Private choices, public costs: Evaluating cost-shifting between private and public health sectors in New Zealand

Penno, Erin; Sullivan, Trudy; Barson, Dave; Gauld, Robin

doi:10.1016/j.healthpol.2020.12.008

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…36 Additionally, the practice of cost-shifting from private to pub-lic services, for example when surgical complications arise in private facilities, requires active management by government. 19 Not-for-profit ownership of health services (community, NGOs, the third sector) New Zealand has a long history (137 years) 37 of non-government non-profit provision of health services, largely in response to unmet need, encompassing a range of populations and issues from ambulance and stroke care to primary care. From the 1980s, community-initiated and led "third sector" providers of comprehensive PHC emerged as a response to the failure of markets to provide services in areas of high socio-economic deprivation, for those who were in low-paid employment, Māori, Pasifika or youth.…”

Section: Private For-profit Ownership Of Health Servicesmentioning

confidence: 99%

“…15 While ownership arrangements do not wholly determine the model of care, they influence how services are run and how professional and business conflicts are managed, as evidenced in recent vigorous discussions over the provision of radiology services. e.g., 16 Notwithstanding the strong influence that ownership arrangements exert on health system performance, 17,18 for example through service accessibility, 4,19,20 current New Zealand health policies pay insufficient attention to this important health system design parameter. This is an important policy omission, since New Zealand's health services are currently provided by a range of service providers with a mixture of state, private for-profit, and NGO owners.…”

mentioning

confidence: 99%

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The ownership elephant is becoming a mammoth: a policy focus on ownership is needed to transform Aotearoa New Zealand’s health system

Crampton,

Reidy,

Matheson

et al. 2023

NZMJ

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Explicit government policy about ownership of health services is an important yet missing element in Aotearoa New Zealand's health system. Policy has not systematically addressed ownership as a health system policy tool since the late 1930s. It is timely to revisit ownership amid health system reform and increasing reliance on private provision (for-profit companies), notably for primary and community care, and also as an integral part of digitalisation. Simultaneously, policy should recognise the importance and potential of both the third sector (NGOs, Pasifika, community-owned services), Māori ownership and direct government provision of services to address health equity. Iwi-led developments over recent decades, along with the establishment of the Te Aka Whai Ora (Māori Health Authority), and Iwi Māori Partnership Boards provide opportunities for emerging Indigenous models of health service ownership, more consistent with Te Tiriti o Waitangi and mātauranga Māori. Four ownership types relevant to health service provision and equity are briefly explored: private for-profit, NGOs and community, government and Māori. These ownership domains operate differently in practice and over time, influencing service design, utilisation and health outcomes. Overall, the New Zealand state should take a deliberate strategic view of ownership as a policy instrument, in particular because of its relevance to health equity.

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Section: Private For-profit Ownership Of Health Servicesmentioning

confidence: 99%

mentioning

confidence: 99%

The ownership elephant is becoming a mammoth: a policy focus on ownership is needed to transform Aotearoa New Zealand’s health system

Crampton,

Reidy,

Matheson

et al. 2023

NZMJ

View full text Add to dashboard Cite

show abstract

“…Fundamentally, the transaction costs theory addresses issues of how organizations can organize their transactions with other organizations and the transaction cost of such activities. In the promotion of an organization's strategic alliance portfolio, the transaction cost theory is used to determine the type, kind and number of strategic alliances that an organization can enter into and the means by which the alliance activities are integrated into the hierarchy of an organization (Penno et al, 2021).…”

Section: Transaction Cost Theorymentioning

confidence: 99%

The Role of Strategic Alliances on Performance of County Assembly Wards: An Assessment of Nakuru County Government in Kenya

2023

EJBM

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The main purpose of this study was to assess the influence of strategic alliances on the performance of the Nakuru County Government in Kenya by assessing the County Assembly Wards. The specific objectives focused on public-private partnerships, research and development, resource sharing, and risk sharing. The study was underpinned on the RBV, knowledge-based, transaction-based, and prospect theories. The study adopted descriptive research design targeting all the 55 Assembly wards in Nakuru County. A multi-stage sampling technique was used to draw out 141 respondents. Primary data was collected using a questionnaire and analyzed both as well as inferentially. The study found that there was a strong and positive relationship between publicprivate partnerships and performance and that public-private partnerships had the strongest relationship with the performance. Further, the study found that public-private partnerships positively and significantly influence the performance. Also, the study found a strong and positive relationship between resource sharing and performance. On the other hand, the study revealed that resource sharing positively and significantly influences the performance and while holding public-private partnerships, research and development sharing and risk sharing constant, resource sharing would have the most positive influence on the performance. In addition, the relationship between research and development and performance also showed a strong and positive relationship. However, the findings showed that while research and development sharing would help improve the performance, it did not have a statistically significant influence on the performance. The findings also indicated that the relationship between risk sharing and performance showed a moderate but positive relationship. On the other hand, the regression analysis revealed that risk sharing did not have a significant influence on the performance. The study hence recommended that future researcher should conduct a comparative study to understand the influence of strategic alliances on the performance of other county assembly wards in Kenya. Finally, this study hopes that these findings will be relevant for stakeholders to address opportunities and challenges that exist in the formation of strategic alliances in public sector organizations.

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“…This was of an already stressed workforce, finding it difficult to cope with the lockdowns and non-urgent patient needs that were put aside to focus on Covid response and patients. The system had been struggling to see and treat non-urgent patients even pre-Covid, meaning those who could pay would resort to the parallel private sector (Penno et al, 2021). The Omicron outbreak placed considerable pressure on the system, pushing it to the brink.…”

Section: Impact On Health Systemmentioning

confidence: 99%

A review of public policies on Covid-19: the New Zealand experience

Gauld

2022

PAP

Self Cite

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PurposeThis article reviews New Zealand's journey through managing Covid-19. It provides a chronological overview of key developments. The article analyses the impacts of Covid-19 on business and society and offers lessons for others from the New Zealand case.Design/methodology/approachThe article draws on various sources, primarily media pieces and government information. It also critically analyses and interprets the New Zealand response.FindingsThe initial onset and response from the New Zealand government, albeit with closed borders, was effective in terms of keeping the country relatively Covid free. The country was slow to introduce vaccinations, but the uptake was swift. A vaccine mandate to coincide with a Delta outbreak was controversial. Importantly, the New Zealand case is characterised by political leadership strongly and explicitly informed by public health expertise and advice which was routinely demonstrated throughout the period in discussion.Originality/valueThe article offers an important overview and analysis of New Zealand's experience with Covid-19 and its response, with particular focus on the way in which the government and public health specialist advisors interacted.

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Private choices, public costs: Evaluating cost-shifting between private and public health sectors in New Zealand

Cited by 5 publications

References 24 publications

The ownership elephant is becoming a mammoth: a policy focus on ownership is needed to transform Aotearoa New Zealand’s health system

The ownership elephant is becoming a mammoth: a policy focus on ownership is needed to transform Aotearoa New Zealand’s health system

The Role of Strategic Alliances on Performance of County Assembly Wards: An Assessment of Nakuru County Government in Kenya

A review of public policies on Covid-19: the New Zealand experience

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