scholarly journals Comparing the average cost of outpatient care of public and for-profit private providers in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Samir Garg ◽  
Narayan Tripathi ◽  
Alok Ranjan ◽  
Kirtti Kumar Bebarta
Keyword(s):  
Average Cost ◽  
Outpatient Care ◽  
Cost Of Care ◽  
Cost Driver ◽  
Public And Private ◽  
Government Subsidies ◽  
For Profit ◽  
Public Facilities ◽  
Private Providers ◽  
The Government

Abstract Introduction Understanding the cost of care associated with different kinds of healthcare providers is necessary for informing the policy debates in mixed health-systems like India’s. Existing studies reporting Out of Pocket Expenditure (OOPE) per episode of outpatient care in public and private providers in India do not provide a fair comparison because they have not taken into account the government subsidies received by public facilities. Public and private health insurance in India do not cover outpatient care and for-profit providers have to meet all their costs out of the payments they take from patients. Methods The average direct cost per acute episode of outpatient care was compared for public providers, for-profit formal providers and informal private providers in Chhattisgarh state of India. For public facilities, government subsidies for various inputs were taken into account. Resources used were apportioned using Activity Based Costing. Land provided free to public facilities was counted at market prices. The study used two datasets: a) household survey on outpatient utilisation and OOPE b) facility survey of public providers to find the input costs borne by government per outpatient-episode. Results The average cost per episode of outpatient care was Indian Rupees (INR) 400 for public providers, INR 586 for informal private providers and INR 2643 for formal for-profit providers and they managed 39.3, 37.9 and 22.9% of episodes respectively. The average cost for government and households put together was greater for using formal for-profit providers than the public providers. The disease profile of care handled by different types of providers was similar. Volume of patients and human-resources were key cost drivers in public facilities. Close to community providers involved less cost than others. Conclusions and recommendations The findings have implications for the desired mix of public and private providers in India’s health-system. Poor regulation of for-profit providers was an important structural cost driver. Purchasing outpatient care from private providers may not reduce average cost. Policies to strengthen public provisioning of curative primary care close to communities can help in reducing cost.

Funding higher education through waqf: a lesson from Pakistan

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Muhammad Usman ◽  
Asmak Ab Rahman
Keyword(s):  
Higher Education ◽  
Educational Institutions ◽  
Public And Private ◽  
Content Type ◽  
For Profit ◽  
Not For Profit ◽  
Academic Activities ◽  
Higher Educational ◽  
The Government

Purpose This paper aims to study waqf practice in Pakistan with regard to its utilisation in funding for higher educational institutions (HEIs) and investigates waqf raising, waqf management and waqf income utilisation. Design/methodology/approach The paper is based on the views of 11 participants who are actively involved in the waqf, its raising, management and income utilisation, and is divided into three subcategories: personnel of higher educational waqf institution, personnel of waqf regulatory bodies and Shari’ah and legal experts as well as archival records, documents and library sources. Findings In Pakistan, both public and private awqaf are existing, but the role of private awqaf is greater in higher education funding. However, due to lack of legal supervision private awqaf is considered as a part of the not-for-profit sector and legitimately registered as a society, foundation, trust or a private limited company. Waqf in Pakistan is more focusing on internal financial sources and waqf income. In terms of waqf management, they have firm guidelines for investing in real estate, the Islamic financial sector and various halal businesses. Waqf uses the income for developmental and operational expenditure, and supports academic activities for students and staff. Waqfs are also supporting some other HEIs and research agencies. Thus, it can be revealed that a waqf can cater a sufficient amount for funding higher educational institutions. Research limitations/implications In Pakistan, both public and private awqaf are equally serving society in different sectors, but the role of private awqaf is much greater in funding higher education. Nevertheless, the government treats private awqaf as a part of not-for-profit sector in the absence of a specific legal framework and registers such organisations as society, foundation, trust or private limited company. The waqf in Pakistan mostly relies on internal financial resources and income from waqf assets. As the waqf managers have over the time evolved firm guidelines for investment in real estate, Islamic financial sector and various other halal businesses, and utilisation of waqf income on developmental and operational expenditures, academic activities of students and educational staff, other HEIs and research agencies, it can be proved that the waqf can potentially generate sufficient amount for funding HEIs. Practical implications The study presents the waqf as a social finance institution and the best alternative fiscal instrument for funding works of public good, including higher education, with the help of three selected waqf cases. Hence, the paper’s findings offer some generalisations, both for the ummah at large and Pakistan. Social implications The paper makes several policy recommendations for policymakers, legislators and academicians, especially the government. As an Islamic social finance institution, the waqf can help finance higher education anywhere around the world in view of the fact that most countries grapple with huge fiscal deficits and are hence financially constrained to meet growing needs of HEIs. Originality/value The study confirms that the waqf can be an alternative source for funding higher education institutions whether it is managed by the government or is privately controlled.

