scholarly journals Improving equity in the distribution and financing of health services in Mauritius, a small island state with deeply rooted welfare state standards

2021 ◽  
Vol 6 (12) ◽  
pp. e006757
Author(s):  
Ajoy Nundoochan
Keyword(s):  
Health Services ◽  
Welfare State ◽  
Private Sector ◽  
Health Financing ◽  
Small Island ◽  
Public Healthcare ◽  
Healthcare Financing ◽  
The Public ◽  
Service Coverage ◽  
Incidence Analysis

BackgroundEnsuring benefits of free healthcare services are accessible to those in need is essential to achieve universal health coverage (UHC). Mauritius has sustained a welfare state over four decades with free health services in all public facilities. However, paradoxically, the national UHC service coverage index stood at only 63 in 2017. An assessment of who benefits from health interventions is, therefore, vital to shape future health financing strategies.MethodsThe study applied benefit incidence analysis (BIA) to understand the distribution of healthcare utilisation and spending in comparison to income distribution. Also, a financial incidence analysis (FIA) was conducted to assess the progressivity of the health financing systems. Data from the national survey on household out-of-pocket (OOP) expenditure for health were used for the purpose of BIA and FIA. Concentration curves and concentration indices (CI) were nationally estimated and disaggregated to rural/urban levels. Kakwani index (KI) was calculated to assess the progressivity of private healthcare financing.ResultsThe CI for outpatient, inpatient and day care within the public health sector is estimated at −0.33, –0.14 and −0.14, respectively. Overall, CI in the public sector is −0.26. Benefit distribution in the private sector is pro-rich with CI of 0.27. Healthcare financing is regressive as demonstrated by a KI of −0.004, with the poorest population groups contributing a large share, in terms of taxes and OOP, to finance the health system.ConclusionThe BIA posits that government spending on public healthcare has resulted in significant pro-poor services distribution. This is largely offset by pro-rich distribution in the private sector. Thus, implying health financing strategies must be reviewed to promote financial protection against catastrophic health payments and bolster efforts to improve UHC service coverage index and achieve UHC Target 3.8 under Sustainable Development Goal 3.

Evaluation of outpatient satisfaction and service quality of Pakistani healthcare projects

2018 ◽  
Vol 8 (4) ◽  
pp. 462-480 ◽  
Author(s):  
Saad Ahmed Javed ◽  
Sifeng Liu
Keyword(s):  
Service Quality ◽  
Private Sector ◽  
Healthcare Delivery ◽  
Grey System Theory ◽  
Public Healthcare ◽  
Grey System ◽  
Healthcare Delivery System ◽  
Public And Private ◽  
Content Type ◽  
The Public

PurposeThe purpose of this paper is to analyse the relationship between outpatient satisfaction and the five constructs of healthcare projects’ service quality in Pakistan using Deng’s grey incidence analysis (GIA) model, absolute degree GIA model (ADGIA), a novel second synthetic degree GIA (SSDGIA) model and two approaches of decision-making under uncertainty.Design/methodology/approachThe study proposes a new synthetic GIA model and demonstrates its feasibility on data (N=221) collected from both public and private sector healthcare projects of Punjab, the most populous province of Pakistan, using a self-administered questionnaire developed using the original SERVQUAL approach.FindingsThe results of decision analysis approach indicated that outpatients’ satisfaction from the private sector healthcare projects is higher as compared to the public healthcare projects’. The results from the proposed model revealed that tangibility and reliability play an important role in shaping the patient satisfaction in the public and private sectors, respectively.Originality/valueThe study is pioneer in evaluating a healthcare system’s service quality using grey system theory. The study proposes the SSDGIA model as a novel method to evaluate parameters comprehensively based on their mutual association (given by absolute degree of grey incidence) and inter-dependencies (given by Deng’s degree of grey incidence), and tests the new model in the given scenario. The study is novel in terms of its analysis of data and modelling. The study also proposes a comprehensive structure of the healthcare delivery system of Pakistan.

scholarly journals Healthcare in the news media: The privileging of private over public

2017 ◽  
Vol 54 (4) ◽  
pp. 574-590 ◽  
Author(s):  
Sophie Lewis ◽  
Fran Collyer ◽  
Karen Willis ◽  
Kirsten Harley ◽  
Kanchan Marcus ◽  
...  
Keyword(s):  
Private Sector ◽  
Healthcare System ◽  
News Media ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Public And Private ◽  
The Public ◽  
Print News ◽  
Private Healthcare ◽  
Time Period

This article reports on a discourse analysis of the representation of healthcare in the print news media, and the way this representation shapes perspectives of healthcare. We analysed news items from six major Australian newspapers over a three-year time period. We show how various framing devices promote ideas about a crisis in the current public healthcare system, the existence of a precarious balance between the public and private health sectors, and the benefits of private healthcare. We employ Bourdieu’s concepts of field and capital to demonstrate the processes through which these devices are employed to conceal the power relations operating in the healthcare sector, to obscure the identity of those who gain the most from the expansion of private sector medicine, and to indirectly increase health inequalities.

