WorldWideScience

Sample records for affordable private health

  1. Mandatory and affordable health insurance

    OpenAIRE

    Len M. Nichols

    2007-01-01

    This paper asserts that America's health care system is broken and cannot be repaired with timid half-measures. It suggests that we need both universal coverage and a more efficient delivery system and that these are not competing objectives: Each is necessary to make the other possible. It further states that if we do not make health care more affordable and our delivery system more efficient and sustainable, a majority of Americans will be uninsured in short order. And the persistence of mi...

  2. Direct subsidies and housing affordability in Australian private rental markets

    OpenAIRE

    Gavin A Wood; Matthew Forbes; Kenneth Gibb

    2005-01-01

    Many countries have undergone a broad retreat from the use of indirect (supply) subsidies to meet low-income housing-affordability problems, shifting to direct subsidies often linked to means-tested income-maintenance systems. Although the reasons for this change of direction are well documented, the efficacy of direct housing subsidies in terms of tackling affordability remains in question. The authors examine in detail one such system, Australia’s Rent Assistance (RA) programme, making use ...

  3. Affordable health benefits for workers without employer coverage.

    Science.gov (United States)

    Etheredge, L; Jones, S B

    1998-02-01

    With 42 million individuals lacking health insurance in 1996, an increase of 1.1 million uninsured from the previous year, new initiatives to deal with health insurance problems merit a high priority among domestic policy initiatives. This paper examines the opportunities for assisting full-time workers (and their families) who do not receive employer-paid health insurance-a group that now includes 49 million individuals-by using three policy tools that Congress and President Clinton have already agreed to use in recent healthcare legislation: (a) equitable tax assistance; (b) market reforms; and (c) competition among health plans that offer economical benefits. Estimates for a model plan illustrate that such strategies could make decent private health insurance more affordable and more accessible for workers and their families who want to purchase it; family insurance protection, with guaranteed issue of insurance and large-group-rated premiums, could be offered at potential savings of 42% (or more). Premiums for worker's coverage, after tax assistance, would be below $1,200 per year, i.e., less than 60 cents per hour. These market-oriented reforms can be accomplished with a limited government role, and, after start-up costs, ongoing federal expenses would be modest, predictable, and controllable. When combined with the new $24 billion child health initiative to assist low-income families, the proposed plan would provide considerable progress toward universal access to affordable insurance coverage. PMID:12856671

  4. Tax subsidies for private health insurance.

    Science.gov (United States)

    Williams, Claudia; Burman, Len; Uccello, Cori; Wheaton, Laura; Kobes, Deborah; Khitatrakun, Surachai; Goodell, Sarah

    2003-05-01

    The exclusion from income and payroll taxes for employer-paid health insurance premiums amounted to more than $240 billion in 2010. As policy-makers search for ways to pay for health care reform and contain health care costs, this exclusion is coming under scrutiny, despite the fact that employee-sponsored insurance (ESI) is an integral part of the health insurance system. This update of a 2003 synthesis looks at the tax subsidy for private health insurance. Key findings include: The current tax subsidy benefits higher-income workers the most. The tax exclusion is worth more to those in higher tax brackets, higher-income workers are three times more likely to work for firms who offer ESI than lower-income workers, and they are more likely to purchase ESI when offered because they can afford it. Families earning $10,000 to $20,000 annually spend more than 25 percent of their income on health insurance but the value of their tax subsidy is only $1,500. By contrast, earners over $200,000 spend less than 5 percent on health insurance but their benefit is worth $4,500. Workers who cannot afford ESI or are ineligible, including the self-employed and many part-time workers, do not receive this subsidy when they purchase private, non-group coverage. PMID:22052181

  5. What Health Care Reform Means for Immigrants: Comparing the Affordable Care Act and Massachusetts Health Reforms.

    Science.gov (United States)

    Joseph, Tiffany D

    2016-02-01

    The 2010 Patient Protection and Affordable Care Act (ACA) was passed to provide more affordable health coverage to Americans beginning in 2014. Modeled after the 2006 Massachusetts health care reform, the ACA includes an individual mandate, Medicaid expansion, and health exchanges through which middle-income individuals can purchase coverage from private insurance companies. However, while the ACA provisions exclude all undocumented and some documented immigrants, Massachusetts uses state and hospital funds to extend coverage to these groups. This article examines the ACA reform using the Massachusetts reform as a comparative case study to outline how citizenship status influences individuals' coverage options under both policies. The article then briefly discusses other states that provide coverage to ACA-ineligible immigrants and the implications of uneven ACA implementation for immigrants and citizens nationwide. PMID:26567382

  6. Private Health Sector Assessment in Kenya

    OpenAIRE

    Barnes, Jeff; O'Hanlon, Barbara; Feeley, Frank III; McKeon, Kimberly; Gitonga, Nelson; Decker, Caytie

    2010-01-01

    Kenya private sector is one of the most developed and dynamic in Sub Saharan Africa. In this context, USAID/Kenya requested that the Private Sector Partnerships-One project (PSP One) conduct an assessment of the private health sector in Kenya. The scope of work involved assessing the role of the private sector in the overall health system, considering the potential of the private sector to...

  7. Mental Health Services at Selected Private Schools

    Science.gov (United States)

    Van Hoof, Thomas J.; Sherwin, Tierney E.; Baggish, Rosemary C.; Tacy, Peter B.; Meehan, Thomas P.

    2004-01-01

    Private schools educate a significant percentage of US children and adolescents. Private schools, particularly where students reside during the academic year, assume responsibility for the health and well-being of their students. Children and adolescents experience mental health problems at a predictable rate, and private schools need a mechanism…

  8. How High is America's Health Care Cost Burden? Findings from the Commonwealth Fund Health Care Affordability Tracking Survey, July-August 2015.

    Science.gov (United States)

    Collins, Sara R; Gunja, Munira; Doty, Michelle M; Buetel, Sophie

    2015-11-01

    One-quarter of privately insured working-age adults have high health care cost burdens relative to their incomes in 2015, according to the Commonwealth Fund Health Care Affordability Index, a comprehensive measure of consumer health care costs. This figure, which is based on a nationally representative sample of people with private insurance who are mainly covered by employer plans, is statistically unchanged from 2014. When looking specifically at adults with low incomes, more than half have high cost burdens. In addition, when privately insured adults were asked how they rated their affordability, greater shares reported their premiums and deductible costs were difficult or impossible to afford than the Index would suggest. Health plan deductibles and copayments had negative effects on many people's willingness to get needed health care or fill prescriptions. In addition, many consumers are confused about which services are free to them and which count toward their deductible. PMID:26634240

  9. Private health insurance: implications for developing countries.

    Science.gov (United States)

    Sekhri, Neelam; Savedoff, William

    2005-02-01

    Private health insurance is playing an increasing role in both high- and low-income countries, yet is poorly understood by researchers and policy-makers. This paper shows that the distinction between private and public health insurance is often exaggerated since well regulated private insurance markets share many features with public insurance systems. It notes that private health insurance preceded many modern social insurance systems in western Europe, allowing these countries to develop the mechanisms, institutions and capacities that subsequently made it possible to provide universal access to health care. We also review international experiences with private insurance, demonstrating that its role is not restricted to any particular region or level of national income. The seven countries that finance more than 20% of their health care via private health insurance are Brazil, Chile, Namibia, South Africa, the United States, Uruguay and Zimbabwe. In each case, private health insurance provides primary financial protection for workers and their families while public health-care funds are targeted to programmes covering poor and vulnerable populations. We make recommendations for policy in developing countries, arguing that private health insurance cannot be ignored. Instead, it can be harnessed to serve the public interest if governments implement effective regulations and focus public funds on programmes for those who are poor and vulnerable. It can also be used as a transitional form of health insurance to develop experience with insurance institutions while the public sector increases its own capacity to manage and finance health-care coverage. PMID:15744405

  10. The Affordable Care Act and implications for young adult health

    OpenAIRE

    Monaghan, Maureen

    2013-01-01

    In the USA, young adults are most likely to be uninsured and least likely to report a usual source of medical care than any age group. The Patient Protection and Affordable Care Act (ACA) recognizes the critical need for expanded insurance coverage for this age group, and multiple provisions of the ACA address insurance coverage and health care utilization in young adults. This paper presents a brief overview of the challenges of maintaining health insurance coverage and accessing health care...

  11. Affordability in Health Care: Operationalizations and Applications in Different Contexts

    OpenAIRE

    Niëns, Laurens

    2014-01-01

    markdownabstract__Abstract__ Over the last decades, total health expenditures have increased significantly (Meltzer, 2001; Folland et al., 2004). Governments in low- and middle-income countries (LMICs) as well as in high-income countries face the difficult challenge of ensuring that necessary interventions are accessible for those who need them, while keeping care affordable. Since good quality health care and new medical interventions can be expensive, the process of balancing the goals of e...

  12. FRUGAL INNOVATIONS: THE FUTURE OF AFFORDABLE HEALTH CARE

    Directory of Open Access Journals (Sweden)

    GEETHA MANI, KALAIVANI ANNADURAI RAJA DANASEKARAN

    2014-06-01

    Full Text Available Frugal innovations are cost-conscious innovations developed to meet the needs in resource-poor settings, withoutcompromising quality. While there have been various innovations in the field of health care in the past decades, there is avast difference in the distribution and utilization of these innovations between developed and developing countries. Frugalinnovations can play a potential role in bridging the gap between countries and ensure affordable health care for all.

  13. Modelling the affordability and distributional implications of future health care financing options in South Africa.

    Science.gov (United States)

    McIntyre, Di; Ataguba, John E

    2012-03-01

    South Africa is considering introducing a universal health care system. A key concern for policy-makers and the general public is whether or not this reform is affordable. Modelling the resource and revenue generation requirements of alternative reform options is critical to inform decision-making. This paper considers three reform scenarios: universal coverage funded by increased allocations to health from general tax and additional dedicated taxes; an alternative reform option of extending private health insurance coverage to all formal sector workers and their dependents with the remainder using tax-funded services; and maintaining the status quo. Each scenario was modelled over a 15-year period using a spreadsheet model. Statistical analyses were also undertaken to evaluate the impact of options on the distribution of health care financing burden and benefits from using health services across socio-economic groups. Universal coverage would result in total health care spending levels equivalent to 8.6% of gross domestic product (GDP), which is comparable to current spending levels. It is lower than the status quo option (9.5% of GDP) and far lower than the option of expanding private insurance cover (over 13% of GDP). However, public funding of health services would have to increase substantially. Despite this, universal coverage would result in the most progressive financing system if the additional public funding requirements are generated through a surcharge on taxable income (but not if VAT is increased). The extended private insurance scheme option would be the least progressive and would impose a very high payment burden; total health care payments on average would be 10.7% of household consumption expenditure compared with the universal coverage (6.7%) and status quo (7.5%) options. The least pro-rich distribution of service benefits would be achieved under universal coverage. Universal coverage is affordable and would promote health system equity, but

  14. Private Health Sector Assessment in Tanzania

    OpenAIRE

    White, James; O’Hanlon, Barbara; Chee, Grace; Malangalila, Emmanuel; Kimambo, Adeline; Coarasa, Jorge; Callahan, Sean; Levey, Ilana Ron; McKeon, Kim

    2013-01-01

    Tanzania exemplifies the developing world's struggle to achieve 'middle-income' country status while confronting widespread poverty and substantial health challenges-such as persistently high child and maternal mortality, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), tuberculosis (TB), and malaria. In this context, Tanzania's National Public Private Partnership (PPP) policy and second Health Sector Strategic Plan (HSSP) included a call for a private health secto...

  15. Implementing the Affordable Care Act: choosing an essential health benefits benchmark plan.

    Science.gov (United States)

    Corlette, Sabrina; Lucia, Kevin W; Levin, Max

    2013-03-01

    To improve the adequacy of private health insurance, the Affordable Care Act requires insurers to cover a minimum set of medical benefits, known as "essential health benefits." In implementing this requirement, states were asked to select a "benchmark plan" to serve as a reference point. This issue brief examines state action to select an essential health benefits benchmark plan and finds that 24 states and the District of Columbia selected a plan. All but five states will have a small-group plan as their benchmark. Each state, whether or not it made a benchmark selection, will have a set of essential health benefits that reflects local, employer-based health insurance coverage currently sold in the state. States adopted a variety of approaches to selecting a benchmark, including intergov­ernmental collaboration, stakeholder engagement, and research on benchmark options. PMID:23547335

  16. National workplace health promotion surveys: the Affordable Care Act and future surveys.

    Science.gov (United States)

    DeJoy, David M; Dyal, Mari-Amanda; Padilla, Heather M; Wilson, Mark G

    2014-01-01

    This commentary reviews findings from the four previous national surveys of workplace health promotion activities (1985, 1992, 1999, and 2004, respectively) and offers recommendations for future surveys mandated under the Affordable Care Act of 2010. Future surveys should place greater emphasis on assessing program quality, reach, and effectiveness. Both employer and employee input should be sought. In addition, sampling plans should differentiate worksites from employers, and results should include public as well as private sector organizations. Ideas are offered for addressing these limitations and for creating a sustainable survey process and multifunctional database of results. PMID:24380423

  17. Medical Progress and Supplementary Private Health Insurance

    OpenAIRE

    Reiner Leidl

    2003-01-01

    In many welfare states, tightening financial constraints suggest excluding some medical services, including new ones, from social security coverage. This may create opportunities for private health insurance. This study analyses the performance of supplementary private health insurance (SPHI) in markets for excluded services in terms of population covered, risk selection and insurer profits. Using a utility-based simulation model, the insurance market is described as a composite of sub-market...

  18. Health Migration: Crossing Borders for Affordable Health Care

    Directory of Open Access Journals (Sweden)

    Jennifer Miller-Thayer

    2010-10-01

    Full Text Available Approximately 45.7 million people in the United States are uninsured and unknown numbers of this population are underinsured, severely limiting their access to medical care. To address this problem, people use innovative strategies to increase their access through cross-border care options. The U.S.-Mexico border provides unique challenges and opportunities for health care in this context. The lower cost of medical and dental procedures and medications in Mexico makes that country an attractive alternative for low-income populations in the United States. Thus segments of the U.S. population practice transnational medical consumerism in an attempt to optimize their health by using the resources available in both countries. This practice has economic benefits for the people who access health care at an affordable rate and for the medical markets of the country providing the care. Drawing on data collected in the field in 2002, 2004, and 2005, this paper presents some of the complexities and dynamics of medical pluralism occurring at the U.S.-Mexico border.Environ 45,7 millions de personnes vivant aux Etats-Unis n’ont pas de couverture sociale et nombreux sont celles à être sous-assurées, ce qui limite considérablement leur accès aux soins. Face à ce problème, les Américains font preuve d'ingéniosité pour améliorer leur accès aux soins : ils se font soigner au-delà des frontières. Dans ce contexte, la frontière entre les Etats-Unis et le Mexique offre des opportunités uniques de soins. Le Mexique constitue en effet une alternative séduisante pour les Américains à faible revenu, car les tarifs des actes médicaux et dentaires, et des médicaments, sont nettement inférieurs à ceux en vigueur aux Etats-Unis. Ainsi, certains Américains pratiquent le consumérisme médical transnational et recourent aux ressources disponibles dans les deux pays afin d’optimiser leur santé. Cette pratique présente des avantages économiques

  19. The Politics of Native American Health Care and the Affordable Care Act.

    Science.gov (United States)

    Skinner, Daniel

    2016-02-01

    This article examines an important but largely overlooked dimension of the Patient Protection and Affordable Care Act (ACA), namely, its significance for Native American health care. The author maintains that reading the ACA against the politics of Native American health care policy shows that, depending on their regional needs and particular contexts, many Native Americans are well-placed to benefit from recent Obama-era reforms. At the same time, the kinds of options made available by the ACA constitute a departure from the service-based (as opposed to insurance-based) Indian Health Service (IHS). Accordingly, the author argues that ACA reforms--private marketplaces, Medicaid expansion, and accommodations for Native Americans--are best read as potential "supplements" to an underfunded IHS. Whether or not Native Americans opt to explore options under the ACA will depend in the long run on the quality of the IHS in the post-ACA era. Beyond understanding the ACA in relation to IHS funding, the author explores how Native American politics interacts with the key tenets of Obama-era health care reform--especially "affordability"--which is critical for understanding what is required from and appropriate to future Native American health care policy making. PMID:26567380

  20. Public-Private Partnerships In Health

    OpenAIRE

    khalid BOUTI; Rajae BORKI

    2015-01-01

    Extract:The current importance of public debt requires governments to increasingly shift towards Public-Private Partnerships (PPPs). They are long-term contracts of private financing method providing or contributing to public service. The payment is made by the public partner and/or users of the service.The World Health Organization (WHO) defines this type of partnership as ‘‘a means to bring together a set of actors for the common goal of improving the health of populations based on mutually...

  1. Private health insurance and regional Australia.

    Science.gov (United States)

    Lokuge, Buddhima; Denniss, Richard; Faunce, Thomas A

    2005-03-21

    Since 1996, an increasing proportion of federal government expenditure has been directed into Australia's healthcare system via private health insurance (PHI) subsidies, in preference to Medicare and the direct funding of public health services. A central rationale for this policy shift is to increase the use of private hospital services and thereby reduce pressure on public inpatient facilities. However, the impact of this reform process on regional Australia has not been addressed. An analysis of previously unpublished Australian Bureau of Statistics data shows that regional Australians have substantially lower levels of private health fund membership. As a result, regional areas appear to be receiving substantially less federal government health funding, compared with cities, than if these funds were allocated on a per-capita basis. We postulate that the lower level of membership in regional areas is mainly due to the limited availability of private inpatient facilities, making PHI less attractive to rural Australians. We conclude that PHI as a vehicle for mainstream federal health financing has potential structural failures that disadvantage regional Australians. PMID:15777145

  2. Do Catalan private hospitals enjoy financial health?

    Directory of Open Access Journals (Sweden)

    Judit Creixans Tenas

    2016-02-01

    Full Text Available Purpose: The present study reflects the economic and financial analysis of  private hospitals with non-charitable character in Catalonia 2008-2013. The private health sector is considered to be a service activity that develops an important social role. The study positions these analysed centers in the Catalan and Spanish health sector and presents the main economic and financial indicators to diagnose the situation of these companies during the period indicated by analysing short and long-term results and analysis of changes in equity and cash flows of the wineries. Design/methodology/approach: The data used comes from the statements of the Catalan hospital centers in the period 2008-2013 and in particular, it contains a sample of 94 Catalan private hospitals, that mostly are considered large-level accounting (according to the General Accounting Plan. The economic and financial  analysis has carried out using descriptive statistics and analysis results and conclusions have been reached. Findings: The study noted that enables private hospitals in this period have a healthy economic and financial status, although it should improve the management of assets. Most sales are concentrated with a small number of hospitals and, regarding the evolution of the results, produces two distinct stages, the first period of decrease (2008-2010 and the second period of growth and recovery from 2011.. Research limitations/implications: It would be desirable to perform the same study by the Spanish private hospitals in order to compare the economic and financial analysis of the Catalan private sector with the Spanish private sector. Practical implications: It allows us to assess the projection of this sector in recent years in Catalonia in order to take the appropriate economic decisions in this regard. Social implications: The results show the changes that have occurred over the years in the economic crisis of the period analysed. Originality / value: For

  3. Wisconsin Blues' conversion: the privatization of a health insurer.

    Science.gov (United States)

    Fetter, Bruce

    2007-12-01

    Wisconsin Blue Cross was chartered in 1939 as a "charitable and benevolent corporation" to cover hospitalization costs at a time when most Americans did not have health insurance. In order to promote the protection that insurance afforded, the Wisconsin legislature exempted the company from most state and local taxes. During World War II, the federal government created tax deductions for both employers and employees, which created new demand for health insurance. The company extended its coverage to physicians' services and, as Blue Cross Blue Shield United of Wisconsin (BCBSUW), became the state's largest health insurer. In 1965, when Medicare and Medicaid further extended health coverage to the elderly, disabled, and indigent, the company took on the additional activity of administering those benefits on behalf of the government. The surge in demand for health care led to inflation in health costs in the 1970s. Many in the insurance industry and government felt this inflation could be controlled through the extension of market competition among insurers. They therefore proposed abandoning their tax exemptions in exchange for the right to operate as for-profit corporations. As a condition of this transformation, the state government required that BCBSUW create charitable foundations to benefit medical education and public health. After privatization, however, the for-profit successors of BCBSUW failed to control both medical costs and company administrative expenses. A substantial share of the profits went to their executives. PMID:18237069

  4. Health promotion: private voluntary organisations in action.

    Science.gov (United States)

    Arnold, J P

    1998-01-01

    Since the country's independence in 1947, India has come a long way in its efforts to improve health services. One initiative taken by the Government is the involvement of private voluntary organizations (PVOs) in the health promotion activity. Several grant-in-aid schemes have been initiated, whereby PVOs obtain government funding for the provision of services and the promotion of health and family welfare activities. The US Agency for International Development has supported the government in this endeavor. Keeping these in mind, Tamil Nadu Voluntary Health Association, a state-level association of voluntary health organizations such as hospitals, dispensaries and community-based health organizations, worked out a proposal for support and collaboration with the Government of India. This association aims to promote health through networking and coordinating with voluntary organizations, strengthening of nongovernmental organization activities, collection and dissemination of relevant information, lobbying, campaigning and liaisoning for health issues. This article highlights the experience of the Association in conceiving and carrying out its proposal/project. In particular, it describes the planning and implementation of the Integrated Project for Development of Primary Health Care and Women's Welfare in Tamil Nadu as well as the achievements of the project. The main goal of this project is to coordinate with various levels of health services to improve the health status of rural Tamil Nadu. PMID:12349576

  5. Policy Dilemmas in Latino Health Care and Implementation of the Affordable Care Act

    Science.gov (United States)

    Ortega, Alexander N.; Rodriguez, Hector P.; Bustamante, Arturo Vargas

    2016-01-01

    The changing Latino demographic in the United States presents a number of challenges to health care policy makers, clinicians, organizations, and other stakeholders. Studies have demonstrated that Latinos tend to have worse patterns of access to, and utilization of, health care than other ethnic and racial groups. The implementation of the Affordable Care Act (ACA) of 2010 may ameliorate some of these disparities. However, even with the ACA, it is expected that Latinos will continue to have problems accessing and using high-quality health care, especially in states that are not expanding Medicaid eligibility as provided by the ACA. We identify four current policy dilemmas relevant to Latinos’ health and ACA implementation: (a) the need to extend coverage to the undocumented; (b) the growth of Latino populations in states with limited insurance expansion; (c) demands on public and private systems of care; and (d) the need to increase the number of Latino physicians while increasing the direct patient-care responsibilities of nonphysician Latino health care workers. PMID:25581154

  6. The rise of private health insurande in Denmark

    DEFF Research Database (Denmark)

    Dejgaard, Thomas Engel

    2011-01-01

    private health insurances in Denmark means that alongside the public healthcare institution there has grown a private institutional layer. The existence of this private institutional layer raises questions of what kind of influence the new private institutions can have on the existing public healthcare...

  7. Public-Private Partnerships In Health

    Directory of Open Access Journals (Sweden)

    khalid BOUTI

    2015-06-01

    Full Text Available Extract:The current importance of public debt requires governments to increasingly shift towards Public-Private Partnerships (PPPs. They are long-term contracts of private financing method providing or contributing to public service. The payment is made by the public partner and/or users of the service.The World Health Organization (WHO defines this type of partnership as ‘‘a means to bring together a set of actors for the common goal of improving the health of populations based on mutually agreed roles and principles.’’Historically, the principle of PPP was established by the Private Finance Initiative (PFI, launched by the conservative government of John Major in 1992. It was from this moment that this model quickly spread to the rest of the world. In the mid-90s and from Australia, PPP agreement began to become part of the language of governments. In 1997, Labour with Tony Blair leading, strongly developed this management method, first and particularly in hospitals and then, in the entire public sector and spreading to the Royal Navy. Today, 10-15% of British public investments are made using PFI method....

  8. Public and private sector compensation: what is affordable in this recession and beyond? -- a conference summary

    OpenAIRE

    Lise Valentine; Richard H. Mattoon

    2009-01-01

    On February 26, 2009, the Federal Reserve Bank of Chicago and The Civic Federation hosted a forum to examine the differences in wages and benefits between the public sector and private sector and to discuss best practices in work force sustainability.

  9. Personal Pensions with Risk Sharing, Affordable, Adequate and Stable Private Pensions in Europe

    NARCIS (Netherlands)

    Bovenberg, Lans; Nijman, Theo

    2015-01-01

    Private pension provision faces the challenging task of providing stable income streams during retirement. The challenge has increased markedly in the last decades due to volatile financial markets, falling interest rates and the withdrawal of employers and external insurers as risk bearers of syste

  10. Private Health Insurance in Malaysia: Policy Options for a Public-Private Partnership

    OpenAIRE

    Nik Rosnah Wan Abdullah; Daniel Ng Kok Eng

    2009-01-01

    Private health insurance has become important in the funding of healthcare in Malaysia. However, there have been rising concerns over the role of the private sector in healthcare financing because of illegitimate and unethical practices. This paper addresses these issues by focusing on the operational aspects of private health insurance to examine whether there are differences in charges between the insured and non-insured patients in Malaysia. The findings are based on an assessment of hospi...

  11. Job mobility among parents of children with chronic health conditions: Early effects of the 2010 Affordable Care Act.

    Science.gov (United States)

    Chatterji, Pinka; Brandon, Peter; Markowitz, Sara

    2016-07-01

    We examine the effects of the 2010 Patient Protection and Affordable Care Act's (ACA) prohibition of preexisting conditions exclusions for children on job mobility among parents. We use a difference-in-difference approach, comparing pre-post policy changes in job mobility among privately-insured parents of children with chronic health conditions vs. privately-insured parents of healthy children. Data come from the 2004 and 2008 Survey of Income and Program Participation (SIPP). Among married fathers, the policy change is associated with about a 0.7 percentage point, or 35 percent increase, in the likelihood of leaving an employer voluntarily. We find no evidence that the policy change affected job mobility among married and unmarried mothers. PMID:27060524

  12. Availability, prices and affordability of the World Health Organization’s essential medicines for children in Guatemala

    Science.gov (United States)

    2012-01-01

    Background Several World Health Organization (WHO) initiatives aim to improve the accessibility of safe and effective medicines for children. A first step in achieving this goal is to obtain a baseline measure of access to essential medicines. The objective of this project was to measure the availability, prices, and affordability of children’s medicines in Guatemala. Methods An adaption of the standardized methodology developed by the World Health Organization and Health Action International (HAI) was used to conduct a cross sectional survey to collect data on availability and final patient prices of medicines in public and private sector medicine outlets during April and May of 2010. Results A subset of the public sector, Programa de Accesibilidad a los Medicamentos (PROAM), had the lowest average availability (25%) compared to the private sector (35%). In the private sector, highest and lowest priced medicines were 22.7 and 10.7 times more expensive than their international reference price comparison. Treatments were generally unaffordable, costing as much as 15 days wages for a course of ceftriaxone. Conclusions Analysis of the procurement, supply and distribution of specific medicines is needed to determine reasons for lack of availability. Improvements to accessibility could be made by developing an essential medicines list for children and including these medicines in national purchasing lists. PMID:22747646

  13. 78 FR 13405 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review

    Science.gov (United States)

    2013-02-27

    ... Care Act; Health Insurance Market Rules; Rate Review'' (77 FR 70584). These standards apply to health... grandfathered health insurance coverage. \\3\\ The applicable definitions for ``individual market,'' ``small group... Affordable Care Act. \\4\\ See 45 CFR 144.103 for definitions of ``plan year'' and ``policy year.'' These...

  14. Health Outcomes and Green Renovation of Affordable Housing

    Science.gov (United States)

    Breysse, Jill; Jacobs, David E.; Weber, William; Dixon, Sherry; Kawecki, Carol; Aceti, Susan; Lopez, Jorge

    2011-01-01

    Objective This study sought to determine whether renovating low-income housing using “green” and healthy principles improved resident health and building performance. Methods We investigated resident health and building performance outcomes at baseline and one year after the rehabilitation of low-income housing using Enterprise Green Communities green specifications, which improve ventilation; reduce moisture, mold, pests, and radon; and use sustainable building products and other healthy housing features. We assessed participant health via questionnaire, provided Healthy Homes training to all participants, and measured ventilation, carbon dioxide, and radon. Results Adults reported statistically significant improvements in overall health, asthma, and non-asthma respiratory problems. Adults also reported that their children's overall health improved, with significant improvements in non-asthma respiratory problems. Post-renovation building performance testing indicated that the building envelope was tightened and local exhaust fans performed well. New mechanical ventilation was installed (compared with no ventilation previously), with fresh air being supplied at 70% of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers standard. Radon was Energy use was reduced by 45% over the one-year post-renovation period. Conclusions We found significant health improvements following low-income housing renovation that complied with green standards. All green building standards should include health requirements. Collaboration of housing, public health, and environmental health professionals through integrated design holds promise for improved health, quality of life, building operation, and energy conservation. PMID:21563714

  15. Demand for private health insurance: Is there a quality gap?

    OpenAIRE

    Costa-i-Font, Joan; Garcia, Jaume

    2001-01-01

    Quality of care is qualified as a main determinant of the demand for voluntary private health insurance (PHI) in National Health Systems (NHS). This paper provides new evidence on the influence of the quality gap between public and private health insurance and other demand determinants in the demand for PHI in Catalonia. The demand for PHI is modelled as a demand for health care quality. Unlike previous studies, the database employed allows for the development of a link bet...

  16. Public health, privatization, and market populism: a time for reflection.

    Science.gov (United States)

    Beauchamp, D

    1997-01-01

    The political, social, and economic ideology fueling the movement toward privatization in health care may be characterized as "market populism." Whether or not public health agencies retain their traditional roles in personal health services delivery, these organizations must serve as the predominant external source for quality monitoring, oversight, enforcement, and advocacy for communities in an environment that regards the private market as a panacea. PMID:10166215

  17. Private sector, human resources and health franchising in Africa

    Directory of Open Access Journals (Sweden)

    Prata Ndola

    2005-01-01

    Full Text Available In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank's Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset quintile groups, for treatment of diarrhoea and acute respiratory infections, proxies for publicly subsidized services. The evidence and theory on using franchise networks to supplement government programmes in the delivery of public health services was assessed. Examples from health franchises in Africa and Asia are provided to illustrate the potential for franchise systems to leverage private providers and so increase delivery-point availability for public-benefit services. We argue that based on the established demand for private medical services in Africa, these providers should be included in future planning on human resources for public health. Having explored the range of systems that have been tested for working with private providers, from contracting to vouchers to behavioural change and provider education, we conclude that franchising has the greatest potential for integration into large-scale programmes in Africa to address critical illnesses of public health importance.

  18. Private sector, human resources and health franchising in Africa.

    Science.gov (United States)

    Prata, Ndola; Montagu, Dominic; Jefferys, Emma

    2005-04-01

    In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. Using data from The World Bank's Health Nutrition and Population Poverty Thematic Reports on 22 countries in Africa, an assessment was made of the use of public and private health services, by asset quintile groups, for treatment of diarrhoea and acute respiratory infections, proxies for publicly subsidized services. The evidence and theory on using franchise networks to supplement government programmes in the delivery of public health services was assessed. Examples from health franchises in Africa and Asia are provided to illustrate the potential for franchise systems to leverage private providers and so increase delivery-point availability for public-benefit services. We argue that based on the established demand for private medical services in Africa, these providers should be included in future planning on human resources for public health. Having explored the range of systems that have been tested for working with private providers, from contracting to vouchers to behavioural change and provider education, we conclude that franchising has the greatest potential for integration into large-scale programmes in Africa to address critical illnesses of public health importance. PMID:15868018

  19. Private Health Insurance for the Poor in Developing Countries?

    OpenAIRE

    Denis Drechsler; Johannes P. Jütting

    2005-01-01

    The financing of health care is a major challenge for developing countries, especially since deficiencies in national health systems specifically harm the poor. Innovative financing mechanisms, such as private health insurance, offer benefits and risks. Their implementation requires caution on the part of policy makers who need to consider adequate regulation in order to optimise health outcomes.

  20. The Impact of Electricity Sector Privatization on Public Health

    DEFF Research Database (Denmark)

    Gonzalez-Eiras, Martin; Rossi, Martín

    2008-01-01

    We use province-level data for Argentina to test for the causal relation between electricity distribution and health. We are interested in the impact of privatization on two output measures, incidence of low birth weight and child mortality rates caused by food poisoning. Privatization improves s...

  1. Racial and Ethnic Health Disparities and the Affordable Care Act: a Status Update.

    Science.gov (United States)

    Sealy-Jefferson, Shawnita; Vickers, Jasmine; Elam, Angela; Wilson, M Roy

    2015-12-01

    Persistent racial and ethnic health disparities exist in the USA, despite decades of research and public health initiatives. Several factors contribute to health disparities, including (but not limited to) implicit provider bias, access to health care, social determinants, and biological factors. Disparities in health by race/ethnicity are unacceptable and correctable. The Patient Protection and Affordable Care Act is a comprehensive legislation that is focused on improving health care access, quality, and cost control. This health care reform includes specific provisions which focus on preventive care, the standardized collection of data on race, ethnicity, primary language and disability status, and health information technology. Although some provisions of the Patient Protection and Affordable Care Act have not been implemented, such as funding for the U.S. Public Health Sciences track, which would have addressed the shortage of medical professionals in the USA who are trained to use patient-centered, interdisciplinary, and care coordination approaches, this legislation is still poised to make great strides toward eliminating health disparities. The purpose of this manuscript is to highlight the unprecedented opportunities that exist for the Patient Protection and Affordable Care Act to reduce racial and ethnic disparities in health in the USA. PMID:26668787

  2. "White Box" Epidemiology and the Social Neuroscience of Health Behaviors: The Environmental Affordances Model.

    Science.gov (United States)

    Mezuk, Briana; Abdou, Cleopatra M; Hudson, Darrell; Kershaw, Kiarri N; Rafferty, Jane A; Lee, Hedwig; Jackson, James S

    2013-07-01

    Crucial advances have been made in our knowledge of the social determinants of health and health behaviors. Existing research on health disparities, however, generally fails to address a known paradox in the literature: While blacks have higher risk of medical morbidity relative to non-Hispanic whites, blacks have lower rates of common stress-related forms of psychopathology such as major depression and anxiety disorders. In this article we propose a new theoretical approach, the Environmental Affordances Model, as an integrative framework for the origins of both physical and mental health disparities. We highlight early empirical support and a growing body of experimental animal and human research on self-regulatory health behaviors and stress coping that is consistent with the proposed framework. We conclude that transdisciplinary approaches, such as the Environmental Affordances Model, are needed to understand the origins of group-based disparities to implement effective solutions to racial and ethnic group inequalities in physical and mental health. PMID:24224131

  3. “White Box” Epidemiology and the Social Neuroscience of Health Behaviors: The Environmental Affordances Model

    Science.gov (United States)

    Mezuk, Briana; Abdou, Cleopatra M.; Hudson, Darrell; Kershaw, Kiarri N.; Rafferty, Jane A.; Lee, Hedwig; Jackson, James S.

    2013-01-01

    Crucial advances have been made in our knowledge of the social determinants of health and health behaviors. Existing research on health disparities, however, generally fails to address a known paradox in the literature: While blacks have higher risk of medical morbidity relative to non-Hispanic whites, blacks have lower rates of common stress-related forms of psychopathology such as major depression and anxiety disorders. In this article we propose a new theoretical approach, the Environmental Affordances Model, as an integrative framework for the origins of both physical and mental health disparities. We highlight early empirical support and a growing body of experimental animal and human research on self-regulatory health behaviors and stress coping that is consistent with the proposed framework. We conclude that transdisciplinary approaches, such as the Environmental Affordances Model, are needed to understand the origins of group-based disparities to implement effective solutions to racial and ethnic group inequalities in physical and mental health. PMID:24224131

  4. Do Catalan private hospitals enjoy financial health?

    OpenAIRE

    Judit Creixans Tenas; Nuria Arimany-Serrat

    2016-01-01

    Objecte: El present treball reflecteix l'anàlisi econòmica financera dels centres hospitalaris privats no benèfics catalans en el període 2008-2013. S'ha considerat el sector sanitari privat per ser una activitat de serveis que compleix un important paper social. L'estudi posiciona els centres analitzats en el sector sanitari català i espanyol i presenta els principals indicadors econòmics i financers per diagnosticar la salut econòmica financera d’aquests hospitals en el perío...

  5. Privatizing the English National Health Service: an irregular verb?

    Science.gov (United States)

    Powell, Martin; Miller, Robin

    2013-10-01

    This article explores different stakeholder perspectives of "privatization" in the English National Health Service (NHS). Much of the academic literature makes empirical claims about privatization on the basis of absent or shaky definitions of the term, resulting in much of the debate on this issue largely being a "non-debate," where opponents talk past rather than to each other. We aim to throw light on privatization by applying the lens of the "three-dimensional" approach (ownership, finance, and regulation) of the mixed economy of welfare to the views of key voices within these debates. These stakeholder perspectives are political (parliamentary debates), public (opinion polls), clinical provider (British Medical Association and Royal College of Nursing), and campaigning groups. We argue that in terms of grammar, "privatize" seems to be an irregular verb: I want more private-sector involvement; you wish to privatize the NHS. The term privatization is multidimensional, and definitions and operationalizations of the term are often implicit, unclear, and conflicting, resulting in differing accounts of the occurrence, chronology, and degree of privatization in the NHS. Stakeholders have divergent interests, and they use "privatization" as a way to express them, resulting in a Tower of Babel. PMID:23794740

  6. Health Care Reform Hinges on Private-Sector Collaboration

    OpenAIRE

    Novelli, Bill

    2009-01-01

    America's health care system is characterized by rising costs, increasing numbers of Americans who lack health insurance coverage, and poor quality of health care delivery. The convergence of these factors is adversely affecting not only the health of Americans but also the ability of businesses to compete successfully in a global marketplace. AARP and other nonprofit organizations are collaborating with the private sector to have more people covered by health insurance and to educate them to...

  7. Global Marketplace for Private Health Insurance : Strength in Numbers

    OpenAIRE

    Preker, Alexander S.; Zweifel, Peter; Onno P. Schellekens

    2010-01-01

    The development challenges of addressing health problems in low- and middle-income countries are daunting but not insurmountable. There are now known and affordable interventions to deal with many aspects of the HIV/AIDS crisis as well as the continued challenge posed by malaria and other major infectious diseases. Three major development objectives of health insurance in low- and middle income countries are highlighted in this volume: securing sustainable financing for health care providers ...

  8. The Affordable Care Act, health care reform, prescription drug formularies and utilization management tools.

    Science.gov (United States)

    Ung, Brian L; Mullins, C Daniel

    2015-01-01

    The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability. PMID:25217142

  9. Covering young adults under the Affordable Care Act: the importance of outreach and Medicaid expansion: findings from the Commonwealth Fund Health Insurance Tracking Survey of Young Adults, 2013.

    Science.gov (United States)

    Collins, Sara R; Rasmussen, Petra W; Garber, Tracy; Doty, Michelle M

    2013-08-01

    There is concern that many young adults (ages 19--29) will remain without health insurance in 2014 despite the Affordable Care Act's reforms, including subsidized private coverage offered in new state marketplaces and expanded Medicaid eligibility. How things turn out will likely depend on outreach efforts and states' decisions on expanding Medicaid. Commonwealth Fund Health Insurance Tracking Survey data from 2011 and 2013 show increasing awareness among young adults of the 2010 requirement that health plans cover children under age 26. Of the estimated 15 million young adults enrolled in a parent's plan in the prior 12 months, 7.8 million would not likely have been eligible to enroll prior to the law. Still, only 27 percent of 19-to-29-year-olds are aware of the marketplaces. Meanwhile, most uninsured young adults living below poverty will not have access to subsidized public or private insurance in states opting out of the Medicaid expansion. PMID:24044138

  10. Accessibility, affordability and use of health services in an urban area in South Africa

    Directory of Open Access Journals (Sweden)

    Ethelwynn L. Stellenberg

    2015-02-01

    Full Text Available Background: Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right.Objectives: The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured population in the Western Cape, South Africa.Method: A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6% was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data.Results: The hypothesis was accepted. The statistical association between affordability (p = < 0.01, accessibility (p = < 0.01 and the use of health services was found to be significant using the Chi-square (χ² test.Conclusion: The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.

  11. Public Ends, Private Means : Strategic Purchasing of Health Services

    OpenAIRE

    Alexander S. Preker; Liu, Xingzhu; Velenyi, Edit V.; Baris, Enis

    2007-01-01

    Public Ends, Private Means: Strategic purchasing of value for money in health services is part of a series of World Bank publications on ways to make public spending on health care more efficient and equitable in developing countries. It reviews the underlying economics in terms of agency theory, behavioral science, contract theory, transaction costs, and public choice theory. It provides a ...

