scholarly journals The Equity of Health Care Spending in South Korea: Testing the Impact of Publicness

Author(s):  
Youngju Kang ◽  
Minyoung Kim ◽  
Kwangho Jung

This paper examined the important organizational and managerial factors of publicness for the equity of health care. The extent of organizational publicness was measured with key independent variables such as ownership, evaluation, and accreditation. The dependent variable was measured by three equity indicators for patients under medical care and veterans care: financial inequity, social equity, and overall equity. We analyzed unbalanced panel data with 328 general hospitals between 2008 and 2012. We performed panel analysis with fixed and random effects. Our findings illustrate that government ownership is significantly associated with differences in equity indicators. Government owned hospitals show the better performance for equity than nonprofit and individually owned hospitals do. Compared to nonprofit and individually owned hospitals, government owned hospitals have a higher share of medical payment bills and health care spending for the disadvantaged but a lower proportion of out-of-pocket payment. Government evaluation is also significantly related to better equity performance. There are, however, significantly negative interactions between hospital government ownership and the size of medical payment bills. We found a significant tendency that the more medical payments, the less responsiveness to the equity of health care in government owned hospitals. Future research in hospital performance is required to consider not only sectoral differences but also the negative proclivity of public hospitals that shrink health care services for the poor. Further research is also expected to explore what sectoral identities and behaviors across public, nonprofit, and private hospitals influence the level of equity or inequity in health care.

2018 ◽  
Vol 31 (1) ◽  
pp. 55-69
Author(s):  
Cynthia Sterling-Fox

Globally, the number of homebound older adults is rising exponentially as the aging population increases. Homebound older adults have complex medical and psychological issues for which many receive home-based primary care services. The purpose of this integrative review was to identify, analyze, and synthesize the existing literature regarding homebound older adults’ need for, use of, and access to five nonprimary health care services. They are dental, nutritional, optical, pharmacy, and psychological services. The integrative review was conducted using a database search of CINAHL, Health Source: Nursing Education, PubMed, Medline, PsycINFO, and Cochrane, that was supplemented by a hand search. Little research was found addressing the five nonprimary health care services. Five themes emerged from the 10 studies. They were (1) complex and interrelated health problems require more health care services; (2) perceived unimportance of nonprimary health care services; (3) barriers to use of and access to nonprimary health care services; (4) the impact of socioeconomic and demographical factors on access to services; and (5) the impact of psychological factors (depression and social isolation) on the use and access to health care services. These findings suggest further inequity and barriers to health care services by homebound older adults. Future research is needed with nonprimary health care providers to examine the clinical outcomes and costs of providing the services to homebound older adults.


Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 670
Author(s):  
Younhee Kim ◽  
Keon-Hyung Lee ◽  
Sung W. Choi

As health care costs and demands for health care services have been rising for decades in the United States, health care reforms have focused on increasing the performance of health care delivery. Competition has been considered as a mechanism to improve the quality of health care services and operational performance. Evidence on health care performance and market competition, however, has not sufficiently been reported to track its progress. The purpose of this study is twofold: First, we measure hospital performance over nine years, using the Malmquist Productivity Index. Second, we examine the impact of market competition on hospital efficiency in Pennsylvania, using a two-stage estimation procedure. The bootstrapped Malmquist productivity indices resulted in noticeable performance improvements. However, no steady performance trends were found during the course of nine years. In examining the impact of market competition, the bootstrapped panel Tobit analysis was applied after computing the efficiency scores with Data Envelopment Analysis. The results of the Tobit model found that hospitals run more efficiently in less competitive regions than in more competitive regions. The finding implies that hospitals underperforming in productivity growth should benchmark best practices of efficient hospitals to improve their productivity level. Another implication is that market competition would not be the best approach to effect the improvement of hospital efficiency in delivering health care services.


2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Turkan Ahmet

The past few decades of ongoing war in Iraq has had a dramatic impact on the health of Iraq’s population. Wars are known to have negative effects on the social and physical environments of individuals, as well as limit their access to the available health care services. This paper explores the personal experiences of my family members, who were exposed to war, as well as includes information that has been reviewed form many academic sources. The data aided in providing recommendations and developing strategies, on both local and international levels, to improve the health status of the populations exposed to war.


Author(s):  
Vijay K. Yalanchmanchili ◽  
N. Partha Sarathy ◽  
U. Vijaya Kumar ◽  
M. Ravi Kiran ◽  
Kalapala Abhilash

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 528
Author(s):  
Cristian Lieneck ◽  
Brooke Herzog ◽  
Raven Krips

The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues.


