Pub Date : 2023-03-05DOI: 10.1177/09720634221150970
O. Eilayyan, A. Arafah
The objectives of this systematic review were to assess the acceptability of self-management interventions for people with asthma and identify contributing factors. A systematic literature search was conducted using PubMed, MEDLINE, EMBASE (OVIDWEB), CINAHL and Cochrane databases. Clinical trials design was included if they met specified criteria. A random-effect meta-regression analysis was conducted to estimate the overall acceptance and drop-out rates and to assess the potential factors that may influence the outcomes. A total of 64 studies were included and 8,092 participants were recruited and participated in the trials. The estimated acceptance rate was 51.1%, while the estimated drop-out rates in the intervention and control groups were 18.2% and 15.6%, respectively. Lack of interest was the main reported reason for refusing to participate and dropping out from the program. Study-related and program-related factors influenced the acceptance and drop-out rates statistically and clinically. The acceptance rate of self-management programs among asthmatic people was not high and the dropout rate was somewhat low. The review suggests optimizing the design of self-management studies and modifying the implemented self-management programs to increase the acceptance rate and decrease the dropout rate.
{"title":"Acceptance and Dropout Rates of Individuals with Asthma Approached in Self-management Interventions: A Systematic Review and Meta-analysis","authors":"O. Eilayyan, A. Arafah","doi":"10.1177/09720634221150970","DOIUrl":"https://doi.org/10.1177/09720634221150970","url":null,"abstract":"The objectives of this systematic review were to assess the acceptability of self-management interventions for people with asthma and identify contributing factors. A systematic literature search was conducted using PubMed, MEDLINE, EMBASE (OVIDWEB), CINAHL and Cochrane databases. Clinical trials design was included if they met specified criteria. A random-effect meta-regression analysis was conducted to estimate the overall acceptance and drop-out rates and to assess the potential factors that may influence the outcomes. A total of 64 studies were included and 8,092 participants were recruited and participated in the trials. The estimated acceptance rate was 51.1%, while the estimated drop-out rates in the intervention and control groups were 18.2% and 15.6%, respectively. Lack of interest was the main reported reason for refusing to participate and dropping out from the program. Study-related and program-related factors influenced the acceptance and drop-out rates statistically and clinically. The acceptance rate of self-management programs among asthmatic people was not high and the dropout rate was somewhat low. The review suggests optimizing the design of self-management studies and modifying the implemented self-management programs to increase the acceptance rate and decrease the dropout rate.","PeriodicalId":45421,"journal":{"name":"Journal of Health Management","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45738945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-03DOI: 10.1177/09720634221150997
N. Sabitha, Shetty Prasanna Kumar
The core variable arrived at were Challenges of postnatal motherhood phenomenon from mothers’ perspective, eight essential themes were developed, and they were as follows: ‘Contented with the birth experience; A wider perspective of womanhood’. ‘Coming up with physiological and emotional challenges; a note worthy experience’. ‘Being happy with the gender of the baby; A God given gift’. ‘Glad to be a mother with a good family support’. ‘Happy to receive the intended care in the hospital; a boon to every mother’. ‘Ready to face challenges; marital perspective’. ‘Newborn care; a tender loving care of womanhood’. ‘Joyous moment to be with the newborn but unhappy due to physical and psychological alteration’. The findings of the study throw light on various challenges faced by mothers and their coping strategies. In this study majority of the mothers had least to moderately expressed challenges and highly expressed challenges were minimal. This could be hypothesised that the study participants were from a rural setting where most of the mothers are unemployed and most of the mothers have a good support system which helps them to face challenges positively. Nevertheless, literature shows that Emotional challenges, Breastfeeding challenges and newborn care challenges are faced globally which can be addressed by creating awareness programmes. This can be achieved through nurse-led clinics on childbirth education in the OBG and Paediatric units with Mathr Shiksha Abhiyaan which will benefit most of the Pregnant and lactating mothers coming to OPD.
