scholarly journals THE IMPACT OF HEALTH SUBSIDY ON HEALTH CARE UTILIZATION IN INDONESIA

2021 ◽  
Vol 3 (2) ◽  
pp. 16-37
Author(s):  
Renosa Tosca Zamaro
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Insurance Premium ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Care Utilization ◽  
Poor People ◽  
Outpatient Visits ◽  
Care Facilities ◽  
The Impact

Equal opportunity and access to health care services regardless of one’s socio-economic background is important for health equity. To achieve this, the Indonesian government introduced a national health insurance program named Jaminan Kesehatan Nasional in 2014 and provided insurance premium subsidies for poor people. The current study evaluates the health subsidy policy’s impact on the utilization of different kinds of health care facilities, both public and private. Two waves of Indonesian socio-economic surveys, namely 2013 and 2018, and two analysis methods, namely logistic regression, and difference-in-differences, were applied in this study. The results show that in first-level health care facilities, the health subsidy improves the probability of outpatient visits in public health centers and polyclinics but decreases the probability of outpatient visits in medical practices. Then, in secondary-level health care facilities, the health subsidy was found to increase the likelihood of outpatient visits in public hospitals; however, it lowers the probability of outpatient visits in private hospitals.

scholarly journals Demand for Public Health Care in Pakistan

2009 ◽  
Vol 48 (2) ◽  
pp. 141-153 ◽  
Author(s):  
Ather H. Akbari ◽  
Wimal Rankaduwa ◽  
Adiqa K. Kiani
Keyword(s):  
Public Health ◽  
Health Care ◽  
Care Quality ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Demand Model ◽  
Outpatient Visits ◽  
Care Facilities ◽  
Government Hospitals ◽  
Per Capita

A health care demand model is estimated for each province in Pakistan to explain the outpatient visits to government hospitals over the period 1989-2006. The explanatory variables include the number of government hospitals per capita, doctors’ fee per visit at a private clinic, income per capita, the average price of medicine and the number of outpatient visits per capita in the previous period. All variables are significant determinants of the demand for health care in at least one province but their signs, magnitudes and the levels of significance vary. These variations may be attributed to cultural, social and religious factors that vary across provinces. Variations in health care quality offered at public hospitals may also be a factor. These factors and improved accessibility of health care facilities should be the focus of public policy aimed at increasing the usage of public sector health care facilities in Pakistan. JEL classification: I110, I180, O150 Keywords: Health Care, Hospitals, Human Resources, Policy, Public Health

scholarly journals Out-of-pocket health expenditure and fairness in utilization of health care facilities in Cambodia in 2005 and 2010

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 2066 ◽  
Author(s):  
Koustuv Dalal ◽  
Olatunde Aremu ◽  
Gainel Ussatayeva ◽  
Animesh Biswas
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Financing ◽  
Household Survey ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Care Utilization ◽  
Survey Period ◽  
Care Facilities ◽  
The Government

Background: Out-of-pocket (OOP) payments for health care are highly pervasive in several low-and-middle income countries. The Cambodian health system has envisaged massive repositioning of various health care financing to ensure equitable access to health care. This analysis examines catastrophic, economic, as well as fairness, impacts of OOP health care payments on households in Cambodia over time. Methods: Data from two waves of a nationally representative household survey conducted in Cambodia (CDHS Surveys 2005 and 2010) were utilized. Healthcare utilizations based on economic status were compared during 2005 and 2010. Variables of interests were i) where care was sought and the instances of treatments, i.e. was treatment sought the first, second or third time; (ii) the mode of payment for treatment of the respondent or for any household member due to sickness or injury in the last 30 days prior to the survey period. Lorenz curves were applied to assess the degree of distribution of inequality in OOP expenditures between different income brackets. Results: The findings revealed that there was inequality and unfairness in health care payments, and catastrophic spending is more common among the poor in Cambodia. The majority of people from poorer households experienced economic hardship and have taken to catastrophic health care spending through sales of personal possessions.  Conclusion: Based on the findings from this analysis, more attention is needed on effective financial protection for Cambodians to promote fairness. The government should increase spending on services being provided at public health care facilities to reduce ever increasing reliance on private sector providers. These approaches would go a long way to reduce the economic burden of care utilization among the poorest.

