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

Background: Access 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). Methods: A 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. Results: We 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. Conclusions: Economic 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.

Benefits of the ISO 9001 and ISO 14001 standards: a literature review

Purpose: The purpose of this paper is to determine the similarities and differences between the benefits derived from implementing the ISO 9001 and the ISO 14001 standards. Methodology/Approach: The paper reviews the literature using an electronic search in the ScienceDirect, ABI/Inform, Emerald databases to identify papers focusing on the adoption of the ISO 9001 and 14001 standards and the benefits derived from implementing them. Findings: The paper identifies 82 articles about ISO 9001 and 29 about ISO 14001. Although some differences can be observed between the benefits considered by ISO 9001 and 14001, there is a great degree of coincidence in the benefits studied. The review suggests 13 benefits as the most usually analyzed (including environmental performance for the case of the ISO 14001 standard) by scholars. It is suggested that both standards have clear benefits on operational, people and customer results and that the effects on financial performance are inconclusive. Limitations/implications: One limitation of this paper is that the works identified are conditioned by the search strategy used. In addition, other key words could be included in future studies such as operational, market, quality, financial performance, and customer satisfaction in order to expand this search. Originality/Value: The main contribution is that the paper identifies the literature gap and future research proposals with regard to the benefits of the ISO 9001 and ISO 14001 standards.