scholarly journals Impact of elective surgery in private hospitals under the civil servant medical benefit scheme to health system

2014 ◽  
Vol 14 (S1) ◽  
Author(s):  
Phatthanawilai Inmai
Keyword(s):  
Health System ◽  
Elective Surgery ◽  
Civil Servant ◽  
Private Hospitals ◽  
Medical Benefit

scholarly journals Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand

2021 ◽  
Vol 6 (2) ◽  
pp. e004117
Author(s):  
Aniqa Islam Marshall ◽  
Kanang Kantamaturapoj ◽  
Kamonwan Kiewnin ◽  
Somtanuek Chotchoungchatchai ◽  
Walaiporn Patcharanarumol ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Universal Coverage ◽  
Civil Servant ◽  
Social Health ◽  
Health Coverage ◽  
Medical Benefit ◽  
The Social ◽  
Universal Health ◽  
Universal Coverage Scheme

Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.

The Growth of Corporate Private Hospitals in Malaysia: Policy Contradictions in Health System Pluralism

1997 ◽  
Vol 27 (4) ◽  
pp. 643-659 ◽  
Author(s):  
Simon Barraclough
Keyword(s):  
Health Care ◽  
Health System ◽  
Rapid Growth ◽  
Urban Areas ◽  
Private Hospital ◽  
Corporate Investment ◽  
Private Hospitals ◽  
Hospital System ◽  
Hospital Sector ◽  
The Government

The rapid growth of corporate investment in the Malaysian private hospital sector has had a considerable impact on the health care system. Sustained economic growth, the development of new urban areas, an enlarged middle class, and the inclusion of hospital insurance in salary packages have all contributed to a financially lucrative investment environment for hospital entrepreneurs. Many of Malaysia's most technologically advanced hospitals employing leading specialists are owned and operated as corporate business ventures. Corporate hospital investment has been actively encouraged by the government, which regards an expanded private sector as a vital complement to the public hospital system. Yet this rapid growth of corporately owned private hospitals has posed serious contradictions for health care policy in terms of issues such as equity, cost and quality, the effect on the wider health system, and the very role of the state in health care provision. This article describes the growth of corporate investment in Malaysia's private hospital sector and explores some of the attendant policy contradictions.

scholarly journals How we managed elective, urgent, and emergency orthopedic surgery during the COVID-19 pandemic

2020 ◽  
Vol 1 (5) ◽  
pp. 93-97 ◽  
Author(s):  
Pietro Domenico Giorgi ◽  
Enrico Gallazzi ◽  
Paolo Capitani ◽  
Giuseppe Antiono D’Aliberti ◽  
Federico Bove ◽  
...  
Keyword(s):  
Health System ◽  
Metropolitan Area ◽  
Elective Surgery ◽  
Scientific Evidence ◽  
National Health System ◽  
Training Programme ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Healthcare Personnel ◽  
Italian National Health

The COVID-19 virus is a tremendous burden for the Italian health system. The regionally-based Italian National Health System has been reorganized. Hospitals' biggest challenge was to create new intensive care unit (ICU) beds, as the existing system was insufficient to meet new demand, especially in the most affected areas. Our institution in the Milan metropolitan area of Lombardy, the epicentre of the infection, was selected as one of the three regional hub for major trauma, serving a population of more than three million people. The aims were the increase the ICU beds and the rationalization of human and structural resources available for treating COVID-19 patients. In our hub hospital, the reorganization aimed to reduce the risk of infection and to obtained resources, in terms of beds and healthcare personnel to be use in the COVID-19 emergency. Non-urgent outpatient orthopaedic activity and elective surgery was also suspended. A training programme for healthcare personnel started immediately. Orthopaedic and radiological pathways dedicated to COVID-19 patients, or with possible infection, have been established. In our orthopaedic department, we passed from 70 to 26 beds. Our goal is to treat trauma surgery's patient in the “golden 72 hours” in order to reduce the overall hospital length of stay. We applied an objective priority system to manage the flow of surgical procedures in the emergency room based on clinical outcomes and guidelines. Organizing the present to face the emergency is a challenge, but in the global plan of changes in hospital management one must also think about the near future. We reported the Milan metropolitan area orthopaedic surgery management during the COVID-19 pandemic. Our decisions are not based on scientific evidence; therefore, the decision on how reorganize hospitals will likely remain in the hands of individual countries.

