Pay the piper and call the tune: changing health care financing mechanisms to address public–private health sector mix inequities

2009 ◽  
pp. 174-196
Author(s):  
Di McIntyre
Keyword(s):  
Health Care ◽  
Health Care Financing ◽  
Health Sector ◽  
Private Health Sector

scholarly journals Ten best resources for conducting financing and benefit incidence analysis in resource-poor settings

2014 ◽  
Vol 30 (8) ◽  
pp. 1053-1058 ◽  
Author(s):  
Virginia Wiseman ◽  
Augustine Asante ◽  
Jennifer Price ◽  
Andrew Hayen ◽  
Wayne Irava ◽  
...  
Keyword(s):  
Health Care ◽  
Service Use ◽  
Health Care Financing ◽  
Health Sector ◽  
Health Financing ◽  
Universal Coverage ◽  
Middle Income ◽  
Country Level ◽  
Benefit Incidence Analysis ◽  
Incidence Analysis

Abstract Many low- and middle-income countries are seeking to reform their health financing systems to move towards universal coverage. This typically means that financing is based on people’s ability to pay while, for service use, benefits are based on the need for health care. Financing incidence analysis (FIA) and benefit incidence analysis (BIA) are two popular tools used to assess equity in health systems financing and service use. FIA studies examine who pays for the health sector and how these contributions are distributed according to socioeconomic status (SES). BIA determines who benefits from health care spending, with recipients ranked by their relative SES. In this article, we identify 10 resources to assist researchers and policy makers seeking to undertake or interpret findings from financing and benefit incidence analyses in the health sector. The article pays particular attention to the data requirements, computations, methodological challenges and country level experiences with these types of analyses.

The Korean Economic Crisis and Coping Strategies in the Health Sector: Pro-Welfarism or Neoliberalism?

2005 ◽  
Vol 35 (3) ◽  
pp. 561-578 ◽  
Author(s):  
Chang-Yup Kim
Keyword(s):  
Health Care ◽  
Economic Crisis ◽  
Access To Health Care ◽  
Health Sector ◽  
Welfare Policies ◽  
The Public ◽  
Access To Health ◽  
Private Health Sector ◽  
Health Care Policies ◽  
And Coping

In South Korea, there have been debates on the welfare policies of the Kim Dae-jung government after the economic crisis beginning in late 1997, but it is unquestionable that health and health care policies have followed the trend of neoliberal economic and social polices. Public health measures and overall performance of the public sector have weakened, and the private health sector has further strengthened its dominance. These changes have adversely affected the population's health status and access to health care. However, the anti-neoliberal coalition is preventing the government's drive from achieving a full success.

scholarly journals (A2) Strategies to Recover the Health Care Capacity Post Earthquake in Chile

2011 ◽  
Vol 26 (S1) ◽  
pp. s1-s1
Author(s):  
C. Bambaren
Keyword(s):  
Health Care ◽  
Health Sector ◽  
Winter Season ◽  
Health Care Facilities ◽  
Small Scale ◽  
Care Facilities ◽  
Private Health Sector ◽  
Foreign Governments ◽  
Set Up ◽  
Care Capacity

BackgroundThe earthquake that struck Chile on February 27th, 2010 produced profound damage of hospital services with 4249 bed lost especially in the regions of Maule and Bio. The capacity of the health was critically reduced in ability to assure health access to affected people by the disaster.Discussion of InterventionsThe first strategy to maintain health services was the deployment of 18 field hospitals from Chilean organizations (Army and Air Force), international organizations and foreign governments. This measure allowed for 533 beds and 16 surgical blocks in the first weeks. There were 14 field hospitals until November. Taking into account the beginning of the winter season, the national government set up another sort of strategy to increase the capacity of the health care facilities: § Strengthening of hospitals without damage that were close to the disaster area. These hospitals were used as referral centers. § Purchasing of 708 beds from the private health sector. § Habilitation of free spaces to be used for inpatients. § Increasing the capacity of home care health programs to release beds. § Construction of some small temporary units to admit patients. § Small-scale interventions to repair damages in hospitals. § Extending the work time until 16 hours in the primary health care facilities. § Improving of the efficient of the using of human and physical resources. § Restructuration of the hospital network that allowed adding 300 new beds.ResultsThe ministry of health recovered more than 94% of loss beds and 92% of surgical blocks through July. However, it is necessary to identify US$ 2720 million for reconstruction program and to establish a national strategy of safe hospitals in order to reduce the future costs of the recovery of damaged health care facilities. *Based on information from PAHO – Chile.

