Health System and Health Expenditure Productivity Changes in Indian States: Has It Changed for the Better in the Post-reform Period?

2019 ◽  
pp. 71-87
Author(s):  
Debashis Acharya ◽  
Biresh K. Sahoo ◽  
T. K. Venkatachalapathy
Keyword(s):  
Health System ◽  
Health Expenditure ◽  
Indian States ◽  
Reform Period

Inter-state Disparities of Efficiency in Foreshortening Under-five Mortality Rate in Rural India

2021 ◽  
pp. 097300522110515
Author(s):  
Shrabanti Maity ◽  
Ummey Rummana Barlaskar
Keyword(s):  
Mortality Rate ◽  
Health System ◽  
Rural Health ◽  
Health Sector ◽  
State Level ◽  
Health Indicators ◽  
Health System Performance ◽  
Indian States ◽  
Under Five ◽  
Efficient Management

The present study aims to assess the efficiency of the rural health system to foreshorten the under-five (U5) mortality rates across Indian states. The study further attempts to pinpoint the factors responsible for state-level inefficiency of the rural health system performance. The empirical results reveal that among the Indian states, Kerala is the most-efficient in foreshortening the U5 mortality rate. The results convey that the states with better health indicators may not have efficient health systems. The study concludes that along with investment in the health sector, efficient management of the investment is intrinsic to better health outcomes.

scholarly journals Catastrophic Expenditure on Medicines: An Analysis Based on The Portuguese Household Budget Survey 2015/2016

2021 ◽  
pp. 1-7
Author(s):  
Carlota QUINTAL ◽  
José LOPES
Keyword(s):  
Health System ◽  
Health Expenditure ◽  
Catastrophic Health Expenditure ◽  
System Evaluation ◽  
Financial Protection ◽  
Catastrophic Expenditure ◽  
Household Budget Survey ◽  
Household Budget

Financial protection is a core dimension of health system evaluation; therefore, several works on catastrophic health expenditure (CHE) have been developed. There are, however, some gaps in the literature; hence, this work aims to look at CHE from a different angle, analysing the money spent by households.

Looking at the bigger picture: effect of performance-based contracting of district health services on equity of access to maternal health services in Zambia

2019 ◽  
Author(s):  
Collins Chansa ◽  
Mulenga Mary Mukanu ◽  
Chitalu Miriam Chama-Chiliba ◽  
Mpuma Kamanga ◽  
Nicholas Chikwenya ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health System ◽  
Health Expenditure ◽  
Maternal Health Services ◽  
Health Facilities ◽  
District Level ◽  
Health Service Provision ◽  
Equity Of Access ◽  
The Impact

Abstract Zambia has been using output-based approaches for over two decades to finance whole or part of the public health system. Between 1996 and 2006, performance-based contracting (PBC) was implemented countrywide with the Central Board of Health (CBoH) as the provider of health services. This study reviews the association between PBC and equity of access to maternal health services in Zambia between 1996 and 2006. A comprehensive document review was undertaken to evaluate the implementation process, followed by a trend analysis of health expenditure at district level, and a segmented regression analysis of data on antenatal care (ANC) and deliveries at health facilities that was obtained from five demographic and health survey datasets (1992, 1996, 2002, 2007 and 2014). The results show that PBC was anchored by high-level political support, an overarching policy and legal framework, and collective planning and implementation with all key stakeholders. Decentralization of health service provision was also an enabling factor. ANC coverage increased in both the lower and upper wealth quintiles during the PBC era, followed by a declining trend after the PBC era in both quintiles. Further, the percentage of women delivering at health facilities increased during the PBC era, particularly in rural areas and among the poor. The positive trend continued after the PBC era with similar patterns in both lower and upper wealth quintiles. Despite these gains, per capita health expenditure at district level declined during the PBC era, with the situation worsening after the PBC era. The study concludes that a nationwide PBC approach can contribute to improved equity of access to maternal health services and that PBC is a cost-efficient and sustainable policy reform. The study calls for policymakers to comprehensively evaluate the impact of health system reforms before terminating them.