Assessing the Preparedness of Healthcare Facilities for Disasters and Emergencies in Damghan, Iran

2021 ◽  
pp. 1-7
Author(s):  
Behrad Pourmohammadi ◽  
Ahad Heydari ◽  
Farin Fatemi ◽  
Ali Modarresi
Keyword(s):  
Health Care ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Mitigation Measures ◽  
Health Staff ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Wide Range ◽  
Care Facilities ◽  
The Impact

Abstract Objectives: Iran is exposed to a wide range of natural and man-made hazards. Health-care facilities can play a significant role in providing life-saving measures in the minutes and hours immediately following the impact or exposure. The aim of this study was to determine the preparedness of health-care facilities in disasters and emergencies. Methods: This cross-sectional study was conducted in Damghan, Semnan Province, in 2019. The samples consisted of all the 11 health-care facilities located in Damghan County. A developed checklist was used to collect the data, including 272 questions in 4 sections: understanding threatening hazards, functional, structural, and nonstructural vulnerability of health-care facilities. The data were analyzed using SPSS 21. Results: The results revealed that the health-care facilities were exposed to 22 different natural and man-made hazards throughout the county. The total level of preparedness of the health-care centers under assessment was 45.8%. The average functional, structural, and nonstructural vulnerability was assessed at 49.3%, 31.6%, and 56.4%, respectively. Conclusions: Conducting mitigation measures is necessary for promoting the functional and structural preparedness. Disaster educational programs and exercises are recommended among the health staff in health-care facilities.

An Assessment of Health Needs in Selected Nigeria Villages

1985 ◽  
Vol 6 (2) ◽  
pp. 161-169 ◽  
Author(s):  
Collins O. Airhihenbuwa
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Cost Of Care ◽  
Health Care Facilities ◽  
High Morbidity ◽  
Community Members ◽  
Care Needs ◽  
Medical Institutions ◽  
Poor Access ◽  
Care Facilities

Two hundred and fifty five heads of households in Iyekuselu District, Bendel State Nigeria, were interviewed. Fifteen villages were randomly selected from the 107 villages that make up the district. There is high morbidity of infectious diseases identified in the study. Limited number of medical professionals and medical institutions present problems of availability of services. This is compounded by high cost of medical services and poor access to health care facilities. The self-perceived health care needs of the heads of households are disease prevention, availability of health services, improved accessibility to health care facilities and reduced cost of care. There is a strong need for health education programs in these villages. This should be attempted with the cooperation of community members, so as to attain the goal of promoting health and preventing diseases.

scholarly journals Delayed access to treatment and frequency of acute respiratory infection as risk factors of severe pneumonia among children aged 12-59 months in Denpasar, Bali

2017 ◽  
Vol 5 (1) ◽  
pp. 61
Author(s):  
Dewa Ayu Ketut Sri Abadi ◽  
Dewa Nyoman Wirawan ◽  
Anak Agung Sagung Sawitri ◽  
I Gusti Ayu Trisna Windiani
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Access To Health Care ◽  
Respiratory Infections ◽  
Severe Pneumonia ◽  
Health Care Facilities ◽  
First Episode ◽  
Access To Treatment ◽  
Healthcare Facilities ◽  
Care Facilities