Performance objectives of public private partnership implementation in Malaysia: perception of key players

2018 ◽  
Vol 12 (1) ◽  
pp. 17-30 ◽  
Author(s):  
Rosnani Mohamad ◽  
Suhaiza Ismail ◽  
Julia Mohd Said
Keyword(s):  
Public Service ◽  
Design Methodology ◽  
High Quality ◽  
Public And Private ◽  
Private Partnership ◽  
Content Type ◽  
The Public ◽  
Public Facilities ◽  
Key Players ◽  
The Government

Purpose The objectives of this present study are twofold. First, it aims to investigate the performance objectives of PPP implementation in Malaysia. Second, it aims to examine the differences in the perceptions of two PPP key players – the public and private sectors – pertaining to the performance objectives. Design/methodology/approach A questionnaire survey was used to elicit the perceptions of the public and private sectors concerning the performance objectives of PPP projects in Malaysia; 237 usable responses were obtained and analysed using SPSS to rank the importance of the performance objectives and to examine the differences in the perceptions between the government and private sectors. Findings The results reveal that the five most important performance objectives for PPP implementation in Malaysia based on overall respondents’ perceptions are “High-quality public service”, “Provide convenient service for society”, “Within or under budget”, “On-time or earlier” and “Satisfy the need for more public facilities”. As for differences in the perceptions of the two key players, only one objective was perceived as statistically more important by the public sector respondents than by their private sector counterparts. Originality/value The contribution of this paper is that it not only provides empirical evidence for the performance objectives for PPP implementation in Malaysia, but also offers evidence concerning the differences in the perceptions of the public and private sectors pertaining to the performance objectives.

scholarly journals The Economic Burden of Measles in Children Under Five in Bangladesh

2020 ◽  
Author(s):  
Gatien de Broucker ◽  
Sayem Ahmed ◽  
Md. Zahid Hasan ◽  
Gazi Golam Mehdi ◽  
Jorge Martin del Campo ◽  
...  
Keyword(s):  
Productivity Loss ◽  
Economic Cost ◽  
Economic Costs ◽  
Post Discharge ◽  
Public And Private ◽  
For Profit ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures ◽  
The Government ◽  
Out Of Pocket Expenses

Abstract Background: This study estimated the economic cost of treating measles in children under-5 in Bangladesh from the caregiver, government, and societal perspectives.Method: We conducted an incidence-based study using an ingredient-based approach. We surveyed the administrative staff and the healthcare professionals at the facilities, recording their estimates supported by administrative data from the healthcare perspective. We conducted 100 face-to-face caregiver interviews at discharge and phone interviews 7 to 14 days post-discharge to capture all expenses, including time costs related to measles. All costs are in 2018 USD ($).Results: From a societal perspective, a hospitalized and ambulatory measles cost $159 and $18, respectively. On average, the government spent $22 per hospitalized measles. At the same time, caregivers incurred $131 and $182 in economic costs, including $48 and $83 in out-of-pocket expenses in public and private not-for-profit facilities, respectively. Seventy-eight percent of the poorest caregivers faced catastrophic health expenditures compared to 21% of the richest. In 2018, 2263 cases of measles were confirmed, totaling $348,073 in economic costs to Bangladeshi society, with $121,842 in out-of-pocket payments for households.Conclusion: Households face substantial out-of-pocket expenses and productivity loss related to measles. Improving vaccination coverage in Sylhet division would likely alleviate most of this burden.

scholarly journals The economic burden of measles in children under five in Bangladesh