A two-tiered public-private health system: Who stays in (private) hospitals in Ireland?

Health Policy ◽  
2020 ◽  
Vol 124 (7) ◽  
pp. 765-771
Author(s):  
Aileen Murphy ◽  
Jane Bourke ◽  
Brian Turner
Keyword(s):  
Health System ◽  
Private Hospitals

scholarly journals Adapting hospital capacity to meet changing demands during the COVID-19 pandemic

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Ruth McCabe ◽  
Nora Schmit ◽  
Paula Christen ◽  
Josh C. D’Aeth ◽  
Alessandra Løchen ◽  
...  
Keyword(s):  
Critical Care ◽  
Medical Staff ◽  
Elective Surgery ◽  
The Other ◽  
Junior Doctors ◽  
Private Hospitals ◽  
Hospital Capacity ◽  
Treat All ◽  
Care Capacity ◽  
The Impact

Abstract Background To calculate hospital surge capacity, achieved via hospital provision interventions implemented for the emergency treatment of coronavirus disease 2019 (COVID-19) and other patients through March to May 2020; to evaluate the conditions for admitting patients for elective surgery under varying admission levels of COVID-19 patients. Methods We analysed National Health Service (NHS) datasets and literature reviews to estimate hospital care capacity before the pandemic (pre-pandemic baseline) and to quantify the impact of interventions (cancellation of elective surgery, field hospitals, use of private hospitals, deployment of former medical staff and deployment of newly qualified medical staff) for treatment of adult COVID-19 patients, focusing on general and acute (G&A) and critical care (CC) beds, staff and ventilators. Results NHS England would not have had sufficient capacity to treat all COVID-19 and other patients in March and April 2020 without the hospital provision interventions, which alleviated significant shortfalls in CC nurses, CC and G&A beds and CC junior doctors. All elective surgery can be conducted at normal pre-pandemic levels provided the other interventions are sustained, but only if the daily number of COVID-19 patients occupying CC beds is not greater than 1550 in the whole of England. If the other interventions are not maintained, then elective surgery can only be conducted if the number of COVID-19 patients occupying CC beds is not greater than 320. However, there is greater national capacity to treat G&A patients: without interventions, it takes almost 10,000 G&A COVID-19 patients before any G&A elective patients would be unable to be accommodated. Conclusions Unless COVID-19 hospitalisations drop to low levels, there is a continued need to enhance critical care capacity in England with field hospitals, use of private hospitals or deployment of former and newly qualified medical staff to allow some or all elective surgery to take place.

scholarly journals Exploring the responsiveness of public and private hospitals in Lagos, Nigeria

2012 ◽  
Vol 1 (1) ◽  
pp. 2 ◽  
Author(s):  
Tomilola Adesanya ◽  
Olayinka Gbolahan ◽  
Obadah Ghannam ◽  
Marisa Miraldo ◽  
Bhavesh Patel ◽  
...  
Keyword(s):  
Health System ◽  
Public Hospitals ◽  
World Health ◽  
World Health Report ◽  
Cross Sectional ◽  
Private Hospitals ◽  
Public And Private ◽  
Health Report ◽  
The World ◽  
Public And Private Hospitals

According to the World Health Report 2000, health system responsiveness is proposed as one of the three key objectives of any health system. This multi-domain concept describes how well a health system responds to the expectations of their users concerning the non-health enhancing aspects of care. In this study we aim to compare the levels of responsiveness experienced by users of private and publicly managed hospitals in Nigeria, and through these insights, to propose recommendations on how to improve performance on this measure. This quantitative, cross-sectional study uses a questionnaire that is adapted from two responsiveness surveys designed by the World Health Organization (WHO). Researchers collected responses from 520 respondents from four hospitals in Lagos, Nigeria. Analysis of the data using statistical techniques found that significant differences exist between the performance of public and private hospitals on certain domains of responsiveness, with privately operated hospitals performing better where differences exist. Users of private hospitals also reported a higher level of overall satisfaction. Private hospitals were found to perform particularly better on the domains of dignity, waiting times, and travel times. These findings have implications for the management of public hospitals in focusing their efforts on improving their performance in low scoring domains. Performance in these hospitals can be improved by emphasis on staff training and demand management.

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