Framework of Indian Healthcare System and Its Challenges

2018 ◽  
pp. 405-429
Author(s):  
Prashant Mehta
Keyword(s):  
Healthcare System ◽  
Healthcare Delivery ◽  
Policy Framework ◽  
Public Healthcare ◽  
System State ◽  
Service Delivery System ◽  
Law And Policy ◽  
Healthcare Reforms ◽  
Lifestyle Diseases ◽  
Populous Country

India, one of the oldest civilizations and second most populous country is ethnically, linguistically, geographically, religious, and demographically diverse is poorly ranked due to complex public healthcare system, which suffers from insufficient funding, poor management. Poor health intertwined with poverty, affordability, accessibility, burden of infectious and non-communicable affecting lives of most Indians. Healthcare ecosystems are complex and still evolving, investments in service delivery system, infrastructure, and technology, are still being experimented and explored. India's booming population; increasing purchasing power; rising awareness of personal health and hygiene; and significant growth in infectious, chronic degenerative, and lifestyle diseases are driving the growing market. In this chapter we will explore accessible and affordable healthcare system, state of public healthcare, healthcare reforms, governance (Constitutional Provisions, Law, and Policy framework) in healthcare delivery, and Opportunity offered by market drivers.

Framework of Indian Healthcare System and its Challenges

2017 ◽  
pp. 247-271 ◽  
Author(s):  
Prashant Mehta
Keyword(s):  
Healthcare System ◽  
Healthcare Delivery ◽  
Policy Framework ◽  
Public Healthcare ◽  
System State ◽  
Service Delivery System ◽  
Law And Policy ◽  
Healthcare Reforms ◽  
Lifestyle Diseases ◽  
Populous Country

India, one of the oldest civilizations and second most populous country is ethnically, linguistically, geographically, religious, and demographically diverse is poorly ranked due to complex public healthcare system, which suffers from insufficient funding, poor management. Poor health intertwined with poverty, affordability, accessibility, burden of infectious and non-communicable affecting lives of most Indians. Healthcare ecosystems are complex and still evolving, investments in service delivery system, infrastructure, and technology, are still being experimented and explored. India's booming population; increasing purchasing power; rising awareness of personal health and hygiene; and significant growth in infectious, chronic degenerative, and lifestyle diseases are driving the growing market. In this chapter we will explore accessible and affordable healthcare system, state of public healthcare, healthcare reforms, governance (Constitutional Provisions, Law, and Policy framework) in healthcare delivery, and Opportunity offered by market drivers.

scholarly journals Tracking aspects of healthcare activity during the first nine months of COVID-19 in Ireland: a secondary analysis of publicly available data

2021 ◽  
Vol 4 ◽  
pp. 98
Author(s):  
Domhnall McGlacken-Byrne ◽  
Sarah Parker ◽  
Sara Burke
Keyword(s):  
Healthcare System ◽  
Healthcare Access ◽  
Healthcare Delivery ◽  
Secondary Analysis ◽  
Public Healthcare ◽  
Language Therapy ◽  
Care Community ◽  
Universal Healthcare ◽  
Allied Healthcare ◽  
The Impact

Background: Sláintecare aims to introduce universal healthcare in Ireland. The COVID-19 pandemic poses both challenges and opportunities to this process. This study explored the impact of COVID-19 on aspects of Irish healthcare during the first nine months of the pandemic and considers the implications for Sláintecare implementation. Methods: Secondary analysis was undertaken on publicly available data on three key domains of the Irish healthcare system: primary care, community-based allied healthcare, and hospitals. Descriptive statistics were computed using Microsoft Excel 2016. Results: Up to March 2021, 3.76 million COVID-19 tests were performed by Ireland’s public healthcare system, 2.48 million (66.0%) of which were referred from the community. General practitioners delivered 2.31 million telephone triages of COVID-19 symptoms, peaking in December 2020 when 416,607 consultations occurred. Patient numbers across eight allied healthcare specialties fell by 35.1% versus previous years, with the greatest reductions seen in speech and language therapy (49.0%) and audiology (46.1%). Hospital waiting lists increased from 729,937 to 869,676 (or by 19.1%) from January 2019 to January 2021. In January 2021, 629,919 patients awaited a first outpatient clinic appointment, with 170,983 (27.1%) waiting longer than 18 months. The largest outpatient lists were observed in orthopaedic surgery (n=77,257); ear, nose and throat surgery (n=68,073); and ophthalmology (n=47,075). The proportion of patients waiting more than 12 months for a day-case gastrointestinal endoscopy rose from 6.0% in January 2020 to 19.0% in January 2021. Conclusions: Healthcare activity has been significantly disrupted by COVID-19, leading to increased wait times and greater barriers to healthcare access during the pandemic. Yet, Ireland’s health system responses also revealed strong willingness and ability to adapt and to implement novel solutions for healthcare delivery, rapidly and at scale. This has demonstrated what is achievable under Sláintecare and provides a unique opportunity to ‘build back better’ towards sustainable recovery.