{"title":"A Qualitative Study on Challenges Faced by Postnatal Mothers","authors":"N. Sabitha, Shetty Prasanna Kumar","doi":"10.1177/09720634221150997","DOIUrl":"https://doi.org/10.1177/09720634221150997","url":null,"abstract":"The core variable arrived at were Challenges of postnatal motherhood phenomenon from mothers’ perspective, eight essential themes were developed, and they were as follows: ‘Contented with the birth experience; A wider perspective of womanhood’. ‘Coming up with physiological and emotional challenges; a note worthy experience’. ‘Being happy with the gender of the baby; A God given gift’. ‘Glad to be a mother with a good family support’. ‘Happy to receive the intended care in the hospital; a boon to every mother’. ‘Ready to face challenges; marital perspective’. ‘Newborn care; a tender loving care of womanhood’. ‘Joyous moment to be with the newborn but unhappy due to physical and psychological alteration’. The findings of the study throw light on various challenges faced by mothers and their coping strategies. In this study majority of the mothers had least to moderately expressed challenges and highly expressed challenges were minimal. This could be hypothesised that the study participants were from a rural setting where most of the mothers are unemployed and most of the mothers have a good support system which helps them to face challenges positively. Nevertheless, literature shows that Emotional challenges, Breastfeeding challenges and newborn care challenges are faced globally which can be addressed by creating awareness programmes. This can be achieved through nurse-led clinics on childbirth education in the OBG and Paediatric units with Mathr Shiksha Abhiyaan which will benefit most of the Pregnant and lactating mothers coming to OPD.","PeriodicalId":45421,"journal":{"name":"Journal of Health Management","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47144499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/09720634231153215
Nizar Shufani
This article aims to identify whether the type of healthcare system financing matters in terms of efficiency. The study covered 35 OECD countries, which follow either the Bismarck system or the Beveridge system. The span of analysis covers the year 2015. Data were derived from OECD statistics and Eurostat databases. In purpose to analyse the impact of the financing method on the overall efficiency of the healthcare system, the developed model of Anderson was employed. Thus, the model allowed us to examine both—the components of the healthcare system, resources, population characteristics, benefits and outcomes, and the relationship of individual components to each other, expressed through efficiency, effectiveness and equality. In addition, statistical methods were used such as descriptive analysis, the independent sample t-test and the Pearson correlation coefficient. It was found that countries of the Bismarck system possess more hospital beds and simultaneously more curative care bed days are provided. It could imply the existence of a supply-induced demand problem. In the case of efficiency, the Bismarck states were found to have a more efficient medical doctor as they provide more consultation per inhabitant than their Beveridge counterparts. However, the Beveridge states were found to have more efficient usage of curative care beds as their bed occupancy rate is higher than Bismarck counterparts.
{"title":"Does the Type of Healthcare Financing Systems Matter for Efficiency?","authors":"Nizar Shufani","doi":"10.1177/09720634231153215","DOIUrl":"https://doi.org/10.1177/09720634231153215","url":null,"abstract":"This article aims to identify whether the type of healthcare system financing matters in terms of efficiency. The study covered 35 OECD countries, which follow either the Bismarck system or the Beveridge system. The span of analysis covers the year 2015. Data were derived from OECD statistics and Eurostat databases. In purpose to analyse the impact of the financing method on the overall efficiency of the healthcare system, the developed model of Anderson was employed. Thus, the model allowed us to examine both—the components of the healthcare system, resources, population characteristics, benefits and outcomes, and the relationship of individual components to each other, expressed through efficiency, effectiveness and equality. In addition, statistical methods were used such as descriptive analysis, the independent sample t-test and the Pearson correlation coefficient. It was found that countries of the Bismarck system possess more hospital beds and simultaneously more curative care bed days are provided. It could imply the existence of a supply-induced demand problem. In the case of efficiency, the Bismarck states were found to have a more efficient medical doctor as they provide more consultation per inhabitant than their Beveridge counterparts. However, the Beveridge states were found to have more efficient usage of curative care beds as their bed occupancy rate is higher than Bismarck counterparts.","PeriodicalId":45421,"journal":{"name":"Journal of Health Management","volume":"25 1","pages":"87 - 96"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45378367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/09720634231153206
Albert Opoku Frimpong
Inequality in healthcare utilisation contributes to socio-economic disparities in health outcomes. The government of Ghana rolled out the Ghana National Health Insurance Scheme (NHIS) as a pro-poor health policy to reduce the financial barrier to accessing healthcare to increase healthcare utilisation, especially among the poor. Evidence showed a pro-rich utilisation inequality in Ghana prior to the nationwide start of the NHIS in 2005. This article applied the concentration index and decomposition methods to the round six of the Ghana Living Standard Survey data to investigate the contribution of the NHIS to utilisation inequality. The results showed the rich to benefit more than the poor from the NHIS and the NHIS contributed to about half of the pro-rich utilisation inequality. The NHIS increased utilisation but more so for the rich than the poor. A policy implication of the article is that pro-poorness of the NHIS might require separate NHIS schemes for the poor and non-poor to enable different policies implemented in the schemes to increase the distributional disparity of health subsidies in favour of the poor.