2020 ◽  
Author(s):  
Gatien de Broucker ◽  
Sayem Ahmed ◽  
Md. Zahid Hasan ◽  
Gazi Golam Mehdi ◽  
Jorge Martin del Campo ◽  
...  
Keyword(s):  
Economic Cost ◽  
Public Expenditures ◽  
Economic Costs ◽  
Post Discharge ◽  
Public And Private ◽  
For Profit ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures ◽  
The Government ◽  
Measles Outbreaks

Abstract Background: This study estimated the economic cost of treating measles in children under-5 in Bangladesh from the caregiver, government, and societal perspectives.Method: We conducted an incidence-based study using an ingredient-based approach. We surveyed the administrative staff and the healthcare professionals at the facilities, recording their estimates supported by administrative data from the healthcare perspective. We conducted 100 face-to-face caregiver interviews at discharge and phone interviews 7 to 14 days post-discharge to capture all expenses, including time costs related to measles. All costs are in 2018 USD ($).Results: From a societal perspective, a hospitalized and ambulatory measles cost $159 and $18, respectively. On average, the government spent $23 per hospitalized measles. At the same time, caregivers incurred $131 and $182 in economic costs, including $48 and $83 in out-of-pocket expenses in public and private not-for-profit facilities, respectively. Seventy-eight percent of the poorest caregivers faced catastrophic health expenditures compared to 21% of the richest. In 2018, 2263 cases of measles were confirmed, totaling $348,073 in economic costs to Bangladeshi society, with $121,842 in out-of-pocket payments for households.Conclusion: The resurgence of measles outbreaks is a substantial cost for society, requiring significant short-term public expenditures, putting households into a precarious financial situation. Improving vaccination coverage in areas where it is deficient (Sylhet division in our study) would likely alleviate most of this burden.

scholarly journals The economic burden of measles in children under five in Bangladesh

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Gatien de Broucker ◽  
Sayem Ahmed ◽  
Md. Zahid Hasan ◽  
Gazi Golam Mehdi ◽  
Jorge Martin Del Campo ◽  
...  
Keyword(s):  
Economic Cost ◽  
Public Expenditures ◽  
Economic Costs ◽  
Post Discharge ◽  
Public And Private ◽  
For Profit ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures ◽  
The Government ◽  
Measles Outbreaks

Abstract Background This study estimated the economic cost of treating measles in children under-5 in Bangladesh from the caregiver, government, and societal perspectives. Method We conducted an incidence-based study using an ingredient-based approach. We surveyed the administrative staff and the healthcare professionals at the facilities, recording their estimates supported by administrative data from the healthcare perspective. We conducted 100 face-to-face caregiver interviews at discharge and phone interviews 7 to 14 days post-discharge to capture all expenses, including time costs related to measles. All costs are in 2018 USD ($). Results From a societal perspective, a hospitalized and ambulatory case of measles cost $159 and $18, respectively. On average, the government spent $22 per hospitalized case of measles. At the same time, caregivers incurred $131 and $182 in economic costs, including $48 and $83 in out-of-pocket expenses in public and private not-for-profit facilities, respectively. Seventy-eight percent of the poorest caregivers faced catastrophic health expenditures compared to 21% of the richest. In 2018, 2263 cases of measles were confirmed, totaling $348,073 in economic costs to Bangladeshi society, with $121,842 in out-of-pocket payments for households. Conclusion The resurgence of measles outbreaks is a substantial cost for society, requiring significant short-term public expenditures, putting households into a precarious financial situation. Improving vaccination coverage in areas where it is deficient (Sylhet division in our study) would likely alleviate most of this burden.

scholarly journals The economic burden of measles in children under five in Bangladesh

2020 ◽  
Author(s):  
Gatien de Broucker ◽  
Sayem Ahmed ◽  
Md. Zahid Hasan ◽  
Gazi Golam Mehdi ◽  
Jorge Martin del Campo ◽  
...  
Keyword(s):  
Economic Cost ◽  
Public Expenditures ◽  
Economic Costs ◽  
Post Discharge ◽  
Public And Private ◽  
For Profit ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures ◽  
The Government ◽  
Measles Outbreaks

