Comparison Quality of Health Services between Public and Private Providers: The Iranian People’s Perspective

Alijanzadeh, Mehran; Zare, Seyed Ali Moosaniaye; Rajaee, Roya; Fard, Seyed Mohammad Ali Mousavi; Asefzadeh, S; Alijanzadeh, Mahnaz; Gholami, Soheyla

doi:10.19082/2935

Cited by 18 publications

(11 citation statements)

References 18 publications

(20 reference statements)

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“…Previous researchers have found that waiting time affects people's perceptions about the given services and in turn, patients would choose to get a treatment from another health care provider the next time (24, 25). However, the HCS in Jakarta, especially CHCs, faces challenges to implement shorter waiting times.…”

Section: Discussionmentioning

confidence: 99%

Jakartans' Perceptions of Health Care Services

Sokang

Westmaas

Kok

2019

Front. Public Health

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Health Care Services (HCSs) should implement ongoing innovation and continuously improve their quality. However, in evaluating the quality of HCSs, too little attention has been given to the experience of the users concerning the acquired services. This study focused on how the community values the current services in order to improve HCSs in Indonesia, especially in Jakarta. Four focus group discussions were conducted among 45 community members in the Grogol Petamburan sub-district, in Jakarta. Participants were recruited using a convenience sampling and the data were analyzed using a combination of human coding and NVivo-12. Overall, we found that participants had a negative view of the government-mandated Community Health Centers (CHCs) and they preferred to visit private clinics and hospitals over the CHCs. Participants associated CHCs with unfriendly staffs, longer waiting times, shorter opening hours, and crowded visitors. At the same time, participants had a positive view on the affordability of the CHCs. Additionally, we found the reasoning of Jakartans' (i.e., the citizens of Jakarta city) on using self- and traditional treatments before visiting HCSs and they also expressed the need for psychological services at CHCs. The discussion focuses on the results as feedback on how the government and health care providers may facilitate the community's needs in providing HCSs in Indonesia, especially Jakarta. In brief, we recommend the policy-makers to improve the hospitality of the staff members and the quality of the medical equipment; also, to provide psychological services at CHCs. These efforts need to be done while paying more attention to the cultural aspects of medicinal uses.

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Section: Discussionmentioning

confidence: 99%

Jakartans' Perceptions of Health Care Services

Sokang

Westmaas

Kok

2019

Front. Public Health

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“…Higher income patients turn to for-pro t providers as a more e cient alternative to government services 7 , which often have long wait times and require lengthy travel, resulting in barriers to access 8 9 . While the evidence indicates that this may not always be the case, for-pro t providers were also often perceived to have better quality than government services 10 . When the public sector fails to provide quality primary care for low income populations, they will either turn to for-pro t clinics, clinics run by charities such as non-governmental organizations (NGOs) and faith-based organizations, or the newer and less common social enterprise clinics.…”

Section: Introductionmentioning

confidence: 99%

Business models for primary health care delivery in low and middle income countries: a scoping study of nine social entrepreneurs

Lokman

Chahine

2020

Preprint

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Background: Social enterprises are organizations created to address social problems that use business models to sustain themselves financially. Social enterprises can help increase access to primary health care in low resource settings. Research on social enterprises in health care have focused either on high-income countries, or on secondary and tertiary care in low- and middle-income countries, where common business models include differential pricing to cross-subsidize low income populations. This is the first study to examine social enterprises providing primary health care in low- and middle-income countries using primary data. The purpose is to determine whether social enterprise is a viable model in this setting and to identify common patterns and characteristics that could inform the work of social entrepreneurs, funders, and researchers in this area.Methods: We identify social entrepreneurs working to deliver primary care in low- and middle-income countries who have been vetted by international organizations dedicated to supporting social entrepreneurship. Through in-depth interviews, we collect information on medical processes, business processes, social impact, and organizational impact according to the Battacharyya et al framework. We then conducted qualitative analysis to identify common patterns emerging within these four categories.Results: Common characteristics in the business models of primary health care social enterprises include flat rate rather than differential pricing; cross-subsidizing across services rather than patients. Subscription packages and in-house IT systems were utilized to generate revenue and increase reach through telemedicine, franchising, and mobile units. In some cases, alternate revenue streams are employed to help break even. About half of the social enterprises interviewed were for-profit, and about half non-profit. The majority faced challenges in engaging with the public sector. This is still a nascent field, with most organizations being under ten years old.Conclusions: Social enterprise has been demonstrated as a feasible model for providing primary care in low resource settings, with key characteristics differing from the previously commonly studied social enterprises in tertiary care. There are opportunities to complement existing public health systems, but most organizations face challenges in doing so. More research and attention is needed by researchers, governments and funders to support social entrepreneurs and avoid parallel systems.

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“…Higher income patients turn to for-profit providers as a more efficient alternative to government services [ 7 ], which often have long wait times and require lengthy travel, resulting in barriers to access [ 8 , 9 ]. While the evidence indicates that this may not always be the case, for-profit providers were also often perceived to have better quality than government services [ 10 ]. When the public sector fails to provide quality primary health care for low income populations, they will either turn to for-profit clinics, clinics run by charities such as non-governmental organizations (NGOs) and faith-based organizations, or the newer and less common social enterprise clinics.…”

Section: Introductionmentioning

confidence: 99%

Business models for primary health care delivery in low- and middle-income countries: a scoping study of nine social entrepreneurs

Lokman

Chahine

2021

BMC Health Serv Res

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Background Social enterprises are organizations created to address social problems that use business models to sustain themselves financially. Social enterprises can help increase access to primary health care in low resource settings. Research on social enterprises in health care have focused either on high-income countries, or on secondary and tertiary care in low- and middle-income countries, where common business models include differential pricing to cross-subsidize low income populations. This is the first study to examine social enterprises providing primary health care in low- and middle-income countries using primary data. The purpose is to determine whether social enterprise is a viable model in this setting and to identify common patterns and characteristics that could inform the work of social entrepreneurs, funders, and researchers in this area. Methods We identify social entrepreneurs working to deliver primary health care in low- and middle-income countries who have been vetted by international organizations dedicated to supporting social entrepreneurship. Through in-depth interviews, we collect information on medical processes, business processes, social impact, and organizational impact according to the Battacharyya et al. framework. We then conducted qualitative analysis to identify common patterns emerging within these four categories. Results Common characteristics in the business models of primary health care social enterprises include flat rate rather than differential pricing and cross-subsidizing across services rather than patients. Subscription packages and in-house IT systems were utilized to generate revenue and increase reach through telemedicine, franchising, and mobile units. In some cases, alternate revenue streams are employed to help break even. About half of the social enterprises interviewed were for-profit, and about half non-profit. The majority faced challenges in engaging with the public sector. This is still a nascent field, with most organizations being under 10 years old. Conclusions Social enterprise has been demonstrated as a feasible model for providing primary health care in low resource settings, with key characteristics differing from the previously commonly studied social enterprises in tertiary care. There are opportunities to complement existing public health systems, but most organizations face challenges in doing so. More research and attention is needed by researchers, governments and funders to support social entrepreneurs and avoid parallel systems.

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Comparison Quality of Health Services between Public and Private Providers: The Iranian People’s Perspective

Cited by 18 publications

References 18 publications

Jakartans' Perceptions of Health Care Services

Jakartans' Perceptions of Health Care Services

Business models for primary health care delivery in low and middle income countries: a scoping study of nine social entrepreneurs

Business models for primary health care delivery in low- and middle-income countries: a scoping study of nine social entrepreneurs

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