Public and Private Healthcare in Slovenia in Relation to Choice and Accessibility of Services

2013 ◽  
Vol 3 (3) ◽  
pp. 1-14 ◽  
Author(s):  
Matic Kavčič ◽  
Majda Pahor
Keyword(s):  
Public Sector ◽  
Evolutionary Process ◽  
Secondary Data ◽  
Healthcare Services ◽  
Background Information ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Public And Private ◽  
The Public ◽  
Private Healthcare

This article starts with background information on the Slovenian healthcare system and the description of the evolutionary process and privatisation reforms that bring a mix of public and private healthcare services. The authors' aim is to conceptualise existing modes of public and private healthcare provision and discuss possible implications for user choice and accessibility of services. A descriptive and exploratory case study approach was employed. Literature and document analysis was complemented by secondary data and semi-structured interviews. The results demonstrate four modes of healthcare services in relation to public-private delivery. The ‘public non-profit' type refers to publicly financed and delivered services. The ‘private within public' type addresses services provided within and by the public sector for patients who pay out-of-pocket. The ‘private for public' type deals with services provided by private entities with concessions. The ‘private for-profit' type refers to completely private provision (without concession) of self-pay services. The strengths and weaknesses of each mode with respect to choice, space-time accessibility, financial accessibility and quality of services are critically discussed. The results of the study show that private healthcare services significantly complement and compete with public sector. In addition, there is a risk that uncontrolled mixing of public and private modes of practice may bring about unethical behaviour and corruption.

scholarly journals Long-term effectiveness of elderly health care voucher scheme strategies: a system dynamics simulation analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ka Chun Chong ◽  
Hong Fung ◽  
Carrie Ho Kwan Yam ◽  
Patsy Yuen Kwan Chau ◽  
Tsz Yu Chow ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Public Sector ◽  
System Dynamics ◽  
The Elderly ◽  
Healthcare Services ◽  
Dynamics Simulation ◽  
Public And Private ◽  
The Public ◽  
The Impact

Abstract Background The elderly healthcare voucher (EHCV) scheme is expected to lead to an increase in the number of elderly people selecting private primary healthcare services and reduce reliance on the public sector in Hong Kong. However, studies thus far have reported that this scheme has not received satisfactory responses. In this study, we examined changes in the ratio of visits between public and private doctors in primary care (to measure reliance on the public sector) for different strategic scenarios in the EHCV scheme. Methods Based on comments from an expert panel, a system dynamics model was formulated to simulate the impact of various enhanced strategies in the scheme: increasing voucher amounts, lowering the age eligibility, and designating vouchers for chronic conditions follow-up. Data and statistics for the model calibration were collected from various sources. Results The simulation results show that the current EHCV scheme is unable to reduce the utilization of public healthcare services, as well as the ratio of visits between public and private primary care among the local aging population. When comparing three different tested scenarios, even if the increase in the annual voucher amount could be maintained at the current pace or the age eligibility can be lowered to include those aged 60 years, the impact on shifts from public-to-private utilization were insignificant. The public-to-private ratio could only be marginally reduced from 0.74 to 0.64 in the first several years. Nevertheless, introducing a chronic disease-oriented voucher could result in a significant drop of 0.50 in the public-to-private ratio during the early implementation phase. However, the effect could not be maintained for an extended period. Conclusions Our findings will assist officials in improving the design of the EHCV scheme, within the wider context of promoting primary care among the elderly. We suggest that an additional chronic disease-oriented voucher can serve as an alternative strategy. The scheme must be redesigned to address more specific objectives or provide a separate voucher that promotes under-utilized healthcare services (e.g., preventive care), instead of services designed for unspecified reasons, which may lead to concerns regarding exploitation.

