Covid-19 exposes the high cost of India’s reliance on private healthcare

Thiagarajan, Kamala

doi:10.1136/bmj.m3506

Cited by 20 publications

(10 citation statements)

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“…Many patients and their families were forced to pay high costs of health services for emergency conditions as well as for COVID-19 treatment at private healthcare facilities. This led to high out of pocket expenditures (OOPE) and pushed many households into poverty (Thiagarajan, 2020). Public health financing is key to financial protection against OOPE, however the existing public health insurance schemes did not provide adequate safety net (Prinja & Singh, 2020).…”

Section: Resultsmentioning

confidence: 99%

Building Resilient Health Systems: Patient Safety during COVID-19 and Lessons for the Future

Narwal

Jain

2021

Journal of Health Management

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Background: The COVID-19 pandemic has profoundly impacted the country’s health systems and diminished its capability to provide safe and effective healthcare. This article attempts to review patient safety issues during COVID-19 pandemic in India, and derive lessons from national and international experiences to inform policy actions for building a ‘resilient health system’. Methods: Systematic review of existing published articles, government and media reports was undertaken. Online databases were searched using key terms related to patient safety during COVID-19 and health systems resilience. Seventy-three papers were included dependent on their relevance to research objectives. Findings: Patient safety was impacted during COVID-19, owing to sub-optimal infection prevention and control measures coupled with reduced access to essential health services. This was largely due to inadequate infrastructure, human and material resources resulting from chronic underinvestment in public health systems, paucity of reliable data for evidence-based actions and limited leadership and regulatory capacity. Conclusions: India’s health systems were found ill prepared to tackle large-scale pandemic, which has major implications for patient safety. The shortcomings observed in the COVID-19 response must be rectified and comprehensive health sector reforms should be initiated for building agile and resilient health systems that can withstand future pandemics.

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Section: Resultsmentioning

confidence: 99%

Building Resilient Health Systems: Patient Safety during COVID-19 and Lessons for the Future

Narwal

Jain

2021

Journal of Health Management

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“…The refusal to admit patients has led to legal action and threats of suspension of hospital licenses in many Indian states (Chatterjee, 2020). These legal sanctions, however, have been ignored in some instances, with the refusal to admit and treat COVID patients still very much being reported across India to the date of writing (Thiagarajan, 2020).…”

Section: Crisis 2: Service Provision and Pricingmentioning

confidence: 99%

The failure of private health services: COVID-19 induced crises in low- and middle-income country (LMIC) health systems

Williams

Yung

Grépin

2021

Global Public Health

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For decades, governments and development partners promoted neoliberal policies in the health sector in many LMICs, largely motivated by the belief that governments in these countries were too weak to provide all the health services necessary to meet population needs. Private health markets became the governance and policy solution to improve the delivery of health services which allowed embedded forms of market failure to persist in these countries and which were exposed during the COVID-19 pandemic. In this article, we analyse the manifestations of these market failures using data from an assembled database of COVID-19 related news items sourced from the Global Database of Events, Language, and Tone. Specifically, we identify how pre-existing market failure and failures of redistribution have led to the rise of three urgent crises in LMICs: a financial and liquidity crisis among private providers, a crisis of service provision and pricing, and an attendant crisis in state-provider relations. The COVID-19 pandemic has therfore exposed important failures of the public-private models of health systems and provides an opportunity to rethink the future orientation of national health systems and commitments towards Universal Health Coverage.

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“…In addition to decreased public expenditure on healthcare, the gujarat model resulted in increased reliance on private healthcare. Scholars have dubbed gujarat's healthcare approach a 'corporate model' because it provides a 'lucrative' business opportunity (Thiagarajan, 2020). The private corporate healthcare model resulted in gujarat having among the highest medical costs in the country with an average cost of $57 per visit compared to $22 in other states (Kalaiyarasan, 2014).…”

Section: Gujaratmentioning

confidence: 99%

COVID-19 in India: A Comparative Analysis of the Kerala and Gujarat Development Models’ Initial Responses

Israelsen

Malji

2021

Progress in Development Studies

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Significant variations in infection, testing, and mortality rates have exposed key differences in the initial COVID-19 response by Indian states. At the onset of the pandemic, states like Gujarat, known for its large economic output, suffered high COVID-19 case fatality rates, a disorganized response, and poor access to healthcare. In contrast, Kerala, a less industrialized state on India’s southwestern coast, experienced low infection rates and fatalities. The low case fatality rate was accompanied by widespread access to care, extensive testing, and an organized response by the state. The emergence of the COVID-19 pandemic provides an opportunity to compare how the Gujarat and Kerala models performed. Since 2000, the Gujarat model has emphasized industrialization and economic development, often at the expense of social development. In contrast, the Kerala model emphasizes social development, often at the expense of economic development. This article analyses the initial response to COVID-19 by Kerala and Gujarat and finds that the Kerala model and its emphasis on social development helped the state respond more effectively to the first wave of the pandemic compared to Gujarat.

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Covid-19 exposes the high cost of India’s reliance on private healthcare

Abstract: India’s private sector props up its healthcare, but the pandemic has exposed exorbitant and inconsistent billing. Kamala Thiagarajan reports on the patients and authorities picking up the tab

Cited by 20 publications

References 1 publication

Building Resilient Health Systems: Patient Safety during COVID-19 and Lessons for the Future

Building Resilient Health Systems: Patient Safety during COVID-19 and Lessons for the Future

The failure of private health services: COVID-19 induced crises in low- and middle-income country (LMIC) health systems

COVID-19 in India: A Comparative Analysis of the Kerala and Gujarat Development Models’ Initial Responses

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