Public or private care: where do specialists spend their time?

2017 ◽  
Vol 41 (5) ◽  
pp. 541 ◽  
Author(s):  
Gary L. Freed ◽  
Erin Turbitt ◽  
Amy Allen
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Patient Care ◽  
Public Hospitals ◽  
Large Majority ◽  
Health Practitioner ◽  
Medical Workforce ◽  
Public And Private ◽  
The Public ◽  
Medical Specialists

Objectives The aim of the present study was to provide data to help clarify the public–private division of clinical care provision by doctors in Australia. Methods A secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields. The specialties were orthopaedic surgery, otolaryngology, ophthalmology, cardiology, neurology, nephrology, gastroenterology and rheumatology. Results For the specialities analysed in the present study, a large majority of the time spent in patient care was provided in the private sector. For the surgical specialties studied, on average less than 30% of clinical time was spent in the public sector. There was considerable variation among specialties in whether a greater proportion of time was spent in out-patient versus in-patient care and how that was divided between the public and private sectors. Conclusions Ensuring Australians have a medical workforce that meets the needs of the population will require assessments of the public and private medical markets, the needs of each market and the adequacy with which current physician clinical time allocation meets those requirements. By appreciating this nuance, Australia can develop policies and strategies for the current and future speciality workforce to meet the nation’s needs. What is known about the topic? Australian medical specialists can split their clinical practice time between the public (e.g. public hospitals, public clinics) and private (e.g. private hospitals, private consulting rooms) sectors. For all medical specialists combined, working hours have been reported to be similar in the public and private sectors. In aggregate, 48% of specialists work across both sectors, 33% work only in public practice and 19% work only in private practice. What does this paper add? Because of the potential for significant variability across specialties, these consolidated figures may be problematic in assessing the public and private allocation of the physician workforce. Herein we provide the first speciality-specific data on the public–private mix of practice in Australia. Among the most important findings from the present study is that, for many specialists in Australia, a large majority of time is spent providing care to patients in the private sector. For the surgical specialties studied, on average less than 30% of clinical time is spent in the public sector. What are the implications for practitioners? Public policies that are designed to ensure an adequate medical workforce will need to take into account the division of time providing care in the public vs. the private sector. Public perceptions of shortages in the public sector may increase the availability of public sector positions.

scholarly journals Availability, prices, and affordability of selected essential cancer medicines in a middle-income country – the case of Mexico

2019 ◽  
Author(s):  
Daniela Moye-Holz ◽  
Margaret Ewen ◽  
Anahi Dreser ◽  
Sergio Bautista-Arredondo ◽  
Rene Soria-Saucedo ◽  
...  
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Public Hospitals ◽  
World Health ◽  
Public And Private ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Public And Private Sector

Abstract Background: More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. Objective: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO’s Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People’s Health Insurance” were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization’s 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.

scholarly journals Analyzing patient trust through the lens of hospitals managers—The other side of the coin

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250626
Author(s):  
Aviad Tur-Sinai ◽  
Royi Barnea ◽  
Orna Tal
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Essential Element ◽  
Shared Responsibility ◽  
Public Hospitals ◽  
Care Providers ◽  
Public And Private ◽  
The Public ◽  
Private And Public ◽  
Public And Private Hospitals

Trust is an essential element in patient-physician relationships, yet trust is perceived differently among providers and customers exist. During January-February 2020 we examined the standpoints of medical managers and administrative directors from the private and public health hospitals on patient-physician trust, using a structured questionnaire. Thirty-six managers in public and private hospitals (24 from the public sector and 12 from the private sector) responded to the survey. Managers in the private sector rated trust higher in comparison to managers in the public sector, including trust related to patient satisfaction, professionalism and accountability. Managers from public hospitals gave higher scores to the need for patient education and shared responsibility prior to medical procedures. Administrative directors gave higher scores to various dimensions of trust and autonomy while medical managers gave higher scores to economic considerations. Trust is a fundamental component of the healthcare system and may be used to improve the provision and quality of care by analyzing standpoints and comparable continuous monitoring. Differences in position, education and training influence the perception of trust among managers in the health system. This survey may allow policy makers and opinion leaders to continue building and maintaining trust between patients and care providers.

scholarly journals Availability, Prices and Affordability of Selected Essential Cancer Medicines in a Middle-Income Country: The Case of Mexico

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 220s-220s
Author(s):  
D. Moye Holz ◽  
M. Ewen ◽  
A. Dreser ◽  
S. Bautista ◽  
R. Soria ◽  
...  
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Public Hospitals ◽  
Public And Private ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Public And Private Sector ◽  
Dose Form