scholarly journals EMPIRICAL ASSESSMENT OF PUBLIC SECTOR REFORM IN NIGERIA: A TREND ANALYSIS BETWEEN 2000 AND 2015

2021 ◽  
pp. 1-13
Author(s):  
Vincent ONODUGO ◽  
Ifeoma NWAKOBY ◽  
Grace OFOEGBU ◽  
Obiamaka EGBO ◽  
Chinwe OKOYEUZU
Keyword(s):  
Public Sector ◽  
Public Service ◽  
Human Resources Management ◽  
Secondary Data ◽  
Civil Servants ◽  
Primary Data ◽  
Public And Private ◽  
Retirement Benefits ◽  
The Public ◽  
The Impact

This study assessed the impact of public sector reforms programmes on the human resources management and civil service of the Nigerian public service. Data for the study were mainly secondary data complemented with primary data collected from stakeholders in the public service that have experienced various reforms in their career. Findings suggest that the impact of reforms on HRM and CSR were largely marginal. The positives of the reforms are mainly in the areas of improvement in salaries and functionality of pension and retirement benefits by making it contributory. These improvements in emoluments narrowed the incentives between public and private sectors and tend to attract skilled hands to the public sector that otherwise would not have been the case. However, all other policy initiatives that were aimed at ensuring effective and efficient use of scarce resources, transparency and accountability by civil servants, incentives and promotion by merit and value for money were at various stages of policy reversal, delayed implementation, and outright abandonment by compromising civil servants that selectively implement only those reforms that suits and benefits their interests. Further, successive regimes after that of former President Olusegun Obasanjo (1999-2007) who initiated most of the reforms, did not have or could not provide enough political will to sustain the benefits and the tempo of these reforms.

scholarly journals Access to healthcare for children with Congenital Zika Syndrome in Brazil: perspectives of mothers and health professionals

2019 ◽  
Vol 34 (7) ◽  
pp. 499-507 ◽  
Author(s):  
Maria S V Albuquerque ◽  
Tereza M Lyra ◽  
Ana P L Melo ◽  
Sandra A Valongueiro ◽  
Thalia V B Araújo ◽  
...  
Keyword(s):  
Health System ◽  
Health Professionals ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Public Healthcare ◽  
Gender Inequalities ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
The Public ◽  
Congenital Zika Syndrome

Abstract The Congenital Zika Syndrome (CZS) epidemic took place in Brazil between 2015 and 2017 and led to the emergence of at least 3194 children born with CZS. We explored access to healthcare services and activities in the Unified Health Service (Sistema Único de Saúde: SUS) from the perspective of mothers of children with CZS and professionals in the Public Healthcare Network. We carried out a qualitative, exploratory study, using semi-structured interviews, in two Brazilian states—Pernambuco, which was the epicentre of the epidemic in Brazil, and Rio de Janeiro, where the epidemic was less intense. The mothers and health professionals reported that healthcare provision was insufficient and fragmented and there were problems with follow-up care. There was a lack of co-ordination and an absence of communication between the various specialized services and between different levels of the health system. We also noted a public–private mixture in access to healthcare services, resulting from a segmented system and related to inequality of access. High reported household expenditure is an expression of the phenomenon of underfunding of the public system. The challenges that mothers and health professionals reported exposes contradictions in the health system which, although universal, does not guarantee equitable and comprehensive care. Other gaps were revealed through the outbreak. The epidemic provided visibility regarding difficulties of access for other children with disabilities determined by other causes. It also made explicit the gender inequalities that had an impact on the lives of mothers and other female caregivers, as well as an absence of the provision of care for these groups. In the face of an epidemic, the Brazilian State reproduced old fashioned forms of action—activities related to the transmitting mosquito and to prevention with an emphasis on the individual and no action related to social determinants.

scholarly journals Long Term Effectiveness of Elderly Health Care Voucher Scheme Strategies: A System Dynamics Simulation Analysis

2020 ◽  
Author(s):  
Ka Chun Chong ◽  
Hong Fung ◽  
Carrie Yam ◽  
Patsy Chau ◽  
Tsz Yu Chow ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Public Sector ◽  
System Dynamics ◽  
The Elderly ◽  
Healthcare Services ◽  
Dynamics Simulation ◽  
Public And Private ◽  
The Public

