time for an appointment and at a doctor’s office. (2) Methods: An online, cross-sectional, self-administered survey [...] Read more.
(1) Background: System-level data on waiting time in the outpatient setting in Hungary is scarce. The objective of the study was to explore self-reported waiting time for an appointment and at a doctor’s office. (2) Methods: An online, cross-sectional, self-administered survey was carried out in 2019 in Hungary among a representative sample (n = 1000) of the general adult population. Chi-squared test and logistic regression analysis were carried out to explore if socioeconomic characteristics, health status, or residence were associated with waiting times and the perception of waiting time as a problem. (3) Results: Proportions of 90%, 41%, and 64% of respondents were seen within a week by family doctor, public specialist, and private specialist, respectively. One-third of respondents waited more than a month to get an appointment with a public specialist. Respondents in better health status reported shorter waiting times; those respondents were less likely to perceive a problem with: (1) waiting time to get an appointment (OR = 0.400) and (2) waiting time at a doctor’s office (OR = 0.519). (4) Conclusions: Longest waiting times were reported for public specialist visits, but waiting times were favorable for family doctors and private specialists. Further investigation is needed to better understand potential inequities affecting people in worse health status. Full article
(This article belongs to the Special Issue Inequalities in Health Care)
Article
Financing Healthcare in Central and Eastern European Countries: How Far Are We from Universal Health Coverage?
Int. J. Environ. Res. Public Health 2021, 18(4), 1382; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041382 - 03 Feb 2021
Viewed by 1265
Abstract
After the fall of communism, the healthcare systems of Central and Eastern European countries underwent enormous transformation, resulting in departure from publicly financed healthcare. This had significant adverse effects on equity in healthcare, which are still evident. In this paper, we analyzed the [...] Read more.
After the fall of communism, the healthcare systems of Central and Eastern European countries underwent enormous transformation, resulting in departure from publicly financed healthcare. This had significant adverse effects on equity in healthcare, which are still evident. In this paper, we analyzed the role of government and households in financing healthcare in eight countries (EU-8): Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia, and Slovenia. A desk research method was applied to collect quantitative data on healthcare expenditures and qualitative data on gaps in universal health coverage. A linear regression analysis was used to analyze a trend in health expenditure over the years 2000–2018. Our results indicate that a high reliance on out-of-pocket payments persists in many EU-8 countries, and only a few countries have shown a significant downward trend over time. The gaps in universal coverage in the EU-8 countries are due to explicit rationing (a limited benefit package, patient cost sharing) and implicit mechanisms (wait times). There is need to increase the role of public financing in CEE countries through budget prioritization, reducing patient co-payments for medical products and medicines, and extending the benefit package for these goods, as well as improving the quality of care. Full article
(This article belongs to the Special Issue Inequalities in Health Care)
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