Background: More alternatives are becoming available for the diagnosis and treatment of cancer in low- and middle-income countries. Yet, because of increasing demands, many governments are now facing the dilemma of making essential cancer medicines available to all while keeping them affordable. Precise information about current access to these medicines is limited, and there's no systematic methodology in place to do so. Aim: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices (public sector procurement and patient prices) against those in other countries of the region. Methods: We adapted the WHO/HAI methodology. We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines (each strength and dose-form specific). Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People's Health Insurance” (SPS) were slightly more available. Only 7 (public sector) and 5 (private sector) out of 49 medicines were deemed affordable. Overall, public sector procurement prices were 41% lower than in other countries of the region. Conclusion: The availability of essential cancer medicines, in the public and private sector, falls below WHO's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.

scholarly journals Availability, prices, and affordability of selected essential cancer medicines in a middle-income country – the case of Mexico

2020 ◽  
Author(s):  
Daniela Moye-Holz ◽  
Margaret Ewen ◽  
Anahi Dreser ◽  
Sergio Bautista-Arredondo ◽  
Rene Soria-Saucedo ◽  
...  
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Public Hospitals ◽  
World Health ◽  
Public And Private ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Public And Private Sector

Abstract Background: More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. Objective: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO’s Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People’s Health Insurance” were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization’s 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.

Relationship between CSR motivations and corporate social performance: a study in the power industry in India

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Moumita Acharyya ◽  
Tanuja Agarwala
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Corporate Social Performance ◽  
Social Performance ◽  
Power Sector ◽  
Public And Private ◽  
Content Type ◽  
The Public ◽  
Self Interest ◽  
Public And Private Sector

PurposeThe paper aims to understand the different motivations / reasons for engaging in CSR initiatives by the organizations. In addition, the study also examines the relationship between CSR motivations and corporate social performance (CSP).Design/methodology/approachThe data were collected from two power sector organizations: one was a private sector firm and the other was a public sector firm. A comparative analysis of the variables with respect to private and public sector organizations was conducted. A questionnaire survey was administered among 370 employees working in the power sector, with 199 executives from public sector and 171 from private sector.Findings“Philanthropic” motivation emerged as the most dominant CSR motivation among both the public and private sector firms. The private sector firm was found to be significantly higher with respect to “philanthropic”, “enlightened self-interest” and “normative” CSR motivations when compared with the public sector firms. Findings suggest that public and private sector firms differed significantly on four CSR motivations, namely, “philanthropic”, “enlightened self-interest”, “normative” and “coercive”. The CSP score was significantly different among the two power sector firms of public and private sectors. The private sector firm had a higher CSP level than the public sector undertaking.Research limitations/implicationsFurther studies in the domain need to address differences in CSR motivations and CSP across other sectors to understand the role of industry characteristics in influencing social development targets of organizations. Research also needs to focus on demonstrating the relationship between CSP and financial performance of the firms. Further, the HR outcomes of CSR initiatives and measurement of CSP indicators, such as attracting and retaining talent, employee commitment and organizational climate factors, need to be assessed.Originality/valueThe social issues are now directly linked with the business model to ensure consistency and community development. The results reveal a need for “enlightened self-interest” which is the second dominant CSR motivation among the organizations. The study makes a novel contribution by determining that competitive and coercive motivations are not functional as part of organizational CSR strategy. CSR can never be forced as the very idea is to do social good. Eventually, the CSR approach demands a commitment from within. The organizations need to emphasize more voluntary engagement of employees and go beyond statutory requirements for realizing the true CSR benefits.

Research from China finds no significant difference in impact of public service motivation (PSM) in public and private sectors

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Employee Performance ◽  
Intention To Leave ◽  
Public And Private ◽  
Content Type ◽  
The Public ◽  
Significant Difference ◽  
Set Up ◽  
The Impact

Purpose The authors assumed PSM would be higher in the public sector, but they set up a trial to find out if this was the case. Design/methodology/approach To test their theories, the authors conducted two independent surveys. The first consisted of 220 usable responses from public sector employees in Changsha, China. The second survey involved 260 usable responses from private sector employees taking an MBA course at a university in the Changsha district. A questionnaire was used to assess attitudes. Findings The results found no significant difference between the impact of public sector motivation (PSM) on employee performance across the public and private sectors. The data showed that PSM had a significant impact on self-reported employee performance, but the relationship did not differ much between sectors. Meanwhile, it was in the private sector that PSM had the greatest impact on intention to leave. Originality/value The authors said the research project was one of the first to test if the concept of PSM operated in the same way across sectors. It also contributed, they said, to the ongoing debate about PSM in China.