scholarly journals ACCREDITATION AND HEALTH CARE QUALITY ASSURANCE IN PAKISTAN: A DESK REVIEW

1970 ◽  
Vol 7 (3) ◽  
pp. 174-179 ◽  
Author(s):  
Fauziah Rabbani ◽  
Imran Naeem Abbasi
Keyword(s):  
Health Care ◽  
Quality Assurance ◽  
Quality Of Care ◽  
National Health ◽  
Health Sector ◽  
World Health ◽  
Private Health Sector ◽  
Regulatory Bodies ◽  
Quality In Healthcare

Background: Pakistan has a well-established healthcare system with 70% healthcare needs catered by private health sector. The latter's unregulated and unchecked expansion has resulted in quackery and compromised quality of care. This situation analysis provides a snapshot of health system's quality assurance and accreditation processes. Methods: Two validated questionnaires from World health Organization gauged the current state of health care accreditation and quality of care initiatives in Pakistan. Information was obtained from peer reviewed articles, grey literature, policy documents on government websites and newspapers. Results: Pakistan has a number of regulatory bodies responsible for ensuring quality in healthcare through accreditation and defined standards. National Institute of Health issues updated clinical quality guidelines pertaining to disease epidemics. A national quality policy was also formulated in 2004. However, implementing and ensuring accreditation has been challenging. Though statutory bodies are in place for registering different cadres of healthcare professionals, policies and mechanisms regarding licensure of healthcare establishments are missing. Emergence of national health vision 2012-2020, provincial health sector strategies and healthcare commission acts have focused on regulation of private health sector and accreditation of healthcare establishments. Despite presence of regulatory bodies, there are implementation gaps. Conclusion: This paper highlights some important gaps regarding accreditation and quality in healthcare. Quality assurance should be incorporated into national health policies, programs and strategies. National health policy should include explicit laws concerning quality Indicators and standards for quality in health care. Need to regulate private health sector and ensuring quality in overall healthcare is more than ever.

scholarly journals Comparative analysis of health institutions, personnel and service in private and public health sector in Serbia in 2009

2011 ◽  
Vol 58 (4) ◽  
pp. 216-228 ◽  
Author(s):  
Milena Gajic-Stevanovic ◽  
Snezana Dimitrijevic ◽  
Nevenka Teodorovic ◽  
Slavoljub Zivkovic
Keyword(s):  
Public Health ◽  
Health Care ◽  
Public Sector ◽  
Private Sector ◽  
Health Care System ◽  
Health Sector ◽  
Public Health Sector ◽  
Private Health Sector ◽  
Hospital Days ◽  
Care System

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.

scholarly journals TB Notification from Private Health Sector in Delhi, India: Challenges Encountered by Programme Personnel and Private Health Care Providers

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Mahasweta Satpati ◽  
Sharath Burugina Nagaraja ◽  
Hemant Deepak Shewade ◽  
Prabhakaran Ottapura Aslesh ◽  
Blesson Samuel ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Sector ◽  
Control Programme ◽  
New Delhi ◽  
Private Health Care ◽  
Care Providers ◽  
Tuberculosis Case ◽  
Social Patterns ◽  
Private Health Sector

Objective. To identify the challenges encountered by private health care providers (PHCP) to notify tuberculosis cases through a programme developed web-based portal mechanism called “NIKSHAY.” Study Design. It is a descriptive qualitative study conducted at two revised national tuberculosis control programme (RNTCP) districts of New Delhi. The study included in-depth interviews of PHCP registered with “NIKSHAY” and RNTCP programme personnel. Grounded theory was used to conceptualise the latent social patterns in implementation of tuberculosis case notification process and promptly identifying their challenges. Results. The analysis resulted in identification of three broad themes: (a) system implementation by RNTCP: it emphasizes the TB notification process by the RNTCP programme personnel; (b) challenges faced by PHCP for TB notification with five different subthemes; and (c) perceived gaps and suggestions: to improvise the TB notification process for the private health sector. The challenges encountered by PHCP were mainly related to unsystematic planning and suboptimal implementation by programme personnel at the state and district level. The PHCP lacked clarity on the need for TB notification. Conclusion. Implementation of TB notification among private health care providers requires systematic planning by the programme personnel. The process should be user-friendly with additional benefits to the patients.

