scholarly journals The role of managed healthcare in the South African context: A systemic approach

2005 ◽  
Vol 36 (3) ◽  
pp. 75-86
Author(s):  
P. F. Hugo ◽  
S. S. Loubser
Keyword(s):  
South Africa ◽  
Supply Chain ◽  
Healthcare Delivery ◽  
Systemic Approach ◽  
Management Tool ◽  
Healthcare Delivery System ◽  
Unknown Quantity ◽  
Private Healthcare ◽  
Management Interventions ◽  
Role Players

Managed healthcare, in the context of this study, is defined as a series of management interventions in the healthcare supply chain, aimed at promoting appropriate and necessary care at a cost which is affordable to the consumer. It has evolved precisely because the healthcare supply chain is inefficient, too costly to be affordable to the majority of consumers in South Africa. Since managed healthcare represents a collection of interventions it is probable that these interventions will provoke responses which either support or counter the objectives of the intervening parties. The study focuses on trends which can be quantified in order to demonstrate this process, as well as on qualitative responses from role-players within the system, in order to explain behavioural changes that give rise to these trends.Managed healthcare is a management tool that is used in the private healthcare environment to manage the provision of care. In the past it was based on retrospective intervention and had cost containment as its main focus. Managed healthcare aims to address efficiency and quality of care but has yet to demonstrate measurable outcomes that would significantly impact on its WHO ratings. However, little attention is paid to the relationships and structure of the system within which care is provided and the dynamics that exist between and amongst role-players. The extent to which these relationships have an effect on the outcomes of the Private Healthcare Delivery System in South Africa is a relative unknown quantity. This article describes the research process which endeavours to develop a systemic approach to understand the current challenges in the PHDS better in order to optimise the outcome of it.

scholarly journals A strategy to enhance positive working relationships among the role players within the managed healthcare context in Gauteng

2000 ◽  
Vol 5 (3) ◽  
pp. 3-14
Author(s):  
Shongy Mahlo ◽  
Marie Muller
Keyword(s):  
South Africa ◽  
Full Text ◽  
Quality Care ◽  
Healthcare Delivery ◽  
High Rate ◽  
Working Relationships ◽  
Healthcare Industry ◽  
Private Healthcare ◽  
The Past ◽  
Role Players

The introduction of managed healthcare in South Africa was aimed at the reduction of medical costs, which were increasing at a high rate for the past few years, particularly so in a private healthcare industry. Managed healthcare is a system of healthcare delivery, which ensures that costs effective quality care is provided to patients. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

scholarly journals Investigating Perceptions of Patients on Healthcare Pricing Within The Private Healthcare Sector In Sri Lanka

2021 ◽  
Vol 16 (3) ◽  
pp. 235-242
Author(s):  
Kanchana Sajeeva Narangoda ◽  
Estie Kruger ◽  
Marc Tennant
Keyword(s):  
Sri Lanka ◽  
Private Sector ◽  
Healthcare Delivery ◽  
Target Population ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Sufficient Evidence ◽  
Healthcare Delivery System ◽  
Private Hospitals ◽  
Private Healthcare

Demand for private sector healthcare services in Sri Lanka is on the rise. This is very evident from the increase in the number of registered private healthcare institutions from 1990 to 2017. [1,2] With the increasing utilization of private sector healthcare services, various qualitative factors,  and service-related issues associated with the healthcare delivery system have become common debates. A major concern, patients have expressed, is about the fees charged by doctors and hospitals. Principle aim of this study was to investigate the perceptions of patients on healthcare pricing within the private healthcare sector in Sri Lanka. The target population of the study was defined as Sri Lankans who have been inpatients in private hospitals within the past year. The focus districts were Colombo, Kandy, and Galle. These 3 districts represented nearly 60% of the total private sector bed capacity. From each district, three main private hospitals were selected. Over 700 patients were invited to participate, 246 surveys were completed, and 215 were retained as 31 had excessive missing and/or unclear data. In all 3 districts the majority of patients were either dissatisfied with or remained neutral (69%) on the hospital fees,(66%) on doctor’s fees,(74%) on the overall price they ended up paying,(76%)  on whether they think the healthcare services they received are value for money. This study did not investigate the reasons or the factors that may affect the satisfaction or dissatisfaction of patients towards the fees they paid Multiple factors can affect patient’s perception on the fees they paid. With negative perception on the above it can be concluded that there is sufficient evidence to challenge private sector healthcare satisfaction level vs price/fees equilibrium in Sri Lanka.

