Entrepreneurial Activity in the Public Sector: Evidence from UK Primary Care

1998 ◽  
pp. 42-61
Author(s):  
Christine Ennew ◽  
Teresa Feighan ◽  
David Whynes
Keyword(s):  
Primary Care ◽  
Public Sector ◽  
Entrepreneurial Activity ◽  
The Public

scholarly journals Long-term effectiveness of elderly health care voucher scheme strategies: a system dynamics simulation analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ka Chun Chong ◽  
Hong Fung ◽  
Carrie Ho Kwan Yam ◽  
Patsy Yuen Kwan Chau ◽  
Tsz Yu Chow ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Public Sector ◽  
System Dynamics ◽  
The Elderly ◽  
Healthcare Services ◽  
Dynamics Simulation ◽  
Public And Private ◽  
The Public ◽  
The Impact

Abstract Background The elderly healthcare voucher (EHCV) scheme is expected to lead to an increase in the number of elderly people selecting private primary healthcare services and reduce reliance on the public sector in Hong Kong. However, studies thus far have reported that this scheme has not received satisfactory responses. In this study, we examined changes in the ratio of visits between public and private doctors in primary care (to measure reliance on the public sector) for different strategic scenarios in the EHCV scheme. Methods Based on comments from an expert panel, a system dynamics model was formulated to simulate the impact of various enhanced strategies in the scheme: increasing voucher amounts, lowering the age eligibility, and designating vouchers for chronic conditions follow-up. Data and statistics for the model calibration were collected from various sources. Results The simulation results show that the current EHCV scheme is unable to reduce the utilization of public healthcare services, as well as the ratio of visits between public and private primary care among the local aging population. When comparing three different tested scenarios, even if the increase in the annual voucher amount could be maintained at the current pace or the age eligibility can be lowered to include those aged 60 years, the impact on shifts from public-to-private utilization were insignificant. The public-to-private ratio could only be marginally reduced from 0.74 to 0.64 in the first several years. Nevertheless, introducing a chronic disease-oriented voucher could result in a significant drop of 0.50 in the public-to-private ratio during the early implementation phase. However, the effect could not be maintained for an extended period. Conclusions Our findings will assist officials in improving the design of the EHCV scheme, within the wider context of promoting primary care among the elderly. We suggest that an additional chronic disease-oriented voucher can serve as an alternative strategy. The scheme must be redesigned to address more specific objectives or provide a separate voucher that promotes under-utilized healthcare services (e.g., preventive care), instead of services designed for unspecified reasons, which may lead to concerns regarding exploitation.

The quality of care in outpatient primary care in public and private sectors in Malaysia

2019 ◽  
Author(s):  
May Chien Chin ◽  
Sheamini Sivasampu ◽  
Nilmini Wijemunige ◽  
Ravindra P Rannan-Eliya ◽  
Rifat Atun
Keyword(s):  
Primary Care ◽  
Public Sector ◽  
Private Sector ◽  
Clinical Care ◽  
Developed Countries ◽  
Prescribing Practices ◽  
Public And Private ◽  
The Public ◽  
The Usa

Abstract In Malaysia, first-contact, primary care is provided by parallel public and private sectors, which are completely separate in organization, financing and governance. As the country considers new approaches to financing, including using public schemes to pay for private care, it is crucial to examine the quality of clinical care in the two sectors to make informed decisions on public policy. This study intends to measure and compare the quality of clinical care between public and private primary care services in Malaysia and, to the extent possible, assess quality with the developed economies that Malaysia aspires to join. We carried out a retrospective analysis of the National Medical Care Survey 2014, a nationally representative survey of doctor–patient encounters in Malaysia. We assessed clinical quality for 27 587 patient encounters using data on 66 internationally validated quality indicators. Aggregate scores were constructed, and comparisons made between the public and private sectors. Overall, patients received the recommended care just over half the time (56.5%). The public sector performed better than the private sector, especially in the treatment of acute conditions, chronic conditions and in prescribing practices. Both sectors performed poorly in the indicators that are most resource intensive, suggesting that resource constraints limit overall quality. A comparison with 2003 data from the USA, suggests that performance in Malaysia was similar to that a decade earlier in the USA for common indicators. The public sector showed better performance in clinical care than the private sector, contrary to common perceptions in Malaysia and despite providing worse consumer quality. The overall quality of outpatient clinical care in Malaysia appears comparable to other developed countries, yet there are gaps in quality, such as in the management of hypertension, which should be tackled to improve overall health outcomes.

