Public–Private Partnership in the Provision of Health Care Services to the Poor in India

Raman, Aparna; Björkman, James Warner

doi:10.4337/9781781007730.00016

Cited by 14 publications

(17 citation statements)

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“…One solution to this could be that subsidized hospital care may offload to the afflicted households but in India subsidized care in government hospitals is not availed due to community perceptions about the quality of care provided there. 26 As our survey was a rolling one, so that the sampled households were interviewed at two different time periods, addressed the issue of seasonality. In collecting data on household expenditure on health, food and non-food items we used different recall periods because expenditures on several items are incurred at different frequencies and may not be captured accurately in a one-month period even if the expenditures are annualized.…”

Section: Discussionmentioning

confidence: 99%

Assessing the magnitude, distribution and determinants of catastrophic health expenditure in urban Lucknow, North India

Misra

Awasthi

Singh

et al. 2015

Clinical Epidemiology and Global Health

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Available online xxxKeywords: Catastrophic health expenditure Determinants Out of pocket payment Hospitalization India a b s t r a c t Introduction: To assess the magnitude, distribution, and determinants of catastrophic health expenditures (CHE) of households in urban Lucknow, North India.Methods: A cohort of 400 households was selected by 2-step cluster sampling and baseline demographic survey was done followed by two six-monthly health surveys. CHE was defined as health expenditures !10% of household's capacity to pay, measured by nonsubsistence spending.Results: From December 2011 to June 2012, 157/400 (39.25%) households reported !1 episodes of illness, with households suffering sickness in the first survey at increased risk for it in the second (Crude Odd's Ratio ¼ 3.33, 95% CI: 2.02e5.45; p value <0.0001). Mean sickness days without hospitalization were 13.13 AE 36 per household. In 24 (6%) households, there was !1 hospitalization. Health expenditure was entirely met through out of pocket payments (OOP). CHE occurred in 45 (11.25%) households, with statistically significant differences across per capita income quintiles (p ¼ 0.036) and 60% falling in the lower two. On logistic regression model, adjusting for per capital income quintile, CHE was associated with hospitalization (Adjusted OR ¼ 100, 95% CI: 25.00e333.33; p < 0.0001) and >13 sickness days without hospitalization (Adjusted OR ¼ 4.21, 95% CI: 1.862e9.524;Conclusions: Since not only hospitalization but also prolonged sickness days without hospitalization was associated with increased risk of CHE, and since almost half the households have sickness, steps should be taken to protect all households from financial hardship through tax based health financing, social health insurance or other forms of prepayment, as currently all health expenses were met through OOP payments.

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Section: Discussionmentioning

confidence: 99%

Assessing the magnitude, distribution and determinants of catastrophic health expenditure in urban Lucknow, North India

Misra

Awasthi

Singh

et al. 2015

Clinical Epidemiology and Global Health

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“…Due to the federal system in India, the decision to accept or promote such partnerships is devolved to each individual State. Other caveats include the private sector’s motives, incentivisation, and ensuring adequate governance and monitoring arrangements [66]. …”

Section: Discussionmentioning

confidence: 99%

The development of mental health services within primary care in India: learning from oral history

Ginneken

Jain

Patel

et al. 2014

Int J Ment Health Syst

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BackgroundIn India very few of those who need mental health care receive it, despite efforts of the 1982 National Mental Health Programme and its district-level component the District Mental Health Programme (DMHP) to improve mental health care coverage.AimsTo explore and unpack the political, cultural and other historical reasons for the DMHP’s failures and successes since 1947 (post-independence era), which may highlight issues for today’s current primary mental health care policy and programme.MethodsOral history interviews and documentary sourcing were conducted in 2010–11 with policy makers, programme managers and observers who had been active in the creation of the NMHP and DMHP.ResultsThe results suggest that the widely held perception that the DMHP has failed is not entirely justified, insofar that major hurdles to the implementation of the plan have impacted on mental health coverage in primary care, rather than faults with the plan itself. These hurdles have been political neglect, inadequate leadership at central, state and district levels, inaccessible funding and improperly implemented delivery of services (including poor training, motivation and retention of staff) at district and community levels.ConclusionAt this important juncture as the 12th Five Year Plan is in preparation, this historical paper suggests that though the model may be improved, the most important changes would be to encourage central and state governments to implement better technical support, access to funds and to rethink the programme leadership at national, state and district levels.

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“…Quality of public services has also been highlighted in previous reports as an influential factor for promoting contribution of private sector to health services delivery. 16 Among financial factors, "development of a relevant and standard financial management system" represented the highest factor loading. The same factor is reported to be crucial to development of PPP in the Brazilian health system.…”

Section: Resultsmentioning

confidence: 99%

Designing a Public-Private Partnership Model for Public Hospitals in Iran

et al. 2016

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In many developing countries, the public sector has the major responsibility to develop the health system infrastructure, where the private sector plays a minor role due to factors such as high costs, long-run return on investment, weak financial power, and the lack of supportive laws and regulations. On the other hand the extensive bureaucracy in public sector induces many problems in the health sector. These include (among other factors) focused decision-making, poor management, poor inter-level communication, and low motivation for high efficiency. 5In Iran, while both public and private sector contribute to provide health services, the public sector is responsible for the majority of health system development expenditures. 6 The lion share of health expenses in Iran is given to the hospitals. However, the situation of hospitals in terms of efficiency is not much satisfactory. (EH) is an abnormal overgrowth of endometrium that may lead to endometrial cancer, especially when accompanied by atypia. The treatment of EH is challenging, and previous studies report conflicting results. Metformin (dimethyl biguanide) is an anti-diabetic and insulin sensitizer agent, which is supposed to have antiproliferative and anticancer effects and the potential to decrease cell growth in endometrium. While some studies have evaluated the anticancer effect of metformin, studies on its potential effect on endometrial hyperplasia are rare. To address this gap, in this comparative trial study, we evaluate the effect of additive metformin to progesterone in patients with EH.

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Public–Private Partnership in the Provision of Health Care Services to the Poor in India

Cited by 14 publications

References 0 publications

Assessing the magnitude, distribution and determinants of catastrophic health expenditure in urban Lucknow, North India

Assessing the magnitude, distribution and determinants of catastrophic health expenditure in urban Lucknow, North India

The development of mental health services within primary care in India: learning from oral history

Designing a Public-Private Partnership Model for Public Hospitals in Iran

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