scholarly journals Diagnostic Radiology in Nigeria: A Country Report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Bukunmi Michael Idowu ◽  
Tolulope Adebayo Okedere
Keyword(s):  
Healthcare System ◽  
Healthcare Delivery ◽  
Diagnostic Radiology ◽  
Public Healthcare ◽  
Country Report ◽  
Public And Private ◽  
Healthcare Facilities ◽  
Adequate Funding ◽  
Radiology Training ◽  
Wide Range

Nigeria is located in West Africa. The Nigerian healthcare system is stratified into three tiers corresponding to the three tiers of government: primary (local), secondary (state), and tertiary (federal). In addition to this public health structure, private facilities play a significant role in healthcare delivery. Nigeria has a shortage of healthcare equipment and personnel, with a doctor per 1,000 population ratio of 0.17, which is one of the lowest on the African continent. Despite these challenges, a wide range of medical imaging services is available in the country, through a network of public and private facilities. The public healthcare system, which serves the majority of Nigerians, is weak due to lack of adequate funding, personnel and equipment. This gap is closely bridged by private healthcare facilities, which account for 70% of health services coverage in the country. Training in diagnostic radiology is evolving, with two postgraduate colleges being responsible for the regulation of radiology training in the country: the National Postgraduate Medical College of Nigeria and the West African College of Surgeons. There are also higher institutions of learning which are responsible for the training of other imaging professionals. The major challenges of radiology practice in Nigeria are the unavailability of constant electricity as well as the problems of equipment availability and repair.

Knowledge and Communication of the National Core Standards Tool

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Winnie Thembisile Maphumulo ◽  
Busisiwe Bhengu
Keyword(s):  
Pearson Correlation ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Sampling Technique ◽  
Quality Of Healthcare ◽  
Survey Study ◽  
Public Healthcare ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Professional Nurses

The National Department of Health in South Africa has introduced the National Core Standards (NCS) tool to improve the quality of healthcare delivery in all public healthcare institutions. Knowledge of the NCS tool is essential among healthcare providers. This study investigated the level of knowledge on NCS and how the NCS tool was communicated among professional nurses. This was a cross-sectional survey study. Purposive sampling technique was used to select hospitals that only offered tertiary services in KwaZulu-Natal. Six strata of departments were selected using simple stratified sampling. The population of professional nurses in the selected hospitals was 3 050. Systematic random sampling was used to recruit 543 participants. The collected data were analysed using SPSS version 25. The study showed that only 16 (3.7%) respondents had knowledge about NCS, using McDonald’s standard of learning outcome measured criteria regarding the NCS tool. The Pearson correlation coefficient between the communication and knowledge was r = 0.055. The results revealed that although the communication scores for the respondents were high their knowledge scores remained low. This study concluded that there is a lack of knowledge regarding the NCS tool and therefore healthcare institutions need to commit themselves to the training of professional nurses regarding the NCS tool. The findings suggest that healthcare institutions implement the allocation of incentives for nurses that attend the workshops for NCS.