  12. Affordability as a discursive accomplishment in a changing National Health Service.

    Science.gov (United States)

    Russell, Jill; Greenhalgh, Trisha

    2012-12-01

    Health systems worldwide face the challenges of rationing. The English National Health Service (NHS) was founded on three core principles: universality, comprehensiveness, and free at the point of delivery. Yet patients are increasingly hearing that some treatments are unaffordable on the NHS. We considered affordability as a social accomplishment and sought to explore how those charged with allocating NHS resources achieved this in practice. We undertook a linguistic ethnography to examine the work practices of resource allocation committees in three Primary Care Trusts (PCTs) in England between 2005 and 2012, specifically deliberations over 'individual funding requests' (IFRs)--requests by patients and their doctors for the PCT to support a treatment not routinely funded. We collected and analysed a diverse dataset comprising policy documents, legal judgements, audio recordings, ethnographic field notes and emails from PCT committee meetings, interviews and a focus group with committee members. We found that the fundamental values of universality and comprehensiveness strongly influenced the culture of these NHS organisations, and that in this context, accomplishing affordability was not easy. Four discursive practices served to confer legitimacy on affordability as a guiding value of NHS health care: (1) categorising certain treatments as only eligible for NHS funding if patients could prove 'exceptional' circumstances; (2) representing resource allocation decisions as being not (primarily) about money; (3) indexical labelling of affordability as an ethical principle, and (4) recontextualising legal judgements supporting refusal of NHS treatment on affordability grounds as 'rational'. The overall effect of these discursive practices was that denying treatment to patients became reasonable and rational for an organisation even while it continued to espouse traditional NHS values. We conclude that deliberations about the funding of treatments at the margins of NHS

  13. Health literacy and the Affordable Care Act: a policy analysis for children with special health care needs in the USA

    Directory of Open Access Journals (Sweden)

    Keim-Malpass J

    2015-04-01

    Full Text Available Jessica Keim-Malpass,1 Lisa C Letzkus,1,2 Christine Kennedy1 1University of Virginia School of Nursing, 2University of Virginia Children’s Hospital, Charlottesville, VA, USA Abstract: Children with special health care needs (CSHCN represent populations with chronic health conditions that are often high utilizers of health care. Limited health literacy has emerged as a key indicator of adverse health outcomes, and CSHCN from limited health literacy families are particularly vulnerable. The purpose of this policy analysis is to outline key provisions in the Affordable Care Act (ACA that incorporate health literacy approaches for implementation and have implications for CSHCN in the USA. Several key provisions are incorporated in the ACA that involve health literacy and have implications for CSHCN. These include: expansion of public insurance coverage and simplifying the enrollment process, provisions assuring equity in health care and communication among all populations, improving access to patient-centered medical homes that can offer care coordination, ensuring enhanced medication safety by changing liquid medication labeling requirements, and provisions to train health care providers on literacy issues. More research is needed to determine how provisions pertaining to health literacy in the ACA are implemented in various states. Keywords: children, special health care needs, health literacy, Affordable Care Act, health policy  

  14. Private finance and sustainable growth of national health expenditures.

    Science.gov (United States)

    Hilsenrath, Peter; Hill, James; Levey, Samuel

    2004-01-01

    This analysis explores the role of the private sector relative to all health spending among Organization for Economic Cooperation and Development (OECD) countries. Bi-variate regression was employed for 31 countries using current data. It was found that the share of GDP allocated to health varies among countries, ranging from 5 percent in Turkey to 14 percent in the United States. Variation in per capita income explains much of this difference but other factors are important too. One appears to be the role of the private sector in financing health expenditures. Our analysis concludes that concern about rising health sector costs should be placed in a larger context: rising health care costs may be justified if benefits are large enough and cover the opportunity costs of alternative uses of resources. PMID:15682949

  15. The U.S. Health Care Crisis Five Years After Passage of the Affordable Care Act: A Data Snapshot.

    Science.gov (United States)

    Hellander, Ida

    2015-01-01

    Despite passage of the Affordable Care Act in 2010, the U.S. health care crisis continues. While coverage has been expanded, the reform will leave 27 million people uninsured in 2024, according to the Congressional Budget Office. Much of the new coverage is of low actuarial value with high cost-sharing requirements, creating barriers to access. Choice of physician is restricted to narrow networks of providers. Recent measures of uninsurance, underinsurance, access to care, and health care costs are given. Changes in Medicare, particularly privatization and the rise of specialty drug tiers that limit access to medically necessary medications, are reviewed. Data on a new wave of consolidation among hospitals, medical groups, insurers, and drug companies are presented. The rise of ultra-high-price drugs, such as Solvadi, is raising pharmaceutical costs, particularly in Medicaid, the program for low-income Americans. International health comparisons continue to show the United States performing poorly in relation to other countries. Recent polling data are presented, showing support for more fundamental reform. PMID:26251349

  16. The Relevance of the Affordable Care Act for Improving Mental Health Care.

    Science.gov (United States)

    Mechanic, David; Olfson, Mark

    2016-03-28

    Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce. PMID:26666969

  17. Private expenditure and the role of private health insurance in Greece: status quo and future trends.

    Science.gov (United States)

    Siskou, Olga; Kaitelidou, Daphne; Economou, Charalampos; Kostagiolas, Peter; Liaropoulos, Lycourgos

    2009-10-01

    The health care system in Greece is financed in almost equal proportions by public and private sources. Private expenditure, consists mostly of out-of-pocket and under-the-table payments. Such payments strongly suggest dissatisfaction with the public system, due to under financing during the last 25 years. This gap has been filled rapidly by the private sector. From this point of view, one might suggest that the flourishing development of private provision may lead in turn to a corresponding growth in private health insurance (PHI). This paper aims to examine the role of PHI in Greece, to identify the factors influencing its development, and to make some suggestions about future policies and trends. In the decade of 1985-1995 PHI show increasing activity, reflecting the intention of some citizens to seek health insurance solutions in the form of supplementary cover in order to ensure faster access, better quality of services, and increased consumer choice. The benefits include programs covering hospital expenses, cash benefits, outpatient care expenses, disability income insurance, as well as limited managed care programs. However, despite recent interest, PHI coverage remains low in Greece compared to other EU countries. Economic, social and cultural factors such as low average household income, high unemployment, obligatory and full coverage by social insurance, lead to reluctance to pay for second-tier insurance. Instead, there is a preference to pay a doctor or hospital directly even in the form of under-the-table payments (which are remarkably high in Greece), when the need arises. There are also factors endogenous to the PHI industry, related to market policies, low organisational capacity, cream skimming, and the absence of insurance products meeting consumer requirements, which explain the relatively low state of development of PHI in Greece. PMID:19593628

  18. Mapping private-public-partnership in health organizations: India experience

    Directory of Open Access Journals (Sweden)

    Nayan Chakravarty

    2015-04-01

    Full Text Available The dream of universal health care demands a much larger and wider approach, engaging not just the public but also the private sector. This paper has attempted mapping the present public-private partnership scenario in India using the WHO health system functions framework, giving an insight into the nature and extent of challenge of the present dominant model. A systematic review methodology was adopted to identify published literature on private-public partnership in India. From an initial pool of 785 articles were identified. Finally a total of 29 published articles meeting the inclusion criteria were included. The descriptive framework of Health system functions by WHO (2000, were used to analyze the data. All papers which were considered for the study were segregated based on the 4 prime health system functions: Financing; Management of non-financial inputs; Health service delivery and Oversight. The literature review reveals that more than half of the papers (51.72% selected for the study were focused on health service delivery functions and quite thin literature were available for other 3 functions, which includes financing, management of non-financial inputs and oversight functions as per WHO. This finding raise an important question if the genesis of most of the public-private partnerships is out of the inability of the public sector in reaching out to a particular target group by virtue of its geographical position or difficulty in working with high risk groups. Considering the limitations of the present model of engagement of private and public sectors, it demands for an alternative model of engagement where the mutual strength that exists with each one of the partners, could be harnessed and complemented. An alternate model is to engage in tri-partite partnership (TPP between the government, non-government and the corporates.

  19. Containing Health Care Costs: A Critical Test of the Public-Private Joint Venture in Health

    OpenAIRE

    Derzon, Robert A.

    1980-01-01

    As the federal government shifted from its traditional roles in health to the payment for personal health care, the relationship between public and private sectors has deteriorated. Today federal and state revenue funds and trusts are the largest purchasers of services from a predominantly private health system. This financing or “gap-filling” role is essential; so too is the purchaser's concern for the costs and prices it must meet. The cost per person for personal health care in 1980 is exp...

  20. GATEWAY FOR PRIVATE HOME HEALTH CARE IN BRITISH COLUMBIA

    OpenAIRE

    Patrick Altejos

    2015-01-01

    This feasibility study assesses the private home health care market in British Columbia for a business concept called Gateway to Home Health Care, or simply “Gateway.” Gateway is a new business concept recommended by the author to solve the increasing incongruence between growing health care demands and the limited care options in B.C. To conduct a feasibility study, the report examines the long-term care (LTC) industry and focuses on the role of the privatehome health care market in B.C. It ...

  1. Illinois Breast and Cervical Cancer Program: Implementing Effective Public-Private Partnerships to Assure Population Health.

    Science.gov (United States)

    Handler, Arden S; Henderson, Vida A; Rosenfeld, Amy; Rankin, Kristin; Jones, Brenda; Issel, L Michele

    2015-01-01

    With the implementation of the Affordable Care Act (ACA), it is essential for the public health sector to elucidate its role with respect to its mission of assuring population health, and to clarify its role with respect to the private health care system. To that end, we examined the value added to the population health enterprise of successful public-private partnerships (PPPs) such as those found in the Illinois Breast and Cervical Cancer Program (IBCCP), the Centers for Disease Control and Prevention's (CDC's) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in Illinois. Key Informant (KI) interviews focused on IBCCP implementation were conducted with IBCCP lead agency (LA) program coordinators (n = 35/36) in winter 2012-2013. Analysis was conducted using Atlas.ti software. The KI interviews revealed the existence of highly developed PPPs between the IBCCP LAs and individual medical providers and hospitals across Illinois. The data suggest that the small amount of funding provided by IBCCP to each LA in Illinois has been used to build and sustain robust PPPs in the majority of the IBCCP communities. The PPPs developed through the IBCCP can be seen as an unplanned benefit of CDC's investment in breast and cervical health through the NBCCEDP. While the IBCCP/NBCCEDP might be considered a "boutique" categorical program which some may consider no longer necessary as individuals gain insurance under the ACA, the KI data underscore the critical role of public sector dollars, not only to serve individuals and communities directly but also to mobilize the private health care sector to act in partnership with public entities and become advocates for underserved communities. PMID:25470661

  2. Women's Preventive Services Guidelines Affordable Care Act Expands Prevention Coverage for Women's Health and Well-Being

    Science.gov (United States)

    ... icio.us Digg Facebook Google Bookmarks Women’s Preventive Services Guidelines Affordable Care Act Expands Prevention Coverage for ... are delivered by a network provider. Women's Preventive Services Guidelines Supported by the Health Resources and Services ...

  3. Landscape and Health: Connecting Psychology, Aesthetics, and Philosophy through the Concept of Affordance.

    Science.gov (United States)

    Menatti, Laura; Casado da Rocha, Antonio

    2016-01-01

    In this paper we address a frontier topic in the humanities, namely how the cultural and natural construction that we call landscape affects well-being and health. Following an updated review of evidence-based literature in the fields of medicine, psychology, and architecture, we propose a new theoretical framework called "processual landscape," which is able to explain both the health-landscape and the medical agency-structure binomial pairs. We provide a twofold analysis of landscape, from both the cultural and naturalist points of view: in order to take into account its relationship with health, the definition of landscape as a cultural product needs to be broadened through naturalization, grounding it in the scientific domain. Landscape cannot be distinguished from the ecological environment. For this reason, we naturalize the idea of landscape through the notion of affordance and Gibson's ecological psychology. In doing so, we stress the role of agency in the theory of perception and the health-landscape relationship. Since it is the result of continuous and co-creational interaction between the cultural agent, the biological agent and the affordances offered to the landscape perceiver, the processual landscape is, in our opinion, the most comprehensive framework for explaining the health-landscape relationship. The consequences of our framework are not only theoretical, but ethical also: insofar as health is greatly affected by landscape, this construction represents something more than just part of our heritage or a place to be preserved for the aesthetic pleasure it provides. Rather, we can talk about the right to landscape as something intrinsically linked to the well-being of present and future generations. PMID:27199808

  4. Landscape and health: Connecting psychology, aesthetics and philosophy through the concept of affordance

    Directory of Open Access Journals (Sweden)

    Laura eMenatti

    2016-05-01

    Full Text Available In this paper we address a frontier topic in the humanities, namely how the cultural and natural construction that we call landscape affects well-being and health. Following an updated review of evidence-based literature in the fields of medicine, psychology and architecture, we propose a new theoretical framework called processual landscape, which is able to explain both the health-landscape and the medical agency-structure binomial pairs. We provide a two-fold analysis of landscape, from both the cultural and naturalist points of view: in order to take into account its relationship with health, the definition of landscape as a cultural product needs to be broadened through naturalization, grounding it in the scientific domain. Landscape cannot be distinguished from the ecological environment. For this reason, we naturalize the idea of landscape through the notion of affordance and Gibson’s ecological psychology. In doing so, we stress the role of agency in the theory of perception and the health-landscape relationship. Since it is the result of continuous and co-creational interaction between the cultural agent, the biological agent and the affordances offered to the landscape perceiver, the processual landscape is, in our opinion, the most comprehensive framework for explaining the health-landscape relationship. The consequences of our framework are not only theoretical, but ethical also: insofar as health is greatly affected by landscape, this construction represents something more than just part of our heritage or a place to be preserved for the aesthetic pleasure it provides. Rather, we can talk about the right to landscape as something intrinsically linked to the well-being of present and future generations.

  5. Landscape and Health: Connecting Psychology, Aesthetics, and Philosophy through the Concept of Affordance

    Science.gov (United States)

    Menatti, Laura; Casado da Rocha, Antonio

    2016-01-01

    In this paper we address a frontier topic in the humanities, namely how the cultural and natural construction that we call landscape affects well-being and health. Following an updated review of evidence-based literature in the fields of medicine, psychology, and architecture, we propose a new theoretical framework called “processual landscape,” which is able to explain both the health-landscape and the medical agency-structure binomial pairs. We provide a twofold analysis of landscape, from both the cultural and naturalist points of view: in order to take into account its relationship with health, the definition of landscape as a cultural product needs to be broadened through naturalization, grounding it in the scientific domain. Landscape cannot be distinguished from the ecological environment. For this reason, we naturalize the idea of landscape through the notion of affordance and Gibson’s ecological psychology. In doing so, we stress the role of agency in the theory of perception and the health-landscape relationship. Since it is the result of continuous and co-creational interaction between the cultural agent, the biological agent and the affordances offered to the landscape perceiver, the processual landscape is, in our opinion, the most comprehensive framework for explaining the health-landscape relationship. The consequences of our framework are not only theoretical, but ethical also: insofar as health is greatly affected by landscape, this construction represents something more than just part of our heritage or a place to be preserved for the aesthetic pleasure it provides. Rather, we can talk about the right to landscape as something intrinsically linked to the well-being of present and future generations. PMID:27199808

  6. [Public-private partnerships for health services: the solution for the peruvian health system?].

    Science.gov (United States)

    Zevallos, Leslie; Salas, Valerio; Robles, Luis

    2014-01-01

    Private investor participation in the provision of public health care services (called “public-private partnership” or PPP) dates from the last century, both in Latin America and Europe. In Peru, legislation for PPPs was published in 2008 in terms of infrastructure, maintenance and service provisions in general; but it was at the end of 2013 when PPP began to be implemented for health services. In Colombia, it was realized that this model was very costly. In Chile, the private sector was not regulated from the beginning and today it is difficult to regulate. Costa Rica never gave full decisional power to private sector; the responsibility for providing health services to its population and maintaining health as a right has always been maintained. In Peru, at this stage of PPPs implementation for health services, other experiences are not taken into account such as: transparency, participation of all stakeholders, development of specific legislation, among others. PMID:25597732

  7. Tax Incentives and the Demand for Private Health Insurance

    OpenAIRE

    Olena Stavrunova; Oleg Yerokhin

    2013-01-01

    This paper studies the effect of an individual insurance mandate (Medicare Levy Surcharge) on the demand for private health insurance (PHI) in Australia. It uses the administrative income tax returns data to show that mandate has several distinct effects on taxpayers' behavior. First, despite the large size of the tax penalty for not having PHI cover relative to the cost of the cheapest eligible insurance policy, the compliance with mandate is relatively low: the proportion of population with...

  8. Financial health and customer satisfaction in private health care providers in Brazil.

    Science.gov (United States)

    Schiozer, Rafael Felipe; Saito, Cristiana Checchia; Saito, Richard

    2011-11-01

    This paper analyzes the relationship between the financial health and organizational form of private health care providers in Brazil. It also examines the major determinants of customer satisfaction associated with the provider's organizational form. An adjusted Altman's z-score is used as an indicator of financial health. A proxy variable based on customer complaints filed at the Brazilian National Agency for Supplementary Health is used as an indicator for customer satisfaction. The study uses a sample of 270 private health care providers and their operations over the period 2003-2005. Panel data analysis includes control variables related to market, operations, and management. Principal results indicate that: (1) private health care providers benefit from economies of scale; (2) self-funded health plans have better financial health; (3) spending on marketing does not have a significant impact on customer satisfaction in Brazil; (4) weak empirical evidence exists showing that good financial performance enhances customer's satisfaction. PMID:22124495

  9. Determinants of accessibility and affordability of health care in post-socialist Tajikistan: evidence and policy options.

    Science.gov (United States)

    Fan, L; Habibov, N N

    2009-01-01

    There is increasing evidence of rising levels of inequality in health care utilisation in the post-socialist countries of Central Asia and the Caucasus. Against this backdrop, we investigate the determinants of accessibility and affordability of health care utilisation in Tajikistan. A modified version of the Andersen Behavioural Model is used to conceptualise the determinants of health care utilisation in Tajikistan. Poisson and Ordered Logit regression models are performed to estimate the determinants of health care utilisation. Empirical results demonstrate that poverty, chronic illness and disability are the most important determinants of health care utilisation and affordability in Tajikistan. Other significant determinants include gender, the level of education of the household head, and the availability of medical personnel at a given population point. These findings suggest an urgent need for health care reform in order to ensure equality in accessibility and affordability for the entire population. PMID:19326278

  10. Performance of private sector health care: implications for universal health coverage.

    Science.gov (United States)

    Morgan, Rosemary; Ensor, Tim; Waters, Hugh

    2016-08-01

    Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers-including their size, objectives, and technical competence-the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole. PMID:27358251

  11. Does the private finance initiative promote innovation in health care? The case of the British National Health Service.

    Science.gov (United States)

    Petratos, Pythagoras

    2005-12-01

    The Private Finance Initiative (PFI) is a specific example of health care privatization within the British National Health Service. In this essay, I critically assess the ways in which various Private Finance Initiatives have increased health care efficiency and effectiveness, as well as encouraged medical innovation. Indeed, as the analysis will demonstrate, significant empirical evidence supports the conclusion that Private Finance Initiatives are a driving force of innovation within the British Health Care System. PMID:16396788

  12. Implementing the Affordable Care Act: The Promise and Limits of Health Care Reform.

    Science.gov (United States)

    Oberlander, Jonathan

    2016-08-01

    The Obama administration has confronted a formidable array of obstacles in implementing the Affordable Care Act (ACA). The ACA has overcome those obstacles to substantially expand access to health insurance, though significant problems with its approach have emerged. What does the ACA's performance to date tell us about the possibilities and limits of health care reform in the United States? I identify key challenges in ACA implementation-the inherently disruptive nature of reform, partisan polarization, the limits of "near universal" coverage, complexity, and divided public opinion-and analyze how these issues have shaped its evolution. The article concludes by exploring the political and policy challenges that lie ahead for the ACA. PMID:27127261

  13. Comparing Individual Health Coverage On and Off the Affordable Care Act's Insurance Exchanges.

    Science.gov (United States)

    McCue, Michael J; Hall, Mark A

    2015-08-01

    The new health insurance exchanges are the core of the Affordable Care Act's (ACA) reforms, but how the law improves the nonsubsidized portion of the individual market is also important. This issue brief compares products sold on and off the exchanges to gain insight into how the ACA's market reforms are functioning. Initial concerns that insurers might seek to enroll lower-risk customers outside the exchanges have not been realized. Instead, more-generous benefit plans, which appeal to people with health problems, constitute a greater portion of plans sold off-exchange than those sold on-exchange. Although insur­ers that sell mostly on the exchanges incur an additional fee, they still devote a greater portion of their premium dollars to medical care. Their projected admin­istrative costs and profit margins are lower than are those of insurers selling only off the exchanges. PMID:26372970

  14. Affordable Care Act (ACA)

    Data.gov (United States)

    Social Security Administration — The Affordable Care Act (ACA) is a federal statute enacted with a goal of increasing the quality and affordability of health insurance. Through a web service, CMS...

  15. Mobile Health for All: Public-Private Partnerships Can Create a New Mental Health Landscape.

    Science.gov (United States)

    Ben-Zeev, Dror

    2016-01-01

    Research has already demonstrated that different mHealth approaches are feasible, acceptable, and clinically promising for people with mental health problems. With a robust evidence base just over the horizon, now is the time for policy makers, researchers, and the private sector to partner in preparation for the near future. The Lifeline Assistance Program is a useful model to draw from. Created in 1985 by the U.S. Federal Communications Commission (FCC), Lifeline is a nationwide program designed to help eligible low-income individuals obtain home phone and landline services so they can pursue employment, reach help in case of emergency, and access social services and healthcare. In 2005, recognizing the broad shift towards mobile technology and mobile-cellular infrastructure, the FCC expanded the program to include mobile phones and data plans. The FCC provides a base level of federal support, but individual states are responsible for regional implementation, including engagement of commercial mobile phone carriers. Given the high rates of disability and poverty among people with severe mental illness, many are eligible to benefit from Lifeline and research has shown that a large proportion does in fact use this program to obtain a mobile phone and data plan. In the singular area of mobile phone use, the gap between people with severe mental illness and the general population in the U.S. is vanishing. Strategic multi-partner programs will be able to grant access to mHealth for mental health programs to those who will not be able to afford them-arguably, the people who need them the most. Mobile technology manufacturing costs are dropping. Soon all mobile phones in the marketplace, including the more inexpensive devices that are made available through subsidy programs, will have "smart" capabilities (ie, internet connectivity and the capacity to host apps). Programs like Lifeline could be expanded to include mHealth resources that capitalize on "smart" functions

  16. Health Education Specialists' Knowledge, Attitudes, and Perceptions of the Patient Protection and Affordable Care Act.

    Science.gov (United States)

    Strong, Jessica; Hanson, Carl L; Magnusson, Brianna; Neiger, Brad

    2016-03-01

    The changing landscape of health care as a result of the Patient Protection and Affordable Care Act (ACA) may provide new opportunities for health education specialists (HES). The purpose of this study was to survey HES in the United States on their knowledge and attitudes of the ACA and assess their perceptions of job growth under the law. A random sample of 220 (36% response rate) certified HES completed a 53-item cross sectional survey administered online through Qualtrics. Findings were compared to public opinion on health care reform. HES are highly favorable of the law (70%) compared to the general public (23%). A total of 85% of respondents were able to list a provision of the ACA, and most (81%) thought the ACA would be successful at increasing insured Americans. Over half (64.6%) believe job opportunities will increase. Those who viewed the law favorably were significantly more likely to score better on a knowledge scale related to the ACA. HES understand publicized provisions but are uncertain about common myths and specific provisions related to Title IV, "Prevention of Chronic Disease and Improving Public Health." Directed and continuing education to HES regarding the ACA is warranted. PMID:26272884

  17. Regulating private health insurance to serve the public interest: policy issues for developing countries.

    Science.gov (United States)

    Sekhri, Neelam; Savedoff, William

    2006-01-01

    Private health insurance plays a large and increasing role around the world. This paper reviews international experiences and shows that private health insurance is significant in countries with widely different income levels and health system structures. It contrasts trends in private health insurance expansion across regions and highlights countries with particularly important experiences of private coverage. It then discusses the regulatory approaches and policies that can structure private health insurance markets in ways that mobilize resources for health care, promote financial risk protection, protect consumers and reduce inequities. The paper argues that policy makers need to confront the role that private health insurance will play in their health systems and regulate the sector appropriately so that it serves public goals of universal coverage and equity. PMID:17175735

  18. Tax incentives and the demand for private health insurance.

    Science.gov (United States)

    Stavrunova, Olena; Yerokhin, Oleg

    2014-03-01

    We analyze the effect of an individual insurance mandate (Medicare Levy Surcharge) on the demand for private health insurance (PHI) in Australia. With administrative income tax return data, we show that the mandate has several distinct effects on taxpayers' behavior. First, despite the large tax penalty for not having PHI coverage relative to the cost of the cheapest eligible insurance policy, compliance with mandate is relatively low: the proportion of the population with PHI coverage increases by 6.5 percentage points (15.6%) at the income threshold where the tax penalty starts to apply. This effect is most pronounced for young taxpayers, while the middle aged seem to be least responsive to this specific tax incentive. Second, the discontinuous increase in the average tax rate at the income threshold created by the policy generates a strong incentive for tax avoidance which manifests itself through bunching in the taxable income distribution below the threshold. Finally, after imposing some plausible assumptions, we extrapolate the effect of the policy to other income levels and show that this policy has not had a significant impact on the overall demand for private health insurance in Australia. PMID:24513860

  19. Assuring Access to Affordable Coverage

    Data.gov (United States)

    U.S. Department of Health & Human Services — Under the Affordable Care Act, millions of uninsured Americans will gain access to affordable coverage through Affordable Insurance Exchanges and improvements in...

  20. Which moral hazard? Health care reform under the Affordable Care Act of 2010.

    Science.gov (United States)

    Mendoza, Roger Lee

    2016-06-20

    Purpose - Moral hazard is a concept that is central to risk and insurance management. It refers to change in economic behavior when individuals are protected or insured against certain risks and losses whose costs are borne by another party. It asserts that the presence of an insurance contract increases the probability of a claim and the size of a claim. Through the US Affordable Care Act (ACA) of 2010, this study seeks to examine the validity and relevance of moral hazard in health care reform and determine how welfare losses or inefficiencies could be mitigated. Design/methodology/approach - This study is divided into three sections. The first contrasts conventional moral hazard from an emerging or alternative theory. The second analyzes moral hazard in terms of the evolution, organization, management, and marketing of health insurance in the USA. The third explains why and how salient reform measures under the ACA might induce health care consumption and production in ways that could either promote or restrict personal health and safety as well as social welfare maximization. Findings - Insurance generally induces health care (over) consumption. However, not every additional consumption, with or without adverse selection, can be considered wasteful or risky, even if it might cost insurers more in the short run. Moral hazard can generate welfare and equity gains. These gains might vary depending on which ACA provisions, insured population, covered illnesses, treatments, and services, as well as health outcomes are taken into account, and because of the relative ambiguities surrounding definitions of "health." Actuarial risk models can nonetheless benefit from incorporating welfare and equity gains into their basic assumptions and estimations. Originality/value - This is the first study which examines the ACA in the context of the new or alternative theory of moral hazard. It suggests that containing inefficient moral hazard, and encouraging its desirable

  1. Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform

    OpenAIRE

    Zallman, Leah; Nardin, Rachel; Sayah, Assaad; McCormick, Danny

    2015-01-01

    Introduction: Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments. Methods: We conducted face to face surveys in four languages with a convenience sample of 976 patients...

  2. Privatizing the welfarist state: health care reforms in Malaysia.

    Science.gov (United States)

    Khoon, Chan Chee

    2003-01-01

    In Malaysia, the shifting balance between market and state has many nuances. Never a significant welfare state in the usual mold, the Malaysian state nonetheless has been a dominant social and economic presence dictated by its affirmative action-type policies, which eventually metamorphosed into state-led indigenous capitalism. Privatisation is also intimately linked with emergence of an indigenous bourgeoisie with favored access to the vast accumulation of state assets and prerogatives. Internationally, it is conditioned by the fluid relationships of converging alliances and contested compromise with international capital, including transnational health services industries. As part of its vision of a maturing, diversified economy, the Malaysian government is fostering a private-sector advanced health care industry to cater to local demand and also aimed at regional and international patrons. The assumption is that, as disposable incomes increase, a market for such services is emerging and citizens can increasingly shoulder their own health care costs. The government would remain the provider for the indigent. But the key assumption remains: the growth trajectory will see the emergence of markets for an increasingly affluent middle class. Importantly, the health care and social services market would be dramatically expanded as the downsizing of public-sector health care proceeds amid a general retreat of government from its provider and financing roles. PMID:17208722

  3. The Affordable Care Act and integrated behavioral health programs in community health centers to promote utilization of mental health services among Asian Americans.

    Science.gov (United States)

    Huang, Susan; Fong, Susana; Duong, Thomas; Quach, Thu

    2016-06-01

    The Affordable Care Act has greatly expanded health care coverage and recognizes mental health as a major priority. However, individuals suffering from mental health disorders still face layered barriers to receiving health care, especially Asian Americans. Integration of behavioral health services within primary care is a viable way of addressing underutilization of mental health services. This paper provides insight into a comprehensive care approach integrating behavioral health services into primary care to address underutilization of mental health services in the Asian American population. True integration of behavioral health services into primary care will require financial support and payment reform to address multi-disciplinary care needs and optimize care coordination, as well as training and workforce development early in medical and mental health training programs to develop the skills that aid prevention, early identification, and intervention. Funding research on evidence-based practice oriented to the Asian American population needs to continue. PMID:27188196

  4. Patient Protection and Affordable Care Act of 2010: reforming the health care reform for the new decade.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Caraway, David L; Parr, Allan T; Fellows, Bert; Hirsch, Joshua A

    2011-01-01

    The Patient Protection and Affordable Care Act (the ACA, for short) became law with President Obama's signature on March 23, 2010. It represents the most significant transformation of the American health care system since Medicare and Medicaid. It is argued that it will fundamentally change nearly every aspect of health care, from insurance to the final delivery of care. The length and complexity of the legislation and divisive and heated debates have led to massive confusion about the impact of ACA. It also became one of the centerpieces of 2010 congressional campaigns. Essentials of ACA include: 1) a mandate for individuals and businesses requiring as a matter of law that nearly every American have an approved level of health insurance or pay a penalty; 2) a system of federal subsidies to completely or partially pay for the now required health insurance for about 34 million Americans who are currently uninsured - subsidized through Medicaid and exchanges; 3) extensive new requirements on the health insurance industry; and 4) numerous regulations on the practice of medicine. The act is divided into 10 titles. It contains provisions that went into effect starting on June 21, 2010, with the majority of provisions going into effect in 2014 and later. The perceived major impact on practicing physicians in the ACA is related to growing regulatory authority with the Independent Payment Advisory Board (IPAB) and the Patient Centered Outcomes Research Institute (PCORI). In addition to these specifics is a growth of the regulatory regime in association with further discounts in physician reimbursement. With regards to cost controls and projections, many believe that the ACA does not fix the finances of our health care system - neither public nor private. It has been suggested that the Congressional Budget Office (CBO) and the administration have used creative accounting to arrive at an alleged deficit reduction; however, if everything is included appropriately and

  5. Storing and using health data in a virtual private cloud.

    Science.gov (United States)

    Regola, Nathan; Chawla, Nitesh V

    2013-01-01

    Electronic health records are being adopted at a rapid rate due to increased funding from the US federal government. Health data provide the opportunity to identify possible improvements in health care delivery by applying data mining and statistical methods to the data and will also enable a wide variety of new applications that will be meaningful to patients and medical professionals. Researchers are often granted access to health care data to assist in the data mining process, but HIPAA regulations mandate comprehensive safeguards to protect the data. Often universities (and presumably other research organizations) have an enterprise information technology infrastructure and a research infrastructure. Unfortunately, both of these infrastructures are generally not appropriate for sensitive research data such as HIPAA, as they require special accommodations on the part of the enterprise information technology (or increased security on the part of the research computing environment). Cloud computing, which is a concept that allows organizations to build complex infrastructures on leased resources, is rapidly evolving to the point that it is possible to build sophisticated network architectures with advanced security capabilities. We present a prototype infrastructure in Amazon's Virtual Private Cloud to allow researchers and practitioners to utilize the data in a HIPAA-compliant environment. PMID:23485880

  6. The Aggregate Demand for Private Health Insurance Coverage in the U.S.

    OpenAIRE

    Carmelo Giaccotto; Rexford E. Santerre; Ahking, Francis W.

    2005-01-01

    This paper estimates the aggregate demand for private health insurance coverage in the U.S. using an error-correction model and by recognizing that people are without private health insurance for voluntary, structural, frictional, and cyclical reasons and because of public alternatives. Insurance coverage is measured both by the percentage of the population enrolled in private health insurance plans and the completeness of the insurance coverage. Annual data for the period 1966-1999 are used ...

  7. Artemisinin combination therapies price disparity between government and private health sectors and its implication on antimalarial drug consumption pattern in Morogoro Urban District, Tanzania

    Directory of Open Access Journals (Sweden)

    Malisa Allen

    2012-03-01

    Full Text Available Abstract Background Universal access to effective treatments is a goal of the Roll Back Malaria Partnership. However, despite official commitments and substantial increases in financing, this objective remains elusive, as development assistance continue to be routed largely through government channels, leaving the much needed highly effective treatments inaccessible or unaffordable to those seeking services in the private sector. Methods To quantify the effect of price disparity between the government and private health systems, this study have audited 92 government and private Drug Selling Units (DSUs in Morogoro urban district in Tanzania to determine the levels, trend and consumption pattern of antimalarial drugs in the two health systems. A combination of observation, interviews and questionnaire administered to the service providers of the randomly selected DSUs were used to collect data. Results ALU was the most selling antimalarial drug in the government health system at a subsidized price of 300 TShs (0.18 US$. By contrast, ALU that was available in the private sector (coartem was being sold at a price of about 10,000 TShs (5.9 US$, the price that was by far unaffordable, prompting people to resort to cheap but failed drugs. As a result, metakelfin (the phased out drug was the most selling drug in the private health system at a price ranging from 500 to 2,000 TShs (0.29–1.18 US$. Conclusions In order for the prompt diagnosis and treatment with effective drugs intervention to have big impact on malaria in mostly low socioeconomic malaria-endemic areas of Africa, inequities in affordability and access to effective treatment must be eliminated. For this to be ensued, subsidized drugs should be made available in both government and private health sectors to promote a universal access to effective safe and affordable life saving antimalarial drugs.

  8. Joiners and leavers stayers and abstainers: Private health insurance choices in Australia

    OpenAIRE

    Stephanie Knox; Elizabeth Savage; Denzil Fiebig; Vineta Salale

    2010-01-01

    The percentage of Australians taking up Private Health Insurance (PHI) was in decline following the introduction of Medicare in 1984 (PHIAC). To arrest this decline the Australian Government introduced a suite of policies, between 1997 and 2000, to create incentives for Australians to purchase private health insurance. These policies include an increased Medicare levy for those without PHI on high incomes, introduced in 1997, a 30% rebate for private hospital cover (introduced 1998), and the ...

  9. Parallel Private Health Insurance in Australia: A Cautionary Tale and Lessons for Canada

    OpenAIRE

    Hurley, Jeremiah; Vaithianathan, Rhema; Thomas F. Crossley; Cobb-Clark, Deborah A.

    2001-01-01

    Canada’s restrictions on the role of private health insurance for publicly insured physician and hospital services are unique among countries with universal, publicly funded health care systems. Pressure is mounting in Canada, however, to loosen these restrictions and create a parallel system of private finance. Advocates argue that creation of a parallel system of private finance will ensure the sustainability of the public system (by reducing public cost pressures), improve access to the pu...

  10. Women's Use of Private and Government Health Facilities for Childbirth in Nairobi's Informal Settlements

    OpenAIRE

    Bazant, Eva S.; Koenig, Michael A.; Fotso, Jean-Christophe; Mills, Samuel

    2009-01-01

    The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at g...

  11. Institutional public private partnerships for core health services: evidence from Italy

    OpenAIRE

    Longo Francesco; Cappellaro Giulia

    2011-01-01

    Abstract Background Public-private partnerships (PPPs) are potential instruments to enable private collaboration in the health sector. Despite theoretical debate, empirical analyses have thus far tended to focus on the contractual or project dimension, overlooking institutional PPPs, i.e., formal legal entities run by proper corporate-governance mechanisms and jointly owned by public and private parties for the provision of public-health goods. This work aims to fill this gap by carrying out ...

  12. INFLUENCE OF SOCIOECONOMIC AND DEMOGRAPHIC ENVIRONMENT ON PRIVATE HEALTH CARE PROVIDERS

    Directory of Open Access Journals (Sweden)

    Lana Kordić

    2013-02-01

    Full Text Available Health care systems face pressure to increase the quality of health care at the same time with pressure to reduce public spending. The attempt to overcome the gap between needs and opportunities can be resolved through the introduction of public-private partnerships. Goals of this study are to investigate variation of the number, form and efficiency of private providers of general/family medicine services in primary health care and the contribution of socioeconomic and demographic environment on those variations, among counties. Socioeconomic and demographic factors are identified as independent variables that influence the health care need and utilization and consequently the decision of private entities to engage in the provision of health care services. This study extended previous studies because it has introduced socioeconomic and demographic variables. This may shed same new lights on the relationship between private providers of health service and efficiency of providing health service in primary health care.

  13. We all want it, but we don't know what it is: toward a standard of affordability for health insurance premiums.

    Science.gov (United States)

    Muennig, Peter; Sampat, Bhaven; Tilipman, Nicholas; Brown, Lawrence D; Glied, Sherry A

    2011-10-01

    The 2010 Patient Protection and Affordable Care Act (P.L. 111-148), or ACA, requires that U.S. citizens either purchase health insurance or pay a fine. To offset the financial burden for lower-income households, it also provides subsidies to ensure that health insurance premiums are affordable. However, relatively little work has been done on how such affordability standards should be set. The existing literature on affordability is not grounded in social norms and has methodological and theoretical flaws. To address these issues, we developed a series of hypothetical vignettes in which individual and household sociodemographic characteristics were varied. We then convened a panel of eighteen experts with extensive experience in affordability standards to evaluate the extent to which each vignette character could afford to pay for one of two health insurance plans. The panel varied with respect to political ideology and discipline. We find that there was considerable disagreement about how affordability is defined. There was also disagreement about what might be included in an affordability standard, with substantive debate surrounding whether savings, debt, education, or single parenthood is relevant. There was also substantial variation in experts' assessed affordability scores. Nevertheless, median expert affordability assessments were not far from those of ACA. PMID:21785011

  14. The Role of the Private Sector in Reproductive Health Services in Bangladesh

    OpenAIRE

    Ahmed Al-Sabir; Bushra Binte Alam; Sameh El-Saharty

    2014-01-01

    The key actors in Bangladesh's Health, Population and Nutrition Sector Development Program (HPNSDP) are the public sector, nongovernmental organizations (NGOs), the non-profit private sector, and the for-profit private sector. The public health infrastructure is considered one of the largest in the health sector; RH providers and facilities are available at all levels. Several NGOs are active in Bangladesh's health sector, including international organizations such as CARE, Save the Children ...

  15. The affordances of broken affordances

    DEFF Research Database (Denmark)

    Grünbaum, Martin Gielsgaard; Simonsen, Jakob Grue

    2015-01-01

    We consider the use of physical and virtual objects having one or more affordances associated to simple interactions with them. Based on Kaptelinin and Nardi’s notion of instrumental affordance, we investigate what it means to break an affordance, and the two ensuing questions we deem most...... important: how users may (i) achieve their goals in the presence of such broken affordances, and may (ii) repurpose or otherwise interact with artefacts with broken affordances. We argue that (A) thorough analyses of breakdowns of affordances and their associated signifiers and feedbacks have implication...

  16. [On the role of the state-private partnership in public health].