scholarly journals ІНСТИТУЦІЙНЕ ЗАБЕЗПЕЧЕННЯ РЕАЛІЗАЦІЇ ДЕРЖАВНО-ПРИВАТНОГО ПАРТНЕРСТВА У СФЕРІ ОХОРОНИ ЗДОРОВ’Я

2019 ◽  
Vol 82 (1) ◽  
pp. 161-168
Author(s):  
TURCHAK D.,
Keyword(s):  
Health Care ◽  
Public Sector ◽  
Economic Effect ◽  
Institutional Support ◽  
Public Private Partnership ◽  
Entrepreneurial Activity ◽  
Healthcare Sector ◽  
Private Partnership ◽  
The Public ◽  
Stimulation Of

У статті з’ясовані особливості інституційного забезпеченняреалізації державно-приватного партнерства у сфері охорони здоров’я.Наведена структура діючих суб’єктів державно-приватногопартнерства у сфері охорони здоров’я. Доведено, що співпраця владнихструктур, бізнесу та суспільного сектора при реалізації механізмів ДППстане підґрунтям для розвитку інноваційних форм проектногоменеджменту, стимулюванню підприємницької діяльності, а такожсприятиме вирішенню медико-соціальних проблем в країні. Крім того,застосування моделей ДПП у сфері охорони здоров’я матимеекономічний ефект для суспільства у вигляді більш якісніших медичнихпослуг при зменшенні бюджетного навантаження. The article clarifies the peculiarities of institutional support for theimplementation of public-private partnership in the field of health care. The structure of the acting public-private partnership in the sphere of healthprotection is presented. It has been proved that cooperation between powerstructures, business and the public sector in the implementation of PPPmechanisms will be the basis for the development of innovative forms ofproject management, stimulation of entrepreneurial activity, and willcontribute to solving medical and social problems in the country. In addition,the use of PPP models in the healthcare sector will have an economic effect forthe society in the form of better quality medical services while reducing thebudgetary burden.

scholarly journals Willingness to pay for private primary care services in Hong Kong: are elderly ready to move from the public sector?

2012 ◽  
Vol 28 (7) ◽  
pp. 717-729 ◽  
Author(s):  
S. Liu ◽  
C. H. K. Yam ◽  
O. H. Y. Huang ◽  
S. M. Griffiths
Keyword(s):  
Primary Care ◽  
Hong Kong ◽  
Public Sector ◽  
Willingness To Pay ◽  
The Public ◽  
Care Services ◽  
Primary Care Services

scholarly journals Long Term Effectiveness of Elderly Health Care Voucher Scheme Strategies: A System Dynamics Simulation Analysis

2020 ◽  
Author(s):  
Ka Chun Chong ◽  
Hong Fung ◽  
Carrie Yam ◽  
Patsy Chau ◽  
Tsz Yu Chow ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Public Sector ◽  
System Dynamics ◽  
The Elderly ◽  
Healthcare Services ◽  
Dynamics Simulation ◽  
Public And Private ◽  
The Public

Abstract Background: The elderly healthcare voucher (EHCV) scheme is expected to increase the number of elders choosing private primary healthcare services and, on the other hand, to reduce reliance on the public sector in Hong Kong. Unfortunately, the scheme was not satisfactorily as reported in the literature to date. In this study, we examined the changes in the ratio of visits between public and private doctors in primary care (as a metric of reliance on the public sector) for different strategic scenarios in the scheme.Methods: Based on the comments from the expertise discussion, a system dynamics model was formulated to simulate the impact of different enhanced strategy in the scheme: Increasing voucher amounts, lowering the age eligibility, and designating vouchers for chronic conditions follow-up. Data and statistics for model calibration were collected from different sources.Results: The simulation results showed that the current EHCV scheme was unable to reduce the utilization of public healthcare services as well as the ratio of visits between public and private when the local population aging was taken into account. When comparing the 3 different tested scenarios, even if the increase of annual voucher amount could be kept with a current pace or the age eligibility could be lowered to 60 years old, the impacts on the shifts from public to private utilization were not apparent in which the public-to-private ratio could only drop slightly from 0.74 to 0.64 in the first several years. Nevertheless, introducing a chronic disease-oriented voucher could result in an apparent drop of public-to-private ratio to 0.50 in the early implementation phase but the effect could not be maintained for a period of time. Conclusions: Our findings assist officials to further improve the design of EHCV scheme, within the bigger context of promoting primary care among the elderly. We suggested an additional chronic disease-oriented voucher could be an alternative strategy but the enhancement on the voucher amount should be considered if a long term planning was required. For not substantially rising the government expenditure for refining the scheme, health promotion works for encouraging co-payment from elderly for is recommended.

scholarly journals Innovative and entrepreneurial activity in the public sector: The changing face of public sector institutions

Innovation ◽  
2010 ◽  
Vol 12 (2) ◽  
pp. 138-153 ◽  
Author(s):  
Belinda Luke ◽  
Martie-Louise Verreynne ◽  
Kate Kearins
Keyword(s):  
Public Sector ◽  
Entrepreneurial Activity ◽  
The Public
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