AMSTERDAM 9 – 12 december 2004 Health promotion in an Intercultural Hospital: some tools Direzione...
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Transcript of AMSTERDAM 9 – 12 december 2004 Health promotion in an Intercultural Hospital: some tools Direzione...
AMSTERDAM 9 – 12 december 2004
Health promotion in an InterculturalHospital: some tools
Direzione Distretti EST OVESTResponsabile Progetto Speciale Immigrati
Giovanna Dallari
•6,3% of the Italian population
•more than 190 ethnic groups
10 Countries with the highest number of population in RER
30%
11%
7%
5%
5%
4%4% 4%
8%
22%
Morocco
Albania
Tunisia
Romania
China
Senegal
Philippine
Pakistan
Ghana
India
Bologna’s LHU 1/1/2004
Residents 812.330
City 373.539
Foreing residents in
Bologna as to 30/09/04
48.000 in the province
24.742 (6,6%) in the city
• Male 12.164
• Female 12.578
10 nationalities in Bologna town at 31/12/03 males and females
0200400600800
10001200140016001800
Filippi
ne
Mar
occo
Cina
Alban
ia
Bangla
desh
Roman
ia
Sri La
nka
Serbi
a M
onte
negr
o
Tunisi
a
Pakist
an
Ucrai
na
Mol
dova
Maschi
Femmine
Regione Emilia Romagna year 2003 Admissions 871.180 35.609 (4%) from DC
- 1.000 2.000 3.000 4.000 5.000 6.000 7.000
BANGLADESH
ALGERIA PERU'
SRI LANKA EGITTO
BRASILE RUSSIA
MACEDONIA ECUADOR
FILIPPINE SENEGAL POLONIA
Ex JugoslaviaMOLDAVIA
INDIA GHANA
PAKISTAN UCRAINA NIGERIA
CINA TUNISIA
ROMANIA MAROCCO
ALBANIA
0200400600800
1000120014001600
MAROCCO
ROMANIA
ALBANIA
TUNISIA
JUGOSLA
VIACIN
A
BANGLADESH
MOLD
AVIA
FILIPPIN
E
PAKISTAN
UCRAINA
Foreing Citizens admissions in Bologna 2003/2004
2003
2004
MDC 2003
Diagnosis
1
10
100
1.000
01-SIS
TEMA N
ERVOSO
02-OCCHIO
03-ORECCHIO
NASO B
OCCA E G
OLA
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ESPIRATORIO
05-APP. C
ARDIOCIR
COLATORIO
06-APP. D
IGERENTE
07-FEGATO, V
IE B
ILIA
RI E P
ANCREAS
08-APP. M
USCOLOSCHELETR., TESS. C
ONNETTIVO
09-PELLE, T
ESSUTO SOTTOCUTANEO, M
AMM
ELLA
10-ENDOCRIN
I METABOLIC
I NUTRIZ
IONALI
11-RENE E
VIE
URIN
ARIE
12-APP. R
IPRODUTTIV
O MASCHIL
E
13-APP. R
IPRODUTTIV
O FEM
MIN
ILE
14-GRAVID
ANZA, PARTO E
PUERPERIO
15-PERIO
DO NEONATALE
16-SANGUE E
ORGANI E
MATOPOIE
T. SIS
T. IM
MUNIT
ARIO
17-M
IELOPROLIF
ER. E N
EOPLASIE SCARSAM
. DIF
FERENZIATE
18-M
AL. INFETTIV
E E PARASSIT
ARIE
19-M
ALATTIE E
DIS
TURBI MENTALI
20-ABUSO A
LCOOL/FARM
ACI DIS
T.MENTALI O
RG.INDOTTI
21-TRAUM
ATISM
I, AVVELEN. E
D EFF.T
OSSICI F
ARMACI
22-USTIO
NI
23-FATT. I
NFLUENZ.SALUTE E
D IL R
ICORSO A
I S.S
ANITARI
24-TRAUM
ATISM
I MULTIP
LI
25-IN
FEZIONI D
A HIV
99-PRE M
DC
NON DEFIN
ITA
11MESI2002
• It is impossible to satisfy the need of each ethnic group.
•Bologna’s LHU has implemented a set of services, focused on individual needs and on the reengineering of health services (more accessible, appropriate and sensitive to all patients and service users).