A Stochastic Queueing Model for Capacity Allocation in the Hierarchical Healthcare Delivery System

2019 ◽  
Vol 36 (01) ◽  
pp. 1950005
Author(s):  
Jianpei Wen ◽  
Hanyu Jiang ◽  
Jie Song
Keyword(s):  
Delivery System ◽  
Optimal Allocation ◽  
Healthcare Delivery ◽  
Capacity Allocation ◽  
Patient Choice ◽  
Management Tool ◽  
Point Problem ◽  
Referral Process ◽  
Healthcare Delivery System ◽  
The Impact

We use the capacity allocation as a demand management tool to optimize the patient flow distribution on a hierarchical healthcare delivery system, which is a mixture of patient choice and gatekeeping. Capacity allocation for such service system can be challenging because of the inherent stochastic referral process and patients’ heterogeneous delay sensitivities. In this research, a stochastic queueing-based model is proposed to find the optimal allocation of the limited service capacity of the second level of experts. Considering the impact of the deficiency of the skill level and the amount of gatekeepers, the stochastic referral process is modeled with a tandem queue. By solving a fixed-point problem, we show that there is an unique optimal allocation and corresponding equilibrium demand. We carry out numerical studies and find that providing two alternatives for patients can be better than gatekeeper system, when the capacity of the gatekeeper is moderate compared to patients’ potential demand. Results also indicate that the optimal allocation is robust in terms of the referral rate and the mistreatment rate when two rates are less than corresponding thresholds.

Reverend Doctor Sox Leleki and His Role in the Black Methodist Consultation

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Sonwabile Mancotywa
Keyword(s):  
South Africa ◽  
Southern Africa ◽  
Political Influence ◽  
Individual Member ◽  
Methodist Church ◽  
Role Players

The Methodist Church of Southern Africa (MCSA) is one of the mainline Christian denominations with a very good history. However, it was not immune from the larger political influence of South Africa that was polarised by apartheid. This article is intended to look at the formation known as the Black Methodist Consultation (BMC), which at that time had an individual member who played an important role in its development and activities. Sox Leleki was one of the key role players of this movement inside the Methodist Church

A SOFT SYSTEMS METHODOLOGY APPROACH TO IMPROVING THE SUPPLY CHAIN OF A CONSTRUCTION PROJECT IN GAUTENG PROVINCE, SOUTH AFRICA

2020 ◽  
Vol 10 (1) ◽  
pp. 86-99
Author(s):  
Lewis Tsuro ◽  
Stan Hardman
Keyword(s):  
South Africa ◽  
Supply Chain ◽  
Construction Project ◽  
Soft Systems Methodology ◽  
Project Planning ◽  
Suitable Model ◽  
Senior Managers ◽  
Good Tool ◽  
Systems Methodology ◽  
Soft Systems

The Soft Systems Methodology (SSM) was developed as a set of tools for identifying and making incremental steps to improve situations with poorly defined causes or solutions. The supply chain forms a key process of any construction project; however, on any given construction site, supply chain inefficiencies could arise from many different avenues. Opinions vary, though, on which of these avenues is more important for increasing supply chain efficiencies; whether any problem even exist across the different aspects of the supply chain; as well as what steps should be taken to resolve them. It was therefore studied, here, whether SSM could be employed as a useful tool to systematically apply in the supply chains of a construction project in South Africa, for understanding and targeting the problematic situations that arise. Following thorough cyclical open-ended interviews with 17 workers, supervisors, foremen, site clerks, senior managers, and the CEO of the principal contractor at a new office park construction project in Rosebank, Johannesburg, and a thematic analysis of the data, SSM was performed to understand the existing challenges, and develop a suitable model for improvement. The study found that SSM was a good tool for understanding the ‘messy’ circumstances surrounding the chosen construction project supply chain, as well as actions that could be taken to improve the supply chain’s efficiency on site. The findings add weight to the argument that SSM could be a good tool for project managers to systematically introduce into their project planning regimens

Prerequisites to support high-quality clinical trials in children and young people

2020 ◽  
pp. archdischild-2019-318677
Author(s):  
Steven Hirschfeld ◽  
Florian B Lagler ◽  
Jenny M Kindblom
Keyword(s):  
Clinical Trials ◽  
Healthcare Delivery ◽  
Paediatric Population ◽  
Ecosystem Functions ◽  
Healthcare Delivery System ◽  
High Quality ◽  
Children And Young People ◽  
The Right ◽  
Support Decision Making

Children have the right to treatment based on the same quality of information that guides treatment in adults. Without the proper evaluation of medicinal products and devices in paediatric clinical trials that are designed to meet the rigorous standards of the competent authorities, children are discriminated from advances in medicine. There are regulatory, scientific and ethical incentives to address the knowledge gap regarding efficacy and safety of medicines in the paediatric population. High-quality clinical trials involving children of all ages can generate data that will ultimately close the knowledge gaps and support decision making.For clinical trials that enrol children, the needs are specialised and often resource intensive. Prerequisites for successful paediatric clinical trials are personnel with training in both paediatrics and neonatology and expertise in clinical trials in these populations. Moreover, national and international networks for efficient collaboration, dissemination of information, and sharing of resources and expertise are also needed, together with competent, efficient and high-quality local infrastructure with effective processes. Monitoring and oversight bodies with the relevant competence, including expertise in paediatrics, is also an important prerequisite for paediatric clinical trials. Compromise in any of these components will compromise the downstream results.This paper discusses the structures and competences needed in order to perform effective, high-quality paediatric clinical trials with the ultimate goal of better medicines and treatments for children. We propose a model of examining the process as a series of components that each has to be optimised, then all the components are actively optimised to function together as an ecosystem, and the resulting ecosystem functions well with the general research system and the healthcare delivery system.

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