    Science.gov (United States)

    Nechaev, V S; Nisan, B A

    2012-01-01

    The article deals with the issues of study of state-private partnership in the framework of development of strategic measures of regulation of this area in public health. It is demonstrated that the regulation of state-private partnership has to combine the dynamism inherent in entrepreneurship and the public stability needed for normal public health functioning. The control functions of state authorities in the area of public health policy developed into concept of "supervision" which obligates the state to manage the health system guided by norms of ethics and financial expediency. The regulation as a main tool of "supervision" in the state-private partnership has to meet the same two requirements. The activation of entrepreneur activity in public health by no means is caused by increase of privatization in this sector. Under these conditions, the implementation of market mechanisms in public health system make is more effective and efficient. PMID:23373344

  17. Public and private health care utilization differences between socioeconomic strata in Jamaica

    Directory of Open Access Journals (Sweden)

    Paul A Bourne

    2010-09-01

    Full Text Available Paul A Bourne1, Denise Eldemire-Shearer1, Tomlin J Paul1, Janet LaGrenade1, Christopher AD Charles21Department of Community Health and Psychiatry, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica; 2King Graduate School, Monroe College, New York and Center for Victim Support, Harlem Hospital Center, New York, NY, USAObjective: To assess trends in the use of private and public health care services among Jamaicans over a 15-year period (1991–2007.Design and methods: Statistics on the use of health care services were taken from the Jamaica Survey of Living Conditions (JSLC for the 15-year period 1993 to 2007. Use of hospital services were represented in income quintiles and compared for private and public facilities. The difference in percentage use between public and private was compared by quintiles over the period and the variability in those differentials assessed.Results: This study highlights the increasing use of private services by increasing wealth, exaggerated for the wealthiest quintile. There is a widening of the differences in utilization between public and private centers as income level increases (P < 0.001.Conclusions: Internal and external economic conditions influence the use of private and public health care services in Jamaica. Although the relative increase in the cost (to the user of public health care is more than that for private health care, the actual cost to use the public health care system is still significantly cheaper than using the private system. Lower income health care users tend to take the lesser cost option.Keywords: health care utilization, public–private health differentials

  18. Occupational Stress and Mental Health of Employees of a Petrochemical Company before and after Privatization

    Directory of Open Access Journals (Sweden)

    A Mahdad

    2010-03-01

    Full Text Available Background: Many countries make many of their governmental sectors private. This transition, however, may affect their employees in numerous ways.Objective: To determine the level of occupational stress and mental health of employees of a petrochemical company in Isfahan, Central Iran, before and 3 months after privatization.Methods: Out of the 700 employees of the studied company, using a stratified random sampling technique, 140 persons were selected. We used Steinmetz occupational stress and GHQ-28 questionnaires to determine the level of stress and mental health status of participants.Results: The reliability of the questionnaires used was acceptable (Chronbach alpha coefficients: 0.85 and 0.86, respectively. Job stress level was significantly increased 3 months after privatization; the mean±SD job stress score before and after privatization were 22.9±10.43 and 28.3±12.25, respectively (p<0.001. The mean±SD mental health score after privatization (17.57±11.63 was also significantly (p<0.001 higher than that before the privatization (13.8±6.0. There was a significant (p<0.001 positive correlation between the mental health status score and job score (r=0.476.Conclusion: After privatization, the job stress of employees increased significantly. This increase was associated with a decrease in mental health. To lessen the side effects of privatization, the process should be performed cautiously.

  19. Medicaid patients seen at federally qualified health centers use hospital services less than those seen by private providers.

    Science.gov (United States)

    Rothkopf, Jennifer; Brookler, Katie; Wadhwa, Sandeep; Sajovetz, Michael

    2011-07-01

    Federally qualified health centers, also known as community health centers, play an essential role in providing health care to millions of Americans. In return for providing primary care to underserved, homeless, and migrant populations, these centers are reimbursed at a higher rate than other providers by public programs such as Medicaid. Under the Affordable Care Act of 2010, the role of the centers is expected to grow. To examine the quality of care that the centers provide, the Colorado Department of Health Care Policy and Financing compared the use of costly hospital-related services by Medicaid clients whose usual source of care was a community health center with the use by clients whose usual source of care was a private, fee-for-service provider. The study found that community health center users were about one-third less likely than the other group to have emergency department visits, inpatient hospitalizations, or preventable hospital admissions. Public funders such as states should work with community health centers to improve the quality and reduce the cost of care even further. PMID:21734208

  20. Is there a 'secession of the wealthy'? Private health insurance uptake and National Health System support

    OpenAIRE

    Costa-Font, J.;; Jofre-Bonet, M

    2008-01-01

    The purchase the private health insurance (PHI) as a mean to partially supplement the National Health System (NHS) coverage is often regarded as a potential signal for a declining support for the NHS. To date, the hypothesis that attitudes towards the NHS might be influenced by the uptake of PHI is still open to empirical scrutiny. Exploiting the fact that PHI is typically purchased by the most affluent, in this paper we test the so called ‘secession of the wealthy’ hypothesis whereby the lik...

  1. Understanding perception and factors influencing private voluntary health insurance policy subscription in the Lucknow region

    OpenAIRE

    Tanuj Mathur; Ujjwal Kanti Paul; Himanshu Narayan Prasad; Subodh Chandra Das

    2014-01-01

    Background Health insurance has been acknowledged by researchers as a valuable tool in health financing. In spite of its significance, a subscription paralysis has been observed in India for this product. People who can afford health insurance are also found to be either ignorant or aversive towards it. This study is designed to investigate into the socio-economic factors, individuals’ health insurance product perception and individuals’ personality traits for unbundling the paradox which...

  2. Differences in essential newborn care at birth between private and public health facilities in eastern Uganda

    Directory of Open Access Journals (Sweden)

    Peter Waiswa

    2015-03-01

    Full Text Available Background: In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. Objective: To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Design: Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. Results: The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007. Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p<0.001. Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. Conclusions: In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was

  3. Regulating the for-profit private health sector: lessons from East and Southern Africa.

    Science.gov (United States)

    Doherty, Jane E

    2015-03-01

    International evidence shows that, if poorly regulated, the private health sector may lead to distortions in the type, quantity, distribution, quality and price of health services, as well as anti-competitive behaviour. This article provides an overview of legislation governing the for-profit private health sector in East and Southern Africa. It identifies major implementation problems and suggests strategies Ministries of Health could adopt to regulate the private sector more effectively and in line with key public health objectives. This qualitative study was based on a document review of existing legislation in the region, and seven semi-structured interviews with individuals selected purposively on the basis of their experience in policymaking and legislation. Legislation was categorized according to its objectives and the level at which it operates. A thematic content analysis was conducted on interview transcripts. Most legislation focuses on controlling the entry of health professionals and organizations into the market. Most countries have not developed adequate legislation around behaviour following entry. Generally the type and quality of services provided by private practitioners and facilities are not well-regulated or monitored. Even where there is specific health insurance regulation, provisions seldom address open enrolment, community rating and comprehensive benefit packages (except in South Africa). There is minimal control of prices. Several countries are updating and improving legislation although, in most cases, this is without the benefit of an overarching policy on the private sector, or reference to wider public health objectives. Policymakers in the East and Southern African region need to embark on a programme of action to strengthen regulatory frameworks and instruments in relation to private health care provision and insurance. They should not underestimate the power of the private health sector to undermine efforts for increased

  4. Reconsidering the role of private health funds in Australia: a dynamic model.

    Science.gov (United States)

    Bridges, John F

    2003-01-01

    In recent years the private sector has played a more important role in the funding and provision of Australian hospital care as a consequence of federal government policies aimed at increasing participation in private health insurance (health funds). These policies include tax incentives, a 30% rebate on premiums and lifetime community rating (premiums set by age). While these policies have improved the short-term profitability of the private sector, its long-term success is not certain. This is because negotiations between health funds and private hospitals are often myopic, the nature of the insurance product may be inefficient, and there is a general lack of academic research on the private sector. This paper highlights the importance of the relationship between health funds and private hospitals in ensuring the long-term viability of the industry. It uses a simple overlapping generations model to demonstrate that it is not only the price that health funds pay that impacts on the capital value of hospitals, but also it is important how they structure their policies and attract individuals. The model demonstrates the potential benefits of implementing health insurance based on intertemporal transfers of funds rather than the current cross-subsidization. Such a policy would see health funds become an important store of capital. Also highlighted are the difficulties of discussing fundamental changes to the health care system. While recent health care reforms have been described as driven by ideology rather than evidence, in the Australian context there is little evidence on which to base policy. Researchers need to be more proactive in their consideration and evaluation of alternative health care policies. Through quality research on the private sector, academics can better guide policy makers at the national and institutional level. PMID:14619282

  5. The use of data mining by private health insurance companies and customers' privacy.

    Science.gov (United States)

    Al-Saggaf, Yeslam

    2015-07-01

    This article examines privacy threats arising from the use of data mining by private Australian health insurance companies. Qualitative interviews were conducted with key experts, and Australian governmental and nongovernmental websites relevant to private health insurance were searched. Using Rationale, a critical thinking tool, the themes and considerations elicited through this empirical approach were developed into an argument about the use of data mining by private health insurance companies. The argument is followed by an ethical analysis guided by classical philosophical theories-utilitarianism, Mill's harm principle, Kant's deontological theory, and Helen Nissenbaum's contextual integrity framework. Both the argument and the ethical analysis find the use of data mining by private health insurance companies in Australia to be unethical. Although private health insurance companies in Australia cannot use data mining for risk rating to cherry-pick customers and cannot use customers' personal information for unintended purposes, this article nonetheless concludes that the secondary use of customers' personal information and the absence of customers' consent still suggest that the use of data mining by private health insurance companies is wrong. PMID:26059954

  6. Affordable Vehicle Avionics Overview

    Science.gov (United States)

    Cockrell, James J.

    2015-01-01

    Public and private launch vehicle developers are reducing the cost of propulsion for small commercial launchers, but conventional high-performance, high-reliability avionics remain the disproportionately high cost driver for launch. AVA technology performs as well or better than conventional launch vehicle avionics, but with a fraction of the recurring costs. AVA enables small launch providers to offer affordable rides to LEO to nano-satellites as primary payloads meaning, small payloads can afford to specify their own launch and orbit parameters

  7. Oral Health Status and Behaviour of Mauritians Visiting Private Dental Clinics

    Science.gov (United States)

    Gunsam, P. Pugo; Banka, S.

    2011-01-01

    Purpose: This paper seeks to assess the oral health status and behaviour of a sample of the Mauritian population visiting private dental clinics. Design/methodology/approach: Oral health status was determined using the World Health Organization (Decayed, Missing, Filled Teeth (DMFT) index indicating the prevalence of caries, and factors associated…

  8. Public-Private Partnerships for Health Promotion: The Experiences of the S[superscript 5] Project

    Science.gov (United States)

    Gold, J.; Hellard, M. E.; Lim, M. S.; Dixon, H.; Wakefield, M.; Aitken, C. K.

    2012-01-01

    There is increasing emphasis on involving the private sector in public health to harness the considerable resources and skills of the business world to address significant health issues. While such collaboration should be encouraged, the involvement of business in public health campaigns can raise unexpected challenges when the approaches and…

  9. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus;

    2016-01-01

    BACKGROUND: Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality.......03 were the factors that most influenced correct treatment of fever in pregnancy. CONCLUSION: Treatment of fever during pregnancy was poor in this study setting. These data highlight the need to develop interventions to improve patient safety and quality of care for pregnant women in the private health......, pharmacy or private clinic. Data was collected using a structured questionnaire targeting one provider who was found on duty in each selected private health facility and consented to the study. The main variables were: provider characteristics, previous training received, type of drugs stocked, treatment...

  10. The development of voluntary private health insurance in the Nordic countries

    OpenAIRE

    Nina Alexandersen; Anders Anell; Oddvar Kaarboe; Juhani S Lehto; Liina-Kaisa Tynkkynen; Karsten Vrangbaek

    2016-01-01

    The Nordic countries represent an institutional setting with tax-based health care financing and universal access to health care services. Very few health care services are excluded from what are offered within the publically financed health care system. User fees are often non-existing or low and capped. Nevertheless, the markets for voluntary private health insurance (VPHI) have been rapidly expanding. In this paper we describe the development of the market for VPHI in the Nordic countries....

  11. Reducing Ex-offender Health Disparities through the Affordable Care Act: Fostering Improved Health Care Access and Linkages to Integrated Care

    Directory of Open Access Journals (Sweden)

    Lacreisha Ejike-King

    2014-04-01

    Full Text Available Despite steadily declining incarceration rates overall, racial and ethnic minorities, namely African Americans, Latinos, and American Indians and Alaska Natives, continue to be disproportionately represented in the justice system. Ex-offenders commonly reenter communities with pressing health conditions but encounter obstacles to accessing care and remaining in care. The lack of health insurance coverage and medical treatment emerge as the some of the most reported reentry health needs and may contribute to observed health disparities. Linking ex-offenders to care and services upon release increases the likelihood that they will remain in care and practice successful disease management. The Affordable Care Act (ACA offers opportunities to address health disparities experienced by the reentry population that places them at risk for negative health outcomes and recidivism. Coordinated efforts to link ex-offenders with these newly available opportunities may result in a trajectory for positive health and overall well-being as they reintegrate into society.

  12. Network Affordances

    DEFF Research Database (Denmark)

    Samson, Audrey; Soon, Winnie

    2015-01-01

    This paper examines the notion of network affordance within the context of network art. Building on Gibson's theory (Gibson, 1979) we understand affordance as the perceived and actual parameters of a thing. We expand on Gaver's affordance of predictability (Gaver, 1996) to include ecological...... and computational parameters of unpredictability. We illustrate the notion of unpredictability by considering four specific works that were included in a network art exhibiton, SPEED SHOW [2.0] Hong Kong. The paper discusses how the artworks are contingent upon the parameteric relations (Parisi, 2013......), of the network. We introduce network affordance as a dynamic framework that could articulate the experienced tension arising from the (visible) symbolic representation of computational processes and its hidden occurrences. We base our proposal on the experience of both organising the SPEED SHOW and participating...

  13. “White Box” Epidemiology and the Social Neuroscience of Health Behaviors: The Environmental Affordances Model

    OpenAIRE

    Mezuk, Briana; Abdou, Cleopatra M.; Hudson, Darrell; Kershaw, Kiarri N.; Rafferty, Jane A.; Lee, Hedwig; Jackson, James S.

    2013-01-01

    Crucial advances have been made in our knowledge of the social determinants of health and health behaviors. Existing research on health disparities, however, generally fails to address a known paradox in the literature: While blacks have higher risk of medical morbidity relative to non-Hispanic whites, blacks have lower rates of common stress-related forms of psychopathology such as major depression and anxiety disorders. In this article we propose a new theoretical approach, the Environmenta...

  14. Introducing a model of cardiovascular prevention in Nairobi's slums by integrating a public health and private-sector approach: the SCALE-UP study

    Directory of Open Access Journals (Sweden)

    Steven van de Vijver

    2013-10-01

    Full Text Available Introduction: Cardiovascular disease (CVD is a leading cause of death in sub-Saharan Africa (SSA, with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlements where access to formal healthcare and resources is limited. Objective: To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sector approaches. Study design: Two non-profit organizations that conduct public health research, Amsterdam Institute for Global Health and Development (AIGHD and African Population and Health Research Center (APHRC, collaborated with private-sector Boston Consulting Group (BCG to develop a service delivery package for CVD prevention in slum settings. A theoretic model was designed based on the integration of public and private sector approaches with the focus on costs and feasibility. Results: The final model includes components that aim to improve community awareness, a home-based screening service, patient and provider incentives to seek and deliver treatment specifically for hypertension, and adherence support. The expected outcomes projected by this model could prove potentially cost effective and affordable (1 USD/person/year. The model is currently being implemented in a Nairobi slum and is closely followed by key stakeholders in Kenya including the Ministry of Health, the World Health Organization (WHO, and leading non-governmental organizations (NGOs. Conclusion: Through the collaboration of public health and private sectors, a theoretically cost-effective model was developed for the prevention of CVD and is currently being implemented in the slums of Nairobi. If results are in line with the theoretical projections and first impressions on the ground, scale-up of the service delivery package could be planned in other poor urban areas in Kenya by

  15. [Hospitals and the Public-Private Combination in the Portuguese Health System].

    Science.gov (United States)

    Fernandes, Adalberto Campos; Nunes, Alexandre Morais

    2016-03-01

    The Portuguese health system has been characterized by the existence of a constant relationship between public and private sector, both in providing and financing health care. In recent decades, the private sector increased their responsiveness of care, extending the engagement in the relationship with the public sector. This relationship stems from the legal framework set out in the law, developing agreements, conventions and more recently through the model of public-private partnerships. In hospital network, this new dynamic relationship contributed, in the last two decades, to accentuate the mixed characteristics of the system, through a clear strengthening of the private component in the hospital network, particularly by investing in differentiated units. PMID:27285098

  16. How does private finance affect public health care systems? Marshaling the evidence from OECD nations.

    Science.gov (United States)

    Tuohy, Carolyn Hughes; Flood, Colleen M; Stabile, Mark

    2004-06-01

    The impact of private finance on publicly funded health care systems depends on how the relationship between public and private finance is structured. This essay first reviews the experience in five nations that exemplify different ways of drawing the public/private boundary to address the particular questions raised by each model. This review is then used to interpret aggregate empirical analyses of the dynamic effects between public and private finance in OECD nations over time. Our findings suggest that while increases in the private share of health spending substitute in part for public finance (and vice versa), this is the result of a complex mix of factors having as much to do with cross-sectoral shifts as with deliberate policy decisions within sectors and that these effects are mediated by the different dynamics of distinctive national models. On balance, we argue that a resort to private finance is more likely to harm than to help publicly financed systems, although the effects will vary depending on the form of private finance. PMID:15328871

  17. Affordability Calculations on a Health Education Campaign to Promote the Use of Aspirin in Wales

    Science.gov (United States)

    Morgan, Gareth

    2008-01-01

    Aspirin has far-reaching public health potential in reducing the risk of heart attacks, ischemic strokes and possibly cancer. Balanced against this potential are undesirable effects of the drug. It seems reasonable to allow every individual over the age of 50 years to make an informed choice about whether or not to take aspirin. A health education…

  18. 78 FR 69418 - Patient Protection and Affordable Care Act; Exchanges and Qualified Health Plans, Quality Rating...

    Science.gov (United States)

    2013-11-19

    ... safety, prevention, population health, patient engagement, patient experience, and efficient resource use... Department of Health and Human Services (the Secretary) holds primary responsibility for establishing the... performance data for the QRS in general topics, such as clinical effectiveness of care, patient safety,...

  19. Perspectives of private health service development in rural regions (basing on the results of Perm experiment)

    OpenAIRE

    Yuliya Krasheninnikova; Elena Zueva; Elena Shuraleva

    2012-01-01

    The article presents an analysis of the intermediate results of the pilot project on the private health care development at the level of first-aid medical posts. The project is being realized in the region of Perm. The initial goal of the experiment was to solve the problem of creating a competitive environment in the health care sphere in Russia and the ultimate one was to improve the quality of medical service and the health of population.Case study of 12 private medical practices in Januar...

  20. Supplemental Private Health Insurance and Depressive Symptoms in Older Married Couples

    Science.gov (United States)

    Min, Meeyoung Oh; Townsend, Aloen L.; Miller, Baila; Rovine, Michael J.

    2005-01-01

    Stress process theory is applied to examine lack of supplemental private health insurance as a risk factor for depressive symptomatology among older married couples covered by Medicare. Dyadic data from 130 African-American couples and 1,429 White couples in the 1993 Asset and Health Dynamics Among the Oldest-Old Survey were analyzed using…

  1. Propulsion Health Management System Development for Affordable and Reliable Operation of Space Exploration Systems

    Science.gov (United States)

    Melcher, Kevin J.; Maul, William A.; Garg, Sanjay

    2007-01-01

    The constraints of future Exploration Missions will require unique integrated system health management capabilities throughout the mission. An ambitious launch schedule, human-rating requirements, long quiescent periods, limited human access for repair or replacement, and long communication delays, all require an integrated approach to health management that can span distinct, yet interdependent vehicle subsystems, anticipate failure states, provide autonomous remediation and support the Exploration Mission from beginning to end. Propulsion is a critical part of any space exploration mission, and monitoring the health of the propulsion system is an integral part of assuring mission safety and success. Health management is a somewhat ubiquitous technology that encompasses a large spectrum of physical components and logical processes. For this reason, it is essential to develop a systematic plan for propulsion health management system development. This paper provides a high-level perspective of propulsion health management systems, and describes a logical approach for the future planning and early development that are crucial to planned space exploration programs. It also presents an overall approach, or roadmap, for propulsion health management system development and a discussion of the associated roadblocks and challenges.

  2. Health literacy and the Affordable Care Act: a policy analysis for children with special health care needs in the USA

    OpenAIRE

    Keim-Malpass J; Letzkus LC; Kennedy C

    2015-01-01

    Jessica Keim-Malpass,1 Lisa C Letzkus,1,2 Christine Kennedy1 1University of Virginia School of Nursing, 2University of Virginia Children’s Hospital, Charlottesville, VA, USA Abstract: Children with special health care needs (CSHCN) represent populations with chronic health conditions that are often high utilizers of health care. Limited health literacy has emerged as a key indicator of adverse health outcomes, and CSHCN from limited health literacy families are particularly vulnera...

  3. Public and Private Roles in Health : Theory and Financing Patterns

    OpenAIRE

    Musgrove, Philip

    1996-01-01

    The appropriate role of the state in health is complex both in economic theory and in practice. Theory identifies three reasons for state action: (i) public goods or services with large externalities (involving efficiency); (ii) poverty (involving equity); and (iii) failings peculiar to insurance markets for health care (where both inefficiency and inequity arise). The insurance domain pre...

  4. Spanish health district tests a new public–private mix

    OpenAIRE

    2009-01-01

    With public health systems facing shrinking budgets, in part due to the global financial crisis, governments are looking at new ways to make the most of limited resources. A handful of Spanish health districts are taking the lead. Mireia Bes reports from Valencia.

  5. Public and/or private health care: Tuberculosis patients' perspectives in Myanmar

    Directory of Open Access Journals (Sweden)

    Sein Than

    2009-07-01

    Full Text Available Abstract Background Tuberculosis is a major public health problem in Myanmar as in other developing countries. About 73% of TB patients seek care at private general practitioners' clinics before presenting to the public TB centre, raising questions about how best to prevent transmission and maintain treatment regimens. Method The study was conducted in two townships in Yangon Division in Myanmar in 2004, and examined treatment seeking behaviour of TB patients and their views towards public and private health care services. This was an exploratory descriptive study. Both quantitative and qualitative research methods were employed in data collection from TB patients, health care professionals, and members of various agencies involved in TB Control Programme. Results A considerable delay was found between the onset of symptoms of TB and seeking treatment (five days – two months. General practitioners were the first point of contact in all cases. Old TB patients influenced the treatment seeking behaviour and choice of treatment clinics of new TB patients. Most patients viewed the public health sector as a place to obtain free treatment and the private sector as a fee-paying, convenient and better place to seek treatment. Conclusion The involvement of private general practitioners is crucial for effective TB control in Myanmar. The selection of GPs for partnership with the public sector is vital to the success of public-private partnership in controlling TB.

  6. De-mystifying the Inconvenient Truth : Does Ex Post Moral Hazard Indeed Exist in Korean Private Health Insurance Market?

    OpenAIRE

    Lim, Jae-Young

    2010-01-01

    There have been heated debates on whether private health insurance creates moral hazard effects. Despite its importance, however, the moral hazard problem of private health insurance is still controversial and understudied. To empirically examine whether or not moral hazard exists in the Korean private health insurance market, we employed two-stage regression for endogeneity control and the Heckman two-step procedure for sample selection bias control, which are expected to produce consistent ...

  7. Public-private sector interactions and the demand for supplementary health insurance in the United Kingdom.

    Science.gov (United States)

    Bíró, Anikó; Hellowell, Mark

    2016-07-01

    We examine the demand for private health insurance (PHI) in the United Kingdom and relate this to changes in the supply of public and private healthcare. Using a novel collection of administrative, private sector and survey data, we re-assess the relationships between the quality and availability of public and private sector inpatient care, and the demand for PHI. We find that PHI coverage in the United Kingdom is positively related to the median of the region- and year-specific public sector waiting times. We find that PHI prevalence ceteris paribus increases with being self-employed and employed, while it decreases with having financial difficulties. In addition, we highlight the complexities of inter-sectoral relations and their impact on PHI demand. Within a region, we find that an increase in private healthcare supply is associated with a decrease in public sector waiting times, implying lower PHI demand. This may be explained by the usage of private facilities by NHS commissioners. These results have important implications for policymakers interested in the role of private healthcare supply in enhancing the availability of and equitable access to acute inpatient care. PMID:27234967

  8. Do Quiet Areas Afford Greater Health-Related Quality of Life than Noisy Areas?

    Directory of Open Access Journals (Sweden)

    Kim N. Dirks

    2013-03-01

    Full Text Available People typically choose to live in quiet areas in order to safeguard their health and wellbeing. However, the benefits of living in quiet areas are relatively understudied compared to the burdens associated with living in noisy areas. Additionally, research is increasingly focusing on the relationship between the human response to noise and measures of health and wellbeing, complementing traditional dose-response approaches, and further elucidating the impact of noise and health by incorporating human factors as mediators and moderators. To further explore the benefits of living in quiet areas, we compared the results of health-related quality of life (HRQOL questionnaire datasets collected from households in localities differentiated by their soundscapes and population density: noisy city, quiet city, quiet rural, and noisy rural. The dose-response relationships between noise annoyance and HRQOL measures indicated an inverse relationship between the two. Additionally, quiet areas were found to have higher mean HRQOL domain scores than noisy areas. This research further supports the protection of quiet locales and ongoing noise abatement in noisy areas.

  9. 76 FR 41865 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans

    Science.gov (United States)

    2011-07-15

    ... on the basis of price, quality, and other factors. The Exchanges, which will become operational by... Federal Employees Health Benefits Program HEDIS Healthcare Effectiveness Data and Information Set HHS U.S... relating to Exchanges, published in the Federal Register on August 3, 2010 (75 FR 45584). Second, ]...

  10. 77 FR 70643 - Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits...

    Science.gov (United States)

    2012-11-26

    ..., states, employers, employees, and Members of Congress. We considered all of these comments as we... received: http://www.regulations.gov . Follow the search instructions on that Web site to view public... Services DOL U.S. Department of Labor EHB Essential Health Benefits ERISA Employee Retirement...

  11. Public-private partnership role in increasing the quality of the health insurance services

    Directory of Open Access Journals (Sweden)

    Dan CONSTANTINESCU

    2012-10-01

    Full Text Available In a context in which the social politics tend to become an optimization instrument for adapting the social security system to the market’s forces, and the talk of some analysts about reinventing the European social model, the partnership between the public sector and the private one in the social domain presumes, besides a tight collaboration, a combination of advantages specific to the private sector, more competitive and efficient, with the ones from the public sector, more responsible toward the society regarding the public money spending. The existence of the private health insurances cannot be tied, causally, to a social politics failure, reason for which they don’t intend, usually, to replace the public insurances, but rather, to offer a complementary alternative for them. In such a context, the public-private partnership’s goal regards both increasing the insurant’s satisfaction and increasing his/her access degree to services, and increasing the investments profitability made by the insurant and insurer. We are facing thus a mixed competitive system that combines the peculiarities of the public and private sectors. Interesting is the fact that, although the different meanings for the quality term may generate some problems regarding implementing quality management in the two health insurance sectors, the experts in the area reckon that establishing a good relationship between public buyers and private providers of healthcare can reduce the costs of public health programs. An essential condition for operating efficiently the partnership model is defining correctly the basic medical services packet financed by the public budget. Which doesn’t exclude the possibility of administrating by the private insurers, the sums of money gathered from the employees and employers contributions to the health fund, as a recently initiated project of law intends to do in Romania.

  12. Affordances revisited

    DEFF Research Database (Denmark)

    Dohn, Nina Bonderup

    2009-01-01

    argued, is a problem for both design and empirical research. Because HCI discussions of the concept have informed CSCL, views presented within this discourse are discussed. A Merleau-Pontian account of affordances is developed, building on his view of the human being as always already being-in-the world...

  13. Commentary: Personalized health planning and the Patient Protection and Affordable Care Act: an opportunity for academic medicine to lead health care reform.

    Science.gov (United States)

    Dinan, Michaela A; Simmons, Leigh Ann; Snyderman, Ralph

    2010-11-01

    The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates the exploration of new approaches to coordinated health care delivery--such as patient-centered medical homes, accountable care organizations, and disease management programs--in which reimbursement is aligned with desired outcomes. PPACA does not, however, delineate a standardized approach to improve the delivery process or a specific means to quantify performance for value-based reimbursement; these details are left to administrative agencies to develop and implement. The authors propose that coordinated care can be implemented more effectively and performance quantified more accurately by using personalized health planning, which employs individualized strategic health planning and care relevant to the patient's specific needs. Personalized health plans, developed by providers in collaboration with their patients, quantify patients' health and health risks over time, identify strategies to mitigate risks and/or treat disease, deliver personalized care, engage patients in their care, and measure outcomes. Personalized health planning is a core clinical process that can standardize coordinated care approaches while providing the data needed for performance-based reimbursement. The authors argue that academic health centers have a significant opportunity to lead true health care reform by adopting personalized health planning to coordinate care delivery while conducting the research and education necessary to enable its broad clinical application. PMID:20844424

  14. Out of pocket payments and social health insurance for private hospital care: Evidence from Greece.

    Science.gov (United States)

    Grigorakis, Nikolaos; Floros, Christos; Tsangari, Haritini; Tsoukatos, Evangelos

    2016-08-01

    The Greek state has reduced their funding on health as part of broader efforts to limit the large fiscal deficits and rising debt ratios to GDP. Benefits cuts and limitations of Social Health Insurance (SHI) reimbursements result in substantial Out of Pocket (OOP) payments in the Greek population. In this paper, we examine social health insurance's risk pooling mechanisms and the catastrophic impact that OOP payments may have on insured's income and well-being. Using data collected from a cross sectional survey in Greece, we find that the OOP payments for inpatient care in private hospitals have a positive relationship with SHI funding. Moreover, we show that the SHI funding is inadequate to total inpatient financing. We argue that the Greek health policy makers have to give serious consideration to the perspective of a SHI system which should be supplemented by the Private Health Insurance (PHI) sector. PMID:27421172

  15. Australia's private health insurance industry: structure, competition, regulation and role in a less than 'ideal world'.

    Science.gov (United States)

    Shamsullah, Ardel

    2011-02-01

    Australia's private health insurance funds have been prominent participants in the nation's health system for 60 years. Yet there is relatively little public awareness of the distinctive origins of the health funds, the uncharacteristic organisational nature of these commercial enterprises and the peculiarly regulated nature of their industry. The conventional corporate responsibility to shareholders was, until recently, completely irrelevant, and remains marginal to the sector. However, their purported answerability to contributors, styled as 'members', was always doubtful for most health funds. After a long period of remarkable stability in the sector, despite significant shifts in health funding policy, recent years have brought notable changes, with mergers, acquisitions and exits from the industry. The research is based on the detailed study of the private health funds, covering their history, organisational character and industry structure. It argues that the funds have always been divorced from the disciplines of the competitive market and generally have operated complacently within a system of comprehensive regulation and generous subsidy. The prospect of the private health funds enjoying an expanded role under a form of 'social insurance', as suggested by the National Health and Hospitals Reform Commission, is not supported. PMID:21367326

  16. Analysis of Developing Public Health Service Sector with Private Finance Initiative in Guangxi

    Institute of Scientific and Technical Information of China (English)

    王宇

    2006-01-01

    In Guangxi Public Health Service Sector (GPHSS), because lack of budget, it has caused a number of problems, such as weakened public health service in rural areas, poor professional quality of medical personnel in public health units at village and township levels, current urban public health service could not meet the health demand for urban residents. This paper is a secondary research. Through analysis of the financial problem and both of the advantages and disadvantages of using the Private Finance Initiative (PFI), it intend to demonstrate that using the PFI could be considered as a good way for the Guangxi government.

  17. The child health implications of privatizing Africa’s urban water supply:

    OpenAIRE

    Kosec, Katrina

    2013-01-01

    Can private-sector participation (PSP) in the urban piped water sector improve child health? The author uses child-level data from 39 African countries during 1986–2010 to show that introducing PSP decreases diarrhea among urban dwelling children under five years of age by 5.6 percentage points, or 35 percent of its mean prevalence.

  18. The development of voluntary private health insurance in the Nordic countries

    DEFF Research Database (Denmark)

    alexandersen, nina; anell, anders; kaarboe, odvar;

    2016-01-01

    -existing or low and capped. Nevertheless, the markets for voluntary private health insurance (VPHI) have been rapidly expanding. In this paper we describe the development of the market for VPHI in the Nordic countries. We outline similarities and differences and provide discussion of the rationale for the...

  19. Joiners, leavers, stayers and abstainers: Private health insurance choices in Australia, CHERE Working Paper 2007/8

    OpenAIRE

    Stephanie Knox; Elizabeth Savage; Denzil Fiebig; Vineta Salale

    2007-01-01

    The percentage of Australians taking up Private Health Insurance (PHI) was in decline following the introduction of Medicare in 1984 (PHIAC). To arrest this decline the Australian Government introduced a suite of policies, between 1997 and 2000, to create incentives for Australians to purchase private health insurance. These policies include an increased Medicare levy for those without PHI on high incomes, introduced in 1997, a 30% rebate for private hospital cover (introduced 1998), and the ...

  20. Making Bioscience Related Health Innovations Work for the Poor: Are Public-Private Partnerships the Answer?

    OpenAIRE

    Chataway, Jo; Hanlin, Rebecca; Murphy, Joseph; Smith, James

    2005-01-01

    Public Private Partnerships (PPPs) in the area of health are currently the focus of considerable debate. They are seen by some as a way of overcoming the crisis of eglected diseasesand the fact that 90% of the world spending on health-related research benefits only 10% of its population. A workshop hosted by the ESRC Genomics Forum and attended by policy experts, practitioners and academics examined the role of global PPPs (GPPPs) in developing new drugs and vaccines designed to combat d...

  1. Entrepreneurs ' perspective on public-private partnership in health care and social services.

    Science.gov (United States)

    Sinisammal, Janne; Leviäkangas, Pekka; Autio, Tommi; Hyrkäs, Elina

    2016-03-21

    Purpose - The purpose of this paper is to probe experiences of entrepreneurs in the social and health care service provision. Design/methodology/approach - Information was collected regarding entrepreneurs' views on the factors affecting the collaboration between public and private sectors. A sample of social and health care entrepreneurs was interviewed using open-ended questions. The interviews were transcribed and analysed using inductive content analysis. Findings - Three main categories of factors affecting the success of partnership were identified: the nature of partnership, business aspects and tension builders. Research limitations/implications - The research was undertaken in rural Finland and the sample consisted 13 entrepreneurs. The results must be considered as observations with more generalised conclusions. Practical implications - The results of this study support municipalities in their social and health care service strategy work and especially in consideration of how to also facilitate a fruitful public-private partnership (PPP)-framework, which will largely depend on mutual understanding and consensus. Originality/value - The reform of the social and health care system has raised intensive public debate throughout Europe. Key issues include the reorganising of social and health care processes as well as PPPs in provision of services. This study observes the views and experiences of private entrepreneurs and points out where some potential problems and solutions of social and health care PPPs are. PMID:26964856

  2. Containing health care costs--a critical test of the public-private joint venture in health.

    Science.gov (United States)

    Derzon, R A

    1980-05-01

    As the federal government shifted from its traditional roles in health to the payment for personal health care, the relationship between public and private sectors has deteriorated. Today federal and state revenue funds and trusts are the largest purchasers of services from a predominantly private health system. This financing or "gap-filling" role is essential; so too is the purchaser's concern for the costs and prices it must meet. The cost per person for personal health care in 1980 is expected to average $950, triple for the aged. Hospital costs vary considerably and inexplicably among states; California residents, for example, spend 50 percent more per year for hospital care than do state of Washington residents. The failure of each sector to understand the other is potentially damaging to the parties and to patients. First, and most important, differences can and must be moderated through definite changes in the attitudes of the protagonists. PMID:6770551

  3. Private Sector An Important But Not Dominant Provider Of Key Health Services In Low- And Middle-Income Countries.

    Science.gov (United States)

    Grépin, Karen A

    2016-07-01

    There is debate about the role of the private sector in providing services in the health systems of low- and middle-income countries and about how the private sector could help achieve the goal of universal health coverage. Yet the role that the private sector plays in the delivery of health services is poorly understood. Using data for the period 1990-2013 from 205 Demographic and Health Surveys in seventy low- and middle-income countries, I analyzed the use of the private sector for the treatment of diarrhea and of fever or cough in children, for antenatal care, for institutional deliveries, and as a source of modern contraception for women. I found that private providers were the dominant source of treatment for childhood illnesses but not for the other services. I also found no evidence of increased use of the private sector over time. There is tremendous variation in use of the private sector across countries and health services. Urban and wealthier women disproportionately use the private sector, compared to rural and poorer women. The private sector plays an important role in providing coverage, but strategies to further engage the sector, if they are to be effective, will need to take into consideration the variation in its use. PMID:27385236

  4. Discourses of social movements about the privatization of Catalan health services

    Directory of Open Access Journals (Sweden)

    Lutiane de Lara

    2015-07-01

    Full Text Available In this paper, we discuss the discourses about the health privatization from the analysis of interviews and manifests of three Catalan movements: Centre d’Anàlisis i Programes Sanitaris (Caps, Grup de Defensa de Sanitat Pública (15MBCNSalut and Plataforma Pel Dret a la Salut (PDS. The content analysis has been adopted as methodology. The analysis has evidenced a dichotomy between public and private systems as a duality that structures discourses favoring the public model and the great efforts made by the movements to guarantee that model. This has shaped the movements as a revolutionary force that defends the public system from private threats by assuming that it essentially represents the people’s ideals. The debate between the traditional and the new in social action has been central to the analysis, as well as the problem of coexistence of different models of action.

  5. What can be done about the private health sector in low-income countries?

    Directory of Open Access Journals (Sweden)

    Mills Anne

    2002-01-01

    Full Text Available A very large private health sector exists in low-income countries. It consists of a great variety of providers and is used by a wide cross-section of the population. There are substantial concerns about the quality of care given, especially at the more informal end of the range of providers. This is particularly true for diseases of public health importance such as tuberculosis, malaria, and sexually transmitted infections. How can the activities of the private sector in these countries be influenced so that they help to meet national health objectives? Although the evidence base is not good, there is a fair amount of information on the types of intervention that are most successful in directly influencing the behaviour of providers and on what might be the necessary conditions for success. There is much less evidence, however, of effective approaches to interventions on the demand side and policies that involve strengthening the purchasing and regulatory roles of governments.

  6. Health-care interventions to promote and assist tobacco cessation:A review of efficacy, effectiveness and affordability for use in national guideline development

    OpenAIRE

    West, Robert; Raw, Martin; McNeill, Ann; Stead, Lindsay; Aveyard, Paul; Bitton, John; Stapleton, John; McRobbie, Hayden; Pokhrel, Subhash; Lester-George, Adam; Borland, Ron

    2015-01-01

    Aims: This paper provides a concise review of the efficacy, effectiveness and affordability of health-care interventions to promote and assist tobacco cessation, in order to inform national guideline development and assist countries in planning their provision of tobacco cessation support. Methods: Cochrane reviews of randomized controlled trials (RCTs) of major health-care tobacco cessation interventions were used to derive efficacy estimates in terms of percentage-point increases relative t...

  7. Women at risk: why increasing numbers of women are failing to get the health care they need and how the Affordable Care Act will help. Findings from the Commonwealth Fund Biennial Health Insurance Survey of 2010.

    Science.gov (United States)

    Robertson, Ruth; Collins, Sara R

    2011-05-01

    Women have greater health care needs than men, and generally play larger roles in the health care of family members. Rising health care costs combined with sluggish income growth has contributed to losses in health insurance among women and rising rates of problems gaining necessary health care and paying medical bills. Women who seek coverage in the individual insurance market face additional hurdles--few plans offer maternity coverage and, in most states, insurance carriers charge higher premium rates to young women than men of the same age. The Affordable Care Act is bringing change for women through required free coverage of preventive care services, small business tax credits, new affordable coverage options, and insurance market reforms, including bans on gender rating. When the law is fully implemented in 2014, nearly all the 27 million working-age women who went without health insurance in 2010 will gain affordable and comprehensive benefits. PMID:21638798

  8. Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector?

