The Inverse Care Law

Fiscella, Kevin; Shin, Peter

doi:10.1097/00004479-200510000-00005

Cited by 70 publications

(30 citation statements)

References 15 publications

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“…However, other publications took into consideration specific aspects of accessibility in connection with the context of vulnerability. Thus, access to health care was measured by the use or nonuse of physician care and, among users, by the number of visits [27,30,32,39,40]. Continuity of health care was measured as self-reports of having a regular source of care [27,30,32,39,43,46].…”

Section: Resultsmentioning

confidence: 99%

“…Thus, access to health care was measured by the use or nonuse of physician care and, among users, by the number of visits [27,30,32,39,40]. Continuity of health care was measured as self-reports of having a regular source of care [27,30,32,39,43,46]. In turn, comprehensiveness was usually viewed in connection with difficulties with access to preventive services such as immunizations, check-ups, and screenings [27,30,35,39,42,44].…”

Section: Resultsmentioning

confidence: 99%

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Mapping the concept of vulnerability related to health care disparities: a scoping review

Grabovschi

Loignon

Fortin

2013

BMC Health Serv Res

117

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BackgroundThe aim of this paper is to share the results of a scoping review that examined the relationship between health care disparities and the multiplicity of vulnerability factors that are often clustered together.MethodsThe conceptual framework used was an innovative dynamic model that we developed to analyze the co-existence of multiple vulnerability factors (multi-vulnerability) related to the phenomenon of the ‘Inverse Care Law’. A total of 759 candidate references were identified through a literature search, of which 23 publications were deemed relevant to our scoping review.ResultsThe review confirmed our hypothesis of a direct correlation between co-existing vulnerability factors and health care disparities. Several gaps in the literature were identified, such as a lack of research on vulnerable populations’ perception of their own vulnerability and on multimorbidity and immigrant status as aspects of vulnerability.ConclusionsFuture research addressing the revealed gaps would help foster primary care interventions that are responsive to the needs of vulnerable people and, eventually, contribute to the reduction of health care disparities in society.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Mapping the concept of vulnerability related to health care disparities: a scoping review

Grabovschi

Loignon

Fortin

2013

BMC Health Serv Res

117

View full text Add to dashboard Cite

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“…In terms of the provision of such services, Tudor-Hart’s inverse care law [5] identified that population groups with the highest health needs -the most deprived and vulnerable groups in society- tended to receive the least health care provision, whilst those with the least health need -the most affluent and advantaged societal groups- received the most health care. In relation to access to, and use of, health services, conceptual frameworks have been developed, such as that of Andersen [6-8], which stress that access to health services should be analysed from the perspective of health policy objectives, the characteristics of the health system, and the results obtained: input (factors affecting service use) and output (health status and health behaviours).…”

Section: Introductionmentioning

confidence: 99%

A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

Agudelo‐Suárez

Gil-González

Vives‐Cases

et al. 2012

BMC Health Serv Res

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BackgroundAccess to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011).MethodsA systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories.ResultsWe located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability.ConclusionsEconomic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.

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“…About 55 million people living in the U.S. speak a language other than English at home, and about 8.6% speak English less than “very well”; this number has been steadily climbing [1,2]. Patients with LEP have difficulty accessing health care [3,4] and face decreased quality of care in domains including satisfaction, health outcomes, and safety [5–13]. …”

Section: Introductionmentioning

confidence: 99%

Interpreter perspectives of in-person, telephonic, and videoconferencing medical interpretation in clinical encounters

Price

Pérez‐Stable

Nickleach

et al. 2012

Patient Education and Counseling

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Objective-To examine professional medical interpreters' perspectives of in-person and remote interpreting modalities.Methods-Survey of interpreters at three medical centers assessing satisfaction with aspects of communication using each modality, and adequacy of videoconferencing medical interpretation (VMI) and telephonic interpretation for 21 common clinical scenarios in the hospital and ambulatory care settings.Results-52 interpreters completed the survey (73% response). All modalities were equally satisfactory for conveying information. Respondents favored in-person to telephonic interpretation for establishing rapport (95% versus 71%, p = .002) and for facilitating clinician understanding of patients' social and cultural backgrounds (92% versus 69%, p = .002). Scenarios with substantial educational or psychosocial dimensions had no more than 70% of respondents rating telephonic interpretation as adequate (25-70%); for all of these scenarios, VMI represented an improvement (52-87%).Conclusion-From the interpreter perspective, telephonic interpretation is satisfactory for information exchange, but less so for interpersonal aspects of communication. In scenarios where telephonic interpretation does not suffice, particularly those with substantial educational or psychosocial components, VMI offers improved communication.Practice implications-Differences in interpreters' perspectives of modalities based on communication needs and clinical scenario suggest mixed use of multiple modalities may be the best language access strategy.

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The Inverse Care Law

Cited by 70 publications

References 15 publications

Mapping the concept of vulnerability related to health care disparities: a scoping review

Mapping the concept of vulnerability related to health care disparities: a scoping review

A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

Interpreter perspectives of in-person, telephonic, and videoconferencing medical interpretation in clinical encounters

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