Abstract Background: This study estimated the economic cost of treating measles in children under-5 in Bangladesh from the caregiver, government, and societal perspectives.Method: We conducted an incidence-based study using an ingredient-based approach. We surveyed the administrative staff and the healthcare professionals at the facilities, recording their estimates supported by administrative data from the healthcare perspective. We conducted 100 face-to-face caregiver interviews at discharge and phone interviews 7 to 14 days post-discharge to capture all expenses, including time costs related to measles. All costs are in 2018 USD ($).Results: From a societal perspective, a hospitalized and ambulatory measles cost $159 and $18, respectively. On average, the government spent $23 per hospitalized measles. At the same time, caregivers incurred $131 and $182 in economic costs, including $48 and $83 in out-of-pocket expenses in public and private not-for-profit facilities, respectively. Seventy-eight percent of the poorest caregivers faced catastrophic health expenditures compared to 21% of the richest. In 2018, 2263 cases of measles were confirmed, totaling $348,073 in economic costs to Bangladeshi society, with $121,842 in out-of-pocket payments for households.Conclusion: The resurgence of measles outbreaks is a substantial cost for society, requiring important short-term public expenditures putting households into a precarious financial situation. Improving vaccination coverage in areas where it is deficient (Sylhet division in our study) would likely alleviate most of this burden.

The quantitative and qualitative contributions of faith based organizations to healthcare: The Kenya case

2017 ◽  
Vol 4 (3) ◽  
pp. 60-71 ◽  
Author(s):  
Alfredo Fort
Keyword(s):  
Health Facility ◽  
Management Practices ◽  
Developing World ◽  
Weighted Average ◽  
Relative Strength ◽  
For Profit ◽  
Faith Based ◽  
Non Governmental Organizations ◽  
Faith Based Organizations ◽  
The Government

Though difficult to ascertain because faith based organizations (FBOs) might keep a low profile, be confused with other non-governmental organizations (NGOs), or survey respondents may not know the nature of facilities attended to, these organizations have a long presence in teaching health personnel and delivering health services in many rural and remote populations in the developing world. It is argued that their large networks, logistics agreements with governments, and mission-driven stance brings them closer to the communities they serve, and their services believed of higher quality than average. Kenya has a long history of established FBOs substantial recent health investment by the government. We aimed to find the quantitative and qualitative contributions of FBOs by analyzing two recent data sources: the live web-based nationwide Master Health Facility List, and the 2010 nationwide Service Provision Assessment (SPA) survey. Using this information, we found that FBOs contribute to 11% of all health facilities’ presence in the country, doubling to 23% of all available beds, indicating their relative strength in owning mid-level hospitals around the country. We also constructed an index of readiness as a weighted average from services offered, good management practices and availability of medicines and commodities for 17 items assessed during the SPA survey. We found that FBOs topped the list of managing authorities, with 70 percent of health facility readiness, followed closely by the government at 69 percent, NGOs at 61 percent and lastly a distant private for profit sector at 50 percent. These results seem to indicate that FBOs continue to contribute to an important proportion of health care coverage in Kenya, and that they do so with a relatively high quality of care among all actors. It would be of interest to replicate the analysis with similar databases for other countries in the developing world.

The Role of the Business Sector in Global Health Politics

2018 ◽  
pp. 385-408
Author(s):  
Kelley Lee ◽  
Julia Smith
Keyword(s):  
Collective Action ◽  
Global Health ◽  
Business Sector ◽  
Policy Debate ◽  
Public And Private ◽  
Health Politics ◽  
For Profit ◽  
Goods And Services ◽  
Private Interests ◽  
Health Related

The influence of for-profit businesses in collective action across countries to protect and promote population health dates from the first International Sanitary Conferences of the nineteenth century. The restructuring of the world economy since the late twentieth century and the growth of large transnational corporations have led the business sector to become a key feature of global health politics. The business sector has subsequently moved from being a commercial producer of health-related goods and services, contractor, and charitable donor, to being a major shaper of, and even participant in, global health policymaking bodies. This chapter discusses three sites where this has occurred: collective action to regulate health-harming industries, activities to provide for public interest needs, and participation in decision-making within global health institutions. These changing forms of engagement by the business sector have elicited scholarly and policy debate regarding the appropriate relationship between public and private interests in global health.

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