    Science.gov (United States)

    Montagu, Dominic; Goodman, Catherine

    2016-08-01

    The private for-profit sector's prominence in health-care delivery, and concern about its failures to deliver social benefit, has driven a search for interventions to improve the sector's functioning. We review evidence for the effectiveness and limitations of such private sector interventions in low-income and middle-income countries. Few robust assessments are available, but some conclusions are possible. Prohibiting the private sector is very unlikely to succeed, and regulatory approaches face persistent challenges in many low-income and middle-income countries. Attention is therefore turning to interventions that encourage private providers to improve quality and coverage (while advancing their financial interests) such as social marketing, social franchising, vouchers, and contracting. However, evidence about the effect on clinical quality, coverage, equity, and cost-effectiveness is inadequate. Other challenges concern scalability and scope, indicating the limitations of such interventions as a basis for universal health coverage, though interventions can address focused problems on a restricted scale. PMID:27358250

  9. A five-year assessment of the affordable care act: market forces still trump the common good in U.S. Health care.

    Science.gov (United States)

    Geyman, John P

    2015-01-01

    The Affordable Care Act (ACA) was enacted in 2010 as the signature domestic achievement of the Obama presidency. It was intended to contain costs and achieve near-universal access to affordable health care of improved quality. Now, five years later, it is time to assess its track record. This article compares the goals and claims of the ACA with its actual experience in the areas of access, costs, affordability, and quality of care. Based on the evidence, one has to conclude that containment of health care costs is nowhere in sight, that more than 37 million Americans will still be uninsured when the ACA is fully implemented in 2019, that many more millions will be underinsured, and that profiteering will still dominate the culture of U.S. health care. More fundamental reform will be needed. The country still needs to confront the challenge that our for-profit health insurance industry, together with enormous bureaucratic waste and widespread investor ownership throughout our market-based system, are themselves barriers to health care reform. Here we consider the lessons we can take away from the ACA's first five years and lay out the economic, social/political, and moral arguments for replacing it with single-payer national health insurance. PMID:25674797

  10. Public and private in italian health care: trends and market quotas

    Directory of Open Access Journals (Sweden)

    Maria Michela Gianino

    2006-12-01

    Full Text Available

    Background: The Italian healthcare system has two components: public and private healthcare providers. Both deliver services on behalf of and payable by the national health care service. This study explores therelationships between public and private healthcare providers.

    Methods: The number of hospital admissions and length of stay or number of times the service was accessed stratified by year 2000, 2001, 2002; DRG; type of hospital admission (ordinary or day hospital/surgery; health provider category: public institutions without a specific reference territory, public institutions with a specific reference territory and accredited private institutions and medical or surgery DRGs. A distinction is made between those DRGs defined as belonging to the private sector and those falling within the public sector, assuming there is a majority market portion for services primarily supplied by the private sector. Case-mix index was utelised as the indicator for the complexity of the cases treated and the comparative performance index was used as the indicator for efficiency. Lastly in order to evaluate the services delivered with an inappropriate organizational profile reference is made the rulings defining Essential Level of assistance.

    Results: The results showed a shift in the reallocation of service volumes for ordinary admissions towards the private sector; the reallocation relates to the volumes but not to the types of cases treated, since the DRG mix remained substantially unchanged over the 3-year period and those DRG that absorb 51% of services were essentially constant. The private sector never achieved a market majority quota but rather controlled market niches with minority quotas. The private institutions treated less complex cases and worked with lower efficiency levels than the public sector. There was also a shift in the distribution of admissions from ordinary admissions to

  11. Can I afford free treatment?: Perceived consequences of health care provider choices among people with tuberculosis in Ho Chi Minh City, Vietnam.

    Science.gov (United States)

    Lönnroth, K; Tran, T U; Thuong, L M; Quy, H T; Diwan, V

    2001-03-01

    Vietnam has a well-organised National TB Control Programme (NTP) with outstanding treatment results. Excellent prospect of cure is provided free of charge. Still, some people prefer to pay for their TB treatment themselves in private clinics. This is a potential threat to TB control since no notification of cases treated in the private sector occurs, and there is no control of the effectiveness of treatment provided in private clinics. Using a qualitative approach within a grounded theory framework, this study explores health-seeking behaviour among people with TB, applying a specific focus on reasons for choices of private versus pubic health care providers. The study identifies a number of characteristics of private TB care, which both seem attractive to patients and at the same time contrast sharply with the structure of the NTP strategy. These include flexible diagnostic procedures, no administrative procedures to establish eligibility for treatment, flexible choices of drug regimens, non-supervised treatment (no DOT), no tracing of defaulters in the household, no official registration of TB cases and thus less threat to personal integrity. A possibility to demand individualised service through the use of fee-for-service payments directly to physicians also seems attractive to many patients. A number of the components of the NTP strategy that have been put in place in order to secure optimal public health outcomes are lacking in the private sector. A dilemma for TB control is that this seems to be an important reason for why many people with TB opt for private providers where quality of care is virtually uncontrolled. The global threat of TB has led to calls for forceful measures to control TB. However, based on the findings in this study it is argued that the use of rigid approaches to TB control that do not encompass a strong component of responsiveness towards the needs of individuals may be counterproductive for public health. PMID:11234866

  12. Colombia: in vivo test of health sector privatization in the developing world.

    Science.gov (United States)

    De Groote, Tony; De Paepe, Pierre; Unger, Jean-Pierre

    2005-01-01

    The reform of the Colombian health sector in 1993 was founded on the internationally advocated paradigm of privatization of health care delivery. Taking into account the lack of empirical evidence for the applicability of this concept to developing countries and the documented experience of failures in other countries, Colombia tried to overcome these problems by a theoretically sound, although complicated, model. Some ten years after the implementation of "Law 100," a review of the literature shows that the proposed goals of universal coverage and equitable access to high-quality care have not been reached. Despite an explosion in costs and a considerable increase in public and private health expenditure, more than 40 percent of the population is still not covered by health insurance, and access to health care proves uncreasingly difficult. Furthermore, key health indicators and disease control programs have deteriorated. These findings confirm the results in other middle- and low-income countries. The authors suggest the explanation lies in the inefficiency of contracting-out, the weak economic, technical, and political capacity of the Colombian government for regulation and control, and the absence of real participation of the poor in decision-making on (health) policies. PMID:15759560

  13. The effect of after-school classes on private tuition, mental health, and academic outcomes: evidence from Korea*

    OpenAIRE

    Daniel Carr; Liang Choon Wang

    2015-01-01

    Using quasi-randomised data from South Korea’s high school equalisation policy area, we show that school-provided after-school classes reduce students’ time spent in private tuition and the associated household expenditure, as well as increase their likelihood of college attendance without any negative mental health impact. Though high and low income groups use a different mix of unassisted study and private tuition to substitute for after-school class, both consume less private tuition as af...

  14. Out of options: why so many workers in small businesses lack affordable health insurance, and how health care reform can help. Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2007.

    Science.gov (United States)

    Doty, Michelle M; Collins, Sara R; Rustgi, Sheila D; Nicholson, Jennifer L

    2009-09-01

    Although employer-sponsored health insurance forms the backbone of the health insurance system in the United States, small businesses are finding it increasingly difficult to provide their workers with comprehensive coverage. In 2007, only 25 percent of employees in small businesses had coverage through their own employers, compared with 74 percent of workers in large firms. Because there are few sources of affordable coverage outside the employer-based system, millions of employees in small businesses are uninsured or have inadequate health insurance. In 2007, 52 percent of workers in small businesses were uninsured or underinsured during the year, compared with half as many employees in large businesses. Congressional bills to reform the health system include provisions specifically aimed at helping small businesses and their employees gain access to affordable, comprehensive coverage. PMID:19757552

  15. Reflections on the role of less-than-comprehensive (exclusionary) private health insurance hospital products in the Australian healthcare system.

    Science.gov (United States)

    Thomas, Peter E

    2012-08-01

    The number of people in Australia that are currently covered by a hospital private health insurance product continues to rise every quarter. In September 2010, for the first time since the introduction of the public universal social insurance scheme, Medicare, more than 10million persons in Australia are covered by private health insurance. Although the number of persons covered by private health insurance continues to grow, the quality and level of cover that members are holding is changing significantly. In an effort to limit premium rises and to reduce the benefits paid for treatment, private health insurers have introduced, and moved a large number of existing members to, less-than-comprehensive private health insurance policies. These policies, known as 'exclusionary' policies, are changing the dynamics of private health insurance in Australia. After examining the emergence and prevalence of these products, this commentary gives three different examples to illustrate how such products are changing the nature of private health insurance in Australia and are now set to create a series of policy issues that will require future attention. PMID:22935116

  16. STOPPING DECEPTIVE HEALTH CLAIMS: THE NEED FOR A PRIVATE RIGHT OF ACTION UNDER FEDERAL LAW.

    Science.gov (United States)

    Hoffmann, Diane; Schwartz, Jack

    2016-01-01

    This Article offers a thorough analysis of an important public health issue, namely how to confront the growing problem of deceptive claims regarding foods and dietary supplements, including increasingly prevalent but unverifiable claims. The authors call for the creation of a limited private right of action under the Federal Trade Commission (FTC) Act for deceptive health-related claims for these products. The proposal responds to the growing market for these products and the inadequacy of current laws and enforcement actions to prevent such claims. In crafting the limited private right of action, the authors attempt to enhance consumer protection without undermining federal agency primacy in enforcement. The Article ends with an appendix setting forth proposed language for a statutory amendment to the FTC Act incorporating the authors' proposal. PMID:27263263

  17. Financial Analysis of the Greek Private Health Sector over the Last Decade (2002-2012)

    OpenAIRE

    George Loukopoulos; Theodoros Roupas

    2014-01-01

    The purpose of this study is to perform a comprehensive financial statement analysis for Hygeia, the largest Private Health Organization in Greece. In this regard, we employ a variety of theoretically advanced approaches. For instance, DuPont analysis based on the decomposition scheme of Nissim and Penman (2001), shows that the capital structure decisions eroded shareholder profits, and specifically their impact was pronounced after the outbreak of the global financial crisis. Considering the...

  18. STRATEGIC MANAGEMENT TOOLS, STAKEHOLDERS AND PERFORMANCE ORGANIZATIONS, PRIVATE HEALTH BRANCH OF THE FEDERAL DISTRICT

    OpenAIRE

    Bruno Vendruscolo; Valmir Emil Hoffmann; Carlos Alberto Freitas

    2012-01-01

    This study aimed to identify the use of management tools and the influence of stakeholders on organizational performance of companies in the private health sector in the Federal District. We used the tools of strategic management, such as budgeting, strategic planning, balanced scorecard, benchmarking, and management software. Study participants consist of individuals involved in strategic processes. We analyzed the past 5 years in organizations to understand the performance. The data collect...

  19. A private organization and public agency partnership in community health education.

    OpenAIRE

    Scarlett, M I; Williams, K R; Cotton, M. F.

    1991-01-01

    The authors address a unique partnership among private and public organizations, that of the American Red Cross and the Centers for Disease Control of the Public Health Service. The partnership stimulates an integrated community response to preventing and controlling human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) at the local level. The partnership channels information and provides education to local communities through the efforts of volunteers and...

  20. The role and uptake of private health insurance in different health care systems: are there lessons for developing countries?

    Directory of Open Access Journals (Sweden)

    Odeyemi IA

    2013-03-01

    Full Text Available Isaac AO Odeyemi,1 John Nixon21Senior Director and Head of Health Economics and Outcomes Research, Astellas Pharma UK Ltd, Chertsey, UK; 2Teaching Associate in Health Economics, Department of Economics and Related Studies, University of York, York, UKBackground: Social and national health insurance schemes are being introduced in many developing countries in moving towards universal health care. However, gaps in coverage are common and can only be met by out-of-pocket payments, general taxation, or private health insurance (PHI. This study provides an overview of PHI in different health care systems and discusses factors that affect its uptake and equity.Methods: A representative sample of countries was identified (United States, United Kingdom, The Netherlands, France, Australia, and Latvia that illustrates the principal forms and roles of PHI. Literature describing each country's health care system was used to summarize how PHI is utilized and the factors that affect its uptake and equity.Results: In the United States, PHI is a primary source of funding in conjunction with tax-based programs to support vulnerable groups; in the UK and Latvia, PHI is used in a supplementary role to universal tax-based systems; in France and Latvia, complementary PHI is utilized to cover gaps in public funding; in The Netherlands, PHI is supplementary to statutory private and social health insurance; in Australia, the government incentivizes the uptake of complementary PHI through tax rebates and penalties. The uptake of PHI is influenced by age, income, education, health care system typology, and the incentives or disincentives applied by governments. The effect on equity can either be positive or negative depending on the type of PHI adopted and its role within the wider health care system.Conclusion: PHI has many manifestations depending on the type of health care system used and its role within that system. This study has illustrated its common applications

  1. Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.

    Directory of Open Access Journals (Sweden)

    Kristjana Einarsdóttir

    Full Text Available BACKGROUND: The Australian Private Health Insurance Incentive (PHII policy reforms implemented in 1997-2000 increased PHI membership in Australia by 50%. Given the higher rate of obstetric interventions in privately insured patients, the reforms may have led to an increase in surgical deliveries and deliveries with longer hospital stays. We aimed to investigate the effect of the PHII policy introduction on birth characteristics in Western Australia (WA. METHODS AND FINDINGS: All 230,276 birth admissions from January 1995 to March 2004 were identified from administrative birth and hospital data-systems held by the WA Department of Health. Average quarterly birth rates after the PHII introduction were estimated and compared with expected rates had the reforms not occurred. Rate and percentage differences (including 95% confidence intervals were estimated separately for public and private patients, by mode of delivery, and by length of stay in hospital following birth. The PHII policy introduction was associated with a 20% (-21.4 to -19.3 decrease in public birth rates, a 51% (45.1 to 56.4 increase in private birth rates, a 5% (-5.3 to -5.1 and 8% (-8.9 to -7.9 decrease in unassisted and assisted vaginal deliveries respectively, a 5% (-5.3 to -5.1 increase in caesarean sections with labour and 10% (8.0 to 11.7 increase in caesarean sections without labour. Similarly, birth rates where the infant stayed 0-3 days in hospital following birth decreased by 20% (-21.5 to -18.5, but rates of births with >3 days in hospital increased by 15% (12.2 to 17.1. CONCLUSIONS: Following the PHII policy implementation in Australia, births in privately insured patients, caesarean deliveries and births with longer infant hospital stays increased. The reforms may not have been beneficial for quality obstetric care in Australia or the burden of Australian hospitals.

  2. Collaboration across private and public sector primary health care services: benefits, costs and policy implications.

    Science.gov (United States)

    McDonald, Julie; Powell Davies, Gawaine; Jayasuriya, Rohan; Fort Harris, Mark

    2011-07-01

    Ongoing care for chronic conditions is best provided by interprofessional teams. There are challenges in achieving this where teams cross organisational boundaries. This article explores the influence of organisational factors on collaboration between private and public sector primary and community health services involved in diabetes care. It involved a case study using qualitative methods. Forty-five participants from 20 organisations were purposively recruited. Data were collected through semi-structured interviews and from content analysis of documents. Thematic analysis was used employing a two-level coding system and cross case comparisons. The patterns of collaborative patient care were influenced by a combination of factors relating to the benefits and costs of collaboration and the influence of support mechanisms. Benefits lay in achieving common or complementary health or organisational goals. Costs were incurred in bridging differences in organisational size, structure, complexity and culture. Collaboration was easier between private sector organisations than between private and public sectors. Financial incentives were not sufficient to overcome organisational barriers. To achieve more coordinated primary and community health care structural changes are also needed to better align funding mechanisms, priorities and accountabilities of the different organisations. PMID:21554068

  3. On the international stability of health care expenditure functions: are government and private functions similar?

    Science.gov (United States)

    Clemente, Jesús; Marcuello, Carmen; Montañés, Antonio; Pueyo, Fernando

    2004-05-01

    This paper studies the stability of health care expenditure functions in a sample of OECD countries. We adopt the cointegration approach and the results show that there is a long-term relationship between total health care expenditure (HCE) and gross domestic product (GDP). However, the existence of cointegration is only shown when we admit the presence of some changes in the elasticities of the model. Our results also provide evidence against the existence of a unique relationship between health and GDP for the sample. Thus, we can conclude that the differences in health systems may cause differences in the aggregate functions. Additionally, we examine aggregate health functions for government (GHCE) and private expenditures (PHCE), again finding evidence of different patterns of behaviour. Finally, we open a discussion on the character of health as a necessary or luxury good. In this context, we find differences between the government and the private function. In order to illustrate these findings, we propose a theoretical model as an example of the influence of political decisions on income elasticity. PMID:15120472

  4. Income, social stratification, class, and private health insurance: a study of the Baltimore metropolitan area.

    Science.gov (United States)

    Muntaner, C; Parsons, P E

    1996-01-01

    Most studies of inequalities and access to health care have used income as the sole indicator of social stratification. Despite the significance of social theory in health insurance research, there are no empirical studies comparing the ability of different models of social stratification to predict health insurance coverage. The aim of this study is to provide a comparative analysis using a variety of theory-driven indicators of social stratification and assess the relative strength of the association between these indicators and private health insurance. Data were collected in a 1993 telephone interview of a random digit dialing sample of the white population in the Baltimore Metropolitan Statistical Area. Indicators of social stratification included employment status, full-time work, education, occupation, industry, household income, firm size, and three types of assets: ownership, organizational, and skill/credential. The association between social stratification and private health insurance was strongest for those having higher household incomes, having attained at least a bachelor's degree, and working in a firm with more than 50 employees, followed by being an owner or manager, and by being employed. The addition of education and firm size improved the prediction of the household income model. The authors conclude that studies of inequalities in health insurance coverage can benefit from the inclusion of theory-driven indicators of social stratification such as human capital, labor market segmentation, and control over productive assets. PMID:8906444

  5. Health care financing in Malaysia: A way forward

    OpenAIRE

    Ashutosh Kumar Verma; Mohamed Azmi Hassali; Fahad Saleem

    2015-01-01

    Malaysia has a two-tier health care system consisting of the public and private sectors. The Ministry of Health is the main provider of health care services in the country. The private health care sector provides services on a nonsubsidized, fee-for-service basis, and mainly serves for those who can afford to pay. For financing health care two types of health insurances are available currently: Private and employee based (aka SOCSO). SOCSO and Employee Provident Fund provide some coverage to ...

  6. Personal Health Practices and Patient Counseling of German Physicians in Private Practice

    OpenAIRE

    Voltmer, Edgar; Frank, Erica; Spahn, Claudia

    2013-01-01

    We examined physicians' personal health behaviors and the influence on their patient counseling practices in a representative sample (N=414) of physicians in private practice in Schleswig-Holstein, Germany. Physicians reported significantly better physical but poorer mental health compared to the general population (GP; P>0.01). The majority presented with normal weight (47.9% male, 73.1% female physicians versus 24.5/41.0% GP) or overweight (47.5% male, 20.0% female versus 52.9/35.6% GP). Fr...

  7. Public and private health care utilization differences between socioeconomic strata in Jamaica

    OpenAIRE

    Bourne, Paul

    2010-01-01

    Paul A Bourne1, Denise Eldemire-Shearer1, Tomlin J Paul1, Janet LaGrenade1, Christopher AD Charles21Department of Community Health and Psychiatry, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica; 2King Graduate School, Monroe College, New York and Center for Victim Support, Harlem Hospital Center, New York, NY, USAObjective: To assess trends in the use of private and public health care services among Jamaicans over a 15-year period (1991–2007).Des...

  8. Product development public-private partnerships for public health: a systematic review using qualitative data.

    Science.gov (United States)

    De Pinho Campos, Katia; Norman, Cameron D; Jadad, Alejandro R

    2011-10-01

    Almost a decade ago, public health initiated a number of innovative ventures to attract investments from multinational drug companies for the development of new drugs and vaccines to tackle neglected diseases (NDs). These ventures - known as product development public-private partnerships (PD PPPs) - represent the participation of the public and private actors toward the discovery and development of essential medicines to reduce the suffering of over one billion people worldwide living with NDs. This systematic review aimed to identify empirical-based descriptive articles to understand critical elements in the partnership process, and propose a framework to shed light on future guidelines to support better planning, design and management of existing and new forms of PPPs for public health. Ten articles met the inclusion criteria and were analyzed and synthesized using qualitative content analysis. The findings show that the development stage of PD PPPs requires a careful initiation and planning process including discussion on values and shared goals, agreement on mutual interests & equality of power relation, exchange of expertise & resources, stakeholder engagement, and assessment of the local health capacity. The management stage of PD PPPs entails transparency, extensive communication and participatory decision-making among partner organizations. This review illustrates the difficulties, challenges and effective responses during the partnering process. This model of collaboration may offer a way to advance population health at present, while creating streams of innovation that can yield future social and financial dividends in enhancing the public's health more widely. PMID:21839562

  9. [Persons insured with the German statutory sickness funds or privately insured: differences in health and health behaviour].

    Science.gov (United States)

    Kriwy, P; Mielck, A

    2006-05-01

    This paper deals with differences in health and health behaviour between those who are insured in the German Statutory Sickness Funds (GKV) and those who are privately insured (PKV). This topic has been largely ignored in German Public Health research. The analyses are based on data from a large survey in Germany conducted in 1998 and including 6822 adults. The multivariate analyses have been performed with OLS and logistic regression, separately for men and women and controlling for age, educational level, income and region. The most important result is that PKV-insured men have fewer diseases and feel more healthy than GKV-insured men. For women, though, no significant association could be found between health and type of health insurance. The interpretation of these results is mainly based on the "selection hypothesis", stating that healthier persons are more likely to be insured in the PKV than in the GKV. This would imply that the "causation hypothesis" (stating that being privately insured has a positive effect on health) is less important. Taking into account the current discussion on the balance between GKV and PKV, it is believed that future research should focus more on these topics. PMID:16773548

  10. The problems of private health insurance in Chile: Looking for a solution to a history of inefficiency and inequity

    OpenAIRE

    Camilo Cid

    2011-01-01

    The concept of health insurance is of vital importance for health policy. Beneficiaries are able to share the risk arising from health expenses, and are ensured access to health care provisions whenever necessary. The need to share an individual’s risk to become ill is the direct consequence of the uncertainty that surrounds the health sector. Chilean health insurance companies are able to reach financial balance (the state-owned insurer) or profits (privately-owned insurers) by setting a pre...

  11. Private health insurance in 1974: a review of coverage, enrollment, and financial experience.

    Science.gov (United States)

    Mueller, M S; Piro, P A

    1976-03-01

    In 1974, more than three-fourths of the civilian population had substantial economic protection through private health insurance against the costs of hospital and surgical care. Smaller proportions were covered at least in part for other health care costs, usually after payment of deductibles and coinsurance. Consumers got back 87 percent of their premium dollars in the form of benefits. The rise in premium income in 1974 lagged 4 percentage points behind the growth in claims incurred. The result was a net underwriting loss of $359.7 million or 1.3 percent of premium income. Most consumers bought their health insurance protection through insurance companies, although Blue Cross-Blue Shield plans served about two-fifths of the insured population for hospital-associated care. In addition, about 6 percent received health care through independent prepayment and self-insured plans. PMID:828776

  12. Comparison of the Effects of Public and Private Health Expenditures on the Health Status: a Panel Data Analysis in Eastern Mediterranean Countries

    Directory of Open Access Journals (Sweden)

    Enayatollah Homaie Rad

    2013-01-01

    Full Text Available BackgroundHealth expenditures are divided in two parts of public and private health expenditures. Public health expenditures contain social security spending, taxing to private and public sectors, and foreign resources like loans and subventions. On the other hand, private health expenditures contain out of pocket expenditures and private insurances. Each of these has different effects on the health status. The present study aims to compare the effects of these expenditures on health in Eastern Mediterranean Region (EMR. MethodsIn this study, infant mortality rate was considered as an indicator of health status. We estimated the model using the panel data of EMR countries between 1995 and 2010. First, we used Pesaran CD test followed by Pesaran’s CADF unit root test. After the confirmation of having unit root, we used Westerlund panel cointegration test and found that the model was cointegrated and then after using Hausman and Breusch-Pagan tests, we estimated the model using the random effects. ResultsThe results showed that the public health expenditures had a strong negative relationship with infant mortality rate. However, a positive relationship was found between the private health expenditures and infant mortality rate (IMR. The relationship for public health expenditures was significant, but for private health expenditures was not. ConclusionThe study findings showed that the public health expenditures in the EMR countries improved health outcome, while the private health expenditures did not have any significant relationship with health status, so often increasing the public health expenditures leads to reduce IMR. But this relationship was not significant because of contradictory effects for poor and wealthy peoples.

  13. Selling Drugs or Providing Health Care? : The role of private pharmacies and drugstores, examples from Zimbabwe and Tanzania

    OpenAIRE

    Viberg, Nina

    2009-01-01

    Background: In low-income countries many people do not have access to formal health care because of poverty and weak health systems. Instead people seek care at private pharmacies and drugstores. Infectious diseases such as sexually transmitted infections (STI) and diarrhoea are common and access to correct management is of big importance. Assessing the quality and finding the potential for improvement of private pharmacy and drugstore practice is therefore of uttermost impo...

  14. Private sector delivery of health services in developing countries: a mixed-methods study on quality assurance in social franchises

    OpenAIRE

    Schlein Karen; De La Cruz Anna York; Gopalakrishnan Tisha; Montagu Dominic

    2013-01-01

    Abstract Background Across the developing world health care services are most often delivered in the private sector and social franchising has emerged, over the past decade, as an increasingly popular method of private sector health care delivery. Social franchising aims to strengthen business practices through economies of scale: branding clinics and purchasing drugs in bulk at wholesale prices. While quality is one of the established goals of social...

  15. Public-private partnerships with large corporations: setting the ground rules for better health.

    Science.gov (United States)

    Galea, Gauden; McKee, Martin

    2014-04-01

    Public-private partnerships with large corporations offer potential benefits to the health sector but many concerns have been raised, highlighting the need for appropriate safeguards. In this paper we propose five tests that public policy makers may wish to apply when considering engaging in such a public-private partnership. First, are the core products and services provided by the corporation health enhancing or health damaging? In some cases, such as tobacco, the answer is obvious but others, such as food and alcohol, are contested. In such cases, the burden of proof is on the potential partners to show that their activities are health enhancing. Second, do potential partners put their policies into practice in the settings where they can do so, their own workplaces? Third, are the corporate social responsibility activities of potential partners independently audited? Fourth, do potential partners make contributions to the commons rather than to narrow programmes of their choosing? Fifth, is the role of the partner confined to policy implementation rather than policy development, which is ultimately the responsibility of government alone? PMID:24581699

  16. Assessing incentives for service-level selection in private health insurance exchanges.

    Science.gov (United States)

    McGuire, Thomas G; Newhouse, Joseph P; Normand, Sharon-Lise; Shi, Julie; Zuvekas, Samuel

    2014-05-01

    Even with open enrollment and mandated purchase, incentives created by adverse selection may undermine the efficiency of service offerings by plans in the new health insurance Exchanges created by the Affordable Care Act. Using data on persons likely to participate in Exchanges drawn from five waves of the Medical Expenditure Panel Survey, we measure plan incentives in two ways. First, we construct predictive ratios, improving on current methods by taking into account the role of premiums in financing plans. Second, relying on an explicit model of plan profit maximization, we measure incentives based on the predictability and predictiveness of various medical diagnoses. Among the chronic diseases studied, plans have the greatest incentive to skimp on care for cancer, and mental health and substance abuse. PMID:24603443

  17. Determinants of employment-based private health insurance coverage in Denmark

    Directory of Open Access Journals (Sweden)

    Astrid Kiil

    2011-10-01

    Full Text Available This study estimates the determinants of having employment-based private health insurance (EPHI based on data from a survey of the Danish workforce conducted in 2009. The study contributes to the literature by exploring the role of satisfaction with the tax-financed health care system as a potential determinant of EPHI ownership and by taking into account that some employees receive EPHI free of charge, while others pay the premium out of their pre-tax income and thus make an actual choice. The results indicate that the probability of having EPHI is positively affected by private sector employment, size of the workplace, whether the workplace has a health scheme, income, being employed as a white-collar worker, and age until the age of 49, while the presence of subordinates, gender, education level, membership of 'denmark' and living in the capital region are not significantly associated with EPHI coverage. As expected, the characteristics related to the workplace are by far the quantitatively most important determinants. The association between EPHI and self-assessed health is found to be quadratic such that individuals in good self-assessed health are more likely to be covered by EPHI than those in excellent and fair, poor or very poor self-assessed health, respectively. Finally, the probability of having EPHI is found to be negatively related to the level of satisfaction with the tax-financed health care system. The findings of the study are not affected notably by distinguishing empirically between employees who receive EPHI free of charge and those who pay the premium out of their pre-tax income. Link to Appendix

  18. Available, accessible and affordable. Malaysia. The Hague Forum.

    Science.gov (United States)

    Ismail, P Z

    1999-01-01

    While Malaysia already had policies for a balanced, equitable, and sustainable development before the 1994 International Conference on Population and Development (ICPD), the conference gave Malaysia the chance to pursue specific and more complex issues. Reproductive health services including family planning have been integrated and are available, accessible, and affordable within the existing health care system, both public and private. Since Malaysia's government needs help implementing Cairo's goals, regular consultations are held with advocacy groups, the private sector, and community groups on program design and implementation. Annual grants to nongovernmental organizations are made to ensure that programs and services ultimately reach the various target groups. While Malaysia has made progress implementing the ICPD program of action, it has more to accomplish. Economic conditions leading to a 20% across-the-board budget cut in July 1998 have not adversely affected the country's population and reproductive health programs. PMID:12322184

  19. Why not private health insurance? 2. Actuarial principles meet provider dreams.

    Science.gov (United States)

    Deber, R; Gildiner, A; Baranek, P

    1999-09-01

    What do insurers and employers feel about proposals to expand Canadian health care financing through private insurance, in either a parallel stream or a supplementary tier? The authors conducted 10 semistructured, open-ended interviews in the autumn and early winter of 1996 with representatives of the insurance industry and benefits managers working with large employers; respondents were identified using a snowball sampling technique. The respondents felt that proposals for parallel private plans within a competitive market are incompatible with insurance principles, as long as a well-functioning and relatively comprehensive public system continues to exist; the maintenance of a strong public system was both socially and economically desirable. With the exception of serving the niche market for the private management of return-to-work strategies, respondents showed little interest in providing parallel coverage. They were receptive to a larger role for supplementary insurance but cautioned that they are not willing to cover all delisted services. As business executives they stated that they are willing to insure only services and clients that will be profitable. PMID:10497614

  20. Meeting the public health challenge of protecting private wells: Proceedings and recommendations from an expert panel workshop.

    Science.gov (United States)

    Fox, Mary A; Nachman, Keeve E; Anderson, Breeana; Lam, Juleen; Resnick, Beth

    2016-06-01

    Private wells serving fewer than 25 people are federally unregulated, and their users may be exposed to naturally occurring agents of concern such as arsenic and radionuclides, as well as anthropogenic contaminants. The Centers for Disease Control and Prevention's Clean Water for Health Program works to protect private wells and prevent adverse health outcomes for the roughly 15% of Americans who rely on them. To understand current and emerging challenges to the private drinking water supply, an interdisciplinary expert panel workshop on "Future and Emerging Issues for Private Wells" was organized to inform strategic planning for the Clean Water for Health Program. The panel assessed current conditions of ground water as a source for private wells, identified emerging threats, critical gaps in knowledge, and public health needs, and recommended strategies to guide future activities to ensure the safety of private drinking water wells. These strategies addressed topics of broad interest to the environmental public health community including: development of new methods to support citizen science; addressing contaminant mixtures; expanding capacity for well testing; evaluating treatment technologies; building an evidence base on best practices on well owner outreach and stewardship; and research and data needs. PMID:26950625

  1. Health problems among migrant construction workers: A unique public-private partnership project

    Directory of Open Access Journals (Sweden)

    Balkrishna B Adsul

    2011-01-01

    Full Text Available Background: Construction sector is a booming industry and involves many hazardous activities. Migrant labor in the industry is susceptible to various health and occupational hazards. In a unique public-private partnership project, a medical team from a public sector teaching hospital in Mumbai provided comprehensive on-site health care services to the construction workers of a private construction company. Objective: To study socio-demographic profile and morbidity pattern of construction workers. Setting and Design: A cross-sectional study at construction site Vidyavihar (West, Mumbai, was carried out over the period of May to November 2010. Materials and Methods: A medical team provided comprehensive on-site health care services, and a Health Card was devised to maintain the record of socio-demographic, occupational details, and complete physical examination findings of the workers who participated in the study. Statistical Analysis Used: Statistical analysis was done using SPSS 15.0. Results: Of the 1337 workers (all males examined, 1289 (96.4% belonged to 15-45 years age group. The mean age of the workers was 26.25 ± 8.49 years. A third of the migrants belonged to West Bengal. The average number of health problems in the workers was 1.41. Regular consumers of tobacco and alcohol were 50.48 and 14.65%, respectively. Nearly one-fifth of the workers had febrile illness, of which 20.71% had suspected malaria; 12.6% had respiratory infections, while 3.4% were found to have hypertension. There was a statistically significant association (P < 0.05 between type of occupation and morbidity status.

  2. Health problems among migrant construction workers: A unique public–private partnership project

    Science.gov (United States)

    Adsul, Balkrishna B.; Laad, Payal S.; Howal, Prashant V.; Chaturvedi, Ramesh M.

    2011-01-01

    Background: Construction sector is a booming industry and involves many hazardous activities. Migrant labor in the industry is susceptible to various health and occupational hazards. In a unique public–private partnership project, a medical team from a public sector teaching hospital in Mumbai provided comprehensive on-site health care services to the construction workers of a private construction company. Objective: To study socio-demographic profile and morbidity pattern of construction workers. Setting and Design: A cross-sectional study at construction site Vidyavihar (West), Mumbai, was carried out over the period of May to November 2010. Materials and Methods: A medical team provided comprehensive on-site health care services, and a Health Card was devised to maintain the record of socio-demographic, occupational details, and complete physical examination findings of the workers who participated in the study. Statistical Analysis Used: Statistical analysis was done using SPSS 15.0. Results: Of the 1337 workers (all males) examined, 1289 (96.4%) belonged to 15–45 years age group. The mean age of the workers was 26.25 ± 8.49 years. A third of the migrants belonged to West Bengal. The average number of health problems in the workers was 1.41. Regular consumers of tobacco and alcohol were 50.48 and 14.65%, respectively. Nearly one-fifth of the workers had febrile illness, of which 20.71% had suspected malaria; 12.6% had respiratory infections, while 3.4% were found to have hypertension. There was a statistically significant association (P < 0.05) between type of occupation and morbidity status. PMID:21808498

  3. THE IMPACTS OF THE AFFORDABLE CARE ACT: HOW REASONABLE ARE THE PROJECTIONS?

    OpenAIRE

    Gruber, Jonathan

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) is the most comprehensive reform of the U.S. medical system in at least 45 years. The ACA transforms the non-group insurance market in the United States, mandates that most residents have health insurance, significantly expands public insurance and subsidizes private insurance coverage, raises revenues from a variety of new taxes, and reduces and reorganizes spending under the nation’s largest health insurance plan, Medicare. Projecting the...

  4. Breastfeeding: Mothers and health practitioners in the context of private medical care in Gauteng

    Directory of Open Access Journals (Sweden)

    Diana du Plessis

    2009-04-01

    Full Text Available Despite the well-documented health benefits of breastfeeding and recommendations by the Department of Health for women to exclusively breastfeed for approximately the first six months of life and continuation beyond one year, a large percentage of South African women do not breastfeed their infants, or only do so for a short period of time. No national South African statistics are available but figures emerging from the attendance of mothers at a baby clinic on the West Rand in Gauteng indicated the following: 64% of the mothers breastfeed up to six weeks, after which the figure rapidly declines to less than 20% at three months (Truter 2007. Several studies have assessed the attitudes of health care personnel towards breastfeeding, but little is known of the type of information given to breastfeeding mothers by private medical practitioners who are the frontline of contact with clients and who may convey information that either promotes or discourages breastfeeding. The following question was thus formulated: With regard to breastfeeding, what are the constraints to breastfeeding in private practice?

    Therefore, in order to understand the constraints to breastfeeding, the purpose of this study was to assess the breastfeeding information given to pregnant women by health professionals in private practice. The specific objectives of the study were to determine the breastfeeding recommendations made by private health professionals during pregnancy, to describe the management of breastfeeding in the consulting rooms of private medical practitioners, and to describe women’s experiences of breastfeeding in private hospitals. In Phase 1 of the study the population comprised all mothers who attended a support group for new mothers at a private post-natal clinic In Phase 2 the population comprised all mothers who attended a community baby clinic or support group. The sample consisted of all primigravidae who breastfed or attempted to breastfeed in the

  5. PUBLIC PRIVATE PARTNERSHIP IN HEALTH SECTOR IN KARNATAKA: WITH SPECIAL REFERENCE TO WOMEN'S HEALTH

    OpenAIRE

    PRASANNA B JOSHI; GURUPRASAD GANESHKAR

    2013-01-01

    Good Health of people is one of the important indicators of a country'sprosperity. Every country has witnessed a deterioration in the health of its people due tochanges in the life styles, food habits, growing consumerism and also pollution that hasresulted in health problems. Therefore health is a prime concern in the task of nationbuilding. To earn good will of the community by providing quality services is one of theobjectives of the Governments both at the national and state levels is to ...

  6. [The contradictions between the universal Unified Health System and the transfer of public funds to private health plans and insurances].

    Science.gov (United States)

    Bahia, Ligia

    2008-01-01

    Trailing the whole group of trends and changes in the scenario of relations between the public and the private, this article analyses the effects of the rise in the rates of return of health plan operators and health insurance companies in 2007. Special attention is given to the segmentation of the system, the complaints about the naturalization of inequitable access to health services and to the depreciation of the original concepts of the Unified Health System. The study also gathers information regarding the production of knowledge about supplementary care with the intent to systemize the bases and methodological approaches adopted by a selected sub-group of scientific papers. Finally, the article develops conjectures and hypotheses with regard to possible associations between growth and stability of the health plan and insurance market and as refers to the nature of scientific production about this issue, taking into consideration the contradictions between the political and economical circuit in which the health plan and insurance companies are operating and the universality of the Brazilian Health System. PMID:18813639

  7. Do financial incentives for supplementary private health insurance reduce pressure on the public system? Evidence from Australia, CHERE Working Paper 2006/11

    OpenAIRE

    Mingshan Lu; Elizabeth Savage

    2006-01-01

    In many developed countries, budgetary pressures have made government investigate private insurance to reduce pressure on their public health system. Between 1997 and 2000 the Australian government implemented a series of reforms intended to increase enrollment in private health insurance and reduce public health care costs. Using the ABS 2001 National Health Survey, we examine the impact of increased insurance coverage on use of the hospital system, in particular on public and private admiss...

  8. Exploring the Public Health Impacts of Private Security Guards on People Who Use Drugs: a Qualitative Study.

    Science.gov (United States)

    Markwick, Nicole; McNeil, Ryan; Small, Will; Kerr, Thomas

    2015-12-01

    Private security guards occupy an increasingly prominent role in the policing of private and public spaces. There are growing concerns regarding security guards' potential to shape violence, discrimination, and adverse health outcomes among vulnerable populations, including people who use drugs (PWUD). This is relevant in Vancouver, Canada, where private security guards have increasingly been employed by private organizations to manage public and private spaces, including those within urban drug scenes. This qualitative study sought to understand interactions between PWUD and private security guards and explore their impacts on health care access, risks, and harms among PWUD. Semi-structured interviews were conducted with 30 PWUD recruited from two ongoing prospective cohort studies. Interviews were transcribed and analyzed using a coding framework comprised of a priori and emergent categories. Study data indicate that participants experience pervasive, discriminatory profiling and surveillance by security guards, which exacerbates existing social marginalization and structural vulnerability, particularly among PWUD of Aboriginal ancestry. Participants reported that security guards restrict PWUD's access to public and private spaces, including pharmacies and hospitals. PWUD also reported that their interactions with security guards often involved interpersonal violence and aggression, experiences that served to increase their vulnerability to subsequent risks and harms. Our findings highlight that private security forces contribute significantly to the everyday violence experienced by PWUD within drug scenes and elsewhere and do so in a manner very similar to that of traditional police forces. These findings point to the urgent need for greater oversight and training of private security guards in order to protect the health and safety of PWUD. PMID:26453195

  9. Community rating in the absence of risk equalisation: lessons from the Irish private health insurance market.

    Science.gov (United States)

    Turner, Brian; Shinnick, Edward

    2013-04-01

    Ireland's private health insurance market operates on the basis of community rating, alongside open enrolment and lifetime cover. A risk equalisation scheme was introduced in 2003 to bolster community rating. However, in July 2008 the Irish Supreme Court set aside this scheme, on the basis of the interpretation of community rating in Irish legislation. This decision has significant implications for the Irish private health insurance market. This paper reviews the development of the market, focusing in particular on community rating. The breakdown of community rating in a market with multiple insurers with differing risk profiles is discussed. Applying this to the Irish market, it can be seen that the Irish Supreme Court judgment has significant implications for the application of community rating. Specifically, while community rating operates within plans, it no longer operates across the market, leading to high-risk lives paying more, on average, than low-risk lives. It has also led to greater opportunities for insurers to engage in market segmentation. This may have relevance for the design and operation of other community rated markets. PMID:22717020

  10. Doctor-Patient Relationship Between Individuals With Fibromyalgia and Rheumatologists in Public and Private Health Care in Mexico.

