Shifting public-health-sector waiting lists to the private sector

2003 ◽  
Vol 19 (1) ◽  
pp. 103-132 ◽  
Author(s):  
Pau Olivella
2020 ◽  
Vol 31 (4) ◽  
pp. 437-449
Author(s):  
Mina Fanea-Ivanovici ◽  
Marius-Cristian Pană ◽  
Mihail Dumitru Sacală ◽  
Cristina Voicu

The aim of the paper is to provide an analysis of the dynamics of the public and private health sectors in Romania. Using descriptive statistics, it first investigates whether the public health sector follows the reformation trends suggested by official strategies and reports, and to what extent the private health sector is a viable alternative to the public one, by analysing the demand for private inpatient services. We look into the reduction in the occupancy degree in public hospitals as a means to increase the efficiency of public health expenditures, which represents one way to reform the public health sector. We also find that the increase in the occupancy degree in private hospitals is negatively correlated with the quality of services provided by public hospitals, but positively correlated with population wealth. Increase in the occupancy degree in private hospitals is an indicator of poor quality of services in public hospitals. It can also be explained by increasing expectations and requirements of beneficiaries as a reflection of increase in wealth and of their will to preserve their health capital. Using regression models, the paper then proposes the Wealth-Health Index, a composite indicator to explore the connection between wealth and health and the dynamics of the private health sector. Investment in physical infrastructure and the size of medical staff in the private sector is positively correlated with wealth increase.


2011 ◽  
Vol 58 (4) ◽  
pp. 216-228 ◽  
Author(s):  
Milena Gajic-Stevanovic ◽  
Snezana Dimitrijevic ◽  
Nevenka Teodorovic ◽  
Slavoljub Zivkovic

Introduction. Collecting data about the structure and function of private health care sector in Serbia and its inclusion in joint health care system is one of the most important issues for making decisions in health care and getting more accurate picture about the possibilities of health care system in Serbia. The aim of this analysis was to compare health institutions, personnel, visits, number of hospital days and morbidity by ICD-10 classification of diseases in public and private health sector in South Backa, Nisava, Toplica and Belgrade district in 2009. Material and Methods. A retrospective comparative analysis was performed using data about private providers of health services obtained from the Institute of Public Health Novi Sad, the Institute of Public Health Nis and the City Institute of Public Health Belgrade. Data about personnel and morbidity in public health sector in Serbia for 2009 was obtained from the Center for Information Technology of the Institute for Public Health of Serbia. Data about public health facilities in South Backa, Nisava, Toplica and Belgrade district in 2009 was obtained from Serbian Chamber of medical institutions. Results. The results showed that health care was provided in Belgrade district in 2009 by total of 1,051 employees in private sector and 31,404 in public sector. We found that public sector had a far wider range of health facilities than private sector, which was mainly due to the number of clinics. In South Backa district private sector had 323 practices, the district of Belgrade 655 and Nisava and Toplica district 173. Seventeen times more visits to households (4,650,423 vs. 267,356) and 111 times greater number of hospital days was provided in public health sector as compared to private health sector (781,083 vs. 7,023) in South Backa district. Conclusion. The conclusion of this analysis was that public health sector has remained the foundation of health care system in Serbia. Private health sector is expanding, but its structure and scope of services is still undervalued as compared to public sector.


2018 ◽  
Vol 19 (03) ◽  
pp. 264-276 ◽  
Author(s):  
Jafar Sadegh Tabrizi ◽  
Elaheh HaghGoshayie ◽  
Leila Doshmangir ◽  
Mahmood Yousefi

BackgroundNew public management (NPM) was developed as a management reform to improve the efficiency and effectiveness in public organizations, especially in health sector. Using the features of private sector management, the managers of health organizations may try to implement the elements of NPM with the hope to improve the performance of their systems.AimsOur aim in the present study was to identify the elements and infrastructures suitable for implementing NPM in the Iranian health complex.MethodIn this qualitative study with conventional content analysis approach, we tried to explore the NPM elements and infrastructures in Iranian public health sector. A series of semi-structured interviews (n=48) were conducted in 2016 with a managers in public and private health complex. Three focus group discussions with nine faculty members were also conducted. A data collection form was used to collect the demographic characteristics and perspectives of the participants.FindingsFrom the perspective of managers, managerialism, decentralization, using market mechanism, performance management, customer orientation and performance budgeting were the main elements of NPM in the Iranian context. The most important infrastructures for implementing this reform were as follows: education and training, information technology, the proper use of human resources, decision support systems, top management commitment, organizational culture, flexibility of rules, rehabilitating of the aging infrastructures, and expanding the coverage of services.ConclusionThe NPM was generally identified to be an effective replacement for the traditional administration method. These reforms may be helpful in strengthening the public health complex and the management capacity, as well. NPM also seems to be useful in interacting the public health sector with the private sector in terms of personnel and resources, performance, reward structure, and methods of doing business.