{"title":"Contribution of the Ghana National Health Insurance Scheme to Inequality in Healthcare Utilisation","authors":"Albert Opoku Frimpong","doi":"10.1177/09720634231153206","DOIUrl":"https://doi.org/10.1177/09720634231153206","url":null,"abstract":"Inequality in healthcare utilisation contributes to socio-economic disparities in health outcomes. The government of Ghana rolled out the Ghana National Health Insurance Scheme (NHIS) as a pro-poor health policy to reduce the financial barrier to accessing healthcare to increase healthcare utilisation, especially among the poor. Evidence showed a pro-rich utilisation inequality in Ghana prior to the nationwide start of the NHIS in 2005. This article applied the concentration index and decomposition methods to the round six of the Ghana Living Standard Survey data to investigate the contribution of the NHIS to utilisation inequality. The results showed the rich to benefit more than the poor from the NHIS and the NHIS contributed to about half of the pro-rich utilisation inequality. The NHIS increased utilisation but more so for the rich than the poor. A policy implication of the article is that pro-poorness of the NHIS might require separate NHIS schemes for the poor and non-poor to enable different policies implemented in the schemes to increase the distributional disparity of health subsidies in favour of the poor.","PeriodicalId":45421,"journal":{"name":"Journal of Health Management","volume":"25 1","pages":"97 - 106"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48207015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/09720634231154367
W. Willis, Ashish Chandra, P. Sodani
In January 2021, hospitals and payer-specific entities in the United States were mandated to comply with the new pricing transparency rules. These rules applied to all standard charges a hospital applied to services provided to and for a consumer. From a financial perspective, the issue of price transparency in health care has for several decades surfaced as a legitimate concern of consumers, health care providers and payers. The aim of this article is to historically examine where and how pricing in health care began and to illustrate financial issues leading up to the current transparency in pricing required by health care payers and providers. A comparative analysis of issues and challenges pertaining to the transparency in pharmaceutical product pricing between the United States and India is also provided in brief.
{"title":"Issues and Challenges Pertaining to Financing in Providing Pricing Transparency in the American Health Care Industry","authors":"W. Willis, Ashish Chandra, P. Sodani","doi":"10.1177/09720634231154367","DOIUrl":"https://doi.org/10.1177/09720634231154367","url":null,"abstract":"In January 2021, hospitals and payer-specific entities in the United States were mandated to comply with the new pricing transparency rules. These rules applied to all standard charges a hospital applied to services provided to and for a consumer. From a financial perspective, the issue of price transparency in health care has for several decades surfaced as a legitimate concern of consumers, health care providers and payers. The aim of this article is to historically examine where and how pricing in health care began and to illustrate financial issues leading up to the current transparency in pricing required by health care payers and providers. A comparative analysis of issues and challenges pertaining to the transparency in pharmaceutical product pricing between the United States and India is also provided in brief.","PeriodicalId":45421,"journal":{"name":"Journal of Health Management","volume":"25 1","pages":"22 - 29"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46074920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/09720634231153210
Jeetendra Yadav, Shaziya Allarakha, Dr. John, G. Menon, C. Venkateswaran, Ravinder Singh
Majority of people in low- and middle-income countries with mental illness do not receive healthcare, leading to chronicity, suffering and increased costs of care. This study estimated the out-of-pocket expenditure (OOPE), catastrophic health expenditure (CHE), and poverty impact due to mental illness in India. Data was acquired from the 76th round data of the National Sample Survey (NSS) on the theme ‘Persons with Disabilities in India Survey’, July–December 2018. Data of 6,679 persons who reported mental illness during the survey was included for analysis. OOPE, CHE, poverty impact and state differentials of healthcare expenditure on mental illness were analysed using standard methods. In total, 18.1% of the household’s monthly consumption expenditure was spent on healthcare on mental illness. About 59.5% and 32.5% of the households were exposed to CHE based on 10% and 20% thresholds, respectively. About 20.7% of the households were forced to become poor from non-poor due to treatment care expenditure on mental illness. Our study suggests the critical need to accelerate on various measures for early diagnosis and management of mental health issues along with financial risk protection for reducing financial impact of healthcare expenditure on mental illness among households in India.