    Science.gov (United States)

    Colmenares-Roa, Tirsa; Huerta-Sil, Gabriela; Infante-Castañeda, Claudia; Lino-Pérez, Leticia; Alvarez-Hernández, Everardo; Peláez-Ballestas, Ingris

    2016-10-01

    The aim of this article was to describe and analyze the doctor-patient relationship between fibromyalgia patients and rheumatologists in public and private health care contexts within the Mexican health care system. This medical anthropological study drew on hospital ethnography and patients' illness narratives, as well as the experiences of rheumatologists from both types of health care services. The findings show how each type of medical care subsystem shape different relationships between patients and doctors. Patient stigmatization, overt rejection, and denial of the disease's existence were identified. In this doctor-patient-with-fibromyalgia relationship, there are difficult encounters, rather than difficult patients. These encounters are more fluid in private consultations compared with public hospitals. The doctor-centered health care model is prevalent in public institutions. In the private sector, we find the characteristics of the patient-centered model coexisting with the traditional physician-centered approach. PMID:27578852

  11. Health status and related behavior of children in a private and a public school of a village in Kathmandu district.

    Science.gov (United States)

    Shrestha, N; Shrestha, S R; Dhakal, N

    2014-12-01

    Children spend around 25% of their time of 260 days in a year in school. Hence early detection of abnormalities in health enables timely corrective measures to be taken. A descriptive study related to health of primary class students was carried out from June to September 2013 in a village which lies inside Kathmandu valley. Health status and related behavior was assessed in 69 students from a public school and 125 students from a private school who belonged to class 1 to 5. The results did not show significant difference between the variables in private and public school. PMID:26930729

  12. Prescribing patterns of antiretroviral drugs in a section of the private health care sector of South Africa

    Directory of Open Access Journals (Sweden)

    Ronel Smit

    2006-04-01

    Full Text Available The general objective of this study was to investigate the prescribing patterns and cost of antiretroviral (ARV drugs in the private health care sector in South Africa by using a medicine claims database. Opsomming Die doel van hierdie studie was om die voorskryfpatrone en medisynekoste van antiretrovirale (ARV geneesmiddels in die private gesondheidsorgsektor in Suid-Afrika te ondersoek. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  13. Power in global health agenda-setting: the role of private funding: Comment on "Knowledge, moral claims and the exercise of power in global health"

    OpenAIRE

    Levine, Ruth E.

    2015-01-01

    The editorial by Jeremy Shiffman, "Knowledge, moral claims and the exercise of power in global health", highlights the influence on global health priority-setting of individuals and organizations that do not have a formal political mandate. This sheds light on the way key functions in global health depend on private funding, particularly from the Bill & Melinda Gates Foundation.

  14. Privatization in a publicly funded health care system: the U.S. experience.

    Science.gov (United States)

    Himmelstein, David U; Woolhandler, Steffie

    2008-01-01

    The United States has four decades of experience with the combination of public funding and private health care management and delivery, closely analogous to reforms recently enacted or proposed in many other nations. Extensive research, herein reviewed, shows that for-profit health institutions provide inferior care at inflated prices. The U.S. experience also demonstrates that market mechanisms nurture unscrupulous medical businesses and undermine medical institutions unable or unwilling to tailor care to profitability. The commercialization of care in the United States has driven up costs by diverting money to profits and by fueling a vast increase in management and financial bureaucracy, which now consumes 31 percent of total health spending. The Veterans Health Administration system--a network of government hospitals and clinics--has emerged as the leader in quality improvement and information technology, indicating the potential for public sector excellence and innovation. The poor performance of U.S. health care is directly attributable to reliance on market mechanisms and for-profit firms, and should warn other nations from this path. PMID:18724573

  15. A case for increased private sector involvement in Ireland's national animal health services.

    Science.gov (United States)

    More, Simon J

    2008-01-01

    Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR) and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise) of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia). The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise) of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands). PMID:21851708

  16. A case for increased private sector involvement in ireland's national animal health services

    Directory of Open Access Journals (Sweden)

    More Simon J

    2008-02-01

    Full Text Available Abstract Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia. The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands.

  17. Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states

    Directory of Open Access Journals (Sweden)

    Mahapatra Prasanta

    2010-11-01

    Full Text Available Abstract Background Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private sectors. Methods Cross-sectional surveys of 1916 public and private sector health workers in Andhra Pradesh and Uttar Pradesh, India, were conducted using a standardized instrument to identify health workers' satisfaction with key work factors related to motivation. Ratings were compared with how important health workers consider these factors. Results There was high variability in the ratings for areas of satisfaction and motivation across the different practice settings, but there were also commonalities. Four groups of factors were identified, with those relating to job content and work environment viewed as the most important characteristics of the ideal job, and rated higher than a good income. In both states, public sector health workers rated "good employment benefits" as significantly more important than private sector workers, as well as a "superior who recognizes work". There were large differences in whether these factors were considered present on the job, particularly between public and private sector health workers in Uttar Pradesh, where the public sector fared consistently lower (P P Conclusion There are common areas of health worker motivation that should be considered by managers and policy makers, particularly the importance of non-financial motivators such as working environment and skill development opportunities. But managers also need to focus on the importance of locally assessing conditions and managing incentives to ensure health workers are motivated in their work.

  18. [Introduction of the DRG system from the point of view of private health insurers].

    Science.gov (United States)

    Fritze, Jürgen; Miebach, Jürgen; Hüdig, Wolfgang

    2002-08-01

    For the first time, there has been a worldwide attempt to fund all hospital services almost completely by a DRG system supplemented by additional charges, rebates, and procedural rates. In the interest of the efficiency and transparency of hospital services the introduction of a German DRG system settling the current implausible price differences would be welcome. The system selected by the medical self-governing bodies in Germany is based upon the Australian AR-DRG classification. In contrast to other systems, the latter provides the best medical plausibility, the highest transparency of the assignment algorithm and the highest potential for flexibility and adaptations to changing morbidity patterns and medical progress. The adaptation to the conditions of the German health care system requires considerable efforts on the part of hospitals as well as sickness funds and health insurers. Hospitals need to establish a cost unit accounting system satisfying the rules of Applied Economics to allow, among other things, the calculation of relative cost weights. The self-governing bodies will have to consent on a complex regulation system. The German Hospital Federation declared the break down of negotiations concerning a provisional DRG system to be optionally available to hospitals in 2003. The Federal Ministry of Health will now have to decide whether to implement the system through executive fiat. The comprehensive DRG system will introduce new risks. The economic risks of the individual hospital, though not the individual insurer's risks, will be partially compensated for in the introductory phase by revenue balance mechanisms, for example. In particular, both the privately insured and civil servants will face a rise in costs as they will no longer benefit from a shorter length of hospital stay. To end this discrimination against private health insurers, the double counting of the costs associated with medical treatment (included in the DRG price and additionally

  19. Health hazard evaluation in private dental practices: a survey in a province of northen Italy.

    Science.gov (United States)

    Veronesi, Licia; Bonanini, Mauro; Dall'Aglio, Paolo; Pizzi, Silvia; Manfiedi, Maddalena; Tanzi, Maria Luisa

    2004-04-01

    The purpose of this questionnaire survey was to evaluate the knowledge and attitudes of private dental health care workers about cross-infection hazards through examination of practising behaviour in respect of infection control. A questionnaire was sent by mail to the private dentists operating in Parma province. The survey concerned 7 groups of questions about demographic data, personal protective equipment, immunization, sterilization and disinfection, waste disposal and occupationally acquired injuries, behaviour. Four hundred questionnaires were sent to the members of the Medical and Dentist College of Parma: 122 were returned and analysed (30.5%). Among the infectious diseases 45% of the interviewed think that the most dangerous diseases are Hepatitis B and C, followed by HIV infection (21.5%). The most used personal protective equipments are gloves (98%), masks (95%) and protective eyewear (94%). Sixty eighth per cent of the dentists treat HBV, HCV, HIV, TB, HSV suffering patients at the end of the working day. Twenty nine point 7% of them claim to have written protocols to follow in case of accident. Altogether the results show a good knowledge of the most important risks related to dentistry activity and of the main procedures for the infection control and management. PMID:15315087

  20. [The relationships between organizations for technical cooperation in health and private consulting businesses].

    Science.gov (United States)

    Barillas, Edgar

    2003-01-01

    In recent years, agencies that provide technical cooperation in health have increased their contractual relationships with private consulting entities. This has made it possible to respond in a timely manner to the support needs that countries have, to develop skills at the national level, and to reduce the operating costs for the cooperation agencies. However, these relationships risk moving the cooperation agencies away from generating ideas and new knowledge, which, until recently, was considered one of their essential roles. Contracting with private enterprises will almost certainly increase in the coming years. This makes it worth reviewing the tasks that correspond to the cooperation agencies in this scenario as well as mechanisms to see that these relationships result in the greatest benefit for deprived groups. Actions that can be undertaken immediately include organizing the "structural capital" (such as programs, databases, strategies, and organizational "culture," structure, systems, and procedures) of the technical cooperation agencies, precisely identifying tasks that cannot be delegated, and adequately designing and controlling terms of reference. PMID:12744803

  1. Support of public–private partnerships in health promotion and conflicts of interest

    Science.gov (United States)

    Hernandez-Aguado, Ildefonso; Zaragoza, G A

    2016-01-01

    Objectives Public–private partnerships (PPPs) are considered key elements in the development of effective health promotion. However, there is little research to back the enthusiasm for these partnerships. Our objective was to describe the diversity of visions on PPPs and to assess the links between the authors and corporations engaged in such ventures. Methods We reviewed the scientific literature through PubMed in order to select all articles that expressed a position or recommendation on governments and industries engaging in PPPs for health promotion. We included any opinion paper that considered agreements between governments and corporations to develop health promotion. Papers that dealt with healthcare provision or clinical preventive services and those related to tobacco industries were excluded. We classified the articles according to the authors' position regarding PPPs: strongly agree, agree, neutral, disagree and strongly disagree. We related the type of recommendation to authors' features such as institution and conflicts of interest. We also recorded whether the recommendations were based on previous assessments. Results Of 46 papers analysed, 21 articles (45.6%) stated that PPPs are helpful in promoting health, 1 was neutral and 24 (52.1%) were against such collaborations. 26 papers (57%) set out conditions to assure positive outcomes of the partnerships. Evidence for or against PPPs was mentioned in 11 papers that were critical or neutral (44%) but not in any of those that advocated collaboration. Where conflicts were declared (26 papers), absence of conflicts was more frequent in critics than in supporters (86% vs 17%). Conclusions Although there is a lack of evidence to support PPPs for health promotion, many authors endorse this approach. The prevalence of ideas encouraging PPPs can affect the intellectual environment and influence policy decisions. Public health researchers and professionals must make a contribution in properly framing the PPP

  2. The Great Recession and Housing Affordability

    OpenAIRE

    Kroll, Cynthia A.

    2013-01-01

    The decline in home prices in the Great Recession and the lack of recovery in prices in the early years of recovery have created a significant improvement in some types of housing affordability measures. Yet incomes also dropped, and rent levels often moved in the opposite direction to home prices, showing that improvements in affordability were far from universal. This paper uses aggregate statistics available from a variety of public and private sources to illustrate different types of affo...

  3. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda: implications for patient safety

    OpenAIRE

    Mbonye, AK; Buregyeya, E.; Rutebemberwa, E.; Clarke, SE; Lal, S; Hansen, KS; Magnussen, P; LaRussa, P

    2016-01-01

    Background Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality of care in the private sector that provides almost a half of health services in Uganda. Methods A survey was conducted from August to October 2014 within 57 parishes in Mukono district, central Uganda...

  4. The problems of private health insurance in Chile: Looking for a solution to a history of inefficiency and inequity

    Directory of Open Access Journals (Sweden)

    Camilo Cid

    2011-12-01

    Full Text Available The concept of health insurance is of vital importance for health policy. Beneficiaries are able to share the risk arising from health expenses, and are ensured access to health care provisions whenever necessary. The need to share an individual’s risk to become ill is the direct consequence of the uncertainty that surrounds the health sector. Chilean health insurance companies are able to reach financial balance (the state-owned insurer or profits (privately-owned insurers by setting a premium rate. Information flow tends to be asymmetric and one of the shortcomings of this system is that the private health insurance companies have better information, which leads to risk selection. A form of regulation would be to set a premium rate proportional to income thus incentivizing contributions in accordance with income (independent of risk and pool efficiency if the whole population is included. A natural solution that would be functional to the current system is the creation of a single pool together with a broad community premium rate to finance the fund. The article analyses the feasibility of a single fund, its requisites, and the health plan that the Chilean government is proposing in its bill to reform the private health insurance sector.

  5. Assessing public and private sector contributions in reproductive health financing and utilization for six sub-Saharan African countries.

    Science.gov (United States)

    Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg

    2011-05-01

    The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. PMID:21555087

  6. Big pharma and health care: unsolvable conflict of interests between private enterprise and public health.

    Science.gov (United States)

    Brezis, Mayer

    2008-01-01

    A landmark paper on Game Theory showed that individual maximization of profit necessarily endangers the public good, and since the problem has no technical solution, "it requires a fundamental extension in morality" (1). We propose here that public health, as a public good, now emerges as a grave example of this problem. Recent events and reports increasingly suggest misalignment between the interests of the pharmaceutical industry and those of public health. Johnson & Johnson illegally and effectively promoted Propulsid off-label for children despite internal company documents raising safety concerns. Death in drug trial has been described as a "trade secret." On Vioxx, Topol wrote: "Sadly, it is clear that Merck's commercial interest exceeded its concern about the drug's toxicity" (2). More and more concerns are raised by scholars and major journal editors about the type and the quality of published evidence, often biased towards efficacy of new products. The industry, funding over 80% of trials, sets up a research agenda guided more by marketing than by clinical considerations. Smart statistical and epidemiological tactics help obtain the desired results. Budget for marketing is by far greater than for research. Massive advertising to physicians and to the public gets increasingly sophisticated: ghost writing, professional guidelines, targeting of consumer groups and manipulating media for disease mongering. Pervasive lobbying and political ties limit the independence of regulatory bodies. Obligation to shareholders overriding public health considerations is not unique to the pharmaceutical industry. The chemical, tobacco and food industries share similar tactics: proclaiming doubts about safety issues, buying researchers, infiltrating universities, boards, media and legislative agencies. By contrast, powerful and cheap health promoting activities, poorly supported by industry because they are too cheap and not patented, are markedly underutilized: technologies

  7. Health care consumers’ perspectives on pharmacist integration into private general practitioner clinics in Malaysia: a qualitative study

    Directory of Open Access Journals (Sweden)

    Saw PS

    2015-03-01

    Full Text Available Pui San Saw,1 Lisa M Nissen,2,3 Christopher Freeman,2,4 Pei Se Wong,3 Vivienne Mak5 1School of Postgraduate Studies and Research, International Medical University, Kuala Lumpur, Malaysia; 2School of Clinical Sciences, Queensland University Technology, Brisbane, QLD, Australia; 3School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia; 4School of Pharmacy, University of Queensland, St Lucia, QLD, Australia; 5School of Pharmacy, Monash University Malaysia, Selangor, Malaysia Background: Pharmacists are considered medication experts but are underutilized and exist mainly at the periphery of the Malaysian primary health care team. Private general practitioners (GPs in Malaysia are granted rights under the Poison Act 1952 to prescribe and dispense medications at their primary care clinics. As most consumers obtain their medications from their GPs, community pharmacists’ involvement in ensuring safe use of medicines is limited. The integration of a pharmacist into private GP clinics has the potential to contribute to quality use of medicines. This study aims to explore health care consumers’ views on the integration of pharmacists within private GP clinics in Malaysia.Methods: A purposive sample of health care consumers in Selangor and Kuala Lumpur, Malaysia, were invited to participate in focus groups and semi-structured interviews. Sessions were audio recorded and transcribed verbatim and thematically analyzed using NVivo 10. Results: A total of 24 health care consumers participated in two focus groups and six semi-structured interviews. Four major themes were identified: 1 pharmacists’ role viewed mainly as supplying medications, 2 readiness to accept pharmacists in private GP clinics, 3 willingness to pay for pharmacy services, and 4 concerns about GPs’ resistance to pharmacist integration. Consumers felt that a pharmacist integrated into a private GP clinic could offer potential benefits such as to provide trustworthy

  8. Sharing risk between payer and provider by leasing health technologies: an affordable and effective reimbursement strategy for innovative technologies?

    Science.gov (United States)

    Edlin, Richard; Hall, Peter; Wallner, Klemens; McCabe, Christopher

    2014-06-01

    The challenge of implementing high-cost innovative technologies in health care systems operating under significant budgetary pressure has led to a radical shift in the health technology reimbursement landscape. New reimbursement strategies attempt to reduce the risk of making the wrong decision, that is, paying for a technology that is not good value for the health care system, while promoting the adoption of innovative technologies into clinical practice. The remaining risk, however, is not shared between the manufacturer and the health care payer at the individual purchase level; it continues to be passed from the manufacturer to the payer at the time of purchase. In this article, we propose a health technology payment strategy-technology leasing reimbursement scheme-that allows the sharing of risk between the manufacturer and the payer: the replacing of up-front payments with a stream of payments spread over the expected duration of benefit from the technology, subject to the technology delivering the claimed health benefit. Using trastuzumab (Herceptin) in early breast cancer as an exemplar technology, we show how a technology leasing reimbursement scheme not only reduces the total budgetary impact of the innovative technology but also truly shares risk between the manufacturer and the health care system, while reducing the value of further research and thus promoting the rapid adoption of innovative technologies into clinical practice. PMID:24969005

  9. Horizontal inequities in Australia?s mixed public/private health care system, CHERE Working Paper 2006/13,

    OpenAIRE

    Eddy van Doorslaer; Philip Clarke; Elizabeth Savage; Jane Hall

    2006-01-01

    Recent OECD country comparative evidence suggests that Australia?s mixed public-private health system does a good job in ensuring high and fairly equal access to doctor, hospital and dental care services. This paper provides some further analysis of the same data from the Australian National Health Survey for 2001 to see to what extent the general finding of horizontal equity remains when the full potential of the data is realized. We extend the common core cross-country comparative analysis ...

  10. Evaluation of quality of TB control services by private health care providers in Plateau state, Nigeria; 2012

    OpenAIRE

    Ibrahim, Luka Mangveep; Oleribe, Obinna O; Nguku, Patrick; Tongwong, Gabriel Chukwak; Mato, Lakda Gonen; Longkyer, Musa Istifanus; Ogiri, Samuel; Nsubuga, Peter

    2014-01-01

    Introduction Tuberculosis (TB) is public health concern in Nigeria. The country uses the Directly Observed Treatment Short course (DOTS) strategy for its control. Plateau state started using the DOTS strategy in 2001 and had the Private health facilities (PHF) as an important stakeholder. We evaluated their contributions to case finding and quality of the services to identify gaps in monitoring and evaluation in the TB control services within the PHF to plan for intervention so as to meet the...

  11. National survey of paediatric audiological services for diagnosis and intervention in the South African private health care sector

    Directory of Open Access Journals (Sweden)

    Miriam E. Meyer

    2014-06-01

    Full Text Available Objective: A national survey of early hearing detection and intervention services was undertaken to describe the current status of diagnostic and intervention services in the South African private health care sector.Methods: All private hospitals with obstetric units (n = 166 were surveyed telephonically. The data was integrated with data collected from self-administered questionnaires subsequently distributed nationally to private audiology practices providing hearing screening at the respective hospitals reporting hearing screening services (n = 87. Data was analysed descriptively to yield national percentages and frequency distributions.Results: Average reported age at diagnosis was 11 months. Most participants (74% indicated that less than 20% of infants fitted with hearing aids received amplification before the age of 6 months. Most (64% participants indicated that the average period between confirmed diagnosis and hearing aid fitting was 1 month, on par with international benchmarks. Only 16%–23% of participants included all diagnostic procedures recommended by the Health Professions Council of South Africa’s 2007 position statement for minimum diagnostic test batteries for infants and young children.Conclusions: Diagnosis of hearing loss, hearing aid fitting and audiological intervention is delayed significantly in the South African private health care sector. Improved services should include integrated systematic hospital-based screening as part of birthing packages with diagnostic referral to specialist paediatric audiologists for accurate assessment and management of patients in a timely manner.

  12. Caring for Non-residents in Barbados: Examining the Implications of Inbound Transnational Medical Care for Public and Private Health Care

    OpenAIRE

    Snyder, Jeremy; Crooks, Valorie; Turner, Leigh; Adams, K.; Johnston, Rory; Fraser, Henry; Kadowaki, L.; Choi, M

    2013-01-01

    Barbados is a tourism dependent island state whose income is very sensitive to perturbations in the global economy and is thus seeking ways to diversify its service exports: Barbados has a two-tiered health system with a publicly funded health system operating alongside numerous private clinics. Private provision of health services in Barbados has grown between 2000-2010. Barbados has an established history of providing health care to ill vacationers, other Caribbean residents and mo...

  13. Leveraging human capital to reduce maternal mortality in India: enhanced public health system or public-private partnership?

    Directory of Open Access Journals (Sweden)

    Madhivanan Purnima

    2009-02-01

    Full Text Available Abstract Developing countries are currently struggling to achieve the Millennium Development Goal Five of reducing maternal mortality by three quarters between 1990 and 2015. Many health systems are facing acute shortages of health workers needed to provide improved prenatal care, skilled birth attendance and emergency obstetric services – interventions crucial to reducing maternal death. The World Health Organization estimates a current deficit of almost 2.4 million doctors, nurses and midwives. Complicating matters further, health workforces are typically concentrated in large cities, while maternal mortality is generally higher in rural areas. Additionally, health care systems are faced with shortages of specialists such as anaesthesiologists, surgeons and obstetricians; a maldistribution of health care infrastructure; and imbalances between the public and private health care sectors. Increasingly, policy-makers have been turning to human resource strategies to cope with staff shortages. These include enhancement of existing work roles; substitution of one type of worker for another; delegation of functions up or down the traditional role ladder; innovation in designing new jobs;transfer or relocation of particular roles or services from one health care sector to another. Innovations have been funded through state investment, public-private partnerships and collaborations with nongovernmental organizations and quasi-governmental organizations such as the World Bank. This paper focuses on how two large health systems in India – Gujarat and Tamil Nadu – have successfully applied human resources strategies in uniquely different contexts to the challenges of achieving Millennium Development Goal Five.

  14. Leveraging human capital to reduce maternal mortality in India: enhanced public health system or public-private partnership?

    Science.gov (United States)

    Krupp, Karl; Madhivanan, Purnima

    2009-01-01

    Developing countries are currently struggling to achieve the Millennium Development Goal Five of reducing maternal mortality by three quarters between 1990 and 2015. Many health systems are facing acute shortages of health workers needed to provide improved prenatal care, skilled birth attendance and emergency obstetric services - interventions crucial to reducing maternal death. The World Health Organization estimates a current deficit of almost 2.4 million doctors, nurses and midwives. Complicating matters further, health workforces are typically concentrated in large cities, while maternal mortality is generally higher in rural areas. Additionally, health care systems are faced with shortages of specialists such as anaesthesiologists, surgeons and obstetricians; a maldistribution of health care infrastructure; and imbalances between the public and private health care sectors. Increasingly, policy-makers have been turning to human resource strategies to cope with staff shortages. These include enhancement of existing work roles; substitution of one type of worker for another; delegation of functions up or down the traditional role ladder; innovation in designing new jobs;transfer or relocation of particular roles or services from one health care sector to another. Innovations have been funded through state investment, public-private partnerships and collaborations with nongovernmental organizations and quasi-governmental organizations such as the World Bank. This paper focuses on how two large health systems in India--Gujarat and Tamil Nadu--have successfully applied human resources strategies in uniquely different contexts to the challenges of achieving Millennium Development Goal Five. PMID:19250542

  15. National health insurance scheme: How receptive are the private healthcare practitioners in a local government area of Lagos state

    Science.gov (United States)

    Christina, Campbell Princess; Latifat, Taiwo Toyin; Collins, Nnaji Feziechukwu; Olatunbosun, Abolarin Thaddeus

    2014-01-01

    Background: National Health Insurance Scheme (NHIS) is one of the health financing options adopted by Nigeria for improved healthcare access especially to the low income earners. One of the key operators of the scheme is the health care providers, thus their uptake of the scheme is fundamental to the survival of the scheme. The study reviewed the uptake of the NHIS by private health care providers in a Local Government Area in Lagos State. Objective: To assess the uptake of the NHIS by private healthcare practitioners. Materials and Methods: This descriptive cross-sectional study recruited 180 private healthcare providers selected by multistage sampling technique with a response rate of 88.9%. Result: Awareness, knowledge and uptake of NHIS were 156 (97.5%), 110 (66.8%) and 97 (60.6%), respectively. Half of the respondents 82 (51.3%) were dissatisfied with the operations of the scheme. Major reasons were failure of entitlement payment by Health Maintenance Organisations 13 (81.3%) and their incurring losses in participating in the scheme 8(50%). There was a significant association between awareness, level of education, knowledge of NHIS and registration into scheme by the respondents P-value payment modalities and ensure strict adherence to laid down policies. PMID:25538373

  16. Canonical affordances in context

    Directory of Open Access Journals (Sweden)

    Alan Costall

    2012-12-01

    Full Text Available James Gibson’s concept of affordances was an attempt to undermine the traditional dualism of the objective and subjective. Gibson himself insisted on the continuity of “affordances in general” and those attached to human artifacts. However, a crucial distinction needs to be drawn between “affordances in general” and the “canonical affordances” that are connected primarily to artifacts. Canonical affordances are conventional and normative. It is only in such cases that it makes sense to talk of the affordance of the object. Chairs, for example, are for sitting-on, even though we may also use them in many other ways. A good deal of confusion has arisen in the discussion of affordances from (1 the failure to recognize the normative status of canonical affordances and (2 then generalizing from this special case.

  17. STRATEGIC MANAGEMENT TOOLS, STAKEHOLDERS AND PERFORMANCE ORGANIZATIONS, PRIVATE HEALTH BRANCH OF THE FEDERAL DISTRICT

    Directory of Open Access Journals (Sweden)

    Bruno Vendruscolo

    2012-06-01

    Full Text Available This study aimed to identify the use of management tools and the influence of stakeholders on organizational performance of companies in the private health sector in the Federal District. We used the tools of strategic management, such as budgeting, strategic planning, balanced scorecard, benchmarking, and management software. Study participants consist of individuals involved in strategic processes. We analyzed the past 5 years in organizations to understand the performance. The data collection was face-to-face, the instruments consisted of qualitative interviews in person, and semi-structured content analysis. We also performed analysis of secondary data and documents. To measure the performance between the organizations we used the method of data envelopment analysis (DEA, using the CCR standard, and the mean change index as the number of employees, physicians, costs, number of appointments, and tests. In the analysis of tools and stakeholders we adapted values for the major and minor influences and the other results found framed. The results cite the presence of management tools in five of the six organizations. The comparison of performance between them presented as a result that organizations 2 and 4 were efficient and 3 was the least efficient. The study identified the need to understand the requirements of stakeholders and the indicators set out to understand organizational performance and its evolution, mainly determined by the management tools. Although not reaching proposed levels, this work creates hypotheses about the use of these tools and analysis of stakeholders in organizational performance.

  18. Statutory caps: an involuntary contribution to the medical malpractice insurance crisis or a reasonable mechanism for obtaining affordable health care?

    Science.gov (United States)

    Chupkovich, P J

    1993-01-01

    extremely important in light of proposed health care legislation entitled the Health Care Liability Reform and Quality of Care Improvement Act of 1992 [the "Health Care Bill"]. This Comment critically examines the constitutionality of statutory caps on damages in medical malpractice actions. It focuses on the public policy behind the caps and the constitutional issues embodied in limiting an individual's recovery. It also analyzes the impact of the Health Care Bill on statutory caps. Part I outlines the medical malpractice insurance crisis, describes the statutory reforms and discusses the public policy behind tort reform. Part II examines the constitutionality of statutory caps and summarizes the arguments of the proponents and the opponents of these caps. Part III discusses the Health Care Bill and its impact on medical malpractice legislation with respect to statutory caps. This Comment concludes that a compromise must be reached that addresses both the growing health care insurance crisis and the protection of individual rights. The Health Care Liability Reform and Quality of Care Improvement Act of 1992 attempts to achieve this compromise. PMID:10126943

  19. Health care marketing: the theory of planned behavior applied to patients' choise between private and public providers in the portuguese health care system.

    OpenAIRE

    Ferreira, Filipa Monteiro

    2011-01-01

    Dissertation submitted in partial fulfillment of the requirements for degree of Master in Statistics and Information Management. Purpose - The Portuguese health care system has been evolving throughout the last 35 years with two relevant facts: the public sector has progressed with improvement in all relevant OECD indicators; the private sector has been widened and reinforced. In this framework, it is important to understand how patient’s intention and behavior are built, so health care...

  20. Assessing the potential of rural and urban private facilities in implementing child health interventions in Mukono district, central Uganda–a cross sectional study

    OpenAIRE

    Rutebemberwa, Elizeus; Buregyeya, Esther; Lal, Sham; Clarke, Sîan E.; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip; Mbonye, Anthony K

    2016-01-01

    Background Private facilities are the first place of care seeking for many sick children. Involving these facilities in child health interventions may provide opportunities to improve child welfare. The objective of this study was to assess the potential of rural and urban private facilities in diagnostic capabilities, operations and human resource in the management of malaria, pneumonia and diarrhoea. Methods A survey was conducted in pharmacies, private clinics and drug shops in Mukono dist...

  1. CLINICIANS�• PERCEPTIONS OF SUPERVISION EMPHASIS AND ITS INFLUENCE ON THE SUPERVISORY RELATIONSHIP IN PRIVATE MENTAL HEALTH AGENCIES IN VIRGINIA  

    OpenAIRE

    Keith, Jennifer Lynn

    2016-01-01

    Private community-based mental health agencies fill a vital role in Virginia's health system in that they increase access to care and provide a wide range of services. In order to operate and receive state funding, these private agencies are responsible for abiding by regulations set forth by the Virginia Department of Behavioral Health and Developmental Services (DBHDS) and the Department of Medical Assistance Services (DMAS). Supervision, as defined by DBHDS and DMAS, features a more admin...

  2. Nonparametric Kernel Estimation of the Impact of Tax Policy on the Demand for Private Health Insurance in Australia

    OpenAIRE

    Gong, Xiaodong; Gao, Jiti

    2015-01-01

    This paper is motivated by our attempt to answer an empirical question: how is private health insurance take-up in Australia affected by the income threshold at which the Medicare Levy Surcharge (MLS) kicks in? We propose a new difference de-convolution kernel estimator for the location and size of regression discontinuities. We also propose a bootstrapping procedure for estimating confidence bands for the estimated discontinuity. Performance of the estimator is evaluated by Monte Carlo simul...

  3. Enhancing Customer Loyalty with Private Label Brands – Factors Influencing Success in the Health and Beauty Retail Industry

    OpenAIRE

    Segebarth, Charlotte

    2014-01-01

    The purpose of this thesis is to give advice on how to develop Private Label Brand strategies that will create and enhance customer loyalty in the Health and Beauty Retail industry. The primary research was conducted by a combination of quantitative and qualitative research methods. In order to give the reader an overall impression of the topic and to support the findings, desk research was conducted by using different secondary sources, such as economic journals, books and industry reports. ...

  4. Common types of tuberculosis and co-infection with HIV at private health institutions in Ethiopia: a cross sectional study

    OpenAIRE

    Alemie, Getahun Asres; Gebreselassie, Feseha

    2014-01-01

    Background Tuberculosis is a global emergency predominantly affecting developing countries. HIV has been the single most important reason for acquisition of tuberculosis for many patients. Conversely, tuberculosis can result in rapid progression of HIV disease. Ethiopia is a country affected seriously by HIV and tuberculosis. The main aim of this study is assessment of the types of tuberculosis and the extent of HIV infection among tuberculosis patients visiting private health institutions in...

  5. District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data.

    Science.gov (United States)

    Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

    2016-09-01

    Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3-200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector's non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with private

  6. District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data

    Science.gov (United States)

    Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

    2016-01-01

    Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3–200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector’s non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with

  7. Shifting the burden of health care finance: a case study of public-private partnership in Singapore.

    Science.gov (United States)

    Lim, Meng-Kin

    2004-07-01

    Since becoming independent in 1965, Singapore has attained high standards in health care provision while successfully transferring a substantial portion of the health care burden to the private sector. The government's share of total health care expenditure contracted from 50% in 1965 to 25% in 2000. At first glance, the efficiency-driven health care financing reforms which emphasize individual over state responsibility appear to have been implemented at the expense of equity. On closer examination, however, Singaporeans themselves seem unconcerned about any perceived inequity of the system. Indeed, they appear content to pay part of their medical expenses, plus additional monies if they demand a higher level of services. In fact, access to needed care for the poor is explicitly guaranteed. Mechanisms also exist to protect against financial impoverishment resulting from catastrophic illness. Singapore's experience provides an interesting case study in public-private partnership, illustrating how a hard-headed approach to health policy can achieve national health goals while balancing efficiency and equity concerns. PMID:15484609

  8. Comparative Investigation of Health Literacy Level of Cardiovascular Patients Hospitalized in Private and Educational Hospitals of Kerman City, Iran

    Science.gov (United States)

    Malekzadeh, Sajedeh; Azami, Mohammad; Mirzaei, Moghadameh; Motamedi, Fatemeh

    2016-01-01

    Introduction: literacy involves a complex set of abilities to understand and use symbolic systems of a culture for personal development and social development in a diverse set of skills required as an adult to exercise behavior are considered in society Objectives: The aim of this study was to evaluate Comparative investigation of health literacy level of cardiovascular patients hospitalized in private and public educational hospitals of Kerman city Methods: This study used survey methods, analytical and cross-sectional manner. Data was collected through questionnaires distributed among 200 patients of cardiovascular-hospitalization took place in the city of Kerman. To analyze the data in the description of the mean, standard deviation and frequency distribution tables and the level of analysis to determine the relationship between gender and marital status of health literacy test or nonparametric test Mann-Whitney T-Test and, for the relationship between group employment and residence, a one-way analysis of variance or Kruskal-Wallis test, to evaluate the relationship between age and income, Pearson and Spearman correlation to investigate the relationship between level of education and health literacy of SPPS software version 21 was used. Results: The results showed that 10% of patients at educational hospitals in Kerman adequate health literacy, and 48% of patients in private hospitals had adequate health literacy. As a result, there is a significant difference of health literacy between the two types of hospital (p-value <0/0001). Conclusions: The results showed that most patients had inadequate and border health literacy have been. Health plans, preparation of simple educational system and understanding, spending more time and have a discussion with the lower speed In connection with the patient’s doctor and medical staff, Including ways to help patients with low health literacy and improve their health literacy is. PMID:27041812

  9. Private Health Insurance Incentives in Australia: The Effects of Recent Changes to Price Carrots and Income Sticks

    OpenAIRE

    Alex Robson; Francesco Paolucci

    2012-01-01

    Three major policy tools govern the demand for private health insurance (PHI) in Australia: premium-related subsidies (i.e. PHI-rebate); income tax surcharges (i.e. the Medicare Levy Surcharge (MLS)); and lifetime community-rating (i.e. Lifetime Health Cover). The first two provide a system of “carrots and sticks” to create incentives for increasing the demand for PHI. The third creates incentives for consumers to purchase PHI earlier than they otherwise would have, and to maintain this cover...

  10. The Health Status of Latino Immigrant Women in the United States and Future Health Policy Implications of the Affordable Care Act

    OpenAIRE

    de Leon Siantz, Mary Lou; Castaneda, Xochitl; Benavente, Viola; Peart, Tasha; Felt, Emily

    2013-01-01

    Immigrant women of Mexican birth face unique health challenges in the United States. They are at increased risk for developing many preventable health conditions due in part to limited access to healthcare and benefits, legal status, and inadequate income. Increased vulnerability of women has established a growing need to focus on their healthcare needs because of their role, position, and influence in the family. The purpose of this article is to review factors that impact the health status ...

  11. Determinants of General Health, Work-Related Strain, and Burnout in Public Versus Private Emergency Medical Technicians in Istanbul.

    Science.gov (United States)

    Tunaligil, Verda; Dokucu, Ali Ihsan; Erdogan, Mehmet Sarper

    2016-07-01

    This study investigated the impact of working for public versus private ambulance services in Turkey and elaborated on predictors of mental, physical, and emotional well-being in emergency medical technicians (EMT-Bs). In this observational cross-sectional study, an 81-question self-report survey was used to gather data about employee demographics, socioeconomic status, educational background, working conditions, and occupational health and workplace safety (OHS), followed by the 12-item General Health Questionnaire (GHQ-12), the Work-Related Strain Inventory (WRSI), and the Maslach Burnout Inventory (MBI) with three subscales: Emotional Exhaustion (MBI-EE), Depersonalization (MBI-DP), and Diminished Personal Accomplishment (MBI-PA). In 2011, 1,038 EMT-Bs worked for publicly operated and 483 EMT-Bs worked for privately owned ambulance services in Istanbul, Turkey, of which 606 (58.4%) and 236 (48.9%) participated in the study (overall participation rate = 55.4%), respectively. On all scales, differences between total mean scores in both sectors were statistically insignificant (p > .05). In the public sector, work locations, false accusations, occupational injuries and diseases, work-related permanent disabilities, and organizational support were found to significantly influence self-reported perceptions of well-being (p public and private sectors were higher earnings (17.5%; 16.7%) and better social opportunities (17.4%; 16.8%). Working conditions, vocational training, and OHS emerged as topics that merit priority attention. PMID:27034407

  12. "Medical tourism" and the global marketplace in health services: U.S. patients, international hospitals, and the search for affordable health care.

    Science.gov (United States)

    Turner, Leigh

    2010-01-01

    Health services are now advertised in a global marketplace. Hip and knee replacements, ophthalmologic procedures, cosmetic surgery, cardiac care, organ transplants, and stem cell injections are all available for purchase in the global health services marketplace. "Medical tourism" companies market "sun and surgery" packages and arrange care at international hospitals in Costa Rica, India, Mexico, Singapore, Thailand, and other destination nations. Just as automobile manufacturing and textile production moved outside the United States, American patients are "offshoring" themselves to facilities that use low labor costs to gain competitive advantage in the marketplace. Proponents of medical tourism argue that a global market in health services will promote consumer choice, foster competition among hospitals, and enable customers to purchase high-quality care at medical facilities around the world. Skeptics raise concerns about quality of care and patient safety, information disclosure to patients, legal redress when patients are harmed while receiving care at international hospitals, and harms to public health care systems in destination nations. The emergence of a global market in health services will have profound consequences for health insurance, delivery of health services, patient-physician relationships, publicly funded health care, and the spread of medical consumerism. PMID:20799670

  13. Factors influencing choice of care-seeking for acute fever comparing private chemical shops with health centres and hospitals in Ghana: a study using case-control methodology.

    OpenAIRE

    Ansah, EK; Gyapong, M; Narh-Bana, S; Bart-Plange, C; Whitty, CJ

    2016-01-01

    Several public health interventions to improve management of patients with fever are largely focused on the public sector yet a high proportion of patients seek care outside the formal healthcare sector. Few studies have provided information on the determinants of utilization of the private sector as against formal public sector. Understanding the differences between those who attend public and private health institutions, and their pathway to care, has significant practical implications. The...

  14. Oral Health Status among 12- and 15-Year-Old Children from Government and Private Schools in Hyderabad, Andhra Pradesh, India

    OpenAIRE

    Sukhabogi, JR; Shekar, CBR; Hameed, IA; Ramana, IV; Sandhu, G

    2014-01-01

    Background: The assessment of oral health status of children in government and private schools provide data on the oral health status of children from different socio-economic background. Aim: The aim of the following study is to assess and to compare the oral hygiene status, gingival status and caries experience between children from government and private schools in Andhra Pradesh, India. Subjects and Methods: A combination of cluster and stratified random sampling was employed to select th...