2021 ◽  
Vol 3 (2) ◽  
pp. 444-453
Author(s):  
Arturo Cervantes Trejo ◽  
Sophie Domenge Treuille ◽  
Isaac Castañeda Alcántara

AbstractThe Institute for Security and Social Services for State Workers (ISSSTE) is a large public provider of health care services that serve around 13.2 million Mexican government workers and their families. To attain process efficiencies, cost reductions, and improvement of the quality of diagnostic and imaging services, ISSSTE was set out in 2019 to create a digital filmless medical image and report management system. A large-scale clinical information system (CIS), including radiology information system (RIS), picture archiving and communication system (PACS), and clinical data warehouse (CDW) components, was implemented at ISSSTE’s network of forty secondary- and tertiary-level public hospitals, applying global HL-7 and Digital Imaging and Communications in Medicine (DICOM) standards. In just 5 months, 40 hospitals had their endoscopy, radiology, and pathology services functionally interconnected within a national CIS and RIS/PACS on secure private local area networks (LANs) and a secure national wide area network (WAN). More than 2 million yearly studies and reports are now in digital form in a CDW, securely stored and always available. Benefits include increased productivity, reduced turnaround times, reduced need for duplicate exams, and reduced costs. Functional IT solutions allow ISSSTE hospitals to leave behind the use of radiographic film and printed medical reports with important cost reductions, as well as social and environmental impacts, leading to direct improvement in the quality of health care services rendered.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mohammed Aboramadan ◽  
Main Naser Alolayyan ◽  
Mehmet Ali Turkmenoglu ◽  
Berat Cicek ◽  
Caterina Farao

Purpose This paper aims to propose a model of the effect of both authentic leadership and management capability on hospital performance. This model proposes work engagement as an intervening mechanism between the aforesaid links. Design/methodology/approach Data were collected from 380 medical staff working in Jordanian Public hospitals and were analysed using the structural equation modelling analysis technique. Findings The results suggest that both authentic leadership and management capability have a positive effect on hospital performance. Although positive, the direct effect of management capability on performance was not significant. Furthermore, work engagement demonstrated to play a full mediation effect between management capability and hospital performance and a partial mediation effect between authentic leadership and hospital performance. Practical implications This study may be of use for public medical services providers in general and other services sectors in terms of the role authentic leadership and management resources can play in contributing to positive work-related outcomes at the individual and organisational levels. Originality/value Considering the mainstream literature in health-care management, to the best of the authors’ knowledge, this is the first study to date to integrate the impact of both authentic leadership and management capabilities in the public health-care sector. Further, the research model has not previously been introduced when taking into account the role that work engagement can play between the examined variables.


2010 ◽  
Vol 16 (6) ◽  
pp. 274-284 ◽  
Author(s):  
Tanya Connell ◽  
Ritin S Fernandez ◽  
Rhonda Griffiths ◽  
Duong Tran ◽  
Meera Agar ◽  
...  

2018 ◽  
Vol 33 (6) ◽  
pp. 607-613
Author(s):  
Mehmet Ali Ceyhan ◽  
Gültekin Günhan Demir ◽  
Gamze Babur Güler

AbstractBackgroundPolitical parties in Turkey execute political public meetings (PPMs) during their election campaign for members of the parliament (MoP). A great number of people attend these meetings. No guidelines exist regarding preparation and organization of health care services provided during these meetings. Furthermore, there is no study evaluating health care problems encountered in previous PPMs.ObjectivePolitical parties arranged PPMs in 2015 during the election campaign for general election of MoP. The present study aimed to investigate the context of health care services, the distribution of assigned health staff, as well as the number and the symptoms of patients admitted in health care tents in these PPMs.MethodsTwo general elections for MoP were done in Turkey on June 7, 2015 and November 1, 2015. Health care services were provided by the City Emergency Medical Services Department (CEMSD) in the cities. Demographic characteristics, symptoms, comorbid conditions, treatment, discharge, and hospital transfer of the patients were obtained from patient medical registration records. Information about the distribution and the number of the assigned staff was received from local CEMSDs. The impact of variables such as the number of attendees, heat index, humidity, and the day of the week on the number of patients and the patient presentation rate (PPR) were analyzed.ResultsA total of 97 PPMs were analyzed. The number of total attendees was 5,265,450 people. The number of patients seeking medical help was 1,991. The PPR was 0.5 (0.23-0.91) patients per 1,000 attendees. Mean age of the patients was 40 (SD=19) years old while 1,174 (58.9%) of the patients were female. A total of 1,579 patients were treated in the tents and returned to the PPM following treatment. Two-hundred and three patients were transferred to a hospital by ambulance. Transfer-to-hospital ratio (TTHR) was 0.05 (0.0-0.13) patients per 1,000 attendees. None of the patients suffered sudden cardiac death (SCD) or cardiac arrest. Medical conditions were the main cause for admission. The most common symptoms were dizziness, low blood pressure, fatigue, and hypertension, respectively. The most commonly used medical agents included pain killers and myorelaxants. The number of attendees, heat index, and weekend days were positively correlated with the number of the patients.Conclusion: The majority of medical conditions encountered in PPMs are easily treatable in health care tents settled in the meeting area. The number of attendees, heat index, and weekend days are factors associated with the number of patients.CeyhanMA, DemirGG, GülerGB. Evaluation of health care services provided in political public meetings in Turkey: a forgotten detail in politics. Prehosp Disaster Med. 2018;33(6):607–613.


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