{"title":"Catastrophic Health Expenditure and Poverty Impact Due to Mental Illness in India","authors":"Jeetendra Yadav, Shaziya Allarakha, Dr. John, G. Menon, C. Venkateswaran, Ravinder Singh","doi":"10.1177/09720634231153210","DOIUrl":"https://doi.org/10.1177/09720634231153210","url":null,"abstract":"Majority of people in low- and middle-income countries with mental illness do not receive healthcare, leading to chronicity, suffering and increased costs of care. This study estimated the out-of-pocket expenditure (OOPE), catastrophic health expenditure (CHE), and poverty impact due to mental illness in India. Data was acquired from the 76th round data of the National Sample Survey (NSS) on the theme ‘Persons with Disabilities in India Survey’, July–December 2018. Data of 6,679 persons who reported mental illness during the survey was included for analysis. OOPE, CHE, poverty impact and state differentials of healthcare expenditure on mental illness were analysed using standard methods. In total, 18.1% of the household’s monthly consumption expenditure was spent on healthcare on mental illness. About 59.5% and 32.5% of the households were exposed to CHE based on 10% and 20% thresholds, respectively. About 20.7% of the households were forced to become poor from non-poor due to treatment care expenditure on mental illness. Our study suggests the critical need to accelerate on various measures for early diagnosis and management of mental health issues along with financial risk protection for reducing financial impact of healthcare expenditure on mental illness among households in India.","PeriodicalId":45421,"journal":{"name":"Journal of Health Management","volume":"25 1","pages":"8 - 21"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47584427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/09720634231153207
Akshaya Balaji, A. Tagat
This article uses nationally representative household survey data between June 2019 and 2020 from India to examine changes in household consumption expenditure following the first wave of the COVID-19 pandemic. We find that across rural and urban households, there was a strong reduction in overall expenditures, in particular, related to food and health. This corroborates findings from existing literature on food insecurity during the first lockdown in India (March–April 2020) and provides the first set of estimates on changes in health expenditure for this period. Although there were expansions to health insurance and subsidized COVID-related healthcare costs in India, our findings likely do not reflect this. We discuss implications for policy and outline future work.