  15. Investments in Global Health: Private and Public Innovation Systems of Essential Pharmaceuticals

    Science.gov (United States)

    Rantanen, Tiina-Riitta

    2006-01-01

    In recent years the scope and application of intellectual property rights has been expanded remarkably in the area of medical research and development. This has strengthened the role of the private sector in developing and producing new medicinal drugs. However, medical research is usually close to a pure public good and thus not efficiently…

  16. Global affordability of fluoride toothpaste

    Directory of Open Access Journals (Sweden)

    Holmgren Christopher J

    2008-06-01

    Full Text Available Abstract Objective Dental caries remains the most common disease worldwide and the use of fluoride toothpaste is a most effective preventive public health measure to prevent it. Changes in diets following globalization contribute to the development of dental caries in emerging economies. The aim of this paper is to compare the cost and relative affordability of fluoride toothpaste in high-, middle- and low-income countries. The hypothesis is that fluoride toothpaste is not equally affordable in high-, middle- and low-income countries. Methods Data on consumer prices of fluoride toothpastes were obtained from a self-completion questionnaire from 48 countries. The cost of fluoride toothpaste in high-, middle- and low-income countries was compared and related to annual household expenditure as well as to days of work needed to purchase the average annual usage of toothpaste per head. Results The general trend seems to be that the proportion of household expenditure required to purchase the annual dosage of toothpaste increases as the country's per capita household expenditure decreases. While in the UK for the poorest 30% of the population only 0.037 days of household expenditure is needed to purchase the annual average dosage (182.5 g of the lowest cost toothpaste, 10.75 days are needed in Kenya. The proportion of annual household expenditure ranged from 0.02% in the UK to 4% in Zambia to buy the annual average amount of lowest cost toothpaste per head. Conclusion Significant inequalities in the affordability of this essential preventive care product indicate the necessity for action to make it more affordable. Various measures to improve affordability based on experiences from essential pharmaceuticals are proposed.

  17. Effectiveness of a workplace-based intervention program to promote mental health among employees in privately owned enterprises in China.

    Science.gov (United States)

    Sun, Jing; Buys, Nicholas; Wang, Xinchao

    2013-12-01

    This study aims to examine the effectiveness of a workplace-based intervention program to improve mental health, work ability, and work productivity in privately owned enterprises in China. A prospective cohort intervention study design was employed in which the intervention program was implemented for 30 months (from July 2009 to December 2012). Nine privately owned retail enterprises in China participated in the intervention study. Researchers administered a self-report survey to 2768 employees. The research team measured participants' job stress, resilience, work ability, absenteeism, depression, and work performance. A comprehensive Health Promotion Enterprise Program was implemented that entailed the following components: policies to support a healthy work environment, psychosocial interventions to promote mental health, provision of health services to people with mental illness, and professional skills training to deal with stress and build resilience. Analysis of variance was used to examine preintervention versus postintervention differences in stress, resilience, and work ability. Logistic regression was used to examine absenteeism related to depression. The results suggest that the intervention program was effective at improving participants' ability to work, their sense of control over their jobs, and, in particular, their ability to meet the mental demands of work. The intervention program also reduced participants' job stress levels and reduced the probability of absenteeism related to depression. The intervention programs incorporating both individual-level and organizational-level factors to promote mental health were effective and have implications for both practice and policy regarding enterprises taking more responsibility for the provision of mental health services to their employees. PMID:23672231

  18. Risk factors and prevalence of newborn hearing loss in a private health care system of Porto Velho, Northern Brazil

    Directory of Open Access Journals (Sweden)

    Juliana Santos de Oliveira

    2013-09-01

    Full Text Available OBJECTIVE: To determine the prevalence of hearing loss and to analyze the results of newborn hearing screening and audiological diagnosis in private health care systems. METHODS Cross-sectional and retrospective study in a database of newborn hearing screening performed by a private clinic in neonates born in private hospitals of Porto Velho, Rondônia, Northern Brazil. The screening results, the risk for hearing loss, the risk indicators for hearing loss and the diagnosis were descriptively analyzed. Newborns cared in rooming in with their mothers were compared to those admitted to the Intensive Care Unit regarding risk factors for hearing loss. RESULTS: Among 1,146 (100% enrolled newborns, 1,064 (92.8% passed and 82 (7.2% failed the hearing screening. Among all screened neonates, 1,063 (92.8% were cared in rooming and 83 (7.2% needed intensive care; 986 (86.0% were considered at low risk and 160 (14.0% at high risk for hearing problems. Of the 160 patients identified as having high risk for hearing loss, 83 (37.7% were admitted to an hospitalized in the Intensive Care Unit, 76 (34.5% used ototoxic drugs and 38 (17.2% had a family history of hearing loss in childhood. Hearing loss was diagnosed in two patients (0.2% of the screened sample. CONCLUSIONS: The prevalence of hearing loss in newborns from private hospitals was two cases per 1,000 evaluated patients. The use of ototoxic drugs, admission to Intensive Care Unit and family history of hearing loss were the most common risk factors for hearing loss in the studied population.

  19. Channels for change: private water and the urban poor

    Energy Technology Data Exchange (ETDEWEB)

    Lynch, Matthew; Matthews, Petter; Ryan-Collins, Lily [Engineers Against Poverty (United Kingdom)

    2010-05-15

    For the rapidly urbanising developing world, safe and affordable water is key to health and livelihoods, as well as meeting the Millennium Development Goals. But providing it demands innovative models. Where the context allows and the approach is appropriate, private sector involvement can generate win-win outcomes. Poor people can gain access to high-quality, affordable services, and companies can gain access to new and profitable business opportunities. Two examples of innovative 'private' water suppliers are the Manila Water Company's Water for the Poor Communities (TPSB) programme, and the Water & Sanitation for the Urban Poor (WSUP) partnership. Both have a multisector approach to service expansion and provision, including partnerships with local authorities; strong community involvement in selecting, designing and operating options; appropriate service levels to reduce costs; and a flexible range of services. Many elements of these models are also replicable.

  20. Strategies for maintaining emotional stability: The case of nurses in private health care industry

    OpenAIRE

    Pushpika Subhashinie Mullakanda; Kumudinei Dissanayake

    2015-01-01

    This study examines the emotional intelligence (EI) of nurses by differentiating inter-personal and intra-personal dimensions, and explores the measures taken by them to maintain emotional stability. Further, it investigates the relationship of demographic factors (age, gender and year of experience) of nurses with their emotional stability. The case organization is a well performing private hospital located closer to the metropolitan city. Study collects data through both quantitative (surve...

  1. Public – private 'partnerships' in health – a global call to action

    Directory of Open Access Journals (Sweden)

    Nishtar Sania

    2004-07-01

    Full Text Available Abstract The need for public-private partnerships arose against the backdrop of inadequacies on the part of the public sector to provide public good on their own, in an efficient and effective manner, owing to lack of resources and management issues. These considerations led to the evolution of a range of interface arrangements that brought together organizations with the mandate to offer public good on one hand, and those that could facilitate this goal though the provision of resources, technical expertise or outreach, on the other. The former category includes of governments and intergovernmental agencies and the latter, the non-profit and for-profit private sector. Though such partnerships create a powerful mechanism for addressing difficult problems by leveraging on the strengths of different partners, they also package complex ethical and process-related challenges. The complex transnational nature of some of these partnership arrangements necessitates that they be guided by a set of global principles and norms. Participation of international agencies warrants that they be set within a comprehensive policy and operational framework within the organizational mandate and involvement of countries requires legislative authorization, within the framework of which, procedural and process related guidelines need to be developed. This paper outlines key ethical and procedural issues inherent to different types of public-private arrangements and issues a Global Call to Action.

  2. Direct costs of dengue hospitalization in Brazil: public and private health care systems and use of WHO guidelines.

    Directory of Open Access Journals (Sweden)

    Alessandra A Vieira Machado

    2014-09-01

    Full Text Available Dengue, an arboviral disease, is a public health problem in tropical and subtropical regions worldwide. In Brazil, epidemics have become increasingly important, with increases in the number of hospitalizations and the costs associated with the disease. This study aimed to describe the direct costs of hospitalized dengue cases, the financial impact of admissions and the use of blood products where current protocols for disease management were not followed.To analyze the direct costs of dengue illness and platelet transfusion in Brazil based on the World Health Organization (WHO guidelines, we conducted a retrospective cross-sectional census study on hospitalized dengue patients in the public and private Brazilian health systems in Dourados City, Mato Grosso do Sul State, Brazil. The analysis involved cases that occurred from January through December during the 2010 outbreak. In total, we examined 8,226 mandatorily reported suspected dengue cases involving 507 hospitalized patients. The final sample comprised 288 laboratory-confirmed dengue patients, who accounted for 56.8% of all hospitalized cases. The overall cost of the hospitalized dengue cases was US $210,084.30, in 2010, which corresponded to 2.5% of the gross domestic product per capita in Dourados that year. In 35.2% of cases, blood products were used in patients who did not meet the blood transfusion criteria. The overall median hospitalization cost was higher (p = 0.002 in the group that received blood products (US $1,622.40 compared with the group that did not receive blood products (US $550.20.The comparative costs between the public and the private health systems show that both the hospitalization of and platelet transfusion in patients who do not meet the WHO and Brazilian dengue guidelines increase the direct costs, but not the quality, of health care.

  3. Adults ages 50-64 and the Affordable Care Act of 2010.

    Science.gov (United States)

    Collins, Sara R; Doty, Michelle M; Garber, Tracy

    2010-12-01

    The Patient Protection and Affordable Care Act, which will provide health insurance to nearly all U.S. citizens and improve the quality of health insurance, will particularly benefit adults ages 50 to 64, a group suffering from extended unemployment and a loss of employer health benefits. Several early provisions that go into effect in 2010, including preexisting condition insurance plans, will provide transitional assistance for adults who have struggled to gain health insurance. The biggest improvements will come in 2014 through a significant expansion in eligibility for Medicaid and the creation of health insurance exchanges with subsidized private insurance for people with low and moderate incomes. Of the 8.6 million adults ages 50 to 64 who were uninsured in 2009, up to 6.8 million may gain subsidized insurance through Medicaid and the exchanges and 1.4 million with higher incomes will have access to comprehensive health plans with new consumer protections. PMID:21155372

  4. Private sector delivery of health services in developing countries: a mixed-methods study on quality assurance in social franchises

    Directory of Open Access Journals (Sweden)

    Schlein Karen

    2013-01-01

    Full Text Available Abstract Background Across the developing world health care services are most often delivered in the private sector and social franchising has emerged, over the past decade, as an increasingly popular method of private sector health care delivery. Social franchising aims to strengthen business practices through economies of scale: branding clinics and purchasing drugs in bulk at wholesale prices. While quality is one of the established goals of social franchising, there is no published documentation of how quality levels might be set in the context of franchised private providers, nor what quality assurance measures can or should exist within social franchises. The aim of this study was to better understand the quality assurance systems currently utilized in social franchises, and to determine if there are shared standards for practice or quality outcomes that exist across programs. Methods The study included three data sources and levels of investigation: 1 Self-reported program data; 2 Scoping telephone interviews; and 3 In-depth field interviews and clinic visits. Results Social Franchises conceive of quality assurance not as an independent activity, but rather as a goal that is incorporated into all areas of franchise operations, including recruitment, training, monitoring of provider performance, monitoring of client experience and the provision of feedback. Conclusions These findings are the first evidence to support the 2002 conceptual model of social franchising which proposed that the assurance of quality was one of the three core goals of all social franchises. However, while quality is important to franchise programs, quality assurance systems overall are not reflective of the evidence to-date on quality measurement or quality improvement best practices. Future research in this area is needed to better understand the details of quality assurance systems as applied in social franchise programs, the process by which quality assurance

  5. Exploring the role of the public and private funded primary health care facilities for children in a pluralistic health care setting of Barbados: one of the English Caribbean countries

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2015-01-01

    Conclusions: The findings demonstrate the complimentary role of the public and the private sector in the primary health care of children in this country. While the private sector has a major role in the curative acute care of children, the public sector plays a pivotal role in the immunization services.

  6. Planos privados de saúde: luzes e sombras no debate setorial dos anos 90 Private health plans: light and shadow in the 1990s health sector debate

    Directory of Open Access Journals (Sweden)

    Ligia Bahia

    2001-01-01

    Full Text Available Este trabalho examina interfaces pública-privadas do mercado de planos e seguros no Brasil, procurando questionar as relações de autonomia e dependência das empresas de assistência médica suplementar com o SUS e alguns dos pressupostos que orientam o processo de regulação governamental. A análise desse mercado se apóia em referenciais extraídos da literatura e sobre informações provenientes de fontes oficiais, empresas de consultoria, dados de empresas de planos e seguros e depoimentos de seus dirigentes. Sugere-se a necessidade de ampliar a agenda de debates e pesquisas sobre o mosaico público-privado que estrutura o sistema de saúde brasileiro.This paper surveys public-private interfaces within the health insurance market in Brazil, seeking to question the relationships of autonomy and dependence between the supplementary health care enterprises and SUS, as well as some aspects conditioning government regulation. The analysis of this market is referenced on the related literature and on information provided by official sources, consulting businesses, health plans and insurances enterprises and their owners' accounts. One suggests the need for broadening the agenda on the public-private mosaic structuring the Brazilian health system.

  7. Does the private sector receive an excessive return from investments in health care infrastructure projects? Evidence from the UK.

    Science.gov (United States)

    Vecchi, Veronica; Hellowell, Mark; Gatti, Stefano

    2013-05-01

    This paper is concerned with the cost-efficiency of Private Finance Initiatives (PFIs) in the delivery of hospital facilities in the UK. We outline a methodology for identifying the "fair" return on equity, based on the Weighted Average Cost of Capital (WACC) of each investor. We apply this method to assess the expected returns on a sample of 77 contracts signed between 1997 and 2011 by health care provider organisations in the UK. We show that expected returns are in general in excess of the WACC benchmarks. The findings highlight significant problems in current procurement practices and the methodologies by which bids are assessed. To minimise the financial impact of hospital investments on health care systems, a regulatory regime must ensure that expected returns are set at the "fair" rate. PMID:23332120

  8. Sources of satisfaction and dissatisfaction among specialists within the public and private health sectors

    DEFF Research Database (Denmark)

    Ashton, Toni; Brown, Paul M.; Sopina, Elizaveta (Liza);

    2013-01-01

    sectors. Such information can assist workforce planning, management and policy and may inform the wider debate about the relationship between the two sectors. Method A postal survey was conducted of 1983 registered specialists throughout New Zealand. Respondents were asked to assess 14 sources of....... Results Completed surveys were received from 943 specialists (47% response rate). Overall mean levels of satisfaction were higher in the private sector than the public sector while levels of dissatisfaction were lower. While the public system is valued for its opportunities for further education and...

  9. Comparing the knowledge, attitude and practices of health care workers in public and private primary care facilities in Lagos State on Ebola virus disease

    OpenAIRE

    Idris, Bilqisu Jibril; Inem, Victor; Balogun, Mobolanle

    2015-01-01

    Introduction The West African sub-region is currently witnessing an outbreak of EVD that began in December 2013. The first case in Nigeria was diagnosed in Lagos, at a private medical facility in July 2014. Health care workers are known amplifiers of the disease. The study aimed to determine and compare EVD knowledge, attitude and practices among HCWs in public and private primary care facilities in Lagos, Nigeria. Methods This was a comparative cross-sectional study. Seventeen public and pri...

  10. Power in Global Health Agenda-Setting: The Role of Private Funding; Comment on “Knowledge, Moral Claims and the Exercise of Power in Global Health”

    Directory of Open Access Journals (Sweden)

    Ruth E. Levine

    2015-05-01

    Full Text Available The editorial by Jeremy Shiffman, “Knowledge, moral claims and the exercise of power in global health”, highlights the influence on global health priority-setting of individuals and organizations that do not have a formal political mandate. This sheds light on the way key functions in global health depend on private funding, particularly from the Bill & Melinda Gates Foundation.

  11. Credible privatization

    NARCIS (Netherlands)

    E.C. Perotti

    1995-01-01

    Privatization shifts residual income and control to private investors, restricting redistribution and improving incentives; thus rapid privatization should be desirable. Empirically, however, the transfer of ownership, as opposed to control, is very gradual. I offer an explanation based on investors

  12. Private Schools

    Data.gov (United States)

    Department of Homeland Security — This Private Schools feature dataset is composed of all Private elementary and secondary education features in the United States as defined by the Private School...

  13. Evaluating drug prices, availability, affordability, and price components: implications for access to drugs in Malaysia.

    Directory of Open Access Journals (Sweden)

    Zaheer Ud Din Babar

    2007-03-01

    Full Text Available BACKGROUND: Malaysia's stable health care system is facing challenges with increasing medicine costs. To investigate these issues a survey was carried out to evaluate medicine prices, availability, affordability, and the structure of price components. METHODS AND FINDINGS: The methodology developed by the World Health Organization (WHO and Health Action International (HAI was used. Price and availability data for 48 medicines was collected from 20 public sector facilities, 32 private sector retail pharmacies and 20 dispensing doctors in four geographical regions of West Malaysia. Medicine prices were compared with international reference prices (IRPs to obtain a median price ratio. The daily wage of the lowest paid unskilled government worker was used to gauge the affordability of medicines. Price component data were collected throughout the supply chain, and markups, taxes, and other distribution costs were identified. In private pharmacies, innovator brand (IB prices were 16 times higher than the IRPs, while generics were 6.6 times higher. In dispensing doctor clinics, the figures were 15 times higher for innovator brands and 7.5 for generics. Dispensing doctors applied high markups of 50%-76% for IBs, and up to 316% for generics. Retail pharmacy markups were also high-25%-38% and 100%-140% for IBs and generics, respectively. In the public sector, where medicines are free, availability was low even for medicines on the National Essential Drugs List. For a month's treatment for peptic ulcer disease and hypertension people have to pay about a week's wages in the private sector. CONCLUSIONS: The free market by definition does not control medicine prices, necessitating price monitoring and control mechanisms. Markups for generic products are greater than for IBs. Reducing the base price without controlling markups may increase profits for retailers and dispensing doctors without reducing the price paid by end users. To increase access and

  14. Rethinking Affordable Housing Delivery: An Analytical Insight

    Directory of Open Access Journals (Sweden)

    Olanrewaju Abdullateef

    2016-01-01

    Full Text Available Malaysia currently has a housing shortage of 12 million units. Towards the year 2020, this would require an annual supply of a minimum of 2 million homes. With the current production rate, the deficits will remain over the next 100 years. The crisis will lead to poor standards of living, un-affordable rental price, high mortgage payment, abandonment, and dilapidation of the existing housing stock. Lack of affordable housing is already a source of concern among many Malaysians. The middle and lower income earners spend more than 30% of their income on rent or for mortgage payment. Housing rent or mortgage is a basic need like foods, education, clothing and health. The government has introduced various measures to address the housing deficit. Despite these measures, the housing supply and distribution gaps continue to grow. To better understand the issues, there is a need to examine how the procurement planning in the affordable housing delivery supply chain and market is formulated, explore how cost of affordable housing would be reduced, identify the user value systems in affordable housing, and identify the criteria in the current regulatory framework? For these purposes, this paper reviews the relevant literature to reach preliminary findings on the stated issues. Among the factors found accounting for housing shortages, the overwhelming factors were that of poor policies, strategies, practice, management, and finance. The findings are meaningful in framing an affordable housing delivery model. It could also be useful to stakeholders involved in affordable housing delivery in Malaysia and elsewhere.

  15. Vietnam Affordable Housing

    OpenAIRE

    World Bank Group

    2015-01-01

    Affordable housing will be instrumental to helping Vietnam achieve its goals for increasing productivity and inclusive urban growth. Since Doi Moi, the country has experienced impressive economic growth, averaged at 7.4 percent per annum from 1990 to 2008, lowering to an average of 6 percent per annum from 2007 to 2013. Strong economic growth has supported a substantial reduction in povert...

  16. The role and uptake of private health insurance in different health care systems: are there lessons for developing countries?

    OpenAIRE

    Odeyemi IA; Nixon J

    2013-01-01

    Isaac AO Odeyemi,1 John Nixon21Senior Director and Head of Health Economics and Outcomes Research, Astellas Pharma UK Ltd, Chertsey, UK; 2Teaching Associate in Health Economics, Department of Economics and Related Studies, University of York, York, UKBackground: Social and national health insurance schemes are being introduced in many developing countries in moving towards universal health care. However, gaps in coverage are common and can only be met by out-of-pocket payments, general taxati...

  17. Health profile of government aided private school children in urban slum of Solapur, Southern Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Rupali R. Rajput

    2016-07-01

    Conclusions: The present study shows pattern of morbidities and malnutrition among school children. Comprehensive periodic health check-up should be carried out for early diagnosis and treatment of the common morbidities. Further studies should be carried out to assess the impact of health education. [Int J Res Med Sci 2016; 4(7.000: 2728-2733

  18. District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia

    Science.gov (United States)

    Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna

    2016-01-01

    Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. PMID:27591203

  19. District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia.

    Science.gov (United States)

    Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna; Iqbal Avan, Bilal

    2016-09-01

    Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. PMID:27591203

  20. European health research and globalisation: is the public-private balance right?

    Directory of Open Access Journals (Sweden)

    McCarthy Mark

    2011-03-01

    Full Text Available Abstract Background The creation and exchange of knowledge between cultures has benefited world development for many years. The European Union now puts research and innovation at the front of its economic strategy. In the health field, biomedical research, which benefits the pharmaceutical and biotechnology industries, has been well supported, but much less emphasis has been given to public health and health systems research. A similar picture is emerging in European support for globalisation and health Case studies Two case-studies illustrate the links of European support in global health research with industry and biomedicine. The European Commission's directorates for (respectively Health, Development and Research held an international conference in Brussels in June 2010. Two of six thematic sessions related to research: one was solely concerned with drug development and the protection of intellectual property. Two European Union-supported health research projects in India show a similar trend. The Euro-India Research Centre was created to support India's participation in EU research programmes, but almost all of the health research projects have been in biotechnology. New INDIGO, a network led by the French national research agency CNRS, has chosen 'Biotechnology and Health' and funded projects only within three laboratory sciences. Discussion Research for commerce supports only one side of economic development. Innovative technologies can be social as well as physical, and be as likely to benefit society and the economy. Global health research agendas to meet the Millenium goals need to prioritise prevention and service delivery. Public interest can be voiced through civil society organisations, able to support social research and public-health interventions. Money for health research comes from public budgets, or indirectly through healthcare costs. European 'Science in Society' programme contrasts research for 'economy', using technical

  1. Accelerated Reforms in Healthcare Financing: The Need to Scale up Private Sector Participation in Nigeria

    Directory of Open Access Journals (Sweden)

    Ufuoma John Ejughemre

    2014-01-01

    Full Text Available The health sector, a foremost service sector in Nigeria, faces a number of challenges; primarily, the persistent under-funding of the health sector by the Nigerian government as evidence reveals low allocations to the health sector and poor health system performance which are reflected in key health indices of the country.Notwithstanding, there is evidence that the private sector could be a key player in delivering health services and impacting health outcomes, including those related to healthcare financing. This underscores the need to optimize the role of private sector in complementing the government’s commitment to financing healthcare delivery and strengthening the health system in Nigeria. There are also concerns about uneven quality and affordability of private-driven health systems, which necessitates reforms aimed at regulation. Accordingly, the argument is that the benefits of leveraging the private sector in complementing the national government in healthcare financing outweigh the challenges, particularly in light of lean public resources and finite donor supports. This article, therefore, highlights the potential for the Nigerian government to scale up healthcare financing by leveraging private resources, innovations and expertise, while working to achieve the universal health coverage.

  2. Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

    Directory of Open Access Journals (Sweden)

    Agha Sohail

    2011-08-01

    Full Text Available Abstract Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana, to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs conducted in Tanzania (2006, Kenya (2004 and Ghana (2002 using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public

  3. Characterizing the Quality Workforce in Private U.S. Child and Family Behavioral Health Agencies.

    Science.gov (United States)

    McMillen, J Curtis; Raffol, Matthew

    2016-09-01

    Behavioral health agencies have been encouraged to monitor performance and improve service quality. This paper characterizes the workforce charged with these tasks through a national survey of 238 behavioral health quality professionals. A latent class analysis suggests only 30 % of these workers report skills in both basic research and quality-specific skills. Respondents wanted to learn a variety of research and data analytic skills. The results call into question the quality of data collected in behavioral health agencies and the conclusions agencies are drawing from their data. Professional school and continuing education programs are needed to prepare this workforce. PMID:26108643

  4. 充满活力的澳大利亚私人医疗服务体系%A Vigorous Private Health Care System in Australia

    Institute of Scientific and Technical Information of China (English)

    陈素红

    2014-01-01

    私人医疗服务是澳大利亚公共卫生与其医疗保障体系的重要组成部分,不仅私立医院、私人诊所占比高,个人参加商业保险的比例也高,私人零售药房成为患者药品的主供渠道,政府则通过各种优惠政策对私人医疗服务系统提供相应的补偿与支持,澳大利亚的经验值得我国医改借鉴。%Private health care services is a powerful part of the public health system and other health security system in Australia. Private hospitals and clinics account for very high proportion of health services. It has very high proportion of commercially insured individuals. Private retail pharmacies are the main source of drug suppliers. The government offers many preferential policies or subsidies to encourage the development of private health care service. Such experiences can be referred by our health care reform.

  5. An analysis of the usage of antibiotics in the private health care sector : a managed health care approach / Renier Coetzee

    OpenAIRE

    Coetzee, Renier

    2004-01-01

    The most frequent intervention performed by physicians is the writing of a prescription. Modern medicine has been remarkably effective in managing diseases. Medicines play a fundamental role in the effectiveness, efficiency and responsiveness of health care systems. However, health care expenditure is a great cause for concern and many nations around the world struggle to contain rising health care costs. Pharmaceutical benefit management programmes such as pharmacoeconomics, drug...

  6. Electronic Health Records: Permanent, Private, and Informative | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... are being compiled today by individuals, their insurance companies, medical providers, etc., would there be a main ... so far off, either. For instance, the Veterans Administration has a good electronic health records system called ...

  7. Effective strategies and interventions: environmental health and the private housing sector

    OpenAIRE

    Stewart, Jill

    2013-01-01

    Effective interventions in environmental health and housing work necessitate a range of methods and approaches to research and understand social and economic issues, how the complexities of peoples’ changing lives are represented in their housing and communities and the involvement of others in their housing, health and social care needs. Developing an evidence base and its application in practice can help deliver available resource to where it is most needed in addressing the complex needs o...

  8. A private sector view of health, surveillance, and communities of color.

    OpenAIRE

    Rabin, S A

    1994-01-01

    The U.S. population is fast evolving into a patchwork of health behaviors, incomes, and ethnic backgrounds. Simple cultural labeling will not do. A growing number of Americans, now numbering about 10 million, cannot or will not describe their race in any one of the Census Bureau's standard categories--white, black, American Indian, Eskimo, Aleut, Asian Pacific, or Hispanic. They group themselves as a multicultural population rather than a single racial or ethnic category. To guide health inte...

  9. The Impact of Market Size and Composition on Health Insurance Premiums: Evidence from the First Year of the Affordable Care Act

    OpenAIRE

    Michael J. Dickstein; Mark Duggan; Joe Orsini; Pietro Tebaldi

    2015-01-01

    Under the Affordable Care Act, individual states have discretion in how they define coverage regions, within which insurers must charge the same premium to buyers of the same age, family structure, and smoking status. We exploit variation in these definitions to investigate whether the size of the coverage region affects outcomes in the ACA marketplaces. We find large consequences for small and rural markets. When states combine small counties with neighboring urban areas into a single region...

  10. [Spending on private health insurance plans of Brazilian families: a descriptive study with data from the Family Budget Surveys 2002-2003 and 2008-2009].

    Science.gov (United States)

    Garcia, Leila Posenato; Ocké-Reis, Carlos Octávio; de Magalhães, Luís Carlos Garcia; Sant'Anna, Ana Claudia; de Freitas, Lúcia Rolim Santana

    2015-05-01

    Spending on health insurance represents an important share of private expenditure on health in Brazil. The study aimed to describe the evolution of spending on private health insurance plans of Brazilian families, according to their income. Data from the Family Budget Surveys (POF) 2002-2003 and 2008-2009 were used. To compare the spending figures among the surveys, the Consumer Price Index (IPCA) was applied. The proportion of families with private health insurance expenses remained stable in both surveys (2002-2003 and 2008-2009), around 24%. However, the household spending on health insurance plans increased. Among those families who spent money oh health insurance plans, the average spending increased from R$154.35 to R$183.97. The average spending on health insurance plans was greater with increasing household income, as well as portions of the family income and total expenditure committed to these expenses. Spending on health insurance is concentrated among higher-income families, for which it was the main component of total health expenditure. PMID:26017945

  11. The Legacy of the U. S. Public Health Services Study of Untreated Syphilis in African American Men at Tuskegee on the Affordable Care Act and Health Care Reform Fifteen Years After President Clinton's Apology.

    Science.gov (United States)

    Mays, Vickie M

    2012-11-01

    This special issue addresses the legacy of the United States Public Health Service Syphilis Study on health reform, particularly the Affordable Care Act (ACA). The 12 manuscripts cover the history and current practices of ethical abuses affecting American Indians, Latinos, Asian Americans and African Americans in the United States and in one case, internationally. Commentaries and essays include the voice of a daughter of one of the study participants in which we learn of the stigma and maltreatment some of the families experienced and how the study has impacted generations within the families. Consideration is given in one essay to utilizing narrative storytelling with the families to help promote healing. This article provides the reader a roadmap to the themes that emerged from the collection of articles. These themes include population versus individual consent issues, need for better government oversight in research and health care, the need for overhauling our bioethics training to develop a population level, culturally driven approach to research bioethics. The articles challenge and inform us that some of our assumptions about how the consent process best works to protect racial/ethnic minorities may be merely assumptions and not proven facts. Articles challenge the belief that low participation rates seen in biomedical studies have resulted from the legacy of the USPHS Syphilis Study rather than a confluence of factors rooted in racism, bias and negative treatment. Articles in this special issue challenge the "cultural paranoia" of mistrust and provide insights into how the distrust may serve to lengthen rather than shorten the lives of racial/ethnic minorities who have been used as guinea pigs on more than one occasion. We hope that the guidance offered on the importance of developing a new framework to bioethics can be integrated into the foundation of health care reform. PMID:23630410

  12. Learning Grasp Affordance Densities

    DEFF Research Database (Denmark)

    Detry, Renaud; Kraft, Dirk; Kroemer, Oliver;

    2011-01-01

    records their outcomes. When a satisfactory number of grasp data is available, an importance-sampling algorithm turns these into a grasp density. We evaluate our method in a largely autonomous learning experiment run on three objects of distinct shapes. The experiment shows how learning increases success......We address the issue of learning and representing object grasp affordance models. We model grasp affordances with continuous probability density functions (grasp densities) which link object-relative grasp poses to their success probability. The underlying function representation is nonparametric...... and relies on kernel density estimation to provide a continuous model. Grasp densities are learned and refined from exploration, by letting a robot “play” with an object in a sequence of graspand-drop actions: The robot uses visual cues to generate a set of grasp hypotheses; it then executes these and...

  13. Health and Safety Challenges, and Perceptions of Private Sector Waste Operators in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Mynepalli K. C. Sridhar

    2014-03-01

    Full Text Available This study assessed the knowledge, and perceptions on safety measure practices and challenges of private sector participation (PSP operators on solid waste management in Lagos State, Nigeria. This was a cross-sectional study and utilized interviewer administered questionnaire. The study employed purposive sampling among 256 PSP operators. Data were analyzed using descriptive statistics, Pearson’s product moment and multiple regression analysis correlation at 5% level of significance. Respondents’ age was 35.7 ± 4.2 years, and included 78.5% male. About 55.9% of the respondents spent up to 5 years in the waste management operations. Some 44.9% had at least completed secondary school education. A good knowledge of waste management was exhibited by 68.4% of the respondents. The respondents who had spent 16 years and above in waste management operations were more knowledgeable (8.0 ± 2.1 compared to those who had spent lesser time (p

  14. Strategies for maintaining emotional stability: The case of nurses in private health care industry

    Directory of Open Access Journals (Sweden)

    Pushpika Subhashinie Mullakanda

    2015-12-01

    Full Text Available This study examines the emotional intelligence (EI of nurses by differentiating inter-personal and intra-personal dimensions, and explores the measures taken by them to maintain emotional stability. Further, it investigates the relationship of demographic factors (age, gender and year of experience of nurses with their emotional stability. The case organization is a well performing private hospital located closer to the metropolitan city. Study collects data through both quantitative (survey and qualitative means (discussion, observation, and interviews using a sample of 40 nurses selected conveniently from different ranks. The study finds that the level of EI of nurses in case hospital is slightly high, and their inter-personal skills are higher than intra-personal skills. They maintain emotional stability by means of emotion gaps, emotional shifts and sharing. Findings suggest that both inter-personal and intra-personal dimensions of EI will not be equally important for nurses in dealing with patients, and the level of EI required in the job is not equal among different ranks of nurses.

  15. 78 FR 42823 - Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non...

    Science.gov (United States)

    2013-07-17

    ... choice of affordable health insurance, and give small businesses the same purchasing power as large... referrals to consumer assistance programs (CAPs) and health insurance ombudsmen for enrollees with... inform consumers about the Exchange and insurance affordability programs to encourage participation....

  16. Never Going Back: An Examination of Financial Health at Selected Private South Carolina Universities

    Science.gov (United States)

    Armstrong, David C., Sr.

    2014-01-01

    This case study examined the leadership styles and overall financial health of the three South Carolina Baptist Convention universities. Each university share a similar story of financial exigency prior to the current president's arrival. Each institution has increased enrollment, endowment, and facilities over the last decade. This case study…

  17. Health gains and financial risk protection afforded by public financing of selected interventions in Ethiopia: An extended cost-effectiveness analysis

    OpenAIRE

    Dr. Stéphane Verguet, PhD; Zachary D Olson, MA; Joseph B Babigumira, PhD; Dawit Desalegn, MD; Kjell Arne Johansson, PhD; Margaret E Kruk, MD; Carol E Levin, PhD; Rachel A Nugent, PhD; Clint Pecenka, PhD; Mark G Shrime, MD; Solomon Tessema Memirie, MD; David A Watkins, MD; Prof. Dean T Jamison, PhD

    2015-01-01

    Background: The way in which a government chooses to finance a health intervention can affect the uptake of health interventions and consequently the extent of health gains. In addition to health gains, some policies such as public finance can insure against catastrophic health expenditures. We aimed to evaluate the health and financial risk protection benefits of selected interventions that could be publicly financed by the government of Ethiopia. Methods: We used extended cost-effectiven...

  18. Dignity for all: affordable assisted living.

    Science.gov (United States)

    Janeski, James F; Pruchnicki, Alec

    2006-01-01

    In 2026, the first of the baby boomers, including Presidents Clinton and Bush, will reach the age of 80, the average age of residents currently in assisted living facilities. In her book The Denial of Aging: Perpetual Youth, Eternal Life, and Other Dangerous Fantasies, Muriel Gillick proposes that the baby boomers will seek assisted living as an alternative to nursing home care. But what about that portion of the population not able to afford the high cost of private assisted living? What option will be available to the low-asset/low-income population in lieu of nursing home care? PMID:17214248

  19. Job satisfaction in the x-ray department of a level III-2 private health institution in Lima, 2015

    Directory of Open Access Journals (Sweden)

    Alexander H. Román Meza

    2015-09-01

    Full Text Available Objective: To describe job satisfaction in the X-Ray Department of a level III-2 private health institution in Lima, in 2015. Material and Methods: The present study is quantitative, descriptive, prospective and cross-sectional. The population was of 22 people, the sample included everyone in the population. The unit of analysis was the Medical Technologists of Radiology. The job satisfaction was evaluated by the “Job Satisfaction Questionnaire S10 / 12” by Melia JL and Peiró JM. Results: Of the total population, 77.3% were hired on a fixed term and 40.9% had been working for 12 months or more. 86.4% of participants were occupationally satisfied. 65.9% expressed satisfaction with the services received dimension, and 10.2% had an indifferent satisfaction with the physical environment dimension. Discussion: The results showed that there is a good percentage of job satisfaction, but analyzing its aspects (dimensions it was determined that the physical environment dimension is where emphasis should be made to improve working conditions in the X- Ray Department, a situation also notorious in some health departments abroad, but in our country it is not common in public institutions, as there are other deficiencies. Conclusions: Job satisfaction was high in the department but in the analysis, it was determined that the physical environment is where the institution must improve, compared to the benefits received and supervision.

  20. A study of occupational health and safety measures in the Laundry Department of a private tertiary care teaching hospital, Bengaluru

    Directory of Open Access Journals (Sweden)

    M. Shashi Kumar

    2014-01-01

    Full Text Available Introduction: The Laundry Department plays an important role in preventing the spread of infection and continuously supplying clean linen to various departments in any hospital. Objectives of the Study: To identify existing practices and occupational safety and health (OSH measures in the Laundry Department and to assess the use of personal protective equipments (PPEs among health care workers. Materials and Methods: A cross-sectional study was carried out in a private tertiary care teaching hospital. An observation checklist was developed, which was partially based on occupational hazard checklist of OSHA for Laundry Department. This was field tested and validated for applicability for this study. Results: The potential biological hazards are infections through exposure to aerosols, spills and splashes during various activities, fungal infection due to wet clothes and environment and infections through fomites. The potential physical hazards are injuries due to slips and falls, exposure to heat, humidity, dust, noise, and vibration. The potential chemical hazards are contact dermatitis and allergic asthma due to exposure to detergents, phenyl solution, bleaching powder, and soap oil solution. The potential ergonomic hazards are musculoskeletal diseases and repetitive stress injuries at the shoulder, elbow, and small joints of the hands. PPEs were not used consistently in most areas of the department.

  1. Privatización de los servicios de salud: las experiencias de Chile y Costa Rica Health services privatization: the experiences of Chile and Costa Rica

    Directory of Open Access Journals (Sweden)

    N. Homedes

    2002-02-01

    Full Text Available El trabajo cuestiona los argumentos que justifican la privatización neoliberal de la financiación, gestión y prestación de servicios de salud, y analiza el significado y estrategias de privatización. Comparamos la privatización en Costa Rica y Chile, y en la discusión se sugiere que el modelo costarricense de privatización selectiva, limitada y concebida autóctonamente de Costa Rica lleva a un sistema de salud más solidario, equitativo, eficiente y satisfactorio para los usuarios que el modelo importado de privatización chileno.This study questions the premises that justify the neoliberal privatization of financing, managing and delivering health services. It also analyses the meaning of privatization and its strategies. We compare privatization in Chile and Costa Rica and suggest that the more limited, selective and locally designed privatization process in Costa Rica has resulted in a more equitable, and efficient health system than the imported privatization model introduced in Chile. The Costa Rican system also produces greater patient satisfaction and at the same time preserves the solidarity principle.

  2. Public–private partnerships improve health outcomes in individuals with early stage Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Galvin JE

    2014-04-01

    Full Text Available James E Galvin,1 Magdalena I Tolea,1 Nika George,2 Cheryl Wingbermuehle31Alzheimer Disease Center, Departments of Neurology, Psychiatry and Population Health, New York University Langone Medical Center, New York, NY, USA; 2Clinical Psychology Program, University of Missouri – St Louis, 3Alzheimer’s Association, St Louis Chapter, St Louis, MO, USAPurpose: In a collaborative effort between the Missouri Department of Health, Area Agencies on Aging (AAA, Alzheimer Association, and academic researchers, we tested whether early dementia detection and comprehensive care consultations would improve health outcomes in care receivers (CRs and their family caregivers (FCGs, therefore addressing an important public health concern.Participants and methods: A total of 244 community-dwelling older adults screened for early-stage dementia by the AAA field staff were referred to the Alzheimer Association and participated in Project Learn MORE (Missouri Outreach and Referral Expanded (PLM – a 2-year, nonrandomized multisite intervention consisting of comprehensive care consultations to improve coping skills. PLM participants were compared against 96 controls receiving the Alzheimer Association’s “usual services” between January 2011 and December 2012. We examined CR and FCG outcomes, including burden, care confidence, and mood, as effects of PLM, on delaying transitions in level of care.Results: CRs showed improved knowledge (P=0.002 and reduced depression (P=0.007, while FCGs demonstrated improved knowledge (P=0.003 and ability to identify sources of support for the CR (P=0.032 and for themselves (P=0.043. However, FCGs were more burdened after PLM (P=0.02, due to increased awareness of Alzheimer’s disease. PLM delayed transitions in care (odds ratio [OR] 3.32, 95% confidence level [CI]: 1.25–8.83 with the number needed to treat =6.82.Conclusion: PLM was successful in improving detection of incident cases of dementia in the community

  3. Which variables influence having private health insurance and to which extend PHI is attractive compare to other fridge benefits offered on the employment market.

    OpenAIRE

    2010-01-01

    Private Health Insurance is a relatively new phenomena in Norwegian health care. This study investigates which variables influence having PHI and to which extend PHI is preferred compare to other fridge benefits. I check whether socio-economic factors like education, marital status, personal income and type of work also age, gender and personal attitudes toward PHI have any meaning for my dependent variable in my questionnaire. The analysis is performed is a logistic regression in SPSS and...

