The Globalized Patient

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Adapting health services for mobile, migrant and minority populations

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The Globalized Patient

  1. 1. The Globalized Patient Adapting health services for mobile, migrant and minority populations
  2. 2. Julia Puebla Fortier Executive DirectorDiversityRx – Resources for Cross Cultural Health Care www.diversityRx.org
  3. 3. DiversityRx:Improving health care for a diverse world!  Policy development Working with:!  Research !  Hospitals and health departments!  Information dissemination !  Universities!  Education and training !  Phillanthropic foundations !  Government agencies !  International organizations
  4. 4. Scenario:You have gone to a conference inanother country and suddenly youdon’t feel well…
  5. 5. Migrants Indigenous people Foreign workers RefugeesMinorities Medical tourists Foreign brides International students Expat professionals
  6. 6. !  Preventing disease and promoting health Goals of !  Improving qualityhealth care !  Reducing errors systems !  Efficiency and cost effectiveness !  Good health outcomes !  Fostering good patient and community relations
  7. 7. Challenge oftreating 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
  8. 8. Structural barriers!  Eligibility for health schemes!  Portability of health insurance!  Undocumented status!  Low-income/inability to pay!  Availability/accessibility of health services
  9. 9. How can we achieve health caregoals for the globalized patient? ! Practice ! Policy ! Strategic Alliances !  Presentation References: www.diversityRx.org/HPH-Resources
  10. 10. Practice:Clinical interventions: one size does not fit all!  Language services!  Sensitive and informed care delivery – individual level !  Epidemiological factors, cultural background, social determinants!  Tailoredpopulation services !  Health promotion, disease prevention, disease support!  Cultural support staff !  Intercultural mediators, community health workers, patient navigators
  11. 11. Challenge: CommunicationRemote medical interpreting!  Use of telephone, video, mobile technology to link in interpreters from remote locations!  Cost effective and efficient use of resources!  United States!  Japan
  12. 12. Challenge: cultural differencesIntercultural mediators!  Community representatives trained to explain cultural issues and support mediation between patients and staff!  Belgium!  Germany
  13. 13. Challenge:Preparing the health care workforce!  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
  14. 14. Practice:Career pathways for immigrant health professionals!  Portugal: support for professional requalification!  United States: requalification courses and retraining as interpreters and cultural mediators
  15. 15. Policy:!  Regional/International frameworks!  Country level policies!  Professional accreditationwww.diversityRx.org/HPH-Resources
  16. 16. Policy:International Frameworks WHO-HPH Task Force on !"!#$%#&%! $()*#%+,-.#+/#&01,(/23%,0./456# WHO Resolution on Migrant (/4#7527,(556#+89.2./2#!.(52:-(,.Migrant Friendly and Culturally Health and Global Consultation ;,(<2 Competent Health Care BCDB !"#$%&(#()%*%+#,(-./0."01(2#"(34567( 6/(8%.+9(:."%(2#"(;6<"./1(./0(#9%"( =5+/%".>+%(?"#5,1 !"%+6@6/."7(1./0."01(2#"( ,6+#(%16/<(6/(9%.+9(&."%( #"<./6A.6#/1 !"#$%!&()*+#,%- ! . %!" /#0 &+/#+1 +23456 47 8 9:4;8: <4=>?:686@4=
  17. 17. Policy:Country level policies!  Spain: universal access, regardless of status. Demographic health status monitoring!  Australia: Cultural responsiveness framework!  United States: CLAS standards
  18. 18. Policy:Professional accreditation!  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
  19. 19. Strategic AlliancesCollaboration between stakeholders to promoteengagement!  Health professional bodies!  Health policymakers!  Cross-sectoral actors!  Community and patient representatives!  Local, national and international non governmental organizationswww.diversityRx.org/HPH-Resources
  20. 20. Strategic AlliancesWhat needs attention!  Coordinated, comprehensive action!  Institutionalization!  Information about best practices and model policies!  Structural fixes: financing access to social protection!  Insertion into other health agendas
  21. 21. Quality for the globalized patientAn achievable goal!  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.
  22. 22. Contact: rcchc@aol.comwww.diversityRx.org/HPH-resources

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