Differentiating between average and high-performing public healthcare managers: implications for public sector talent management

2020 ◽  
Vol 44 (3) ◽  
pp. 434
Author(s):  
Sandra G. Leggat ◽  
Zhanming Liang ◽  
Peter F. Howard
Keyword(s):  
Public Sector ◽  
Health Service ◽  
Health Services ◽  
Talent Management ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
High Performing ◽  
The Public ◽  
Public Healthcare Sector ◽  
Service Managers

ObjectiveEnsuring sufficient qualified and experienced managers is difficult for public sector healthcare organisations in Australia, with a limited labour market and competition with the private sector for talented staff. Although both competency-based management and talent management have received empirical support in association with individual and organisational performance, there have been few studies exploring these concepts in the public healthcare sector. This study addresses this gap by exploring the perceived differences in demonstration of core competencies between average and higher-performing managers in public sector healthcare organisations. MethodsMixed methods were used to define and measure a set of competencies for health service managers. In addition, supervisors of managers were asked to identify the differences in competence between the average and high-performing managers reporting to them. ResultsSupervisors could clearly distinguish between average and higher-performing managers and identified related competencies. ConclusionsThe consistent pattern of competence among community health and hospital public sector managers demonstrated by this study could be used to develop a strategic approach to talent management for the public healthcare sector in Australia. What is known about this topic?Although there are validated competency frameworks for health service managers, they are rarely used in practice in Australia. What does this paper add?This paper illustrates the perceived differences in competencies between top and average health services managers using a validated framework. What are the implications for practitioners?The public health sector could work together to provide a more effective and efficient approach to talent management for public hospitals and community health services.

scholarly journals A NOVA CONFIGURAÇÃO DA POLÍTICA DE SAÚDE NO BRASIL: o Rio de Janeiro como laboratório

2016 ◽  
Vol 20 (1) ◽  
pp. 121
Author(s):  
Débora Holanda Leite Menezes ◽  
Janete Luzia Leite
Keyword(s):  
Public Health ◽  
Health Services ◽  
Common Good ◽  
Rio De Janeiro ◽  
Value Of Life ◽  
Public Healthcare ◽  
Public Health Services ◽  
The Public ◽  
Management Models ◽  
Key Word

Este texto discute as mudanças na gestão dos serviços públicos de saúde no Brasil a partir de 1990. Objetiva analisar como, ao longo dos últimos 30 anos, estes serviços perdem seu caráter público e universal, assumindo um cariz privatista. A metodologia conta com uma revisão bibliográfica e um estudo sobre o funcionamento da rede pública de saúde do Rio de Janeiro – locus privilegiado devido ao grande número de unidades de saúde, e pela rápida adesão de seus governantes aos novos modelos de gestão. Conclui que os maiores prejuízos da adoção destes modelos recairão sobre a população pobre, que depende dos serviços públicos de saúde. Ademais, a precarização das condições de trabalho e salário dos profissionais de saúde também deriva sobremaneira de um modelo que desconhece o valor da vida e da saúde, posto que este bem comum representa só mais uma mercadoria. Quem não paga, não tem. Palavras-chave: Serviços de saúde, Privatização, Novos modelos de gestão, Rio de Janeiro.THE NEW CONFIGURATION OF HEALTH POLICY IN BRAZIL: Rio de Janeiro as a Laboratory Abstract: This text discusses the changes in the management of public health services in Brazil since 1990. It aims to analyze how, over the last 30 years, these services lose their public and universal character, assuming a privatized nature. The methodology includes a literature review and a study on the functioning of the public healthcare system of Rio de Janeiro - privileged locus because of the number of health facilities, and the rapid accession of their rulers to new management models. It concludes that the biggest losses of the adoption of these models will fall on the poor, who depend on public health services. Furthermore, the precarious working conditions and salaries of health professionals also comes on way to a model that ignores the value of life and health, since this common good is just another commodity. Who does not pay, do not have. Key word: Health services, Privatization, New management models, Rio de Janeiro.

scholarly journals Determinant Factors of Health Financing Among Public and Private Sector in Malaysia

2021 ◽  
Vol 14 (12) ◽  
pp. 99
Author(s):  
Zariyawati M. A. ◽  
Hirnissa, M. T. ◽  
Nurul-Farhanim, M. S. ◽  
Soh, W. N.
Keyword(s):  
Private Sector ◽  
Influence Factors ◽  
Health Financing ◽  
Well Being ◽  
Access To Healthcare ◽  
Human Right ◽  
Public And Private ◽  
Medical Expenses ◽  
The Public ◽  
Public And Private Sector

