the globalized patient
DESCRIPTION
Adapting health services for mobile, migrant and minority populationsTRANSCRIPT
The Globalized Patient Adapting health services for mobile,
migrant and minority populations
Julia Puebla Fortier
Executive Director
DiversityRx – Resources for Cross Cultural Health Care
www.diversityRx.org
DiversityRx: Improving health care for a diverse world
! Policy development
! Research
! Information dissemination
! Education and training
Working with:
! Hospitals and health departments
! Universities
! Phillanthropic foundations
! Government agencies
! International organizations
Scenario:
You have gone to a conference in another country and suddenly you don’t feel well…
Medical tourists Foreign brides International students
Expat professionals
Migrants Indigenous people Foreign workers Refugees
Minorities
Goals of health care
systems
! Preventing disease and promoting health
! Improving quality
! Reducing errors
! Efficiency and cost effectiveness
! Good health outcomes
! Fostering good patient and community relations
Challenge of treating the globalized patient
! Access and appropriate utilization
! Communication barriers
! Different cultural practices or disease constructs
! Discriminatory or insensitive treatment
! Unique issues of mobility: ! Unfamiliarity with regionally prevalent illnesses ! Effects of displacement, trauma, torture,
trafficking
Structural barriers
! Eligibility for health schemes
! Portability of health insurance
! Undocumented status
! Low-income/inability to pay
! Availability/accessibility of health services
How can we achieve health care goals for the globalized patient?
! Practice
! Policy
! Strategic Alliances
! Presentation References:
www.diversityRx.org/HPH-Resources
Practice:
! Language services
! Sensitive and informed care delivery – individual level ! Epidemiological factors, cultural background, social
determinants
! Tailored population services
! Health promotion, disease prevention, disease support
! Cultural support staff
! Intercultural mediators, community health workers, patient navigators
Clinical interventions: one size does not fit all
Challenge: Communication
! Use of telephone, video, mobile technology to link in interpreters from remote locations
! Cost effective and efficient use of resources
! United States
! Japan
Remote medical interpreting
Challenge: cultural differences
! Community representatives trained to explain cultural issues and support mediation between patients and staff
! Belgium
! Germany
Intercultural mediators
Challenge:
! Training for clinical, support and administrative personnel ! Epidemiological context ! Responsiveness to linguistic and cultural issues ! Non-discrimination and rights to health services Qatar: training for medical students and health professionals at Weill Cornell Medical College and Hamad Medical Corporation
Preparing the health care workforce
Practice:
! Portugal: support for professional requalification
! United States: requalification courses and retraining as interpreters and cultural mediators
Career pathways for immigrant health professionals
Policy:
! Regional/International frameworks
! Country level policies
! Professional accreditation
www.diversityRx.org/HPH-Resources
Policy: International Frameworks
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WHO-HPH Task Force on Migrant Friendly and Culturally
Competent Health Care
WHO Resolution on Migrant Health and Global Consultation
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Policy:
! Spain: universal access, regardless of status. Demographic health status monitoring
! Australia: Cultural responsiveness framework
! United States: CLAS standards
Country level policies
Policy:
! United States: Joint Commission accreditation of hospitals standards for patient-centered communication
! New Zealand health professionals registration boards requirements for cultural competence
! Canada (Ontario) nursing requirements for cultural competence
Professional accreditation
Strategic Alliances
! Health professional bodies
! Health policymakers
! Cross-sectoral actors
! Community and patient representatives
! Local, national and international non governmental organizations
Collaboration between stakeholders to promote engagement
www.diversityRx.org/HPH-Resources
Strategic Alliances
! Coordinated, comprehensive action
! Institutionalization
! Information about best practices and model policies
! Structural fixes: financing access to social protection
! Insertion into other health agendas
What needs attention
Quality for the globalized patient
! In order for hospitals and health systems to achieve their overall quality goals, they must provide quality services to ALL patients.
! Models from around the world show us that quality health care for the globalized patient – migrant, mobile, minority and other vulnerable populations – is achievable.
! Let’s use their examples to examine our current practices and policies and build strategic alliances to improve access raise health status for all.
An achievable goal
www.diversityRx.org/HPH-resources
Contact: [email protected]