Abstract Background: The elderly healthcare voucher (EHCV) scheme is expected to increase the number of elders choosing private primary healthcare services and, on the other hand, to reduce reliance on the public sector in Hong Kong. Unfortunately, the scheme was not satisfactorily as reported in the literature to date. In this study, we examined the changes in the ratio of visits between public and private doctors in primary care (as a metric of reliance on the public sector) for different strategic scenarios in the scheme.Methods: Based on the comments from the expertise discussion, a system dynamics model was formulated to simulate the impact of different enhanced strategy in the scheme: Increasing voucher amounts, lowering the age eligibility, and designating vouchers for chronic conditions follow-up. Data and statistics for model calibration were collected from different sources.Results: The simulation results showed that the current EHCV scheme was unable to reduce the utilization of public healthcare services as well as the ratio of visits between public and private when the local population aging was taken into account. When comparing the 3 different tested scenarios, even if the increase of annual voucher amount could be kept with a current pace or the age eligibility could be lowered to 60 years old, the impacts on the shifts from public to private utilization were not apparent in which the public-to-private ratio could only drop slightly from 0.74 to 0.64 in the first several years. Nevertheless, introducing a chronic disease-oriented voucher could result in an apparent drop of public-to-private ratio to 0.50 in the early implementation phase but the effect could not be maintained for a period of time. Conclusions: Our findings assist officials to further improve the design of EHCV scheme, within the bigger context of promoting primary care among the elderly. We suggested an additional chronic disease-oriented voucher could be an alternative strategy but the enhancement on the voucher amount should be considered if a long term planning was required. For not substantially rising the government expenditure for refining the scheme, health promotion works for encouraging co-payment from elderly for is recommended.

scholarly journals Differential diffusion of pharmaceutical innovations in a mixed market middle - income economy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nurhafiza Md Hamzah ◽  
Kok Fong See
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Anatomical Therapeutic Chemical ◽  
Market Concentration ◽  
Defined Daily Dose ◽  
Public And Private ◽  
Negatively Associated ◽  
The Public ◽  
Healthcare Market ◽  
Private Healthcare

Abstract Background Policymakers are faced with the challenge of balancing patient’s access for effective and affordable medicines to sustain the rising healthcare costs. In a mixed healthcare market such as Malaysia, coverage decisions of new medicines are different: public funded health system has a formulary listing process whereas for private sector, which is a market-based economy, depends on patient’s willingness to pay and insurance coverage. There is little overlap between public and private healthcare service delivery with access to new innovative medicines, as differentiated by sources of funding. The objectives of this study were to examine the diffusion of New Chemical Entities (NCEs) into the public and private healthcare market between 2010 and 2014, and determine the factors explaining the diffusion. Methods We matched medicines from the product registration database by medicine formulation to medicines in IQVIA National Pharmaceutical Audit database for each year. The price per Defined Daily Dose (DDD), market concentration and generic utilization share variables were calculated. A panel fixed effect model was performed to measure diffusion of NCEs for each year and test possible determinants of diffusion of NCEs for overall market and sector specifics. Results The utilization of NCEs was larger in the private sector compared to the public sector but the speed of diffusion over time was higher in the public sector. Price per DDD was negatively associated with diffusion of NCEs, while generic utilization share was significantly regressive in the public sector. Market concentration was negatively associated with utilization of NCEs, however result tends to be mixed according to sector and Anatomical Therapeutic Chemical (ATC) category. Conclusions Understanding key aspects of sectoral variation in diffusion of NCEs are crucial to reduce the differences of access to new medicines within a country and ensure resources are used on cost effective treatments.

scholarly journals Empirical Assessment of Public Sector Reform in Nigeria: A Trend Analysis between 2000 and 2015