Health is a necessity for human well-being and productive. Hence, access to healthcare when needed is considered by many to be a basic human right. Therefore, it is important to invest in health financing to ensure access to healthcare for future needs, such as medical expenses. The current study aims to investigate the factors that influence employee spending on health financing in the public and private sectors in Malaysia. Further, we also examine whether the intention to spend on health financing differs between public and private sector employees. Multiple regression analysis and an independent-samples T-test were applied using SPSS to achieve this objective. Findings of this study reveal that employer and social influence factors influence the intention to spend on health financing in both sectors. Meanwhile, job factors only influence employees in the public sector to spend on health financing. We also found that the intention to spend on health financing differs between public and private sector employees.

Reforming Public Healthcare in the Republic of Ireland with Information Systems

2011 ◽  
pp. 1151-1171
Author(s):  
David Sammon ◽  
Frederic Adam
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Public Healthcare ◽  
The Public ◽  
The Republic ◽  
Returns On Investment ◽  
Substantial Change ◽  
Is Projects ◽  
Causes Of Failure

The need for reforming public healthcare towards greater efficiency and measurable returns on investment has been felt by governments in many countries. In Ireland, this led to the PPARS project, which sought to implement SAP across all public healthcare sites. This project, however, was unsuccessful and led to a parliamentary inquiry. To understand why the PPARS project failed, we carried out an extensive case study of the project and compared our findings to the implementation of JD Edwards in a multinational in the private sector. Our study reveals that despite specific circumstances in the public sector that contributed to the failure of the ERP project, the primary causes of failure result from a lack of understanding of what ERP involves and a failure to prepare adequately, which can be found in any organisation, public or private. This leads to significant lessons for ERP implementations and IS projects involving substantial change.

The Financing Health System Problem in Algeria

2016 ◽  
Vol 3 (7) ◽  
pp. 48
Author(s):  
Ali Dehmene Mohammed
Keyword(s):  
Health Services ◽  
Private Sector ◽  
Health System ◽  
Health Sector ◽  
The State ◽  
Social Changes ◽  
The Public ◽  
Demand For Health ◽  
Great Development

The health sector in Algeria witnesses a great development, especially during the last two decades of the last century to coincide with the economic and social changes of the country. But despite the enormity of what the state spends on this sensitive sector in order to meet the growing demand for health services provided by the public or private sector, which, however, take advantage of these services was still below the required level where the sector remains vulnerable to various problems

scholarly journals Who benefits from healthcare spending in Cambodia? Evidence for a universal health coverage policy

2019 ◽  
Vol 34 (Supplement_1) ◽  
pp. i4-i13 ◽  
Author(s):  
Augustine D Asante ◽  
Por Ir ◽  
Bart Jacobs ◽  
Limwattananon Supon ◽  
Marco Liverani ◽  
...  
Keyword(s):  
Private Sector ◽  
Universal Health Coverage ◽  
Public Hospital ◽  
Health Spending ◽  
Health Financing ◽  
Healthcare Spending ◽  
Health Coverage ◽  
The Public ◽  
The Poor ◽  
Universal Health

Abstract Cambodia’s healthcare system has seen significant improvements in the last two decades. Despite this, access to quality care remains problematic, particularly for poor rural Cambodians. The government has committed to universal health coverage (UHC) and is reforming the health financing system to align with this goal. The extent to which the reforms have impacted the poor is not always clear. Using a system-wide approach, this study assesses how benefits from healthcare spending are distributed across socioeconomic groups in Cambodia. Benefit incidence analysis was employed to assess the distribution of benefits from health spending. Primary data on the use of health services and the costs associated with it were collected through a nationally representative cross-sectional survey of 5000 households. Secondary data from the 2012–14 Cambodia National Health Accounts and other official documents were used to estimate the unit costs of services. The results indicate that benefits from health spending at the primary care level in the public sector are distributed in favour of the poor, with about 32% of health centre benefits going to the poorest population quintile. Public hospital outpatient benefits are quite evenly distributed across all wealth quintiles, although the concentration index of −0.058 suggests a moderately pro-poor distribution. Benefits for public hospital inpatient care are substantially pro-poor. The private sector was significantly skewed towards the richest quintile. Relative to health need, the distribution of total benefits in the public sector is pro-poor while the private sector is relatively pro-rich. Looking across the entire health system, health financing in Cambodia appears to benefit the poor more than the rich but a significant proportion of spending remains in the private sector which is largely pro-rich. There is the need for some government regulation of the private sector if Cambodia is to achieve its UHC goals.

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