Public-Private-Academic Cooperation as a Trust Building Mechanism

2016 ◽  
pp. 199-223
Author(s):  
Nicholas Virzi ◽  
Juan Portillo ◽  
Mariela Aguirre
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Trust Building ◽  
Public And Private ◽  
The Public ◽  
National Competitiveness ◽  
Working Together ◽  
The Government ◽  
Innovation And Entrepreneurship

The chapter will be a case study from an Ordoliberal perspective of the conception, implementation and policy output of the newly created Private Council of Competitiveness (PCC) in Guatemala, a country wracked by mistrust of the public sector by the private sector. The PCC was founded as a private sector initiative, in conjunction with academia, to work with the government to spawn new efforts aimed at augmenting Guatemala's national competitiveness, by fomenting innovation, entrepreneurship and closer ties between academia and the public and private sectors. The chapter utilizes first hand interviews with the members of the PCC and key public sector players, academics, and other top representatives from the private sector to show how working together built the trust necessary to make the PCC a successful working body with the potential to produce important initiatives in matters of competitiveness, innovation and entrepreneurship.

Underlying values and competencies of public and private sector managers

2016 ◽  
Vol 5 (4) ◽  
pp. 371-387 ◽  
Author(s):  
Sean D. Darling ◽  
J. Barton Cunningham
Keyword(s):  
Decision Making ◽  
Public Sector ◽  
Private Sector ◽  
Critical Incident ◽  
Visionary Leadership ◽  
Political Environment ◽  
Public And Private ◽  
Content Type ◽  
The Public ◽  
Public And Private Sector

Purpose The purpose of this paper is to identify unique values and competencies linked to private and public sector environments. Design/methodology/approach This study is based on critical incident interviews with a sample of senior leaders who had experience in both the public and private sectors. Findings The findings illustrate distinct public and private sector relevant competencies that reflect the unique values of their organizations and the character of the organization’s environments. This paper suggests a range of distinct public sector competencies including: managing competing interests, managing the political environment, communicating in a political environment, interpersonal motivational skills, adding value for clients, and impact assessment in decision-making. These were very different than those identified as critical for the private sector environment: business acumen, visionary leadership, marketing communication, market acumen, interpersonal communication, client service, and timely and opportunistic decision-making. Private sector competencies reflect private sector environments where goals need to be specifically defined and implemented in a timely manner related to making a profit and surviving in a competitive environment. Public sector competencies are driven by environments exhibiting more complex and unresolvable problems and the need to respond to conflicting publics and serving the public good while surviving in a political environment. Originality/value A key message of this study is that competency frameworks need to be connected to the organization’s unique environments and the values that managers are seeking to achieve. This is particularly important for public organizations that have more complex and changing environments.

scholarly journals Aggregate Public-Private Remuneration Patterns in South Africa

2020 ◽  
Author(s):  
Andreas Wörgötter ◽  
Sihle Nomdebevana
Keyword(s):  
South Africa ◽  
Public Sector ◽  
Private Sector ◽  
Inflation Targeting ◽  
Public And Private ◽  
The Public ◽  
Causal Direction ◽  
Long Run ◽  
Causality Tests ◽  
Public And Private Sector

AbstractThis paper investigates the public-private remuneration patterns in South Africa with time-series methods for the first time since the introduction of an inflation-targeting framework in 2000. Co-integration tests and analysis confirm that there is a stable, long-run relationship between nominal and real remuneration in the public and private sector. The adjustment to the deviations from this long-run relationship is strong and significant for public-sector remuneration, while private-sector wages neither respond to deviations from the long-run relationship nor lagged changes in public-sector remuneration. The causal direction from private- to public-sector remuneration does not change if real earnings are calculated with the gross domestic product deflator. This is confirmed by simple Granger-causality tests.

scholarly journals Contraction and Expansion: The Divergence of Private Sector and Public Sector Unionism in the United States

1988 ◽  
Vol 2 (2) ◽  
pp. 63-88 ◽  
Author(s):  
Richard B Freeman
Keyword(s):  
United States ◽  
Public Sector ◽  
Private Sector ◽  
Developed Countries ◽  
The United States ◽  
Public And Private ◽  
The Public ◽  
Union Status ◽  
Contraction And Expansion ◽  
Public Sector Unionism

The institutional structure of the American labor market changed remarkably from the 1950s and 1960s to the 1980s. What explains the decline in union representation of private wage and salary workers? Why have unions expanded in the public sector while contracting in the private sector? Is the economy-wide fall in density a phenomenon common to developed capitalist economies, or is it unique to the United States? To what extent should economists alter their views about what unions do to the economy in light of the fact that they increasingly do it in the public sector? To answer these questions I examine a wide variety of evidence on the union status of public and private workers. I contrast trends in unionization in the United States with trends in other developed countries, particularly Canada, and use these contrasts and the divergence between unions in the public and private sectors of the United States to evaluate proposed explanations.

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