Background and purpose: Period prevalence of pneumonia among children in Indonesia increased from 2.1 in 2007 to 2.7 per 1000 children in 2013. The highest incidence was found among children aged 12-23 months. This study aims to examine association between delayed access to health care facilities and severity of children pneumonia.Methods: A case control study was conducted in Denpasar City. A total of 132 children were recruited to participate in this study, consisted of 44 cases and 88 controls. Cases were selected from 161 children with severe pneumonia who registered at Pulmonology Department of Sanglah General Hospital between January 2015 to April 2016. Controls were selected from 261 children aged 12-59 months with mild pneumonia who visited out-patient service at all community health centres in Denpasar City between January 2015 and April 2016. Cases and controls were matched by sex. Data were collected by interview with the parents in their houses. Data were analysed using multivariate analysis with logistic regression.Results: Risk factors associated to severity of pneumonia among children aged 12-59 months were delayed access to treatment for more than three days (AOR=2.15;95%CI: 1.39-3.32), non-health care facilities at first episode of illness (AOR=4.02; 95%CI: 1.53-10.61) and frequent episodes of respiratory infections (>4 times) over the last 6 months (AOR=5.45; 95%CI: 2.13-13.96).Conclusion: Delayed access to treatment, did not access healthcare facilities at first episode of illness, and high frequency of acute respiratory infections are risk factors of severe pneumonia among children.

scholarly journals The impact of introducing ambulance and delivery fees in a rural hospital in Tanzania.

2020 ◽  
Author(s):  
Corinna Vossius ◽  
Estomih Md ◽  
Robert Moshiro ◽  
Paschal M ◽  
Jan Terje Kvaløy ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Low Birthweight ◽  
Care Facility ◽  
Health Care Facility ◽  
Skilled Birth Attendance ◽  
Health Care Facilities ◽  
Birth Attendance ◽  
Vaginal Deliveries ◽  
The Impact

Abstract Background: Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees . Methods: Retrospective analysis of data from a prospective observational study. Data was compared between the period before introduction of fees from February 2010 through June 2013 and the period after from January 2014 through January 2017. Logistic regression modelling was used to construct risk-adjusted variable-life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes. Results: A total of 28,601 births were observed. The monthly number of births was reduced by 17.3% during the post-introduction period. Spontaneous vaginal deliveries were registered less frequently, while labour complication and caesarean sections were more frequent. There was a reduction of newborns with birth weight less than 2500 grams. The observed changes were stable over time. For most variables, a significant change could be detected after a few weeks. Conclusion: After the introduction of ambulance and delivery fees an increase in labour complications and caesarean sections of about 80 per 1000 births and a decrease in non-cephalic presentations and newborns with low birthweight of about 17 per 1000 births each was observed. This might indicate that women delay the decision to seek skilled birth attendance or do not seek help at all, possibly due to financial reasons. Lower rates of births in a safe health care facility like HLH is of great concern, as access to skilled birth attendance is a key requirement in order to further reduce perinatal mortality. Therefore, free delivery care should be a high priority.

scholarly journals (A3) Health Care Facilities Affected by the Earthquake in Chile

2011 ◽  
Vol 26 (S1) ◽  
pp. s1-s2
Author(s):  
C. Bambaren
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Sector ◽  
Health Care Facilities ◽  
Cold Chain ◽  
Care Services ◽  
Biomedical Equipment ◽  
Care Facilities ◽  
Health Care Infrastructure ◽  
The Impact

IntroductionOn February 27, 2010, a 8,8 MW earthquake struck the central and southern coast of Chile, that was followed by a tsunami that destroyed some cities such as Constitution, Ilaco, Talcahuando and Dichato. The national authorities reported 512 dead and 81,444 homes were affected. It was the one of the five most powerful earthquakes in the human modern history. The most affected regions were Maule (VII) and Bio (VIII).ResultsThe impact of the quake in the health sector was enormous especially on the health care infrastructure. The preliminary evaluations showed that 18 hospitals were out of service due severe structural and no-structural damages, interruption of the provision of water or because they were at risk to landslides. Another 31 hospitals had moderate damage. The Ministry of Health lost 4249 beds including 297 (7%) in critical care units. Twenty-two percent of the total number of beds and thirty-nine surgical facilities available in the affected regions were lost in a few minutes due to quake. At least eight hospitals should be reconstructed and other hospitals will need complex repair.ConclusionThe effect of the earthquake was significant on hospital services. It included damages to the infrastructure and the loss of furniture and biomedical equipment. The interruption of the cold chain caused loss of vaccines. National and foreign field hospitals, temporary facilities and the strengthening of the primary health care facilities had been important to assure the continuation of health care services. *Based on information from PAHO – Chile.

