Background Social diversity can affect healthcare outcomes in situations when access to healthcare is limited for specific groups. Although the principle of equality is one of the central topics on the agenda of the European Union (EU), its scope in the field of healthcare, however, is relatively unexplored. The aim of this study is to identify and systematically analyze primary and secondary legislation of the EU Institutions that concern the issue of access to healthcare for various minority groups. In our research, we have concentrated on three features of diversity: a) gender identity and sexual orientation, b) race and ethnicity, and c) religion or belief. Method and materials For the purpose of this analysis, we conducted a search of database Eur-Lex, the official website of European Union law and other public documents of the European Union, based on specific keywords accompanied by review of secondary literature. Relevant documents were examined with regard to the research topic. Our search covered documents that were in force between 13 December 2007 and 31 July 2019. Results Generally, the EU legal system prohibits discrimination on grounds of religion or belief, racial or ethnic origin, sex, and sexual orientation. However, with regard to the issue of non-discrimination in access to healthcare EU secondary law provides protection against discrimination only on the grounds of racial or ethnic origin and sex. The issue of discrimination in healthcare on the grounds of religion or belief, gender identity and sexual orientation is not specifically addressed under EU secondary law. Discussion The absence of regulations regarding non-discrimination in the EU secondary law in the area of healthcare may result from the division of competences between the European Union and the Member States. Reluctance of the Member States to adopt comprehensive antidiscrimination regulations leads to a situation, in which protection in access to healthcare primarily depends on national regulations. Conclusions Our study shows that EU antidiscriminatory law with regard to access to healthcare is fragmentary. Prohibition of discrimination of the level of European binding law does not fully encompass all aspects of social diversity.
Diversity competency is an approach for improving access to healthcare for members of minority groups. It includes a commitment to institutional policies and practices aimed at the improvement of the relationship between patients and healthcare professionals. The aim of this research is to investigate whether and how such a commitment is included in internal documents of hospitals in Croatia, Germany, Poland, and Slovenia. Using the methods of documentary research and thematic analysis we examined internal documents received from hospitals in these countries. In all four countries, the documents concentrate on general statements prohibiting discrimination with regard to healthcare provision. Specific regulations concerning ethnicity and culture focus on the issue of language barriers. With regard to religious practices, the documents from Croatia, Poland, and Slovenia focus on dominant religious groups. Observance of other religious practices and customs is rarely addressed. Healthcare needs of patients with non-heteronormative sexual orientation, intersexual, and transgender patients are explicitly addressed in only a few internal documents. Diversity competency policies are not comprehensively implemented in hospital internal regulations in hospitals under investigation. There is a need for the development and implementation of comprehensive policies in hospitals aiming at the specific needs of minority groups.
Background The aim of the study was a comparative analysis of legislative measures against discrimination in healthcare on the grounds of a) race and ethnicity, b) religion and belief, and c) gender identity and sexual orientation in Croatia, Germany, Poland and Slovenia. Methods We conducted a search for documents in national legal databases and reviewed legal commentaries, scientific literature and official reports of equality bodies. We integrated a comparative method with text analysis and the critical interpretive approach. The documents were examined in their original languages: Croatian, German, Polish, and Slovenian. Results All examined states prohibit discrimination and guarantee the right to healthcare on the constitutional level. However, there are significant differences among them on the statutory level, regarding both anti-discriminatory legal measures and other legislation affecting access to healthcare for groups of diverse race or ethnicity, religion or belief, sexual orientation or gender identity. Croatia and Slovenia show the most comprehensive legislation concerning non-discrimination in healthcare in comparison to Germany and even more Poland. Except for Slovenia, explicit provisions protecting equal access for members of the abovementioned groups are insufficiently represented in healthcare legislation. Conclusions The study identified legislative barriers to access to healthcare for persons of diverse race or ethnicity, religion or belief, sexual orientation or gender identity in Croatia, Germany, Poland and Slovenia. The discrepancies in the level of implementation of anti-discriminatory measures among these states show that there is a need for comprehensive EU-wide regulations, which would implement the principle of equal treatment in the specific context of healthcare. General anti-discrimination regulations should be strengthened by inclusion of anti-discrimination provisions directly into national legislation relating specifically to the area of healthcare.
Aim: To analyze the knowledge on Advanced Life Support procedures performed in Intensive Care Unit patients in the COVID-19 era as new challenges and procedures among medical staff from January 1 to April 30, 2021. Material and methods: The survey included 102 people, mostly women (68%), the percentage of men was 32%. Results: The vast majority of respondents – 82% are convinced that they know new ALS procedures in ICU patients in the time of the COVID-19 pandemic. The knowledge of procedures among medical personnel was influenced by the fact that they had qualification courses or specializations. The obtained results should be considered alarming, as they show significant gaps in the knowledge of the ALS guidelines during the COVID-19 pandemic. Conclusions: Most of the respondents got acquainted with the new procedures for performing ALS procedures in the time of the COVID-19 pandemic on their own, hence an important conclusion of this survey is the absolute greater popularization, availability and periodic repetition of training among medical personnel in the field of ALS.
The aim: Analysis of injuries suffered in street and road traffic and in public places in the Śląskie Voivodeship in the city of Katowice from January 1, 2017 to October 10, 2017. Material and methods: The study was based on a retrospective data analysis covering 248 Medical Rescue Activity Cards of the Voivodship Ambulance Service in Katowice – Katowice station from January 1 to October 10 2017. Results: Among 248 victims were 120 men and 128 women. 8 women who were injured were pregnant. In the analyzed material, 234 people (94%) were sober, while 14 people (6%) were found to be under the influence of alcohol. Among 248 victims, 83 people suffered multi-organ trauma, while 62 people were injured. 14 patients (5.6%) assessed pain using the NRS scale, while analgesic treatment was initiated in 22 people (8.9%). Conclusions: The most common type of injuries among victims of street and road traffic and in public places in Katowice from January 1 to October 10 2017 were bruises. Most often injuries occurred on Wednesday and Saturday, the least often on Sunday. None of the persons injured in prehospital procedures had a vacuum mattress, some had an orthopedic board (18.1%) and a cervical collar (32.3%). The personnel of the Emergency Medical Teams do not routinely use tools to assess the intensity of pain (only 5.6% of victims have documented pain assessment using the NRS scale on the MCR card). Consider changing the format of the medical records used by emergency teams to include a separate heading to assess pain intensity.
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