Diversity Competency and Access to Healthcare in Hospitals in Croatia, Germany, Poland, and Slovenia

Abstract

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.

Caring for Transgender People in Healthcare: A Qualitative Study with Hospital Staff in Croatia

“…The concept of diversity competence implies the implementation of policies and practices in healthcare institutions that promote taking the individual needs of patients into account when providing healthcare, especially those who belong to various minority groups in society. Unlike the concept of cultural competence, which primarily refers to racial and ethnic minorities, the concept of diversity competence includes a much wider range of minority groups, including gender minorities [ 28 ]. The questions are, to what extent are experts in the healthcare system familiar with the concept of diversity competence?…”

“…In Croatia, so far, a small number of studies have been conducted on access to healthcare for transgender people or their experiences in the healthcare system [ 25 , 26 , 27 , 28 ]. In research from 2014 on the experiences of people who had undergone medical gender reassignment, the participants talked about experiences of unpleasant and discriminatory behavior by health professionals, such as deprecation, a lack of understanding, and an unwillingness to provide medical help, along with being insulted, ignored, and provoked [ 25 ].…”

“…Barriers were more often experienced by people assigned as male at birth and those with lower incomes. In another study from 2021, internal documents of public healthcare institutions were analyzed to determine the regulation of minority groups’ access to the healthcare system [ 28 ]. None of the included health institutions had an internal document focusing on the specific needs of gender minority patients.…”

Diversity awareness, diversity competency and access to healthcare for minority groups: perspectives of healthcare professionals in Croatia, Germany, Poland, and Slovenia

“…This type of interview includes expert questions, narrative segments, and focus segments with narrative characters (26). The interview questions were prepared on the basis of a literature review and results of the previous research conducted by the team of authors (19)(20)(21). Moreover, questions of validity and possible bias in the results were extensively discussed by the team of authors.…”

“…These countries were selected for several reasons. First, although all four countries are Member States of the European Union and through this subject to European regulations concerning equality in access to healthcare, their national policies vary in regard to protection from discrimination in healthcare (19,20), which has direct consequences for diversity competency of healthcare organizations in these countries (21). Moreover, they vary under socio-cultural aspects.…”