2020 ◽  
pp. 205-210
Author(s):  
Onodugo Vincent Aghaegbunam ◽  
Nwakoby Ifeoma ◽  
Ofoegbu Grace N. ◽  
Egbo Obiamaka P. ◽  
Okoyeuzu Chinwe
Keyword(s):  
Public Sector ◽  
Public Service ◽  
Human Resources Management ◽  
Secondary Data ◽  
Civil Servants ◽  
Primary Data ◽  
Public And Private ◽  
Retirement Benefits ◽  
The Public ◽  
The Impact

This study assessed the impact of public sector reforms programmes on the human resources management and civil service of the Nigerian public service. Data for the study were mainly secondary data complemented with primary data collected from stakeholders in the public service that have experienced various reforms in their career. Findings suggest that the impact of reforms on HRM and CSR were largely marginal. The positives of the reforms are mainly in the areas of improvement in salaries and functionality of pension and retirement benefits by making it contributory. These improvements in emoluments narrowed the incentives between public and private sectors and tend to attract skilled hands to the public sector that otherwise would not have been the case. However, all other policy initiatives that were aimed at ensuring effective and efficient use of scarce resources, transparency and accountability by civil servants, incentives and promotion by merit and value for money were at various stages of policy reversal, delayed implementation, and outright abandonment by compromising civil servants that selectively implement only those reforms that suits and benefits their interests. Further, successive regimes after that of former President Olusegun Obasanjo (1999-2007) who initiated most of the reforms, did not have or could not provide enough political will to sustain the benefits and the tempo of these reforms.

Corrupt Practices in the Public Health Sector: A Focus on Metropolitan Local Government Areas of Kano State, Nigeria

2020 ◽  
Vol 18 (2) ◽  
pp. 149
Author(s):  
Mohammed Mustapha Namadi
Keyword(s):  
Public Health ◽  
Local Government ◽  
Health Sector ◽  
Sampling Technique ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Healthcare Provision ◽  
The Public ◽  
Public Health Sector ◽  
The Government

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.

Relationship between CSR motivations and corporate social performance: a study in the power industry in India

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Moumita Acharyya ◽  
Tanuja Agarwala
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Corporate Social Performance ◽  
Social Performance ◽  
Power Sector ◽  
Public And Private ◽  
Content Type ◽  
The Public ◽  
Self Interest ◽  
Public And Private Sector

PurposeThe paper aims to understand the different motivations / reasons for engaging in CSR initiatives by the organizations. In addition, the study also examines the relationship between CSR motivations and corporate social performance (CSP).Design/methodology/approachThe data were collected from two power sector organizations: one was a private sector firm and the other was a public sector firm. A comparative analysis of the variables with respect to private and public sector organizations was conducted. A questionnaire survey was administered among 370 employees working in the power sector, with 199 executives from public sector and 171 from private sector.Findings“Philanthropic” motivation emerged as the most dominant CSR motivation among both the public and private sector firms. The private sector firm was found to be significantly higher with respect to “philanthropic”, “enlightened self-interest” and “normative” CSR motivations when compared with the public sector firms. Findings suggest that public and private sector firms differed significantly on four CSR motivations, namely, “philanthropic”, “enlightened self-interest”, “normative” and “coercive”. The CSP score was significantly different among the two power sector firms of public and private sectors. The private sector firm had a higher CSP level than the public sector undertaking.Research limitations/implicationsFurther studies in the domain need to address differences in CSR motivations and CSP across other sectors to understand the role of industry characteristics in influencing social development targets of organizations. Research also needs to focus on demonstrating the relationship between CSP and financial performance of the firms. Further, the HR outcomes of CSR initiatives and measurement of CSP indicators, such as attracting and retaining talent, employee commitment and organizational climate factors, need to be assessed.Originality/valueThe social issues are now directly linked with the business model to ensure consistency and community development. The results reveal a need for “enlightened self-interest” which is the second dominant CSR motivation among the organizations. The study makes a novel contribution by determining that competitive and coercive motivations are not functional as part of organizational CSR strategy. CSR can never be forced as the very idea is to do social good. Eventually, the CSR approach demands a commitment from within. The organizations need to emphasize more voluntary engagement of employees and go beyond statutory requirements for realizing the true CSR benefits.