  4. Introducing a model of cardiovascular prevention in Nairobi's slums by integrating a public health and private-sector approach: the SCALE-UP study

    OpenAIRE

    Vijver, Steven; Oti, Samuel; Cohen Tervaert, Thijs; Hankins, Catherine; Kyobutungi, Catherine; Gomez, Gabriela G; Brewster, Lizzy; Agyemang, Charles; Lange, Joep

    2013-01-01

    Introduction: Cardiovascular disease (CVD) is a leading cause of death in sub-Saharan Africa (SSA), with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlementswhere access to formal healthcare and resources is limited.Objective: To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sec...

  5. Affordable Care Act risk adjustment: overview, context, and challenges.

    Science.gov (United States)

    Kautter, John; Pope, Gregory C; Keenan, Patricia

    2014-01-01

    Beginning in 2014, individuals and small businesses will be able to purchase private health insurance through competitive marketplaces. The Affordable Care Act (ACA) provides for a program of risk adjustment in the individual and small group markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge and the incentive for plans to avoid sicker enrollees. This article--the first of three in the Medicare & Medicaid Research Review--describes the key program goal and issues in the Department of Health and Human Services (HHS) developed risk adjustment methodology, and identifies key choices in how the methodology responds to these issues. The goal of the HHS risk adjustment methodology is to compensate health insurance plans for differences in enrollee health mix so that plan premiums reflect differences in scope of coverage and other plan factors, but not differences in health status. The methodology includes a risk adjustment model and a risk transfer formula that together address this program goal as well as three issues specific to ACA risk adjustment: 1) new population; 2) cost and rating factors; and 3) balanced transfers within state/market. The risk adjustment model, described in the second article, estimates differences in health risks taking into account the new population and scope of coverage (actuarial value level). The transfer formula, described in the third article, calculates balanced transfers that are intended to account for health risk differences while preserving permissible premium differences. PMID:25364625

  6. Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa

    Directory of Open Access Journals (Sweden)

    Shabir Moosa

    2016-03-01

    Full Text Available Background: The South African government intends to contract with ‘accredited provider groups’ for capitated primary care under National Health Insurance (NHI. South African solo general practitioners (GPs are unhappy with group practice. There is no clarity on the views of GPs in group practice on contracting to the NHI.Objectives: To describe the demographic and practice profile of GPs in group practice in South Africa, and evaluate their views on NHI, compared to solo GPs.Methods: This was a descriptive survey. The population of 8721 private GPs in South Africa with emails available were emailed an online questionnaire. Descriptive statistical analyses and thematic content analysis were conducted.Results: In all, 819 GPs responded (568 solo GPs and 251 GPs in groups. The results are focused on group GPs. GPs in groups have a different demographic practice profile compared to solo GPs. GPs in groups expected R4.86 million ($0.41 million for a hypothetical NHI proposal of comprehensive primary healthcare (excluding medicines and investigations to a practice population of 10 000 people. GPs planned a clinical team of 8 to 12 (including nurses and 4 to 6 administrative staff. GPs in group practices saw three major risks: patient, organisational and government, with three related risk management strategies.Conclusions: GPs can competitively contract with NHI, although there are concerns. NHI contracting should not be limited to groups. All GPs embraced strong teamwork, including using nurses more effectively. This aligns well with the emergence of family medicine in Africa.Keywords: Capitation, human resource, primary health care,  family medicine, South Africa, health systems

  7. Enhancing client welfare through better communication of private mental health data between rural service providers

    Directory of Open Access Journals (Sweden)

    Oliver Kisalay Burmeister

    2015-11-01

    Full Text Available Client welfare is detrimentally affected by poor communication of data between rural service providers, which in part is complicated by privacy legislation. A study of service provision involving interviews with mental health professionals, found challenges in communicative processes between agencies were exacerbated by the heavy workloads. Dependence on individual interpretations of legislation, and on manual handling, led to delays that detrimentally affected client welfare. The main recommendation arising from this article is the creation of an ehealth system that is able to negotiate differing levels of access to client data through centralised controls, where the administration of that system ensures that it stays current with changing legislative requirements. The main contribution of the proposed model is to combine two well-known concepts: data integration and generalisation. People with mental illness are amongst the most vulnerable members of society, and current ehealth systems that provide access to medical records inadequately cater to their needs.

  8. The private health insurance choices of medicare beneficiaries: how much does price matter?

    Science.gov (United States)

    Rice, Thomas; Jacobson, Gretchen; Cubanski, Juliette; Neuman, Tricia

    2014-12-01

    This article presents, critiques, and analyzes the influence of prices on insurance choices made by Medicare beneficiaries in the Medicare Advantage, Part D, and Medigap markets. We define price as health insurance premiums for the Medicare Advantage and Medigap markets, and total out-of-pocket costs (including premiums and cost sharing) for the Part D market. In Medicare Advantage and Part D, prices only partly explain insurance choices. Enrollment decisions also may be influenced by other factors such as the perceived quality of the higher-premium plans, better provider networks, lower cost-sharing for services, more generous benefits, and a preference for certain brand-name products. In contrast, the one study available on the Medigap market concludes that price appears to be associated with plan selection. This may be because Medigap benefits are fully standardized, making it easier for beneficiaries to compare alternative policies. The article concludes by discussing policy options available to Medicare. PMID:25371217

  9. Assessing the potential of rural and urban private facilities in implementing child health interventions in Mukono district, central Uganda-a cross sectional study

    DEFF Research Database (Denmark)

    Rutebemberwa, Elizeus; Buregyeya, Esther; Lal, Sham;

    2016-01-01

    in diagnostic capabilities, operations and human resource in the management of malaria, pneumonia and diarrhoea. METHODS: A survey was conducted in pharmacies, private clinics and drug shops in Mukono district in October 2014. An assessment was done on availability of diagnostic equipment for malaria, record...... attended to at least one sick child in the week prior to the interview. CONCLUSION: There were big gaps between rural and urban private facilities with rural ones having less trained personnel and less zinc tablets' availability. In both rural and urban areas, record keeping was low. Child health...

  10. Public Private Partnerships in Health Care: European PPP models and factors influencing the positive outcome of such ventures

    OpenAIRE

    Siroky, Joseph Yan

    2012-01-01

    A number of European countries are turning to private finance for public hospitals and other healthcare infrastructure. Public-private partnerships (PPP) are intended to bind private sector efficiencies, secure appropriate risk transfer between hospital operators, infrastructure owners and other partners, and ensure optimum whole-life asset management. This paper discusses the different factors that influence significantly the outcomes of European PPP ventures, the scope of different PPP mode...

  11. Contracting private sector providers for public sector health services in Jalisco, Mexico: perspectives of system actors

    Directory of Open Access Journals (Sweden)

    González Luz

    2009-10-01

    Full Text Available Abstract Introduction Contracting out health services is a strategy that many health systems in the developing world are following, despite the lack of decisive evidence that this is the best way to improve quality, increase efficiency and expand coverage. A large body of literature has appeared in recent years focusing on the results of several contracting strategies, but very few papers have addressed aspects of the managerial process and how this can affect results. Case description This paper describes and analyses the perceptions and opinions of managers and workers about the benefits and challenges of the contracting model that has been in place for almost 10 years in the State of Jalisco, Mexico. Both qualitative and quantitative information was collected. An open-ended questionnaire was used to obtain information from a group of managers, while information provided by a self-selected group of workers was collected via a closed-ended questionnaire. The analysis contrasted the information obtained from each source. Discussion and Evaluation Findings show that perceptions of managers and workers vary for most of the items studied. For managers the model has been a success, as it has allowed for expansion of coverage based on a cost-effective strategy, while for workers the model also possesses positive elements but fails to provide fair labour relationships, which negatively affects their performance. Conclusion Perspectives of the two main groups of actors in Jalisco's contracting model are important in the design and adjustment of an adequate contracting model that includes managerial elements to give incentives to worker performance, a key element necessary to achieve the model's ultimate objectives. Lessons learnt from this study could be relevant for the experience of contracting models in other developing countries.

  12. SunShot Initiative: Making Solar Energy Affordable for All Americans (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2013-10-01

    Through SunShot, DOE supports efforts by private companies, universities, and national laboratories to drive down the cost of solar electricity to $0.06 per kilowatt-hour, making solar energy affordable for more American families and businesses.

  13. Protecting the delivery of heart failure: Regenerative Medicine/Stem Cell Therapeutics: Potential protections afforded by the Department of Health and Human Services and Health Resources Service Administration's Bureau of Special Programs

    Institute of Scientific and Technical Information of China (English)

    Gary S Friedman; John S. Tomicki; Neil Cohen; Robert Marshall; Philip Lowry; Jeffrey Warsh

    2006-01-01

    malpractice liability have not impeded the development and growth of organ/cell/tissue transplantation despite increased risks of infection, malignancy and cardiovascular disease in transplant recipients. Currently, human transplantation is only performed using FDA/CBER-approved, non-embryonic stem cells from peripheral blood, bone marrow or umbilical cord blood. Federal legislation passed in 2005 (HR2520 and S1317: The Bone Marrow and Cord Blood Cell Transplantation Program) authorizes the Secretary of Health and Human Services acting through the Director of HRSA to ensure uniform stem cell units distribution and outcomes monitoring via the federally-designated C.W. Bill Young Cell Transplant Program.Historically in the U.S., human biological therapies (vaccines, organ transplant and stem cell transplant) have required federal protections to ensure continued distribution, fair access and avoidance of inhibitory product liability via protections afforded under the "stewardship" of the Secretary of Health and Human Services. The National Childhood Vaccine Injury Act of 1986 established the NVICP to equitably and expeditiously compensate individuals, or families of individuals, who have been declared injured by vaccines, thereby stabilizing a once imperiled vaccine supply by substantially reducing the threat of liability for vaccine companies, physicians, and other health care professionals who administer vaccines. Vaccines were the first biologics administered to U.S. citizens en masse and presage stem cell therapeutics(which may similarly be administered to millions) will similarly necessitate that a Stem Cell Injury Compensation Program(SCICP) will also need to be in place to demonstrate an intention to do good, an understanding that industry may do well,but that the health care consumer has a right of protection-all recognized from the outset. The Federal Tort Claims Act(FTCA) addresses liability claims via the Executive, Judicial and Legislative branches of Government

  14. Health care financing in Malaysia: A way forward

    Directory of Open Access Journals (Sweden)

    Ashutosh Kumar Verma

    2015-01-01

    Full Text Available Malaysia has a two-tier health care system consisting of the public and private sectors. The Ministry of Health is the main provider of health care services in the country. The private health care sector provides services on a nonsubsidized, fee-for-service basis, and mainly serves for those who can afford to pay. For financing health care two types of health insurances are available currently: Private and employee based (aka SOCSO. SOCSO and Employee Provident Fund provide some coverage to private-sector employees. There are several challenges in pure Bismarckian model (private insurance etc. like smaller portion of total population will be "economically active," international competition to attract firms, and maintain/increase employment will put downward pressure on labor taxes. How to sustain universal coverage in this context? In a population setting where unemployment is high informal sector, payroll taxes will not be a major source of funds. However, it is possible to create a universal health financing system by transforming the role of budget funding from directly subsidizing provision to subsidizing the purchase of services on behalf of the entire population. The integration of services between the public and private sector is very much needed, at a cost the people can afford. At present, there is no national health insurance scheme in place. Although there are many models proposed, the main question that the policymakers need to be aware of is that of the equity of access to holistic health services for all Malaysians.

  15. The Forum for Defence of the Brazilian Unified Health System (Sistema Único de Saúde) and its role in building community participation in the fight against the privatization of health.

    Science.gov (United States)

    de Lara, Lutiane; Guareschi, Neuza Maria de Fátima

    2016-03-01

    Based on a Foucauldian framework, this article discusses the involvement of the Forum for Defence of the Sistema Único de Saúde in the fight against health care privatization. Community participation is a locus of experience that produces subjects implicated in the production of public health care. The locus of experience in this instance derives from the rejection of private elements that historically have been part of Brazilian public policies. It is an experience that produces workers and service users as agents able to defend the public system and endowed with instituting power. PMID:26987838

  16. Positive and negative emotional responses to workrelated trauma of intensive care nurses in private health care facilities

    Directory of Open Access Journals (Sweden)

    Lizelle Van der Vyver

    2011-02-01

    Full Text Available Intensive care nursing is a stressful occupation and nurses are continually subjected to both primary and secondary trauma. Responses may be positive in the form of compassion satisfaction, or negative in the form of compassion fatigue. However, nurses tend to deny the negative impact of secondary trauma which leads to the silencing response and subsequent burnout. This article explores and describes the presence of these emotions and the relationships between them. A quantitative approach with a non-probability sampling method was used. The sample consisted of 30 registered nurses working in private health care intensive care units in East London, Eastern Cape. Data were gathered via the Professional Quality of Life Scale: Compassion Satisfaction and Fatigue Subscales – Revision IV (ProQOL – R-IV and the Silencing Response Scale and were analysed according to descriptive statistics and correlation coefficients. Findings suggest a high risk for compassion fatigue, a moderate risk for burnout and the silencing response and moderate potential for compassion satisfaction. A marked negative relationship was found between compassion satisfaction and burnout and a substantial positive relationship between compassion fatigue and burnout, as well as compassion fatigue and the silencing response.

    Opsomming

    Intensiewesorgverpleging is ‘n stresvolle beroep en verpleegsters word gedurig aan beide primêre en sekondêre trauma blootgestel. Reaksie hierop kan óf positief wees, in die vorm van empatie-tevredenheid, óf negatief, in die vorm van empatie-uitputting. Verpleegsters is egter geneig om die negatiewe impak van sekondêre trauma te ontken,wat gevolglik tot stilswye en uitbranding kan lei. Hierdie artikel ondersoek en beskryf die teenwoordigheid en verwantskap tussen hierdie emosies. ‘n Kwantitatiewe benadering met ‘n nie-waarskynlikheidsteekproefmetode is gebruik. Die steekproef het bestaan uit 30 geregistreerde

  17. Achieving affordable housing through energy efficiency strategy

    International Nuclear Information System (INIS)

    Cooperation between public and private sector has achieved a remarkable widespread, in the Italian context, over the last two decades. Nevertheless, the increasing difficulty in accessing the capital market and the rising cost of funding sources, both noticeable over the past few years, led to a slowdown of Public–Private Partnership (PPP) initiatives. Meanwhile, the community is expressing new needs to be satisfied, such as the conversion of brownfields, the recovery of housing stock dating back to former times, as well as the refurbishment of public offices or schools. Emerging priorities include the supply of affordable dwellings for low to medium income households. This essay aims to examine a case study in which PPP and buildings energy efficiency have been successfully combined, in order to jointly contribute to the achievement of a social housing settlement. Thanks to energy efficiency measures—concerning building envelope insulation, heating system and other installations—the agreed rent results far higher than social rent of protected tenancies, and furthermore above the range of fair rents characterising other regulated tenancies, but mildly lower than market rents. All this allows to achieve an equity yield rate satisfying from the perspective of a venture philanthropy investment. -- Highlights: •Provision of affordable dwellings is an emerging priority within Italian context. •Lack of public funds leads to promote Public–Private Partnership schemes. •Without public grants the adoption of a venture philanthropy approach is needed. •The examined case study allows to explain the role of buildings energy efficiency. •Buildings energy efficiency may boost feasibility of social housing transactions

  18. The Concept of Disciplinary Affordance

    OpenAIRE

    Airey, John; Eriksson, Urban; Fredlund, Tobias; Linder, Cedric

    2014-01-01

    Since its introduction by Gibson (1979) the concept of affordance has been discussed at length by a number of researchers. Most famous, perhaps is the disagreement between Gibson and Norman (1988) about whether affordances are inherent properties of objects or are only present when perceived by an organism. More recently, affordance has been drawn on in the educational arena, particularly with respect to multimodality (see Linder (2013) for a recent example). Here, Kress et al (2001) claim th...

  19. Measuring access to medicines: a survey of prices, availability and affordability in Shaanxi province of China.

    Directory of Open Access Journals (Sweden)

    Minghuan Jiang

    Full Text Available OBJECTIVE: To measure the prices and availability of selected medicines in Shaanxi Province after the implementation of new healthcare reform in 2009. METHODS: Data on the prices and availability of 47 medicines were collected from 50 public and 36 private sector medicine outlets in six regions of Shaanxi Province, Western China using a standardized methodology developed by the World Health Organization and Health Action International from September to October 2010. Medicine prices were compared with international reference prices to obtain a median price ratio. Affordability was measured as the number of days' wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. FINDINGS: The mean availabilities of originator brands and lowest-priced generics were 8.9% and 26.5% in the public sector, and 18.1% and 43.6% in the private sector, respectively. The public sector procured generics and originator brands at median price ratios of 0.75 and 8.49, respectively, while patients paid 0.97 and 10.16. Final patient prices for lowest-priced generics and originator brands in the private sector were about 1.53 and 8.36 times their international retail prices, respectively. Public sector vendors applied high markups of 30.4% to generics, and 19.6% to originator brands. In the private sector, originator brands cost 390.7% more, on average, than their generic equivalents. Generic medicines were priced 17.3% higher in the private sector than the public sector. The lowest-paid government worker would need 0.1 day's wages to purchase captopril for lowest-priced generics from private sector, while 6.6 days' wages for losartan. For originator brands, the costs rise to 1.2 days' wages for salbutamol inhaler and 15.6 days' wages for omeprazole. CONCLUSIONS: The prices, availability and affordability of medicines in China should be improved to ensure equitable access to basic medical treatments, especially for

  20. Delayed privatization

    OpenAIRE

    Bernardo Bortolotti; Paolo Pinotti

    2008-01-01

    This paper studies the timing of privatization in 21 major developed economies in the 1977-2002 period. Duration analysis shows that political fragmentation plays a significant role in explaining government's decision to privatize: privatization is delayed longer in democracies characterized by a larger number of parties and operating under proportional electoral rules, as predicted by war of attrition models of economic reform. Results are robust to various assumptions on the underlying stat...

  1. Enrollment in Private Medical Insurance and Utilization of Medical Services Among Children and Adolescents: Data From the 2009-2012 Korea Health Panel Surveys

    OpenAIRE

    Ryu, Dong Hee; Kam, Sin; Doo, Young-Taek

    2016-01-01

    Objectives: The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services. Methods: The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012. Results: At the initial assessment, less than 20% of the study population had not enrolled in any PMI pro...

  2. Prescribing patterns of methylphenidate and atomoxetine containing products in a section of the private health care sector of South Africa / Stephan Rothmann

    OpenAIRE

    Rothmann, Stephan

    2009-01-01

    The general aim of this study was to investigate the prescribing patterns of products that contain methylphenidate or atomoxetine in a section of the private health care sector of South Africa. A quantitative, retrospective drug uitilisation review was performed according to data obtained from the database of a South African medicine claims pharmacy benefit management company's for three consecutive study years (Le. 2005 to 2007). The results indicated that a total of 7,990 patients had b...

  3. Equity and the Sun Quality Health Private Provider Social Franchise: comparative analysis of patient survey data and a nationally representative TB prevalence survey

    OpenAIRE

    Montagu, Dominic; Sudhinaraset, May; Lwin, Thandar; Onozaki, Ikushi; Win, Zaw; Aung, Tin

    2013-01-01

    Abstract Introduction Since 2004, the Sun Quality Health (SQH) franchise network has provided TB care in Myanmar through a network of established private medical clinics. This study compares the wealth distribution of the TB patients to non-TB patients to determine if TB is most common among the poor, and compares the wealth of all TB patients to SQH TB patients to assess whether the franchise achieves its goal of serving the poor. ...

  4. The relationship between occupational stress and dysmenorrhea in midwives employed at public and private hospitals and health care centers in Iran (Mashhad) in the years 2010 and 2011

    OpenAIRE

    Kordi, Masoumeh; Mohamadirizi, Soheila; Shakeri, Mohamad Taghi

    2013-01-01

    Background: According to the biopsychosocial model, menstrual symptoms are caused not only by a combination of biological factors such as hormonal disorders and lifestyle, but also by psychological and social factors such as working environment. This study aimed to determine the relation between occupational stress and dysmenorrhea in Iranian midwives. Materials and Methods: This prospective correlational study was performed on 150 midwives at public and private hospitals and health care cent...

  5. Informing the 'Visible Hand' Defining and Measuring What Governments Do - and Can Do - with Private Health Providers in Africa

    OpenAIRE

    Spreng, Connor; Ifelayo, Ojo

    2012-01-01

    Measures of the overall business environment have been around for many years, and the World Bank Group has been at the forefront, for example, with the doing business indicators. But it's a different story when it comes to the environment for private businesses in the social sectors. Indeed, the private sector's role itself is somewhat controversial, making it all the more important to develop a useful definition of effective policy and practice in this area. In 2011, the World Bank and Inter...

  6. The Affordable Care Act: Dispersing the Fog of Misinformation

    OpenAIRE

    Max J. Skidmore

    2012-01-01

    Editor Max J. Skidmore provides a concise history and political analysis of the attacks on American efforts to achieve near universal health care, and also reviews an innovative history of the 2010 Patient Protection and Affordable Care Act.

  7. Improving health in the Arctic region through safe and affordable access to household running water and sewer services: an Arctic Council initiative

    Directory of Open Access Journals (Sweden)

    Thomas W. Hennessy

    2016-04-01

    Full Text Available Important health disparities have been documented among the peoples of the Arctic and subarctic, including those related to limited access to in-home improved drinking water and sanitation services. Although improving water, sanitation and hygiene (WASH has been a focus of the United Nations for decades, the Arctic region has received little attention in this regard. A growing body of evidence highlights inequalities across the region for the availability of in-home drinking WASH services and for health indicators associated with these services. In this review, we highlight relevant data and describe an initiative through the Arctic Council's Sustainable Development Working Group to characterize the extent of WASH services in Arctic nations, the related health indicators and climate-related vulnerabilities to WASH services. With this as a baseline, efforts to build collaborations across the Arctic will be undertaken to promote innovations that can extend the benefits of water and sanitation services to all residents.

  8. Improving health in the Arctic region through safe and affordable access to household running water and sewer services: an Arctic Council initiative.

    Science.gov (United States)

    Hennessy, Thomas W; Bressler, Jonathan M

    2016-01-01

    Important health disparities have been documented among the peoples of the Arctic and subarctic, including those related to limited access to in-home improved drinking water and sanitation services. Although improving water, sanitation and hygiene (WASH) has been a focus of the United Nations for decades, the Arctic region has received little attention in this regard. A growing body of evidence highlights inequalities across the region for the availability of in-home drinking WASH services and for health indicators associated with these services. In this review, we highlight relevant data and describe an initiative through the Arctic Council's Sustainable Development Working Group to characterize the extent of WASH services in Arctic nations, the related health indicators and climate-related vulnerabilities to WASH services. With this as a baseline, efforts to build collaborations across the Arctic will be undertaken to promote innovations that can extend the benefits of water and sanitation services to all residents. PMID:27132632

  9. Extending transaction cost economics: towards a synthesised approach for analysing contracting in health care markets with experience from the Australian private sector.

    Science.gov (United States)

    Donato, Ronald

    2010-12-01

    Transaction cost economics (TCE) has been the dominant economic paradigm for analysing contracting, and the framework has been applied in a number of health care contexts. However, TCE has particular limitations when applied to complex industry settings and there have been calls to extend the framework to incorporate dynamic theories of industrial organisation, specifically the resource-based view (RBV). This paper analyses how such calls for theoretical pluralism are particularly germane to health care markets and examines whether a combined TCE-RBV provides a more comprehensive approach for understanding the nature of contractual arrangements that have developed within the Australian private health care sector and its implications for informing policy. This Australian case study involved a series of interviews with 14 senior contracting executives from the seven major health funds (i.e. 97% of the insured population) and seven major private hospital groups (i.e. 73% of the private hospital beds). Study findings reveal that both the TCE perspective with its focus on exchange hazards, and the RBV approach with its emphasis on the dynamic nature of capabilities, each provide a partial explanation of the developments associated with contracting between health funds and hospital groups. For a select few organisations, close inter-firm relational ties involving trust and mutual commitment attenuate complex exchange hazards through greater information sharing and reduced propensity to behave opportunistically. Further, such close relational ties also provide denser communication channels for creating and transmitting more complex information enabling organisations to tap into each other's complementary resources and capabilities. For policymakers, having regard to both TCE and RBV considerations provides the opportunity to apply competition policy beyond the current static notions of efficiency and welfare gains, and cautions policymakers against specifying ex ante the

  10. Improving health in the Arctic region through safe and affordable access to household running water and sewer services: an Arctic Council initiative

    OpenAIRE

    Hennessy, Thomas W; Bressler, Jonathan M.

    2016-01-01

    Important health disparities have been documented among the peoples of the Arctic and subarctic, including those related to limited access to in-home improved drinking water and sanitation services. Although improving water, sanitation and hygiene (WASH) has been a focus of the United Nations for decades, the Arctic region has received little attention in this regard. A growing body of evidence highlights inequalities across the region for the availability of in-home drinking WASH services an...

  11. Cardiovascular Health Outcomes of Latinos in the Affordable Housing as an Obesity Mediating Environment (AHOME) Study: A Study of Rental Assistance Use

    OpenAIRE

    Chambers, Earle C.; Rosenbaum, Emily

    2013-01-01

    Studies have shown that households subsidized with vouchers live in higher quality units and exhibit fewer physical, mental, and social problems than do their peers living in public housing. However, none of these studies have included cardiovascular outcomes. The objective of this study was to assess if use/type of rental assistance is independently associated with poor cardiovascular health among Latino adults (ages ≥18) who are eligible for federal low-income rental assistance and living i...

  12. Affordable Access to Space (AAS): Affordable Vehicle Avionics Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Affordable Vehicle Avionics (AVA) is being developed at NASA Ames Research Center and is sponsored by Space Technology Mission Directorate (STMD) Game Changing...

  13. Small firm self-insurance under the Affordable Care Act.

    Science.gov (United States)

    Buettgens, Matthew; Blumberg, Linda J

    2012-11-01

    The Affordable Care Act changes the small-group insurance market substan­tially beginning in 2014, but most changes do not apply to self-insured plans. This exemp­tion provides an opening for small employers with healthier workers to avoid broader sharing of health care risk, isolating higher-cost groups in the fully insured market. Private stop-loss or reinsurance plans can mediate the risk of self-insurance for small employ­ers, facilitating the decision to self-insure. We simulate small-employer coverage decisions under the law and find that low-risk stop-loss policies lead to higher premiums in the fully insured small-group market. Average single premiums would be up to 25 percent higher, if stop-loss insurance with no additional risk to employers than fully insuring is allowed--an option available in most states absent further government action. Regulation of stop-loss at the federal or state level can, however, prevent such adverse selection and increase stabil­ity in small-group insurance coverage. PMID:23214183

  14. [For a coordination of the supportive care for people affected by severe illnesses: proposition of organization in the public and private health care centres].

    Science.gov (United States)

    Krakowski, Ivan; Boureau, François; Bugat, Roland; Chassignol, Laurent; Colombat, Philippe; Copel, Laure; d'Hérouville, Daniel; Filbet, Marylène; Laurent, Bernard; Memran, Nadine; Meynadier, Jacques; Parmentier, Gérard; Poulain, Philippe; Saltel, Pierre; Serin, Daniel; Wagner, Jean-Philippe

    2004-05-01

    The concept of continuous and global care is acknowledged today by all as inherent to modern medicine. A working group gathered to propose models for the coordination of supportive care for all severe illnesses in the various private and public health care centres. The supportive care are defined as: "all care and supports necessary for ill people, at the same time as specific treatments, along all severe illnesses". This definition is inspired by that of "supportive care" given in 1990 by the MASCC (Multinational Association for Supportive Care in Cancer): "The total medical, nursing and psychosocial help which the patients need besides the specific treatment". It integrates as much the field of cure with possible after-effects as that of palliative care, the definition of which is clarified (initial and terminal palliative phases). Such a coordination is justified by the pluridisciplinarity and hyperspecialisation of the professionals, by a poor communication between the teams, by the administrative difficulties encountered by the teams participating in the supportive care. The working group insists on the fact that the supportive care is not a new speciality. He proposes the creation of units. departments or pole of responsibility of supportive care with a "basic coordination" involving the activities of chronic pain, palliative care, psycho-oncology, and social care. This coordination can be extended, according to the "history" and missions of health care centres. Service done with the implementation of a "unique counter" for the patients and the teams is an important point. The structure has to comply with the terms and conditions of contract (Consultation, Unit or Centre of chronic pain, structures of palliative care, of psycho-oncology, of nutrition, of social care). A common technical organization is one of the interests. The structure has to set up strong links with the private practitioners, the networks, the home medical care (HAD) and the nurses

  15. A protocol for developing an evaluation framework for an academic and private-sector partnership to assess the impact of major food and beverage companies’ investments in community health in the United States

    OpenAIRE

    Huang, Terry T-K; Ferris, Emily; Crossley, Rachel; Guillermin, Michelle; Costa, Sergio; Cawley, John

    2015-01-01

    Public health leaders increasingly recognize the importance of multi-sector partnerships and systems approaches to address obesity. Public-private partnerships (PPP), which are joint ventures between government agencies and private sector entities, may help facilitate this process, but need to be delivered through comprehensive, transparent frameworks to maximize potential benefits and minimize potential risks for all partners. The City University of New York (CUNY) School of Public Health an...

  16. Housing Affordability Data System (HADS)

    Data.gov (United States)

    Department of Housing and Urban Development — The Housing Affordability Data System (HADS) is a set of files derived from the 1985 and later national American Housing Survey (AHS) and the 2002 and later Metro...

  17. Partnerships for affordable and equitable disaster insurance

    Science.gov (United States)

    Mysiak, J.; Pérez-Blanco, C. D.

    2015-08-01

    Extreme events are becoming more frequent and intense, inflating the economic damages and social hardship set-off by natural catastrophes. Amidst budgetary cuts, there is a growing concern on societies' ability to design solvent disaster recovery strategies, while addressing equity and affordability concerns. The participation of private sector along with public one through Public-Private Partnerships (PPPs) has gained on importance as a means to address these seemingly conflicting objectives through the provision of (catastrophic) natural hazard insurance. This is the case of many OECD countries, notably some EU Member States such as the United Kingdom and Spain. The EU legislator has adapted to this new scenario and recently produced major reforms in the legislation and regulation that govern the framework in which PPPs for (catastrophic) natural hazard insurance develop. This paper has a dual objective: (1) review the complex legal background that rules the provision of insurance against natural catastrophes in the EU after these major reforms, (2) assess the implications of the reforms and offer concise Policy Guiding Principles.

  18. Limited analytical capacity for cyanotoxins in developing countries may hide serious environmental health problems: simple and affordable methods may be the answer.

    Science.gov (United States)

    Pírez, Macarena; Gonzalez-Sapienza, Gualberto; Sienra, Daniel; Ferrari, Graciela; Last, Michael; Last, Jerold A; Brena, Beatriz M

    2013-01-15

    In recent years, the international demand for commodities has prompted enormous growth in agriculture in most South American countries. Due to intensive use of fertilizers, cyanobacterial blooms have become a recurrent phenomenon throughout the continent, but their potential health risk remains largely unknown due to the lack of analytical capacity. In this paper we report the main results and conclusions of more than five years of systematic monitoring of cyanobacterial blooms in 20 beaches of Montevideo, Uruguay, on the Rio de la Plata, the fifth largest basin in the world. A locally developed microcystin ELISA was used to establish a sustainable monitoring program that revealed seasonal peaks of extremely high toxicity, more than one-thousand-fold greater than the WHO limit for recreational water. Comparison with cyanobacterial cell counts and chlorophyll-a determination, two commonly used parameters for indirect estimation of toxicity, showed that such indicators can be highly misleading. On the other hand, the accumulated experience led to the definition of a simple criterion for visual classification of blooms, that can be used by trained lifeguards and technicians to take rapid on-site decisions on beach management. The simple and low cost approach is broadly applicable to risk assessment and risk management in developing countries. PMID:23220602

  19. The need for absolute truth and self-rumination as basic suppressors in the relationship between private self-consciousness and mental health.

    Science.gov (United States)

    Şimşek, Ömer Faruk; Ceylandağ, Aylin Ecem; Akcan, Gizem

    2013-01-01

    Self-reflection has not so far been shown to have any specific benefits for mental health except for self-knowledge. Recent research showed that the controversy concerning the relationship between self-reflection and mental health could completely be eliminated if self-rumination and the need for absolute truth, especially the need for absolute truth, were considered as suppressor variables. This research replicated these findings in a different sample and expanded these findings by showing that the same is true for private self-consciousness. The need for absolute truth as a new variable was shown to be highly important in understanding the effects of self-consciousness on mental health. PMID:24837822

  20. How shall we examine and learn about public-private partnerships (PPPs) in the health sector? Realist evaluation of PPPs in Hong Kong.

    Science.gov (United States)

    Wong, Eliza L Y; Yeoh, Eng-Kiong; Chau, Patsy Y K; Yam, Carrie H K; Cheung, Annie W L; Fung, Hong

    2015-12-01

    The World Health Organization advocates the goal of universal coverage of health systems to ensure that everyone can avail the services they need and are protected from the associated financial risks. Governments are increasingly engaging and interacting with the private sector in initiatives collectively referred to as public-private partnerships (PPPs) to enhance the capacity of health systems to meet this objective. Understanding the values that motivate partners and demonstrating commitment for building relationships were found to be key lessons in building effective PPPs; however there, remain many research gaps. This study focusses on the practice of PPPs at the inter-organisational (meso) level and interpersonal (micro) level in Hong Kong Special Administrative Region (HKSAR). The influence of the structural components of different PPPs on stakeholder interpretation and actions, as well as the eventual outcomes of the PPPs, is examined, in terms of a realist evaluation, which applies a context-mechanism-outcome configuration as the research methodology. Seven key factors initiating commitment in a partnership, critical for sustainable PPPs, were identified as follows: (1) building of trust; (2) clearly defined objectives and roles; (3) time commitment; (4) transparency and candid information, particularly in relation to risk and benefit; (5) contract flexibility; (6) technical assistance or financial incentive behind procedural arrangements; and (7) the awareness and acceptability of structural changes related to responsibility and decisions (power and authority). PMID:26605970

  1. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approache...... a medical simulation. Based on these empirical studies, this paper introduces and discusses the concept of collaborative affordances, which describes a set of properties of the medical record that foster collaborative collocated work....

  2. An affordable humanitarian mine detector

    Science.gov (United States)

    Daniels, David J.; Curtis, Paul; Amin, Rajan; Dittmer, Jon

    2004-09-01

    This paper describes the further development of the MINETECT affordable humanitarian mine detector produced by ERA Technology with sponsorship from the UK Department for International Development. Using a radically different patented approach from conventional ground penetrating radar (GPR) designs in terms of the man machine interface, MINETECT offers simplicity of use and affordability, both key factors in humanitarian demining operations. Following trials in 2002 and reported at SPIE 2002, further development work including research on classifying mines, based on data from planned trials in the United Kingdom, is presented. MINETECT has the capability of detecting completely non-metallic mines and offers a considerable improvement in hand-held mine detection.

  3. Determinantes na escolha entre atendimento de saúde privada e pública por idosos Determinants of elders' choice between private and public health care providers

    Directory of Open Access Journals (Sweden)

    Antônio M G Bós

    2004-02-01

    Full Text Available OBJETIVO: Idosos usam a rede pública ou privada de atendimento de saúde de acordo com a sua situação econômica, social, demográfica e epidemiológica. Analisar como esses fatores influenciam a escolha do local de atendimento e comparar o impacto das rendas individual e familiar do idoso nessa decisão são os objetivos do estudo. MÉTODOS: Foram utilizados dados de um estudo realizado pelo Conselho Estadual do Idoso do Rio Grande do Sul, em 1995, com 7.920 idosos, com idade acima de 60 anos. A coleta de dados foi feito mediante questionário que incluía questões sobre influência do gênero, idade, escolaridade, renda individual e familiar, tamanho da família, participação na renda familiar e auto-avaliação da saúde do idoso. As chances de uso da rede privada de atendimento de saúde foi medida pela regressão logística. RESULTADOS: No acesso à rede privada de atendimento a renda familiar do idoso teve um impacto muito mais expressivo do que a individual. Com um aumento na renda familiar em um salário mínimo, as chances do idoso utilizar a rede privada aumentam 20% contra um acréscimo de apenas 7% no mesmo aumento na renda individual. Também influenciaram positivamente: gênero feminino, idade, escolaridade e tamanho menor da família. CONCLUSÕES: As decisões sobre onde o idoso recebe cuidados de saúde dependem das necessidades e recursos da família e não somente da situação individual do idoso. Conseqüentemente, a saúde do idoso de família de renda baixa recebe prioridade menor e é desproporcionalmente prejudicada pelo pouco recurso familiar e deficiências do sistema público de atendimento.OBJECTIVE: Elderly choose between utilizing private or public health care providers based on their socioeconomic, demographic, and epidemiological condition. The purposes of this study was to evaluate how these factors affect the choice of health care provider and to compare the impact of their choice on individual and family

  4. The perceptions of the Department of Education with regard to the health and well-being of farm schools/schools on private property in the Free State / by Vincent Taole Semela

    OpenAIRE

    Semela, Vincent Taole

    2010-01-01

    This study focuses on improving the provision of education, effective teaching and learning at farm schools or schools on private property through health promotion. Comprehensive school health education has received significant visibility through numerous national, state and local authorities. Healthy People (2000), makes a nationwide commitment to health promotion and disease prevention, which includes objectives that fall within the framework of comprehensive schools' health promotion. ...

  5. Operating private hospitals in Mexico.

    Science.gov (United States)

    Barcie, Joseph S

    2015-01-01

    Mexico is one of the richest countries in Latin America and over the last several decades there have been many changes in the healthcare delivery systems, from universal healthcare coverage for all Mexicans to the fast paced expansion of private healthcare. Like many countries, Mexico has both private and public health systems and hospital administrators are facing challenges on multiple fronts in addition to facing exciting new opportunities. In this article you will get a bird's eye view of this ever changing panorama. How the new growing middle class consumerism has impacted physicians, health insurance and private healthcare industry. PMID:26521381

  6. Malaysian Affordability Housing Policies Revisited

    Directory of Open Access Journals (Sweden)

    Samad Diwa

    2016-01-01

    Full Text Available Housing has always been a significant aspiration of family expression and distinctly priciest investment by household. It plays a momentous role in the country’s economy and so central to the societal well-being that is emplaced in the United Nation Universal declaration of Human rights. Yet in developed and developing world alike, cities struggle to provide decent housing for lower and middle income population. The provision of affordable housing is a major policy concern around the world with Malaysia being no exception; rising income hardly keep pace with price hike of housing unit and housing interventions has majorly concentrated on demand side leading to a non-responsive supply sector. Therefore, this paper highlights affordable housing issues pertaining Malaysia. It formulates Malaysian Map of affordability and conducts an evaluation of global housing schemes to better identify policy priorities for Malaysia. It’s significant to harmonize supply and demand side factors in the housing market to ensure that housing supply fits the needs of citizens based on the location, price and target group. In case of Malaysia supply oriented initiative are of urgency in short and medium run. This must be supported by long term demand side schemes in parallel. Convergence of these two factors is essential for a balanced equilibrium and obtaining affordability.

  7. Neoliberal Justice and the Transformation of the Moral: The Privatization of the Right to Health Care in Colombia.

    Science.gov (United States)

    Abadía-Barrero, César Ernesto

    2016-03-01

    Neoliberal reforms have transformed the legislative scope and everyday dynamics around the right to health care from welfare state social contracts to insurance markets administered by transnational financial capital. This article presents experiences of health care-seeking treatment, judicial rulings about the right to health care, and market-based health care legislation in Colombia. When insurance companies deny services, citizens petition the judiciary to issue a writ affirming their right to health care. The judiciary evaluates the finances of all relevant parties to rule whether a service should be provided and who should be responsible for the costs. A 2011 law claimed that citizens who demand, physicians who prescribe, and judges who grant uncovered services use the system's limited economic resources and undermine the state's capacity to expand coverage to the poor. This article shows how the consolidation of neoliberal ideology in health care requires the transformation of moral values around life. PMID:25335474

  8. Health-care-seeking patterns in the emerging private sector in Burkina Faso: a population-based study of urban adult residents in Ouagadougou.