{"title":"Unhealthy Shock: Changes in Household Expenditures in the First Wave of COVID-19 in India","authors":"Akshaya Balaji, A. Tagat","doi":"10.1177/09720634231153207","DOIUrl":"https://doi.org/10.1177/09720634231153207","url":null,"abstract":"This article uses nationally representative household survey data between June 2019 and 2020 from India to examine changes in household consumption expenditure following the first wave of the COVID-19 pandemic. We find that across rural and urban households, there was a strong reduction in overall expenditures, in particular, related to food and health. This corroborates findings from existing literature on food insecurity during the first lockdown in India (March–April 2020) and provides the first set of estimates on changes in health expenditure for this period. Although there were expansions to health insurance and subsidized COVID-related healthcare costs in India, our findings likely do not reflect this. We discuss implications for policy and outline future work.","PeriodicalId":45421,"journal":{"name":"Journal of Health Management","volume":"25 1","pages":"77 - 86"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42502143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/09720634231153241
Md. Tanzeer Alam, Tasnim Murad Mamun, R. Akter
In Bangladesh, especially the informal sector workers are deprived of proper healthcare owing to high cost and lack of security like health insurance. The study aims to estimate the willingness to pay (WTP) of the informal sector workers for premium-based health insurance on the basis of data collected from 210 households, where double bounded dichotomous choice (DBDC) model was applied. The study estimates that this working-class people are willing to pay a monthly premium of on average around BDT (Bangladeshi Taka) 315 (USD 3.66) in response to enjoy the facilities of health insurance scheme for a household comprising up to four family members. Moreover, the per household estimated average monthly optimum tariff rate of almost BDT 300 (USD 3.54) and monthly mean social optimum tariff rate of about BDT 100 (USD 1.18) indicate the assurance of socially desirable welfare for all of the market participants. By charging this tariff, approximately 97 percent of the people would enjoy access to community-based health insurance, in addition to generating revenue that is around 1.13 times the project’s cost. Even by charging this monthly mean social optimum tariff, approximately 97 percent of the households would enjoy the access to community-based health insurance; the generating revenue through that tariff rate is around 1.13 times of the probable cost for high service package health scheme. In order to alleviate the burden of the out-of-pocket (OOP) costs for this vulnerable community, the study advises policymakers to initiate health insurance scheme by maintaining effective supervision over market dynamics and fixing the best fit premium rate.
{"title":"Households’ Willingness to Pay for Community-Based Health Insurance in the Southwest Region of Bangladesh","authors":"Md. Tanzeer Alam, Tasnim Murad Mamun, R. Akter","doi":"10.1177/09720634231153241","DOIUrl":"https://doi.org/10.1177/09720634231153241","url":null,"abstract":"In Bangladesh, especially the informal sector workers are deprived of proper healthcare owing to high cost and lack of security like health insurance. The study aims to estimate the willingness to pay (WTP) of the informal sector workers for premium-based health insurance on the basis of data collected from 210 households, where double bounded dichotomous choice (DBDC) model was applied. The study estimates that this working-class people are willing to pay a monthly premium of on average around BDT (Bangladeshi Taka) 315 (USD 3.66) in response to enjoy the facilities of health insurance scheme for a household comprising up to four family members. Moreover, the per household estimated average monthly optimum tariff rate of almost BDT 300 (USD 3.54) and monthly mean social optimum tariff rate of about BDT 100 (USD 1.18) indicate the assurance of socially desirable welfare for all of the market participants. By charging this tariff, approximately 97 percent of the people would enjoy access to community-based health insurance, in addition to generating revenue that is around 1.13 times the project’s cost. Even by charging this monthly mean social optimum tariff, approximately 97 percent of the households would enjoy the access to community-based health insurance; the generating revenue through that tariff rate is around 1.13 times of the probable cost for high service package health scheme. In order to alleviate the burden of the out-of-pocket (OOP) costs for this vulnerable community, the study advises policymakers to initiate health insurance scheme by maintaining effective supervision over market dynamics and fixing the best fit premium rate.","PeriodicalId":45421,"journal":{"name":"Journal of Health Management","volume":"25 1","pages":"107 - 116"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47611437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/09720634231153721
M. Almunawar, M F Anshari, Nabilah Binti Datuk Mohd Rosdi, A. Kisa, M. Younis
Healthcare can be seen as a value shop, in which solutions to health problems are offered in exchange for valuable contributions. However, the full value exchange between the healthcare provider and the patient is not always apparent. The value shop concept runs the risk of considering only what the patient pays (i.e., money, either paid by the patient or reimbursed by the government) while ignoring another important value, data. Yet without this data, the patient’s problem cannot be solved. This article offers a new paradigm in which a health provider can deliver better value by integrating all dimensions of the provider’s and patient’s value.