Renovation in hospitals: a case study on the use of control cubes for local repairs in health-care facilities

2020 ◽  
Vol 18 (3) ◽  
pp. 247-257
Author(s):  
Ehsan Mousavi ◽  
Vivek Sharma ◽  
Dhaval Gajjar ◽  
Shervin Shoai Naini
Keyword(s):  
Health Care ◽  
Air Quality ◽  
Indoor Air Quality ◽  
Indoor Air ◽  
Health Care Facilities ◽  
Repair Work ◽  
Content Type ◽  
Care Facilities ◽  
Pathogenic Agents ◽  
The Impact

Purpose The purpose of this study is to evaluate the effectiveness of the control cubes for dust control in health-care facilities. Research shows that more than 80% of pathogenic agents in hospitals are spread into the air, where they either remain airborne or deposit on the surface. At the same time, renovation and repair activities, including regular maintenance, are a necessity in active health-care facilities and a multitude of studies have documented their impact on indoor air quality. The dust that is generated by construction activities may potentially carry pathogenic agents, varying from coarse particles (≤10 µm, PM10) to fine particles (≤2.5 µm, PM2.5), including airborne bacteria, and fungal spores linked to high patient mortality in immune-compromised patients. Design/methodology/approach This study measures the impact and effectiveness of one such preventative measure, namely, the control cube (CC), on air quality during renovation and repair. CC is a temporary structure, typically made from stainless steel, around the local repair zone to minimize the spread of dust and potential microorganisms. The current paper presents a comparative analysis to identify the effectiveness of a CC equipped with the high-efficiency particulate filtration (HEPA) filter in a hospital setting by simulating construction renovation and repair work. Findings A baseline was established to measure the effectiveness of CCs and the impact of negative pressure on the indoor air quality in a hospital during simulated renovation work. Results showed that CCs are very effective in minimizing the spread of dust due to construction activities in the hospital. However, it is imperative to ensure that the air inside the CC is cleaned via filtration. Originality/value CCs are very effective, and this paper investigates the best approach for facility managers to implement this strategy.

FAIRNESS OF UTILIZING HEALTH CARE FACILITIES AND OUT-OF-POCKET PAYMENT BURDEN: EVIDENCE FROM CAMBODIA

2012 ◽  
Vol 45 (3) ◽  
pp. 345-357 ◽  
Author(s):  
KOUSTUV DALAL ◽  
OLATUNDE AREMU
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Health Care Facilities ◽  
Care Utilization ◽  
Cross Sectional ◽  
Middle Income ◽  
Distinct Level ◽  
Out Of Pocket Payments ◽  
Care Facilities ◽  
Low And Middle Income

SummaryCatastrophic spending on health care through out-of-pocket payment is a huge problem in most low- and middle-income countries all over the world. The collapse of health systems and poverty have resulted in the proliferation of the private health sector in Cambodia, but very few studies have examined the fairness in ease of utilization of these services based on mode of payment. This study examined the utilization of health services for sickness or injury and identified its relationship with people's ability to pay for treatment seeking at various instances. Based on cross-sectional data from the Cambodian 2007 Demographic and Health Survey, the economic index estimated through principal component analysis and Lorenz curve was used to quantify the degree of fairness and equality in utilization and payment burden among the respondents. A distinct level of fairness was found in health care utilization and out-of-pocket payments. Specifically, use of private health care facilities and over-the-counter remedies dominate, and out-of-pocket payments cut across all socioeconomic strata. As many countries in low- and middle-income regions, and most importantly those in transition such as Cambodia, are repositioning their health systems, efforts should be made towards maintaining equitable access through adoption of finance mechanisms that make utilization of health care services fair and equitable.

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