2020 ◽  
Vol 18 (2) ◽  
pp. 149
Author(s):  
Mohammed Mustapha Namadi

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Phumzile Hlongwa ◽  
Laetitia C. Rispel

Abstract Background Collaboration among different categories of health professionals is essential for quality patient care, especially for individuals with cleft lip and palate (CLP). This study examined interprofessional collaboration (IPC) among health professionals in all CLP specialised centres in South Africa’s public health sector. Methods During 2017, a survey was conducted among health professionals at all the specialised CLP centres in South Africa’s public health sector. Following informed consent, each member of the CLP team completed a self-administered questionnaire on IPC, using the Interprofessional Competency Framework Self-Assessment Tool. The IPC questionnaire consists of seven domains with 51 items: care expertise (8 items); shared power (4 items); collaborative leadership (10 items); shared decision-making (2 items); optimising professional role and scope (10 items); effective group function (9 items); and competent communication (8 items). STATA®13 was used to analyse the data. Descriptive analysis of participants and overall mean scores were computed for each domain and analysed using ANOVA. All statistical tests were conducted at 5% significance level. Results We obtained an 87% response rate, and 52 participants completed the questionnaire. The majority of participants were female 52% (n = 27); with a mean age of 41.9 years (range 22–72). Plastic surgeons accounted for 38.5% of all study participants, followed by speech therapists (23.1%), and professional nurses (9.6%). The lowest mean score of 2.55 was obtained for effective group function (SD + -0.50), and the highest mean score of 2.92 for care expertise (SD + -0.37). Explanatory factor analysis showed that gender did not influence IPC, but category of health professional predicted scores on the five categories of shared power (p = 0.01), collaborative leadership (p = 0.04), optimising professional role and scope (p = 0.03), effective group function (p = 0.01) and effective communication (p = 0.04). Conclusion The seven IPC categories could be used as a guide to develop specific strategies to enhance IPC among CLP teams. Institutional support and leadership combined with patient-centred, continuing professional development in multi-disciplinary meetings will also enrich IPC.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e039242
Author(s):  
Pragashnie Govender

IntroductionEarly childhood is a critical time when the benefits of early interventions are intensified, and the adverse effects of risk can be reduced. For the optimal provision of early intervention, professionals in the field are required to have specialised knowledge and skills in implementing these programmes. In the context of South Africa, there is evidence to suggest that therapists are ill-prepared to handle the unique challenges posed in neonatal intensive care units and wards with at-risk infants in the first few weeks of life. This is attributed to several reasons; however, irrespective of the causative factors, the need to bridge this knowledge-to-practice gap remains essential.Methods and analysisThis study is a multimethod stakeholder-driven study using a scoping review followed by an appreciative inquiry and Delphi process that will aid in the development, implementation and evaluation of a knowledge translation intervention to bridge knowledge-gaps in occupational and physiotherapists working in the field. Therapists currently working in the public health sector will be recruited for participation in the various stages of the study. The analysis will occur via thematic analysis for qualitative data and percentages and frequencies for descriptive quantitative data. Issues around trustworthiness and rigour, and reliability and validity, will be ensured within each of the phases, by use of a content validity index and inter-rater reliability for the Delphi survey; thick descriptions, peer debriefing, member checking and an audit trail for the qualitative data.Ethics and disseminationThe study has received full ethical approval from the Health Research and Knowledge Management Directorate of the Department of Health and a Biomedical Research Ethics Committee. The results will be published in peer-reviewed academic journals and disseminated to the relevant stakeholders within this study.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Khurana ◽  
S Roy ◽  
M Gupta

Abstract Problem Human resources in the public health sector is of prime importance in a limited resource setting country, who at times work in a high-pressure, limited resource environment and where skilled staff continue to remain in short supply. The role of Human Resource for Health (HRH) team responsible for managing this health workforce is crucial. They play an important role in improving the human resource practices and creating an enabling organizational culture for optimal resource utilization. The paper explores the profile of the HRH teams of the states of India, their knowledge levels, and perceptions of their role. Methods The participants were HR Managers from 29 states of India who look after HRH in National Health Mission and State Health Departments. Cross-sectional survey tool was used for data collection. Quantitative data analysis included univariate and bivariate analysis. One Way ANOVA test of significance and post-hoc tests using Tukey's method was used to ascertain the groups with significant difference. Results Most of the HRH team members are postgraduates or have management background. Their experience varies from <1year to > 25 years. Mostly of them perceive their role to be limited to implementing bare essential HRM practices, mostly administrative. The educational qualification of the members did not have any significant bearing on their technical knowledge related to HRM practices; but their experience in public health sector showed a significant association. Lessons This study lends evidence to the principle that professionals who have been in the system for long, know about HRH and the associated policies better, and hence may be better equipped to handle HRH and establish good HR Management (HRM) systems. Better role clarity among the HRH teams, expansion of their current scope of work to include advanced practices of HRM and continuous capacity building mechanisms are needed to help strengthen the development and management of HRH. Key messages This study, a first of its kind in the country, lend evidence related to the principle for deciding the profile of team who should be entrusted with managing and development of HRH. The Study gives evidence to focus on the role clarity of HRH to zero down their knowledge and skills gaps and enhance their competencies through better capacity building.


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