PP329 An Australian Cost-Effectiveness Analysis Of The EluviaTM Drug-Eluting Stent For Treatment Of Symptomatic Lower-Limb Peripheral Artery Disease

2020 ◽  
Vol 36 (S1) ◽  
pp. 28-29
Author(s):  
William A. Gray ◽  
Thathya V. Ariyaratne ◽  
Robert I. Griffiths ◽  
Peter W.M. Elroy ◽  
Stacey L. Amorosi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Healthcare System ◽  
Lower Limb ◽  
Sensitivity Analyses ◽  
Public Healthcare ◽  
System Perspective ◽  
Healthcare System Perspective ◽  
Drug Eluting ◽  
Zilver Ptx ◽  
Cost Parameters

IntroductionDespite advances in endovascular interventions, including the introduction of drug-eluting stents (DES), high target lesion revascularization (TLR) rates still burden the treatment of symptomatic lower-limb peripheral arterial disease (PAD). EluviaTM, a novel, sustained-release, paclitaxel-eluting DES, was shown to further reduce TLRs when compared with the paclitaxel-coated Zilver® PTX® stent, in the IMPERIAL randomized controlled trial. This evaluation estimated the cost-effectiveness of Eluvia when compared with Zilver PTX in Australia, based on 12-month clinical outcomes from the IMPERIAL trial.MethodsA state-transition, decision-analytic model with a 12-month time horizon was developed from an Australian public healthcare system perspective. Cost parameters were obtained from the Australian National Hospital Cost Data Collection Cost Report (2016–17). All costs were captured in Australian dollars (AUD), where AUD 1 = USD 0.69 (June 2020). Complete sets of clinical parameters (primary patency loss, TLR, amputation, and death) and cost parameters from their respective distributions were bootstrapped in samples of 1,000 patients, for each intervention arm of the model. One-way and probabilistic sensitivity analyses were performed.ResultsAt 12 months, modeled TLR rates were 4.5 percent for Eluvia and 8.9 percent for Zilver PTX, and mean total direct costs were AUD 6,537 [USD 4,511] and AUD 6,908 [USD 4,767], respectively (Eluvia average per patient savings; overall cohort=AUD 371 [USD 256]; diabetic cohort=AUD 625 [USD 431]). In probabilistic sensitivity analyses, Eluvia was cost-effective relative to Zilver PTX in 92.0 percent of all simulations at a threshold of $10,000 per TLR avoided. Eluvia was more effective and less costly (dominant) than Zilver PTX in 76.0 percent of simulations.ConclusionsIn the first year after the intervention, Eluvia was more effective and less costly than Zilver PTX, making Eluvia the dominant treatment strategy for treatment of symptomatic lower-limb PAD, from an Australian public healthcare system perspective. These findings should be considered when formulating policy and practice guidelines in the context of priority setting and making evidence-based resource allocation decisions for treatment of PAD in Australia.

scholarly journals Network governance forms in healthcare: empirical evidence from two Italian cancer networks

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Romiti ◽  
Mario Del Vecchio ◽  
Gino Sartor
Keyword(s):  
Healthcare System ◽  
Governance Structure ◽  
Network Governance ◽  
Public Healthcare ◽  
Structured Interviews ◽  
General Validity ◽  
Regional Administration ◽  
Trade Offs ◽  
Italian Regions ◽  
Cancer Networks

Abstract Background This study focuses on the application of Provan and Kenis’ modes of network governance to the specific field of public healthcare networks, extending the framework to an analysis of systems in which networks are involved. Thus, the aim of this study is to analyze and compare the governance of two cancer networks in two Italian regions that underwent system reconfiguration processes due to reforms in the healthcare system. Methods A qualitative study of two clinical networks in the Italian healthcare system was conducted. The sample for interviews included representatives of the regional administration (n = 4), network coordinators (n = 6), and general and clinical directors of health organizations involved in the two networks (n = 25). Data were collected using semi-structured interviews. Results Our study shows that healthcare system reforms have a limited impact on network governance structures. In fact, strong inertial tendencies characterize networks, especially network administrative organization models (NAO). Networks tend to find their own balance with respect to the trade-offs analyzed using a mix of formal and informal ties. Our study confirms the general validity of Provan and Kenis’ framework and shows how other specific factors and contingencies may affect the possibility that cancer networks find positive equilibria between competing needs of inclusivity and efficiency, internal and external legitimacy, and stability and flexibility. It also shows how networks react to external changes. Conclusions Our study shows the importance of considering three factors and contingencies that may affect network effectiveness: a) the importance of looking at network governance modes not in isolation, but in relationship to the governance of regional systems; b) the influence of a specific network’s governance structure on the network’s ability to respond to tensions and to achieve its goals; and c) the need to take into account the role of professionals in network governance.

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