OP109 Comparison Of The Health System Establishment Periods In Eighty-Eight Countries

2018 ◽  
Vol 34 (S1) ◽  
pp. 41-42
Author(s):  
Xuan Cheng ◽  
Hai-Chao Lei ◽  
Yu-Jie Yang ◽  
Na-Na Fan ◽  
Yi-Ming Pan ◽  
...  
Keyword(s):  
Cold War ◽  
Mortality Rate ◽  
Health System ◽  
Health Systems ◽  
Health Expenditure ◽  
Lower Mortality ◽  
Dependency Ratio ◽  
System Establishment ◽  
Per Capita ◽  
The Cold War

Introduction:Health system reform is considered a tough issue worldwide. Great efforts have been made toward health system building and strengthening. However, it is still unclear which health system is appropriate for different countries. This study aimed to systematically compare the characteristics of the establishment periods between eighty-eight counties of National Health Service (NHS) and Social Health Insurance (SHI).Methods:Forty-eight NHS countries and forty SHI countries with data availability were selected. The establishment years of current health systems and other eighteen indicators in economics, society, population and health during establishment periods were collected. Comparison between NHS and SHI was conducted by descriptive analysis of every indicator.Results:Most NHS countries were established during the cold war, while SHI had been set up since the cold war ended. The median of gross domestic product (GDP) per capita, urbanization rate and aging rate of SHI were USD 1535 in current dollars, 58.2 percent and 9.8 percent, respectively; compared with USD 1387, 41.2 percent and 4.7 percent, respectively of NHS. NHS countries had a smaller total population, lower mortality rate and elderly dependency ratio, while the birth rate and children's dependency ratio were higher. SHI countries showed a higher life expectancy and lower mortality rate in infants and children. NHS countries spent less in total health expenditure and a lower proportion of GDP. The median health expenditure per capita of SHI and NHS were USD 188 and USD 131 in current dollars, respectively. There was little difference among maternal mortality rates, and public and private health expenditure proportions.Conclusions:NHS and SHI countries had different characteristics during the health system establishment periods. NHS was established earlier than SHI overall, so that SHI revealed higher levels in economic and social development. Health outcomes of NHS countries were slightly lower than SHI ones, while health expenditure was more in SHI countries. Specific social, economic, demographic and health conditions should be considered when countries are building their own health systems.

scholarly journals Family medicine in Denmark: Are there lessons for Botswana and Africa?

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Vincent Setlhare
Keyword(s):  
Family Medicine ◽  
Health System ◽  
Patient Care ◽  
Health Expenditure ◽  
Health Indicators ◽  
Improve Patient Care ◽  
Good Health ◽  
Task Shifting ◽  
Resource Utilisation ◽  
African Countries

Family medicine is a new specialty in Botswana and many African countries and its definitionand scope are still evolving. In this region, healthcare is constrained by resource limitation andinefficiencies in resource utilisation. Experiences in countries with good health indicators canhelp inform discussions on the future of family medicine in Africa. Observations made duringa visit to family physicians (FPs) in Denmark showed that the training of FPs, the practice offamily medicine and the role of support staff in a family practice were often different andsometimes unimaginable by African standards. Danish family practices were friendly andenmeshed in an egalitarian and efficient health system, which is supported by an effectiveinformation technology network. There was a lot of task shifting and nurses and clerical staffattended to simple or uncomplicated aspects of patient care whilst FPs attended to morecomplicated patient problems. Higher taxation and higher health expenditure seemed toundergird the effective health system. An egalitarian relationship amongst patients andhealthcare workers (HCW) may help improve patient care in Botswana. Task shifting shouldbe formalised, and all sectors of primary healthcare should have fast and effective informationtechnology systems. HCW training and roles should be revised. Higher health expenditure isnecessary to achieve good health indicators.Keywords: task shifting, Family Medicine, Family Physician, Denmark, health expenditure, egalitarian

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