Emergency Medical Practice: Advancing Cultural Competence and Reducing Health Care Disparities

Padela, Aasim I.; Punekar, Imran R A

doi:10.1111/j.1553-2712.2008.00305.x

Cited by 55 publications

(37 citation statements)

References 48 publications

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“…Cultural identity has been suggested as one indicator for different behaviour in the health system [26]. As those patients are acquainted to the healthcare system of their country of origin, they have less knowledge about the accessibility and organisation of out-of-hours services in other countries.…”

Section: Discussionmentioning

confidence: 99%

Out of hours care: a profile analysis of patients attending the emergency department and the general practitioner on call

et al. 2010

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BackgroundOveruse of emergency departments (ED) is of concern in Western society and it is often referred to as 'inappropriate' use. This phenomenon may compromise efficient use of health care personnel, infrastructure and financial resources of the ED. To redirect patients, an extensive knowledge of the experiences and attitudes of patients and their choice behaviour is necessary. The aim of this study is to quantify the patients and socio-economical determinants for choosing the general practitioner (GP) on call or the ED.MethodsData collection was conducted simultaneously in 4 large cities in Belgium. All patients who visited EDs or used the services of the GP on call during two weekends in January 2005 were enrolled in the study in a prospective manner. We used semi-structured questionnaires to interview patients from both services.Results1611 patient contacts were suitable for further analysis. 640 patients visited the GP and 971 went to the ED. Determinants that associated with the choice of the ED are: being male, having visited the ED during the past 12 months at least once, speaking another language than Dutch or French, being of African (sub-Saharan as well as North African) nationality and no medical insurance. We also found that young men are more likely to seek help at the ED for minor trauma, compared to women.ConclusionsPatients tend to seek help at the service they are acquainted with. Two populations that distinctively seek help at the ED for minor medical problems are people of foreign origin and men suffering minor trauma. Aiming at a redirection of patients, special attention should go to these patients. Informing them about the health services' specific tasks and the needlessness of technical examinations for minor trauma, might be a useful intervention.

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Section: Discussionmentioning

confidence: 99%

Out of hours care: a profile analysis of patients attending the emergency department and the general practitioner on call

et al. 2010

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“…It is well known that those people have other choice behaviour and encounter different problems than other people do and often receive a lesser quality of medical care due to language or cultural differences. Also accessibility of health care services is different (42,43). On the other hand, ethnic and racial minorities are exposed to different environmental and health risks, which also lead to other choice behaviour (44).…”

Section: Limitationsmentioning

confidence: 99%

Use of Out-of-Hours Services: The Patient’s Point of View on Co-Payment a Mixed Methods Approach

Philips

Remmen

Paepe

et al. 2013

Acta Clinica Belgica

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Introduction: In many countries out of hours (OOH) care is offered by different health care services. General practitioners (GP) tend to offer services in competition with emergency departments (ED). Patients behaviour depends on a number of factors. In this study, we highlight the knowledge and ideas of patients concerning the co-payment system.Methods: We used a mixed methods design, combining quantitative and qualitative research. During two weekends in January 2005, all patients using the ED or the GP OOH service, were invited for an interview with a structured questionnaire. A stratified random sample of patients participated in a semi-structured interview. Both methods add complementary data to answer the research questions.Results: Most mentioned reasons for seeking help at the ED are: accessibility (15.0%), proximity (6.4%) and competence of the staff (5.6%). Reasons for choosing the GP are: GP is easy to find, minor medical problem or anxiety and confidence in the GP. The odds of not knowing the co-payment system are significantly higher in patients visiting the ED (OR 1.783; 95% CI: 1.493-2.129). Mostly GP users recognize the problem of ED overuse. They suggested especially to provide clear information about the tasks of the different services and about the payment system, to reduce ED overuse.Conclusion and discussion: When intending to shift from ED to GP services for minor medical problems, aiming at just one measure is no option. Information campaigns aiming to address the entire population, can clarify the role of each player in out-of-hours care.

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“…Recognizing the importance of health providers' cultural competence, scholars have conceptualized ways to improve their cultural competence training (De Leon Siantz 2008;Lu and Hecht 2014;Padela and Punekar 2009). Rosenberg et al (2006) discussed two commonly used training methods; one focuses on the physician themselves, the other on the patients.…”

Section: Cultural Communication Competence Interventions In Health Carementioning

confidence: 99%

12. Culture and competence: Ethnicity and race

Hecht¹,

Lu²

2015

Communication Competence

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Increased racial/ethnic diversity and mobility worldwide is leading inevitably to more frequent communication across racial/ethnic cultures where cultural communication competence is vital. Instead of treating cultures as static, demographic categories, we explicate these competencies by adopting the definition in speech code theory that views culture as the codes and practices that accomplish goals. Consequently, cultural communication competence would constitute the codes and practices that help achieve communication goals in specific contexts with specific groups of people. The codes describe the rule systems that define communication competence in various cultures such as the expectations of appropriate and effective communication in a given context. Practices are the enactments of competent communication often considered skills. Finally, functions describe desirable communication outcomes and provide an understanding of what it takes to achieve those outcomes. Lack of communication competence across racial/ ethnic cultures is implicated in adverse physical, psychological, educational, and relational outcomes. The chapter uses the health context as an exemplar to examine how codes and practices affect health outcomes and how interventions can improve cultural health communication competencies.

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Emergency Medical Practice: Advancing Cultural Competence and Reducing Health Care Disparities

Cited by 55 publications

References 48 publications

Out of hours care: a profile analysis of patients attending the emergency department and the general practitioner on call

Out of hours care: a profile analysis of patients attending the emergency department and the general practitioner on call

Use of Out-of-Hours Services: The Patient’s Point of View on Co-Payment a Mixed Methods Approach

12. Culture and competence: Ethnicity and race

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