Enhancing Healthcare Services for Vulnerable Groups

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Healthcare Organizations, Systems, and Providers".

Deadline for manuscript submissions: 15 September 2026 | Viewed by 2974

Special Issue Editors


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Guest Editor
Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain
Interests: long-term care; migration and health; qualitative research; patient safety; emergency care
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Nursing Science, Physiotherapy and Medicine Department, Faculty of Health Sciences, University of Almeria, 04120 Almería, Spain
Interests: long-term care; migration and health; qualitative research; epistemology; philosophy and healthcare; emergency care; critical care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Equitable access to health services is a fundamental human right, yet multiple geographic, economic, sociocultural, and systemic barriers prevent this right from being realized. Despite advances in medicine and technology, disparities persist and disproportionately affect vulnerable populations, such as the elderly, low-income individuals, migrants, ethnic minorities, and those living in rural areas. This Special Issue aims to encourage research, analyze and identify main barriers and causes, and promote innovative solutions for improving health services from a holistic perspective. We seek contributions that offer innovative solutions, both at the policy level and in clinical practice. Topics of interest include, but are not limited to, the design of community interventions, emergency services, the use of telemedicine to reach remote areas, the implementation of culturally sensitive approaches, and the evaluation of health programs that aim to reduce barriers to access. We welcome original research (quantitative and qualitative), review articles, case reports, case series, meta-analyses, meta-synthesis studies, systematic reviews, and intervention proposals.

Topics

  • Barriers to access and overcoming them: This topic focuses on the obstacles that prevent vulnerable populations from accessing medical care. Examples: geographical and transportation, economic, information and knowledge, and sociocultural-related barriers, as well as those related to beliefs and/or stigmatization.
  • Role of technology and innovation: This includes challenges and opportunities of using technology in different contexts, ethical considerations, and the use of telemedicine and other technologies to improve access.
  • Community care and citizen participation: This addresses the importance of involving the community in the design and implementation of health programs.
  • Health policies and systems: This involves the analysis of public policies and their impact on access to health, strategies to promote equity and social justice in care, and coordination between sectors.
  • Culturally sensitive care and staff training: This topic examines how training healthcare staff in cultural competence can improve health outcomes for diverse populations.
  • Barriers in vulnerable groups: This involves migrant and refugee populations, persons deprived of liberty, ethnic minorities, persons with disabilities, children and adolescents, older adults, and persons with comorbidities.
  • Care in urgent and emergency services to improve care and priority for vulnerable populations.

Dr. María del Mar Jiménez Lasserrotte
Dr. Jose Granero-Molina
Guest Editors

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Keywords

  • access to health services
  • barriers to access
  • health equity
  • health disparities
  • patient-centered care
  • community health
  • social determinants of health
  • vulnerable populations
  • interventions to improve access
  • innovative care models
  • equitable public policies
  • urgent and emergency care

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Published Papers (4 papers)