scholarly journals Perceived Service Quality in Public and Private Health Sector in Turkey in the Context of

2011 ◽  
Author(s):  
Müjgan Hacıoğlu Deniz ◽  
Elif Haykır Hobikoğlu
Keyword(s):  
Health Care ◽  
Service Quality ◽  
Health System ◽  
Health Sector ◽  
Health Expenditures ◽  
Satisfaction Level ◽  
Public And Private ◽  
Dual Structure ◽  
Private Health Sector ◽  
Public And Private Hospitals

As a result of the fast and radical changes in Turkish health sector during the last ten years, a dual structure has emerged in Turkey. In this study we have tried to point out basic variables on which patient preferences towards getting health care from public or private sector depends, and also by what percentage these variables provide satisfaction to patients in the context of value-based health care system. By taking a poll we have measured the magnitude of health expenditures goes to public and private hospitals and in return of these expenditures, the level of satisfaction people get in the context of value-based health system. We have also tried to compare these two different kinds of hospitals by considering service quality and different prices. In health sector which is one of the biggest and basic sectors of Turkey, in order to achieve efficiency in using resources, we can benefit from the "value-based healthsystem" which will pave the way for optimum allocation of resources. Around the globe and especially in developed and rich countries like UK and USA, the "value-based health system" is getting more and more importance and having a crucial role in optimising resources in health industry. Considering the dual structure of health sector, people’s satisfaction level in comparison with their health expenditures was searched and end up with a conclusion about the satisfaction level according to prices charged by different hospitals.

Social Logics in Reproduction Health

2018 ◽  
Vol 3 (6) ◽  
Keyword(s):  
Health Care ◽  
Child Health ◽  
Reproductive Health ◽  
Health Sector ◽  
Cultural Representations ◽  
Reproductive Health Care ◽  
Social Actors ◽  
Efficient Management ◽  
Social Logic ◽  
And Child Health

The issue that underlies a worrying question of maternal and child health in Côte d'Ivoire is that of social logic. Social logic is perceived as "cultural constructions of actors with regard to morbidity that cause to adopt reproductive health care". Based on this understanding, the concept of social logic in reproductive health is similar to a paradigm that highlights the various factors that structure and organise sociological resistance to mothers' openness to healthy reproductive behaviours; that is, openness to change for sustainable reproductive health. Far from becoming and remaining a prisoner of blind culturalism with the social logic that generates the health of mothers, new-borns and children, practically-relevant questions are raised. Issues of "bad governance", socio-cultural representations and behaviours in conflict with modern epidemiological standards are addressed in a culturally-sensitive manner, an important issue for the provision of care focused on the needs of mothers seeking answers to health problems. Developing these original community characteristics helps to orient a reading list in a socioanthropological perspective with a view to explaining and understanding different problems encountered, experiences acquired by social actors during the implementation of antenatal, postnatal and family planning care. This context of building logic with regard to reproductive health care is key to identifying real bottlenecks in maternity services and achieving efficient management of maternal, new-born and child health care for the benefit of populations and actors in the public health sector.

Modernization, Globalization, Trends, and Convergence in Health Expenditure in Latin America and the Caribbean

2015 ◽  
Vol 1 (2) ◽  
pp. 321-346 ◽  
Author(s):  
Shiri Noy ◽  
Patricia A. McManus
Keyword(s):  
Health Care ◽  
Latin America ◽  
Health Care Systems ◽  
Health Care Financing ◽  
Health Spending ◽  
Modernization Theory ◽  
The Public ◽  
National Differences ◽  
Care Systems ◽  
Public Private Mix

Are health care systems converging in developing nations? We use the case of health care financing in Latin America between 1995 and 2009 to assess the predictions of modernization theory, competing strands of globalization theory, and accounts of persistent cross-national differences. As predicted by modernization theory, we find convergence in overall health spending. The public share of health spending increased over this time period, with no convergence in the public-private mix. The findings indicate robust heterogeneity of national health care systems and suggest that globalization fosters human investment health policies rather than neoliberal, “race to the bottom” cutbacks in public health expenditures.

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