scholarly journals Public and private sectors collective response to combat COVID-19 in Malaysia

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ching Siang Tan ◽  
Saim Lokman ◽  
Yao Rao ◽  
Szu Hua Kok ◽  
Long Chiau Ming
Keyword(s):  
Insurance Coverage ◽  
Healthcare Providers ◽  
Screening Tests ◽  
Public Healthcare ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public ◽  
Private Healthcare ◽  
Care Services ◽  
Challenges And Opportunities

AbstractOver the last year, the dangerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly around the world. Malaysia has not been excluded from this COVID-19 pandemic. The resurgence of COVID-19 cases has overwhelmed the public healthcare system and overloaded the healthcare resources. Ministry of Health (MOH) Malaysia has adopted an Emergency Ordinance (EO) to instruct private hospitals to receive both COVID-19 and non-COVID-19 patients to reduce the strain on public facilities. The treatment of COVID-19 patients at private hospitals could help to boost the bed and critical care occupancy. However, with the absence of insurance coverage because COVID-19 is categorised as pandemic-related diseases, there are some challenges and opportunities posed by the treatment fees management. Another major issue in the collaboration between public and private hospitals is the willingness of private medical consultants to participate in the management of COVID-19 patients, because medical consultants in private hospitals in Malaysia are not hospital employees, but what are termed “private contractors” who provide patient care services to the hospitals. Other collaborative measures with private healthcare providers, e.g. tele-conferencing by private medical clinics to monitor COVID-19 patients and the rollout of national vaccination programme. The public and private healthcare partnership must be enhanced, and continue to find effective ways to collaborate further to combat the pandemic. The MOH, private healthcare sectors and insurance providers need to have a synergistic COVID-19 treatment plans to ensure public as well as insurance policy holders have equal opportunities for COVID-19 screening tests, vaccinations and treatment.

Mapping public value processes

2014 ◽  
Vol 27 (4) ◽  
pp. 334-352 ◽  
Author(s):  
John Alford ◽  
Sophie Yates
Keyword(s):  
Public Sector ◽  
Child Nutrition ◽  
Process Mapping ◽  
Public Value ◽  
Public And Private ◽  
Content Type ◽  
The Public ◽  
Public Managers ◽  
Big Picture ◽  
Comprehensive Framework

Purpose – The purpose of this paper is to add to the analytic toolkit of public sector practitioners by outlining a framework called Public Value Process Mapping (PVPM). This approach is designed to be more comprehensive than extant frameworks in either the private or public sectors, encapsulating multiple dimensions of productive processes. Design/methodology/approach – This paper explores the public administration and management literature to identify the major frameworks for visualising complex systems or processes, and a series of dimensions against which they can be compared. It then puts forward a more comprehensive framework – PVPM – and demonstrates its possible use with the example of Indigenous child nutrition in remote Australia. The benefits and limitations of the technique are then considered. Findings – First, extant process mapping frameworks each have some but not all of the features necessary to encompass certain dimensions of generic or public sector processes, such as: service-dominant logic; external as well internal providers; public and private value; and state coercive power. Second, PVPM can encompass the various dimensions more comprehensively, enabling visualisation of both the big picture and the fine detail of public value-creating processes. Third, PVPM has benefits – such as helping unearth opportunities or culprits affecting processes – as well as limitations – such as demonstrating causation and delineating the boundaries of maps. Practical implications – PVPM has a number of uses for policy analysts and public managers: it keeps the focus on outcomes; it can unearth a variety of processes and actors, some of them not immediately obvious; it can help to identify key processes and actors; it can help to identify the “real” culprits behind negative outcomes; and it highlights situations where multiple causes are at work. Originality/value – This approach, which draws on a number of precursors but constitutes a novel technique in the public sector context, enables the identification and to some extent the comprehension of a broader range of causal factors and actors. This heightens the possibility of imagining innovative solutions to difficult public policy issues, and alternative ways of delivering public services.

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