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Research

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18 pages, 429 KB  
Article
The Perceptions of Healthcare Professionals Regarding Violence Against Women in Ecuador: A Qualitative Study
by Anabel Fernández-Vargas, Otilia Vanessa Cordero-Ahiman, Diana Patricia Vanegas-Coveña, Andrea C. Valencia-Altamirano, Juan José González-Gerez, Cayetano Fernández-Sola and José Manuel Hernández-Padilla
Healthcare 2026, 14(9), 1146; https://doi.org/10.3390/healthcare14091146 - 24 Apr 2026
Viewed by 331
Abstract
Objective: The aim of this study was to explore how healthcare professionals in the Republic of Ecuador perceive violence against women, its underlying social determinants, and their role in prevention and response within the healthcare setting. Methodology: A qualitative descriptive study was conducted [...] Read more.
Objective: The aim of this study was to explore how healthcare professionals in the Republic of Ecuador perceive violence against women, its underlying social determinants, and their role in prevention and response within the healthcare setting. Methodology: A qualitative descriptive study was conducted using purposive sampling. Ten healthcare professionals with experience in managing cases of violence against women participated. Data were collected through semi-structured interviews and analysed using Braun and Clarke’s reflective thematic analysis. The ATLAS.ti software was used throughout the analysis process. Results: The participants emphasised the normalisation of microaggressions, institutional shortcomings in prevention systems, and the need for gender-sensitive professional training. Three main themes emerged from the data analysis: (1) the characteristics and identification of violence against women, (2) the social dimensions of violence against women, and (3) combating violence against women in clinical and educational settings. Conclusions: The healthcare professionals highlighted the need to recognise normalised and less visible forms of violence reflected in everyday attitudes and behaviours. They emphasised the importance of early identification, multidisciplinary care and sex education as preventive strategies. The social context and deep-rooted power dynamics favour the perpetuation of violence against women. Healthcare professionals can play an important role in the prevention of violence against women by improving care for survivors, identifying areas for improvement within existing prevention systems, and promoting sex education. Full article
(This article belongs to the Special Issue Enhancing Healthcare Services for Vulnerable Groups)
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9 pages, 365 KB  
Article
Regional Differences in Medicare Reimbursements and Gastroenterology Workforce Dynamics: Implications for Access to Care
by Jason N. Chen, Eric C. H. Leung, Jacob Evans, Cassidy Swain, Arham Siddiqui, Duke Appiah and Sameer Islam
Healthcare 2026, 14(2), 267; https://doi.org/10.3390/healthcare14020267 - 21 Jan 2026
Viewed by 560
Abstract
Background: As the U.S. population ages, the need for gastrointestinal (GI) care and procedures grows. Medicare is a significant payer for these procedures, but declining reimbursements raise concerns about the availability of GIs and thus equitable access to care. This study examines the [...] Read more.
Background: As the U.S. population ages, the need for gastrointestinal (GI) care and procedures grows. Medicare is a significant payer for these procedures, but declining reimbursements raise concerns about the availability of GIs and thus equitable access to care. This study examines the relationship between Medicare reimbursements for GI procedures and the regional supply and demand of GI physicians. Methods: This study analyzed the Medicare facility and non-facility setting physician reimbursements for the top 10 GI procedures for 2003, 2013, and 2023. Facility reimbursements were compared across four regions (Northeast, Midwest, South, and West) and compared to regional GI physician supply and demand data for 2013 and 2025 projections. Linear regression and mixed-effects models were used to evaluate relationships between reimbursements, physician supply, and demand. Results: The national average adjusted facility setting physician reimbursements for the top 10 GI procedures declined by 45.6% from 2003 to 2023. In 2013 and projected for 2025, the South had the highest GI physician supply and demand, but consistently lower facility setting physician reimbursements compared to the Northeast and West. Associations between supply, demand, and reimbursements were observed, though regional patterns showed paradoxical trends, such as similar low reimbursements in the South and Midwest despite differing supply levels. Conclusions: Regional inconsistencies between physician supply and reimbursements highlight the complexity of economic and healthcare dynamics. Declining Medicare reimbursements for GI procedures are multifactorial and, as the aging population grows, these reductions may widen disparities. Further investigation is needed to address barriers and ensure equitable access to GI care. Full article
(This article belongs to the Special Issue Enhancing Healthcare Services for Vulnerable Groups)
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15 pages, 267 KB  
Article
Challenges and Social Implications of Informal Caregiving for People with Alzheimer’s: A Qualitative Study
by Andrea Alcaraz-Córdoba, María López-Cano, Olivia Ibáñez-Masero, María Isabel Ventura-Miranda, María Dolores Ruiz-Fernández and Angela María Ortega-Galán
Healthcare 2025, 13(24), 3271; https://doi.org/10.3390/healthcare13243271 - 12 Dec 2025
Viewed by 1103
Abstract
Aim: The aim of this study was to explore the experiences and challenges faced by informal caregivers of people with Alzheimer’s, including the social and emotional aspects of their caregiving role. Methods: A descriptive qualitative study was conducted using one focus [...] Read more.
Aim: The aim of this study was to explore the experiences and challenges faced by informal caregivers of people with Alzheimer’s, including the social and emotional aspects of their caregiving role. Methods: A descriptive qualitative study was conducted using one focus group discussion and eleven semi-structured interviews with informal caregivers of individuals diagnosed with Alzheimer’s disease. The data collected were analyzed through thematic analysis using ATLAS.ti qualitative software version 23. Results: The results reveal two themes: (1) “Life centred on compassionate care for the other person”, which reflects the role performed from a perspective of emotional and compassionate commitment to those in need of care, and (2) “Abandonment by caregivers”, which expresses the emotional cost associated with caregiving. Conclusions: Informal caregivers of people with Alzheimer’s disease undertake their roles guided by compassion, which involves substantial personal sacrifice. This commitment often leads to self-abandonment, impacting their emotional and physical health, social relationships, and personal aspirations. It is therefore crucial to implement psychosocial interventions grounded in compassion and to strengthen both formal and informal social support systems for caregivers. Full article
(This article belongs to the Special Issue Enhancing Healthcare Services for Vulnerable Groups)

Review

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24 pages, 870 KB  
Review
Enhancing Healthcare Services for Vulnerable Aging Populations: A Comparative Analysis of Puerto Rico and International Case Studies
by Varun Nannuri, Sara Belligoni, Darya Sulkouskaya, Rutwa Shah, Om Pathak and Fernando I. Rivera
Healthcare 2026, 14(7), 829; https://doi.org/10.3390/healthcare14070829 - 24 Mar 2026
Viewed by 520
Abstract
This study examines healthcare system strains in rapidly aging societies through a comparative analysis of Puerto Rico, Cuba, Japan, the Philippines, and South Korea. While existing research documents global aging and physician migration trends, few studies explore how these challenges manifest in conjunction [...] Read more.
This study examines healthcare system strains in rapidly aging societies through a comparative analysis of Puerto Rico, Cuba, Japan, the Philippines, and South Korea. While existing research documents global aging and physician migration trends, few studies explore how these challenges manifest in conjunction with each other. Puerto Rico presents a critical case, with 24% of its population aged 65+, severe physician migration, and systemic underfunding under U.S. Medicaid structures. Using a structured comparative case methodology, we analyze policy responses across four nations with divergent approaches: Cuba, Japan, the Philippines, and South Korea. Data from government reports, academic literature, and World Health Organization (WHO) datasets show that (1) proactive medical education investments outperform reactive measures, (2) dedicated long-term care financing is essential but structurally unavailable in Puerto Rico, and (3) territorial status in the case of Puerto Rico, constrains policy innovation. Conventional aging frameworks are challenged by revealing how high-income territories can exhibit low systemic adaptability. Proposed are targeted reforms for Puerto Rico, including Medicaid restructuring and workforce incentives, with broader implications for aging societies under constrained sovereignty. This study fills a critical space in understanding how geopolitical contexts shape healthcare system vulnerabilities. Full article
(This article belongs to the Special Issue Enhancing Healthcare Services for Vulnerable Groups)
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