{"title":"Reconsidering Patient Value to Create Better Healthcare","authors":"M. Almunawar, M F Anshari, Nabilah Binti Datuk Mohd Rosdi, A. Kisa, M. Younis","doi":"10.1177/09720634231153721","DOIUrl":"https://doi.org/10.1177/09720634231153721","url":null,"abstract":"Healthcare can be seen as a value shop, in which solutions to health problems are offered in exchange for valuable contributions. However, the full value exchange between the healthcare provider and the patient is not always apparent. The value shop concept runs the risk of considering only what the patient pays (i.e., money, either paid by the patient or reimbursed by the government) while ignoring another important value, data. Yet without this data, the patient’s problem cannot be solved. This article offers a new paradigm in which a health provider can deliver better value by integrating all dimensions of the provider’s and patient’s value.","PeriodicalId":45421,"journal":{"name":"Journal of Health Management","volume":"25 1","pages":"68 - 76"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49029052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/09720634231153235
S. Nagarajan, Shruti Tripathy, P. Sodani, Rachna Sharma
Several countries with diverse health systems have achieved universalization (UHC). The trajectory towards universal coverage almost always has three typical features: (i) a political process driven by a range of regulatory changes to simplify access; (ii) an increase in health spending; (iii) an increase in the share of pooled spending rather than paid out-of-pocket. Therefore, a study was undertaken to understand the extent of the provider-purchaser relationship of governments to achieve UHC while reforming healthcare. The present paper focuses on extensive secondary research across countries and evaluates the experiences of select developed and developing economies with India’s experiments on- Financing mechanisms, management arrangements, governance and health outcomes; to offer a comparison of practices and their impact. While Italy, the UK, Germany, Australia, Japan, Canada and most recently China are countries that have achieved UHC; countries like USA and Brazil are on the verge of achieving UHC. These nine countries represent the entire spectrum of pure purchasing models, mixed and pure provisioning models to help us leverage from their experience. All countries that have attained UHC have a well-defined package of services that the government commits to fund and provide for (both public and private). Additionalities around wellness and cosmetic care is managed through supplementary insurance. Overall funding is through an autonomous body, at arm’s length of government; primarily to govern and manage the state’s health priorities. And the government purely behaves as a regulator setting policy and giving directions to the providers. However, ensuring the sustenance of such a mixed model requires; (i) a well-regulated ecosystem that thrives on evidence, (ii) the governments must clearly define the role/s of each stakeholder and hold them accountable for their deliverables in attaining UHC.
{"title":"Universalising Healthcare in India: Managing the Provider–Purchaser Split","authors":"S. Nagarajan, Shruti Tripathy, P. Sodani, Rachna Sharma","doi":"10.1177/09720634231153235","DOIUrl":"https://doi.org/10.1177/09720634231153235","url":null,"abstract":"Several countries with diverse health systems have achieved universalization (UHC). The trajectory towards universal coverage almost always has three typical features: (i) a political process driven by a range of regulatory changes to simplify access; (ii) an increase in health spending; (iii) an increase in the share of pooled spending rather than paid out-of-pocket. Therefore, a study was undertaken to understand the extent of the provider-purchaser relationship of governments to achieve UHC while reforming healthcare. The present paper focuses on extensive secondary research across countries and evaluates the experiences of select developed and developing economies with India’s experiments on- Financing mechanisms, management arrangements, governance and health outcomes; to offer a comparison of practices and their impact. While Italy, the UK, Germany, Australia, Japan, Canada and most recently China are countries that have achieved UHC; countries like USA and Brazil are on the verge of achieving UHC. These nine countries represent the entire spectrum of pure purchasing models, mixed and pure provisioning models to help us leverage from their experience. All countries that have attained UHC have a well-defined package of services that the government commits to fund and provide for (both public and private). Additionalities around wellness and cosmetic care is managed through supplementary insurance. Overall funding is through an autonomous body, at arm’s length of government; primarily to govern and manage the state’s health priorities. And the government purely behaves as a regulator setting policy and giving directions to the providers. However, ensuring the sustenance of such a mixed model requires; (i) a well-regulated ecosystem that thrives on evidence, (ii) the governments must clearly define the role/s of each stakeholder and hold them accountable for their deliverables in attaining UHC.","PeriodicalId":45421,"journal":{"name":"Journal of Health Management","volume":"25 1","pages":"53 - 67"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43546188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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