13. LA POPOLAZIONE TARGET E I PROBLEMI RILEVANTI13. LA POPOLAZIONE TARGET E I PROBLEMI RILEVANTI
Le disuguaglianze di salute nella nostra popolazione, Le disuguaglianze di salute nella nostra popolazione, indipendentemente dall’indicatore di salute e sociale indipendentemente dall’indicatore di salute e sociale utilizzato, sono consistenti: a qualsiasi livello della scala utilizzato, sono consistenti: a qualsiasi livello della scala sociale ci si ponga, il livello inferiore presenta un profilo sociale ci si ponga, il livello inferiore presenta un profilo epidemiologico piùepidemiologico più ……..
AI.
13
1313 POPOLAZIONE POPOLAZIONE IMMIGRATA E ALTRE IMMIGRATA E ALTRE POPOLAZIONI A RISCHIO DI POPOLAZIONI A RISCHIO DI ESCLUSIONE SOCIALE.ESCLUSIONE SOCIALE.
ACTIONACTION PLANPLAN
Actions and Instruments (1)• Law, medical literature and experiences at the
local, national and international level analysis;• involvement of all stakeholders within the
community;• a comprehensive health program and
monitoring process;• patient’s education programs to self health
care;• intercultural mediators (liaison officers)
training courses;• analysis of quality perception in different
health services.
MISSIONMISSION
Garantire Garantire
la rilevazione dei bisogni, la rilevazione dei bisogni,
la pianificazione, la programmazione, il coordinamento, il la pianificazione, la programmazione, il coordinamento, il
monitoraggio e la verifica delle attività monitoraggio e la verifica delle attività
erogate in favore di Cittadini Stranieri Immigrati, erogate in favore di Cittadini Stranieri Immigrati,
sia a livello ospedaliero sia a livello distrettuale, sia a livello ospedaliero sia a livello distrettuale,
attraverso attraverso la messa in rete dei soggetti aziendali e delle Istituzioni la messa in rete dei soggetti aziendali e delle Istituzioni
pubbliche, private e di associazionismo volontariopubbliche, private e di associazionismo volontario che si che si
occupano di quel target di popolazione.occupano di quel target di popolazione.
PROGETTO SPECIALE IMMIGRATIPROGETTO SPECIALE IMMIGRATI
• Multicultural menu;• a web site showing all the information on tools, documents, projects, laws,
activities, news, links, etc. related to the immigrant’s social and health care;
• informative brochures in different languages;
• intercultural liaison officers help bridging the cultural and linguistic gap between patient and healthcare professional - eight linguistic areas covered;
• free telephone line and information centre:– offers counselling and information on health services in eight languages to support foreign
citizens and socio – sanitary professional;– a consultative instrument which enables users to contribute effectively to service
development.
• training courses for social and health professionals, including Dietologists and administrative staff
• Mammographic screening
Actions and Instruments (2)
Particular relevance…
• Progetto Speciale Immigrati
• Liaison officer and free telephone line
• Benchmarking
• Interistitutional and interprofessional network
• Web site
Progetto Speciale ImmigratiProgetto Speciale Immigrati
MISSION
To identify the needs, to plan, to program, to To identify the needs, to plan, to program, to coordinate, to check and to evaluate all the coordinate, to check and to evaluate all the actions proposed and carried out to improve actions proposed and carried out to improve access to health and social services - in the access to health and social services - in the hospital and in the outpatient clinics.hospital and in the outpatient clinics.
The project supports a network involving The project supports a network involving volunteers associations, public and private volunteers associations, public and private sectors.sectors.
Liaison officers (intercultural mediators)
• On 1998 the Liaison officers course, organized by the Local Government (U.E. funds – 350+350 hours) was set up for the first time.
• Liaison officers created AMISS (Associazione Mediatrici Interculturali Socio Sanitarie), the Socio-Sanitary Liaison Officers Organization.
Objectives• To ensure equal access to Health and Social Services
in the Province of Bologna.
• To help in the reengeneering of the hospital structure and activities.
• To implement communication and educational activities to protect migrants from social and cultural differences.
To achieve a better access and a better health situation.
Main subjects
• Information about sanitary assitance rights.• Information about the correct use of services
offered by health service and social services offered by local governments.
• Contribution in the reengineering of the hospital and ward’s services.
• Connection with volunteer services.• Set up of innovative activities.• Teaching in the Multicultural Course for health
and social services providers.
Objectives
• To create a reference point for institutions in charge of access improvement to Health Services.
• To facilitate best practice diffusion.
• To create a net between public and private institutions that are related to access opportunities for migrant citizens.
Future plans
• To enhance all the activities to the entire Azienda
• Enquiry on the health status of 3.500 workers
• Different spiritual care
• Cross-culture communication enhanced by use of translated information cards and pictorial aids, also useful for illiterate people.