Researchers compare receipt of health care from public and private providers serving one North Carolina Indian tribe

2004 ◽  
Keyword(s):  
Health Care ◽  
North Carolina ◽  
Public And Private ◽  
Private Providers ◽  
Indian Tribe

Health Care Policy in Argentina

2019 ◽  
Author(s):  
Giuseppe M. Messina
Keyword(s):  
Health Care ◽  
Health Care Policy ◽  
Private Insurance ◽  
Complex Structure ◽  
Occupational Status ◽  
Insurance Companies ◽  
Care Policy ◽  
Public And Private ◽  
Private Providers ◽  
Unequal Access

In Argentina, the provision of health care is divided into three components: a highly decentralized universal public sector, funded from general taxation; a constellation of compulsory collective insurance schemes, financed by contributions withdrawn from the salaries of workers in the formal labor market; and a system of private insurance companies used primarily by the middle and upper classes. Regarding the delivery of medical services, the configuration is mixed, as the weight of public and private providers is roughly equal. This complex structure, which derives from the historical development of particular institutions, produces high costs and unequal access to care according to a person’s geographical residence, occupational status, and purchasing power.

scholarly journals Achilles' Heels of Health Care Systems

2010 ◽  
Vol 10 (1) ◽  
pp. 21-40 ◽  
Author(s):  
Jan Mertl
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Private Insurance ◽  
Theoretical Background ◽  
Health Care Facilities ◽  
Public And Private ◽  
Private Providers ◽  
German Model ◽  
Care Systems ◽  
Privately Financed

Achilles' Heels of Health Care Systems The aim of this article is to research the organization of health care systems and their typical failures in relationship with the need for health care. It is based on extensive theoretical background from economics and social policy, where the concepts used have already been defined. It emphasizes the differences between public and private insurance, and the various models of health care. It shows waiting lists, deficits and not realized health care as inevitable attributes of particular model. While based theoretically, it pays attention to empirical evidence in countries that are the most similar to their theoretical incarnation, e. g. the British model of publicly financed government-owned health care facilities, German model of publicly financed private providers and the American model of privately financed private providers. Finally it discusses the question of convergence of health care systems and the possible way of solving the issues described.

scholarly journals Quality and Accountability in Health Care Delivery: Audit-Study Evidence from Primary Care in India

2016 ◽  
Vol 106 (12) ◽  
pp. 3765-3799 ◽  
Author(s):  
Jishnu Das ◽  
Alaka Holla ◽  
Aakash Mohpal ◽  
Karthik Muralidharan
Keyword(s):  
Health Care ◽  
Public Sector ◽  
Health Care Quality ◽  
Care Delivery ◽  
Care Quality ◽  
Rural India ◽  
Correct Treatment ◽  
Public And Private ◽  
Market Prices ◽  
Private Providers

We present unique audit-study evidence on health care quality in rural India, and find that most private providers lacked medical qualifications, but completed more checklist items than public providers and recommended correct treatments equally often. Among doctors with public and private practices, all quality metrics were higher in their private clinics. Market prices are positively correlated with checklist completion and correct treatment, but also with unnecessary treatments. However, public sector salaries are uncorrelated with quality. A simple model helps interpret our findings: Where public-sector effort is low, the benefits of higher diagnostic effort among private providers may outweigh costs of potential overtreatment. (JEL H42, I11, I18, O15)

scholarly journals As predicted by theory: choice and competition in a publicly funded and regulated regional health system yield improved access and cost control

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jonas Wohlin ◽  
Clara Fischer ◽  
Karin Solberg Carlsson ◽  
Sara Korlén ◽  
Pamela Mazzocato ◽  
...  
Keyword(s):  
Cost Control ◽  
Care Quality ◽  
Patient Choice ◽  
Public Healthcare ◽  
Successful Implementation ◽  
Publicly Funded ◽  
Public And Private ◽  
Bundled Payment ◽  
Private Providers ◽  
Number Of Patients

Abstract Background New Public Management (NPM) has been widely used to introduce competition into public healthcare. Results have been mixed, and there has been much controversy about the appropriateness of a private sector-mimicking governance model in a public service. One voice in the debate suggested that rather than discussing whether competition is “good” or “bad” the emphasis should be on exploring the conditions for a successful implementation. Methods We report a longitudinal case study of the introduction of patient choice and allowing private providers to enter a publicly funded market. Patients in need of hip or knee replacement surgery are allowed to choose provider, and those are paid a fixed reimbursement for the full care episode (bundled payment). Providers are financially accountable for complications. Data on number of patients, waiting lists and times, costs to the public purchaser, and complications were collected from public registries. Providers were interviewed at three points in time during a nine-year follow-up period. Time-series of the quantitative data were exhibited and the views of actors involved were explored in a thematic analysis of the interviews. Results The policy goals of improving access to care and care quality while controlling total costs were achieved in a sustained way. Six themes were identified among actors interviewed and those were consistent over time. The design of the patient choice model was accepted, although all providers were discontent with the level of reimbursement. Providers felt that quality, timeliness of service and staff satisfaction had improved. Public and private providers differed in terms of patient-mix and developed different strategies to adjust to the reimbursement system. Private providers were more active in marketing and improving operation room efficiency. All providers intensified cooperation with referring physicians. Close attention was paid to following the rules set by the purchaser. Discussion and conclusions The sustained cost control was an effect of bundled payment. What this study shows is that both public and private providers adhere long-term to regulations by a public purchaser that also controls entrance to the market. The compensation was fixed and led to competition on quality, as predicted by theory.

scholarly journals Navigating change – managers’ experience of implementation processes in disability health care: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anette Granberg ◽  
Marie Matérne ◽  
Lars-Olov Lundqvist ◽  
Anna Duberg
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Contextual Factors ◽  
Implementation Process ◽  
Public And Private ◽  
Implementation Processes ◽  
Telephone Interviews ◽  
External Conditions ◽  
The Many ◽  
Dance Intervention

Abstract Background Effective implementation processes play a central role in health care organizations and affect the care of patients. Managers are pivotal in facilitating the use of new practices, but their experience and how it affects the implementation outcome are still largely unknown. In the field of disability health care in particular, managers experiences have scarcely been investigated. Therefore, the aim of this study is to explore managers’ experiences of the implementation process when transferring new practices into disability health care settings. Methods Semi-structured individual telephone interviews were conducted with managers at disability health care organizations in four administrative regions in central Sweden. A total of 23 managers with formal managerial responsibility from both public and private health care were strategically selected to be interviewed. The interviews were analysed using reflexive thematic analysis with an inductive approach. Results The analysis resulted in two themes about factors influencing the implementation process: firstly, Contextual factors set the agenda for what can be achieved, which highlighted aspects that hinder or enable the implementation process, such as internal and external conditions, the workplace culture, the employees and managers’ attitudes and openness to change: secondly, Leadership in the winds of change, which described the challenges of balancing managerial tasks with leading the change, and the importance of a leadership that involves the participation of the employees. Conclusions This study explored how and to what extent managers address and manage the implementation process and the many associated challenges. The findings highlight the importance of leadership support and organizational structure in order to transfer new practices into the work setting, and to encourage an organizational culture for leading change that promotes positive outcomes. We suggest that identifying strategies by focusing on contextual factors and on aspects of leadership will facilitate implementation processes. Trial registration The SWAN (Structured Water Dance Intervention) study was retrospectively registered on April 9, 2019 and is available online at ClinicalTrials.gov (ID: NCT03908801).

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