    Directory of Open Access Journals (Sweden)

    Idrissa Beogo

    Full Text Available BACKGROUND: The private medical care sector is expanding in urban cities in Sub-Saharan Africa (SSA. However, people's health-care-seeking behaviors in this new landscape remain poorly understood; furthermore, distinguishing between public and private providers and among various types of private providers is critical in this investigation. This study assessed, by type, the healthcare providers urban residents in Burkina Faso visit, and their choice determinants. METHOD: We conducted a population-based survey of a representative sample of 1,600 households in Ouagadougou from July to November 2011, consisting of 5,820 adults. We assessed the types of providers people typically sought for severe and non-severe conditions. We applied generalized estimating equations in this study. RESULTS: Among those surveyed, 97.7% and 53.1% indicated that they seek a formal provider for treating severe and non-severe conditions, respectively. Among the formal provider seekers, 20.5% and 17.0% chose for-profit (FP providers for treating severe and non-severe conditions, respectively. Insurance coverage was held by 2.0% of those surveyed. Possessing insurance was the strongest predictor for seeking FP, for both severe (odds ratio [OR]  = 1.15, 95% confidence interval [CI] = 1.04-1.28, and non-severe conditions (OR = 1.22, 95% CI = 1.07-1.39. Other predictors included being a formal jobholder and holding a higher level education. By contrast, we observed no significant difference in predisposing, enabling, or need characteristics between not-for-profit (NFP provider seekers and public provider seekers. Proximity was the primary reason for choosing a provider. CONCLUSION: The results suggested that FP providers play a crucial role in the urban healthcare market in SSA. Socioeconomic status and insurance status are significant predictors of provider choice. The findings can serve as a crucial reference for policymakers in response to the emergence of FP providers

  9. Behavioral differences between public and private not-for-profit hospitals in the Italian National Health Service.

    Science.gov (United States)

    Barbetta, Gian Paolo; Turati, Gilberto; Zago, Angelo M

    2007-01-01

    In this paper we attempt to identify behavioral differences between public and private not-for-profit hospitals, by exploiting the introduction of the DRG-based payment system in the Italian NHS during the second half of the 1990s. We estimate the technical efficiency of a sample of hospitals for the period 1995-2000 considering an output distance function, and adopting both parametric (COLS and SF) and nonparametric (DEA) approaches. Our results show a convergence of mean efficiency scores between not-for-profit and public hospitals, and seem to suggest that differences in economic performances between competing ownership forms are more the result of the institutional settings in which they operate than the effect of the incentive structures embedded in the different proprietary forms. We also observe a decline in technical efficiency, probably due to policies aimed at reducing hospitalization rates. PMID:16929498

  10. Mercury exposure in the work place and human health: dental amalgam use in dentistry at dental teaching institutions and private dental clinics in selected cities of Pakistan.

    Science.gov (United States)

    Khwaja, Mahmood A; Nawaz, Sadaf; Ali, Saeed Waqar

    2016-03-01

    During the past two decades, mercury has come under increasing scrutiny with regard to its safety both in the general population and in occupationally exposed groups. It's a growing issue of global concern because of its adverse environmental and health impacts. Very few investigations on mercury amalgam use in the dentistry sector have been carried out in South Asia and there is little data reported on mercury contamination of indoor/outdoor air at dental sites. According to an earlier SDPI study, reported in 2013, alarmingly high mercury levels were observed in air (indoor as well as outdoor) at 11 of the 34 visited dental sites (17 dental teaching institutions, 7 general hospitals & 10 dental clinics) in five main cities of Pakistan. 88% of the sites indicated indoor mercury levels in air above the USA EPA reference level of 300 ng/m3. According to our study, carried out at 38 dental teaching institutions in 12 main cities (in Khyber Pakhtunkhwa, Punjab and Sindh provinces) of Pakistan, respondents were of the opinion that the currently offered BDS curriculum does not effectively guide outgoing dental professionals and does not provide them adequate knowledge and training about mercury/mercury amalgam and other mercury related human health and mercury waste issues. 90% of respondents supported the review and revision of the present dental curriculum offered at dental teaching institutions in the country, at the earliest. A study has also been conducted to assess the status of mercury amalgam use in private dental clinics in Gilgit, Hunza, Peshawar, Rawalpindi and Islamabad. More than 90 private dental clinics were visited and dental professionals/private clinics in-charge were interviewed during June-July, 2015. The focus areas of the study were Hg amalgam toxicity, its waste management practices and safety measures practiced among the dental practitioners. In the light of the findings described and discussed in this brief report, to safeguard public health and

  11. Situation analysis of health care waste management in private sector hospitals in federal capital territory, islamabad, pakistan

    International Nuclear Information System (INIS)

    The deleterious and harmful effects of hospital waste on environment and human health is well documented in Pakistan. The hospital waste that may be produced as a result of patient care in hospitals, clinical settings including the diagnostic laboratories is one of the potential health hazards. It significantly contributes to the transfusion transmitted diseases and ever increasing incidence of HBV, HCV and HIV. (author)

  12. Optics learning through affordable kit

    Science.gov (United States)

    P, Anusha N.; Shaji, Chitra; Sharan, Alok

    2014-10-01

    An affordable kit which helps to understand some of the optical phenomena qualitatively and quantitatively is presented in this paper. It supplements optics taught in classes. The kit consists of equipments which are available in the market at nominal cost such as laser pointer, lenses, glass plates, razor blades, coins, ball bearing etc. Experiments which come under wave optics (interference and diffraction) and ray optics (reflection and refraction) are explained using this kit.

  13. Optics learning through affordable kit

    International Nuclear Information System (INIS)

    An affordable kit which helps to understand some of the optical phenomena qualitatively and quantitatively is presented in this paper. It supplements optics taught in classes. The kit consists of equipments which are available in the market at nominal cost such as laser pointer, lenses, glass plates, razor blades, coins, ball bearing etc. Experiments which come under wave optics (interference and diffraction) and ray optics (reflection and refraction) are explained using this kit

  14. Optics learning through affordable kit

    Energy Technology Data Exchange (ETDEWEB)

    P, Anusha N, E-mail: anushnp@gmail.com, E-mail: chitrashaji@gmail.com, E-mail: aloksharan@gmail.com; Shaji, Chitra, E-mail: anushnp@gmail.com, E-mail: chitrashaji@gmail.com, E-mail: aloksharan@gmail.com; Sharan, Alok, E-mail: anushnp@gmail.com, E-mail: chitrashaji@gmail.com, E-mail: aloksharan@gmail.com [Department of Physics, Pondicherry University, Puducherry-605014 (India)

    2014-10-15

    An affordable kit which helps to understand some of the optical phenomena qualitatively and quantitatively is presented in this paper. It supplements optics taught in classes. The kit consists of equipments which are available in the market at nominal cost such as laser pointer, lenses, glass plates, razor blades, coins, ball bearing etc. Experiments which come under wave optics (interference and diffraction) and ray optics (reflection and refraction) are explained using this kit.

  15. The Patient Protection and Affordable Care Act: the victory of unorthodox lawmaking.

    Science.gov (United States)

    Beaussier, Anne-Laure

    2012-10-01

    The 2010 Patient Protection and Affordable Care Act was a major legislative achievement of the 111th Congress. This law structurally reforms the US health care system by encouraging universal health care coverage through regulated competition among private insurance companies. When looking at the process for reform, what strikes an observer of US health care policy in the first place is that the Democratic majority was able to enact something in a political field characterized by strong resistance to change. This article builds on that observation. Arguments concentrate on the legislative process of the reform and support the idea that it may be partly explained by considering an evolution of US legislative institutions, mostly in the sense of a more centralized legislative process. Based on approximately one hundred semidirected interviews, I argue that the Democratic majority, building on lessons from both President Bill Clinton's health care reform attempt and the Republicans' strategy of using strong congressional leadership to pass social reforms, was able to overcome institutional constraints that have long prevented comprehensive change. A more centralized legislative process, which has been described as "unorthodox lawmaking," enabled the Democratic leadership to overcome multiple institutional and political veto players. PMID:22700946

  16. Promoting Prevention Through the Affordable Care Act: Workplace Wellness

    OpenAIRE

    Anderko, Laura; Roffenbender, Jason S.; Goetzel, Ron Z.; Millard, Francois; Wildenhaus, Kevin; DeSantis, Charles; Novelli, William

    2012-01-01

    Public health in the United States can be improved by building workplace “cultures of health” that support healthy lifestyles. The Affordable Care Act (ACA), which includes the Prevention and Public Health Fund, will support a new focus on prevention and wellness, offering opportunities to strengthen the public’s health through workplace wellness initiatives. This article describes the opportunity the ACA provides to improve worker wellness.

  17. Financial health and customer satisfaction in private health care providers in Brazil Desempenho financeiro e satisfação do consumidor das operadoras de saúde suplementar no Brasil

    Directory of Open Access Journals (Sweden)

    Rafael Felipe Schiozer

    2011-11-01

    Full Text Available This paper analyzes the relationship between the financial health and organizational form of private health care providers in Brazil. It also examines the major determinants of customer satisfaction associated with the provider's organ-izational form. An adjusted Altman's z-score is used as an indicator of financial health. A proxy variable based on customer complaints filed at the Brazilian National Agency for Supplementary Health is used as an indicator for customer satisfaction. The study uses a sample of 270 private health care providers and their operations over the period 2003-2005. Panel data analysis includes control variables related to market, operations, and management. Principal results indicate that: (1 private health care providers benefit from economies of scale; (2 self-funded health plans have better financial health; (3 spending on marketing does not have a signif-icant impact on customer satisfaction in Brazil; (4 weak empirical evidence exists showing that good financial performance enhances customer's satisfaction.Este artigo analisa a situação financeira das operadoras de saúde suplementar no Brasil, de acordo com a modalidade de gestão. Adicionalmente, examina os principais determinantes para a satisfação do consumidor desses serviços. Como indicador principal de saúde financeira, utiliza-se uma versão adaptada do z-score de Altman. A proxy para satisfação do consumidor é o nível de reclamações fundamentadas registradas junto à Agência Nacional de Saúde Suplementar. Utilizamos uma amostra de 270 operadoras de saúde suplementar para o período 2003-2005, e regressões de dados em painel, com variáveis de controle de mercado, operacionais e de gestão. Os resultados principais indicam que (1 as operadoras de saúde se beneficiam de economias de escala; (2 as empresas que operam no modelo de autogestão têm situação financeira melhor que as demais; (3 as despesas com marketing não impactam a satisfa

  18. [Health promotion and wellness programs in private corporate organizations. Problems of trans-national and trans-cultural transferability].

    Science.gov (United States)

    Fidler, A H; Calkins, D R; Fuentes, E G

    1992-09-01

    Health promotion and wellness programmes in corporate organisations are subjects of considerable interest to both the providers (companies) and the consumers (employees). Economic considerations constitute a significant factor in businesses' interest in adopting health promotion programmes and in the wellness communities attempts to sell such programming to business. Substantial elements of both the business and wellness communities believe that health promotion programmes are financially profitable in addition to, and as a result of, improving employee's health. A fact which has not yet attracted significant research activities is a comparative analysis of corporate health promotion and wellness programmes in different societies with different cultural backgrounds, corporate cultures and external environments. Especially the emerging of a "New Europe" after the full realisation of the Common Market (EC) after 1992 and the tremendous economic possibilities after substantial political changes in the political structure of the eastern part of Europe (on its way to capitalism) might make it worth to look into corporate wellness programs of European organisations and to discuss pros and cons after comparing them with the ones of their American counterparts. Most important facts in which US organisations differ from most European corporations are not only the internal corporate culture but also the external environment, such as direct government interventions and political pressure from the consumer interest groups (strong unions). In many European countries the government imposes a very tight regulatory and legal framework and dictates the way corporate organisations have to share the burden of health related costs and have to provide occupational, wellness or preventive programmes for their employees.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1421833

  19. Fisiognomica emozionale. Affordances, estasi, atmosfere

    Directory of Open Access Journals (Sweden)

    Tonino Griffero

    2015-06-01

    Full Text Available Through an atmospherological approach, primarily inspired by the so-called Aisthetik or New Aesthetics (Gernot Böhme and the New Phenomenology (Hermann Schmitz, the paper defines the atmospheric perception as a first pathemic impression and investigates the relationship between this kind of perception and the expressive qualities of the surrounding spaces. The aim is to understand atmospheres as (amodal, transmodal, sinaesthetic affordances that permeate the lived space, namely as ‘ecological’ and affective invites or meanings which are ontologically rooted in things and quasi-things.

  20. Affordable Housing: An Economic Perspective

    OpenAIRE

    John F. McDonald

    2015-01-01

    The economist's approach to social problems has two interrelated parts, consistent measurement and use of a cost-benefit test to assess alternative policies. This essay examines both parts of the economist's method, primarily in the context of the United States but with attention paid to the United Kingdom also. It will seek to demonstrate that the problem of affordable housing can be measured and is large, even in the U. S. Furthermore, it will suggest that the problem primarily is one of po...

  1. The marriage of green and affordable

    OpenAIRE

    Trisha Miller

    2008-01-01

    Developers are beginning to apply green design to affordable housing. The budding practice has the potential to provide significant benefits to lower-income families, who pay proportionately more for energy and are disproportionately affected by poor air quality. This article discusses the case for uniting green and affordable and highlights the first national design and construction criteria for green affordable homes.

  2. Perceiving Affordances for Fitting through Apertures

    Science.gov (United States)

    Ishak, Shaziela; Adolph, Karen E.; Lin, Grace C.

    2008-01-01

    Affordances--possibilities for action--are constrained by the match between actors and their environments. For motor decisions to be adaptive, affordances must be detected accurately. Three experiments examined the correspondence between motor decisions and affordances as participants reached through apertures of varying size. A psychophysical…

  3. International migration of health professionals and the marketization and privatization of health education in India: from push-pull to global political economy.

    Science.gov (United States)

    Walton-Roberts, Margaret

    2015-01-01

    Health worker migration theories have tended to focus on labour market conditions as principal push or pull factors. The role of education systems in producing internationally oriented health workers has been less explored. In place of the traditional conceptual approaches to understanding health worker, especially nurse, migration, I advocate global political economy (GPE) as a perspective that can highlight how educational investment and global migration tendencies are increasing interlinked. The Indian case illustrates the globally oriented nature of health care training, and informs a broader understanding of both the process of health worker migration, and how it reflects wider marketization tendencies evident in India's education and health systems. The Indian case also demonstrates how the global orientation of education systems in source regions is increasingly central to comprehending the place of health workers in the global and Asian rise in migration. The paper concludes that Indian corporate health care training systems are increasingly aligned with the production of professionals orientated to globally integrated health human resource labour markets, and our conceptual analysis of such processes must effectively reflect these tendencies. PMID:25445935

  4. A literature review of the regional implementation of the central Swedish government's health care reforms on choice and privatization.

    Science.gov (United States)

    Ekman, Björn; Wilkens, Jens

    2015-12-01

    The introduction in 2010 of the Freedom of Choice Act represents one of the most far-reaching reforms of the Swedish health system. While it is mandatory for the regional counties to introduce choice plans for primary care it is voluntary for ambulatory specialist services. The voluntary nature of the regulations for the latter types of care generates a potential gap between the central government's reform attempts and the regional implementation of the plans. We review the regional implementation of this reform with respect to specialist services from a political economy perspective. Data on the scope of implementation show that counties of the same political ideology as the central government have introduced the most choice plans for specialist care. In particular, counties ruled by right-wing majorities have introduced the Choice Act to a considerably larger extent than left-wing counties. This creates a highly uneven situation across the various parts of the country, possibly at odds with the basic premises of the country's health law of equal access to care. The introduction of choice plans forms part of a decidedly contentious set of issues that are high on the political agenda of Sweden. The nature and impacts of these reforms are also a concern to the general public and the broader industry. Considerably more rigorous analyses will be needed to assess the impact on key policy parameters such as overall system efficiency and equitable access to services as a result of these changes to the health care markets. PMID:26650814

  5. MANAGING CUSTOMER RELATIONSHIPS IN PRIVATE HEALTH CARE FACILITIES - A STUDY WITH REFERENCE TO GREATER NOIDA CITY OF UTTAR PRADESH

    Directory of Open Access Journals (Sweden)

    Arun Kumar Panda

    2011-03-01

    Full Text Available Customer relationship management (CRM which has overriding significance for any business isno less significant for hospital services. Hospitals are most important elements in any health caredelivery system. A hospital plays a major role in maintaining and restoring the health of the people.Care of the sick and injured, preventive health care, health research, and training of medical andparamedical staff are general broad functions of a hospital. It involves to the outpatient and inpatienthospital services and on many occasions emergency medical services. An important resource in ahospital is a human resource. This should be particularly emphasized. This should be particularlyemphasized in the content of a hospital since relationship of medical staff plays important role intreating patients - the hospital customers. In health care, CRM practices are essentially patient -focused strategies that involve effective management of hospital interface and interaction withpatients. Effective CRM practices in a hospital may mean providing services related information toa patient very quickly. Responding to the patent appointment and an admission requests promptly,dealing with patient queries and complaints expeditiously, exercising all kinds of flexibilities inserving patients to the patients. This research paper made an attempt to analyze the factorsinfluencing the customers to select the hospital and to suggest better ways and means to retain thecustomers. For the study, the researcher has collected data from 200 respondents of 10 privatehospitals located in Greater Noida city. For this purpose stratified random sampling method was usedto select the samples. The present study highlights the extent of utilization of the hospital services bythe selected sample respondents. It also shed light on the common problems faced by therespondents. The major features of the service sectors especially on hospital performance is projectedin order to utilize the

  6. Affordable In-Space Transportation

    Science.gov (United States)

    Curtis, L. A.; VanDyke, M. K.; Lajoie, R. M.; Woodcock, G. R.

    1996-01-01

    Current and proposed launch systems will provide access to low-Earth orbit (LEO), and destinations beyond LEO, but the cost of delivering payloads will preclude the use of these services by many users. To develop and encourage revolutionary commercial utilization of geosynchronous orbit (GEO) and to provide an affordable means to continue NASA space science and exploration missions, the transportation costs to in-space destinations must be reduced. The principal objective of this study was to conceptually define three to four promising approaches to in-space transportation for delivery of satellites and other payloads, 3,000- to 10,000-lb class, to GEO destinations. This study established a methodology for evaluating in-space transportation systems based on life-cycle cost. The reusable concepts seemed to fare better in the evaluation than expendable, since a major driver in the life-cycle cost was the stage production cost.

  7. DEDUCTIBILITY OF CONTRIBUTIONS TO VOLUNTARY PRIVATE PENSIONS

    Directory of Open Access Journals (Sweden)

    LILIANA MUNTEAN

    2011-01-01

    Full Text Available The present paper approaches the notion of public and private pension in Romania. Pension can be seen in terms of a replacement income to individuals whose age no longer affords to operate in the labour market. Pension reform in Romania has allowed besides the public pension system, called Pillar I, which is a distributive system based on solidarity between generations also a private pension system that records the contributions of participants in individual accounts, based on capitalization, investment and accumulation of these contributions.

  8. Georgia’s Cancer Awareness and Education Campaign: Combining Public Health Models and Private Sector Communications Strategies

    Directory of Open Access Journals (Sweden)

    Demetrius M. Parker

    2004-07-01

    Full Text Available The Georgia Cancer Awareness and Education Campaign was launched in September 2002 with the goals of supporting cancer prevention and early detection efforts, heightening awareness of and understanding about the five leading cancers among Georgia residents, and enhancing awareness and education about the importance of proper nutrition, exercise, and healthy lifestyles. The inaugural year of the campaign is outlined, beginning with adherence to the public health principles of surveillance, risk factor identification, intervention evaluation, and implementation. A strategic and integrated communications campaign, using tactics such as paid advertising, public service announcements, local community relations, media releases, a documentary film, special events, and other components, is described in detail with links to multimedia samples. With an estimated budget of $3.1 million, the first year of the campaign focuses on breast and cervical cancer screening and early detection.

  9. Commercial Platforms Allow Affordable Space Research

    Science.gov (United States)

    2013-01-01

    At an altitude of about 240 miles, its orbital path carries it over 90 percent of the Earth s population. It circles the Earth in continuous free fall; its crew of six and one Robonaut pass the days, experiencing 16 sunrises and 16 sunsets every 24 hours, in microgravity, an environment in which everything from bodily functions to the physical behavior of materials changes drastically from what is common on the ground. Outside its shielded confines, temperatures cycle from one extreme to the other, radiation is rampant, and atomic oxygen corrodes everything it touches. A unique feat of engineering, the International Space Station (ISS) also represents the most remarkable platform for scientific research ever devised. In 2005, anticipating the space station s potential for NASA and non-NASA scientists alike, the NASA Authorization Act designated the US segment of the ISS as a national laboratory, instructing the Agency to "increase the utilization of the ISS by other Federal entities and the private sector." With the ISS set to maintain operations through at least 2020, the station offers an unprecedented long-term access to space conditions, enabling research not previously possible. "There will be new drug discoveries, new pharmaceuticals, a better understanding of how we affect the planet and how we can maintain it," says Marybeth Edeen, the ISS National Laboratory manager, based at Johnson Space Center. The ISS, she says, represents a major example of the government s role in making such advancements possible. "The government is key in that researchers cannot afford to build the kind of infrastructure that the government can provide. But we then have to make that infrastructure available at a reasonable cost." Enter Jeff Manber, who saw in the ISS National Lab an extraordinary opportunity to advance science, education, and business in ways never before seen.

  10. Access to paediatric essential medicines: a survey of prices, availability, affordability and price components in Shaanxi Province, China.

    Directory of Open Access Journals (Sweden)

    Xiao Wang

    Full Text Available OBJECTIVE: To evaluate the prices and availability of paediatric essential medicines in Shaanxi Province, China. METHODS: Price and availability data for 28 paediatric essential medicines were collected from 60 public hospitals and 60 retail pharmacies in six areas of Shaanxi Province using a standardised methodology developed by the World Health Organization and Health Action International, during November to December 2012. Affordability was measured as the number of days' wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. Data on medicine price components were collected from hospitals, wholesalers and distributors to obtain price mark-ups. FINDINGS: The mean availabilities of originator brands (OBs and lowest-priced generics (LPGs were 10.8% and 27.3% in the public hospitals and 11.9% and 20.6% in the private pharmacies. The public procurement and retail prices were 2.25 and 2.59 times the international reference prices (IRPs for three OBs, and 0.52 and 0.93 times for 20 LPGs. In the private sector, the final prices for OBs and LPGs were 3.89 and 1.25 times their IRPs. The final price in the private sector was 2.7% lower than in the public sector for OBs, and 14.1% higher for LPGs. Generally, standard treatments cost less than 1 day's wages in both sectors. Distribution mark-ups applied to brand salbutamol in Xi'an was 65.5%, and up to 185.3% for generic. Cumulative mark-ups for LPGs in Ankang were also high, from 33% to 50%. The manufacturer's selling price is the largest contributor to the final price in both areas. CONCLUSIONS: The government should approve a list of national paediatric essential medicines. The availability, price and affordability of these should be improved in both public hospitals and private pharmacies to enable children to obtain effective treatment. Measures should be taken to improve the efficiency of the centralised medicine purchasing system.

  11. Glosario crítico EN-ES de términos que figuran en la "Health Insurance Portability and Accountability Act (HIPAA", en la "Patient Protection and Affordable Care Act (PPACA" y en la legislación conexa en materia sanitaria de los Estados Unidos

    Directory of Open Access Journals (Sweden)

    Juan Manuel Martín Arias

    2012-12-01

    Full Text Available La "Health Insurance Portability and Accountability Act (HIPAA" y la "Patient Protection and Affordable Care Act (PPACA" son actualmente las dos leyes más importantes de los EE. UU. en materia de asistencia sanitaria. En este glosario crítico hemos recogido los términos de traducción difícil o engañosa que aparecen en estas dos leyes y en otras de menor importancia, que, juntas, constituyen el entramado jurídico-administrativo del sistema sanitario de los EE. UU. El glosario se ha elaborado desde la perspectiva de la traducción EN-ES, por lo que la elección de las entradas se ha basado no solo en su importancia legal-administrativa, sino también en su relevancia para el traductor. ----------------------------------------- An EN-ES critical glossary of terms that appear in the Health Insurance Portability and Accountability Act (HIPAA, the Patient Protection and Affordable Care Act (PPACA and related US health care legislation. The Health Insurance Portability and Accountability Act (HIPAA and the Patient Protection and Affordable Care Act (PPACA are currently the two most important health care laws in the United States. In this critical glossary, we have compiled terms from these two laws or from other, less important legislation that forms the legal and administrative framework of the United States healthcare system. The terms which appear here are those which translators may find difficult or misleading. This glossary has been created for EN-ES translation, so entries have been chosen not only for their legal and administrative importance, but also for their relevance for translators.

  12. California Community Colleges: Making Them Stronger and More Affordable. National Center Report #07-1

    Science.gov (United States)

    Zumeta, William; Frankle, Deborah

    2007-01-01

    This report highlights the affordability gaps faced by California's community colleges. Despite the lowest tuition in the country and tuition waivers for the lowest-income students, many California students struggle to afford the total cost of education, which includes housing, food, health care, and textbooks. And although California students are…

  13. Humanizing Oral Health Care through Continuing Education on Social Determinants of Health: Evaluative Case Study of a Canadian Private Dental Clinic.

    Science.gov (United States)

    Lévesque, Martine; Levine, Alissa; Bedos, Christophe

    2016-01-01

    Primary care practitioners are frequently unprepared to take into account the effects of social determinants on underprivileged patients' health and health management. To address this issue among dental professionals, an original onsite continuing education (CE) course on poverty was co-developed by researchers, dental professionals, and community organizations. Integrating patient narratives and a short film, course material aims to elicit critical reflection and provide coaching for practice improvements. A qualitative case study conducted with a large Montreal Canada dental team reveals CE course participants' newfound understandings and increased sensitivity to the causes of poverty and the nature of life on welfare. Participants also describe revised interpretations of certain patient behaviors, subtle changes in communication with patients and improved equity in appointment-giving policy. Unintended outcomes include reinforced judgment and a tendency to moralize certain patient categories. Implications for health professional educators, researchers, and dental regulatory authorities are discussed. PMID:27524746

  14. Can consumers make affordable care affordable? The value of choice architecture.

    Science.gov (United States)

    Johnson, Eric J; Hassin, Ran; Baker, Tom; Bajger, Allison T; Treuer, Galen

    2013-01-01

    Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a "smart" default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year. PMID:24367484

  15. Can consumers make affordable care affordable? The value of choice architecture.

    Directory of Open Access Journals (Sweden)

    Eric J Johnson

    Full Text Available Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a "smart" default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year.

  16. Grau de cobertura dos planos de saúde e distribuição regional do gasto público em saúde Level of private health insurance coverage and regional distribution of public health expenditure

    Directory of Open Access Journals (Sweden)

    Samuel Kilsztajn

    2001-12-01

    Full Text Available O artigo analisa o grau de cobertura dos planos de saúde segundo as classes de rendimento mensal familiar e por unidade da federação e a distribuição dos recursos da Rede-SUS e do gasto público total em saúde por usuário dos serviços públicos de saúde nas regiões Norte-Nordeste e Centro-Sul do país. São apresentados e discutidos também os indicadores do gasto público total em saúde como percentual do PIB gerado nas regiões.This paper analyses the level of private health insurance coverage by classes of income and by states in Brazil and the distribution of the total public health expenditure by public health users in the North-Northeast and Central-South regions of the country. The paper also presents and discusses the total public health expenditure as a percentage of regional GDP.

  17. Equity and the Sun Quality Health Private Provider Social Franchise: comparative analysis of patient survey data and a nationally representative TB prevalence survey

    Science.gov (United States)

    2013-01-01

    Introduction Since 2004, the Sun Quality Health (SQH) franchise network has provided TB care in Myanmar through a network of established private medical clinics. This study compares the wealth distribution of the TB patients to non-TB patients to determine if TB is most common among the poor, and compares the wealth of all TB patients to SQH TB patients to assess whether the franchise achieves its goal of serving the poor. Methods The study uses data from two sources: 1) Myanmar’s first nationally representative TB prevalence study conducted in 2009, and 2) client exit interviews from TB patients from SQH clinics. In total, 1,114 TB-positive individuals were included in the study, including 739 from the national sample and 375 from the SQH sample. Results TB patients at SQH clinics were poorer than TB-positive individuals in the overall population, though not at a statistically significant level (p > 0.05). After stratification we found that in urban areas, TB patients at SQH clinics were more likely to be in the poorest quartile compared to general TB positive population (16.8% vs. 8.6%, respectively; p  0.05). Conclusion Franchised clinics in Myanmar are reaching poor populations of TB patients in urban areas; more efforts are needed in order to reach the most vulnerable in rural areas. PMID:23305063

  18. Piloting the Affordable Medicines Facility-malaria: what will success look like?

    Science.gov (United States)

    Yamey, Gavin; Schäferhoff, Marco; Montagu, Dominic

    2012-06-01

    The Affordable Medicines Facility-malaria is an innovative financing mechanism, managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria. This initiative aims to increase the use of artemisinin-based combination therapies for treating malaria. A pilot is underway in eight countries to determine whether the mechanism reduces the consumer price of these drugs and increases their availability in public and private outlets, their market share and their use. To evaluate the pilot, an analysis was done to estimate predetermined "benchmarks" of success at 1 and 2 years. The analysis used a mixed-methods approach, triangulating data from a literature review with information from 33 interviews with experts. A sensitivity analysis and other methods were used to verify the results. Benchmarks used to determine success include an increase in availability of artemisinin-based combination therapies of 40 percentage points from baseline, and an increase in their use of 10-15 percentage points from baseline at year 2. These benchmarks were based on evidence that national public health programmes aimed at increasing the use of a specific health commodity in developing countries have generally achieved only modest changes in use within a 2-year time frame. Evaluation should also take individual country contexts into account. PMID:22690035

  19. Seamless health care for chronic diseases in a dual health care system: managed care and the role of family physicians.

    Science.gov (United States)

    Lee, A

    1998-01-01

    Neither private nor state run health care systems are perfect. Although there is increasing evidence that Health Maintenance Organizations (HMOs) provide comparable care at lower cost, HMOs tend to select healthy patients. The dual health care system in Hong Kong spends about 3.9 per cent of GDP, with health indices among the best in the world. Hong Kong still faces the problem of escalating health care expenditure. One should take advantage of the dual health care system to evolve a new paradigm for a primary-led seamless health care service. The Diabetes Centre of a university teaching hospital together with the University of Community and Family Medicine has started a structured shared care programme in diabetes mellitus, involving general practitioners in both the private and public sectors integrating the primary and secondary care, and the private and public sectors. This programme starts to develop an infrastructure for providing quality care at an affordable cost for a large pool of patients with chronic disease. Unlike other "managed care schemes", this one is not run by profit-oriented companies, but by health professionals with an interest in providing best possible care at an affordable cost. The "disease management" approach needs a care delivery system without traditional boundaries; and a continuous improvement process which develops and refines the knowledge base, guidelines and delivery system. PMID:10351265

  20. RESIDUAL INCOME MEASURE OF HOUSING AFFORDABILITY

    OpenAIRE

    Norazmawati Md. Sani

    2013-01-01

    Housing affordability is an indicator of householder’s ability to own a house. While residual income measure is a popular measurement of housing affordability. Every measurement has its own criteria and elements that make it different from another. The objective of this research is to examine the residual income measure of housing affordability as well as to examine the variables that affect low-cost homeownership amongst the low-income group in Kuala Lumpur. In order to measure the housing a...

  1. Are Marketplace Plans Affordable? Consumer Perspectives from the Commonwealth Fund Affordable Care Act Tracking Survey, March-May 2015.

    Science.gov (United States)

    Collins, Sara R; Gunja, Munira; Rasmussen, Petra W; Doty, Michelle M; Beutel, Sophie

    2015-09-01

    Most employers who provide health insurance to employees subsidize their premiums and provide a comprehensive benefit package. Before the Affordable Care Act, people who lacked health insurance through a job and purchased it on their own paid the full cost of their plans, which often came with skimpy benefit packages and high deductibles. Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March--May 2015, indicate that the law's tax credits have made premium costs in health plans sold through the marketplaces roughly comparable to employer plans, at least for people with low and moderate incomes. At higher incomes, the phase-out of the subsidies means that adults in marketplace plans have higher premium costs than those in employer plans. Overall, larger shares of adults in marketplace plans reported deductibles of $1,000 or more, compared with those in employer plans, though these differences were narrower among low-and moderate-income adults. PMID:26445739

  2. Dopamine, affordance and active inference.

    Directory of Open Access Journals (Sweden)

    Karl J Friston

    2012-01-01

    Full Text Available The role of dopamine in behaviour and decision-making is often cast in terms of reinforcement learning and optimal decision theory. Here, we present an alternative view that frames the physiology of dopamine in terms of Bayes-optimal behaviour. In this account, dopamine controls the precision or salience of (external or internal cues that engender action. In other words, dopamine balances bottom-up sensory information and top-down prior beliefs when making hierarchical inferences (predictions about cues that have affordance. In this paper, we focus on the consequences of changing tonic levels of dopamine firing using simulations of cued sequential movements. Crucially, the predictions driving movements are based upon a hierarchical generative model that infers the context in which movements are made. This means that we can confuse agents by changing the context (order in which cues are presented. These simulations provide a (Bayes-optimal model of contextual uncertainty and set switching that can be quantified in terms of behavioural and electrophysiological responses. Furthermore, one can simulate dopaminergic lesions (by changing the precision of prediction errors to produce pathological behaviours that are reminiscent of those seen in neurological disorders such as Parkinson's disease. We use these simulations to demonstrate how a single functional role for dopamine at the synaptic level can manifest in different ways at the behavioural level.

  3. Integrated Vehicle Health Management in the Automotive Industry

    OpenAIRE

    Holland, Steven

    2010-01-01

    The time has come to port integrated vehicle health management concepts originally pioneered in aerospace and other domains into the automotive industry. ï‚· The successful automotive manufacturer must remain highly customer-focused to ensure delivery of high value at an affordable price. ï‚· IVHM success will require partnering between the automotive manufacturer, its suppliers, as well as external technology providers located in private industry, academia and governmental labs ...on a globa...

  4. A protocol for developing an evaluation framework for an academic and private-sector partnership to assess the impact of major food and beverage companies' investments in community health in the United States.

    Science.gov (United States)

    Huang, Terry T-K; Ferris, Emily; Crossley, Rachel; Guillermin, Michelle; Costa, Sergio; Cawley, John

    2015-01-01

    Public health leaders increasingly recognize the importance of multi-sector partnerships and systems approaches to address obesity. Public-private partnerships (PPP), which are joint ventures between government agencies and private sector entities, may help facilitate this process, but need to be delivered through comprehensive, transparent frameworks to maximize potential benefits and minimize potential risks for all partners. The City University of New York (CUNY) School of Public Health and the Healthy Weight Commitment Foundation (HWCF) propose to engage in a unique academic-private-sector research partnership to evaluate the impact and effectiveness of the food and beverage industry's investment in obesity and hunger prevention and reduction through community-level healthful eating and active living programs. The CUNY-HWCF academic-private partnership protocol described here incorporates best practices from the literature on PPP into the partnership's design. The CUNY-HWCF partnership design demonstrates how established guidelines for partnership components will actively incorporate and promote the principles of successful PPPs identified in various research papers. These identified principles of successful PPP, including mutuality (a reciprocal relationship between entities), and equality among partners, recognition of partners' unique strengths and roles, alignment of resources and expertise toward a common cause, and coordination and delegation of responsibilities, will be embedded throughout the design of governance, management, funding, intellectual property and accountability structures. The CUNY-HWCF partnership responds to the call for increased multi-sector work in obesity prevention and control. This framework aims to promote transparency and the shared benefits of complementary expertise while minimizing shared risks and conflicts of interest. This framework serves as a template for future academic-private research partnerships. PMID:26417451

  5. Affordable Care Act and Women

    Science.gov (United States)

    ... Privacy Policy FOIA Plain Writing Act No Fear Act Disclaimers Viewers & Players Assistant Secretary for Planning and Evaluation, Room 415F U.S. Department of Health and Human Services 200 Independence Avenue, SW Washington, D.C. ...

  6. Food Affordability, 2006-2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — This table contains data on the average cost of a market basket of nutritious food items relative to income for female-headed households with children, for...

  7. [Adapting a private health care facility to the new Peruvian Public Health Sistem. Quality rating in a Middle Income Economy country].

    Science.gov (United States)

    Andrissi, Laura

    2015-01-01

    The aim of the study is the Assessment of Quality Sevices provided by a no-profit Medical Center in Peruvian Sierra, through an evidence-based decision-making process to identify infrastructure and capacity building interventions, to achieve accreditation and economic sustainability and increase competitiveness in the renewed Peruvian National Health System. The quali-quantitative collection of data shows how is fundamental an Healthcare Management focused on the responsiveness of services to the real needs and the local culture to reach the goals. PMID:26057174

  8. State trends in premiums and deductibles, 2003-2009: how building on the Affordable Care Act will help stem the tide of rising costs and eroding benefits.

    Science.gov (United States)

    Schoen, Cathy; Stremikis, Kristof; How, Sabrina K H; Collins, Sara R

    2010-12-01

    Rapidly rising health insurance costs have strained U.S. families and employers in recent years. This issue brief examines data for all states on changes in private employer premiums and deductibles for 2003 and 2009. The analysis finds that premiums for businesses and their employees increased 41 percent across states from 2003 to 2009, while per-person deductibles jumped 77 percent in large as well as small firms. If these trends continue at the rate prior to enactment of the Affordable Care Act, the average premium for family coverage will rise 79 percent by 2020, to more than $23,000. The authors describe how health reform offers the potential to reduce insurance cost growth while improving value and protection. If reforms succeed in slowing premium growth by 1 percentage point annually in all states, by 2020 employers and families together will save $2,323 annually for family coverage, compared with projected trends. PMID:21125770

  9. The concept of a structural affordance

    Directory of Open Access Journals (Sweden)

    Adrian Alsmith

    2012-12-01

    Full Text Available I provide an analysis of the concept of an “affordance” that enables one to conceive of “structural affordance” as a kind of affordance relation that might hold between an agent and its body. I then review research in the science of humanoid bodily movement to indicate the empirical reality of structural affordance.

  10. The concept of a structural affordance

    OpenAIRE

    Adrian Alsmith

    2012-01-01

    I provide an analysis of the concept of an “affordance” that enables one to conceive of “structural affordance” as a kind of affordance relation that might hold between an agent and its body. I then review research in the science of humanoid bodily movement to indicate the empirical reality of structural affordance.

  11. Section 8: Affordable Housing for Exceptional Families

    Science.gov (United States)

    Wright, Wesley E.

    2009-01-01

    Shelter is a basic human need. Unfortunately, affordable housing is a need that low income families who are caring for children and adults with disabilities can rarely afford without assistance. Because participating families generally pay rent of no more than 30 percent of their adjusted monthly income, the Section 8 program can provide…

  12. Private Equity Waves

    OpenAIRE

    Smit, Han; Berg, Ward

    2006-01-01

    textabstractThis study presents a dynamic model for the private equity market in which information revelation and uncertainty rationally explain the cyclical pattern of investment flows into private equity. The net benefit of private equity over public equity is i) uncertain and ii) agents have private information about the benefits of their investment. When these distinguishing characteristics determine investment behavior in private equity markets, rational investment waves may arise endoge...

  13. Private Equity Waves

    OpenAIRE

    2006-01-01

    This study presents a dynamic model for the private equity market in which information revelation and uncertainty rationally explain the cyclical pattern of investment flows into private equity. The net benefit of private equity over public equity is i) uncertain and ii) agents have private information about the benefits of their investment. When these distinguishing characteristics determine investment behavior in private equity markets, rational investment waves may arise endogenously. Inve...

  14. 78 FR 8456 - Coverage of Certain Preventive Services Under the Affordable Care Act

    Science.gov (United States)

    2013-02-06

    ...; states; secular organizations; private citizens; and women's rights and reproductive health advocacy...-Free Hotline at 1-866-444- EBSA (3272) or visit the Department of Labor's Web site ( www.dol.gov/ebsa ). In addition, information from HHS on private health insurance coverage can be found on CMS's Web...

  15. Small businesses and the Affordable Care Act of 2010.

    Science.gov (United States)

    Collins, Sara R; Davis, Karen; Nicholson, Jennifer L; Stremikis, Kristof

    2010-09-01

    The Patient Protection and Affordable Care Act (ACA) includes several short- and long-term provisions designed to help small businesses pay for and maintain health insurance for their workers, and to allow workers without employer coverage to gain access to affordable, comprehensive health insurance. Provisions include a small business tax credit to offset premium costs for firms that offer coverage starting this taxable year, establishment of state-based insurance exchanges that promise to lower administrative costs and pool risk more broadly, and creation of new market rules and an essential benefit standard to protect small firms and their workers. Analysis shows that up to 16.6 million workers are in firms that would be eligible for the tax credit in 2010 to 2013. Over the next 10 years, small businesses and organizations could receive an estimated $40 billion in federal support through the premium credit program. PMID:20812427

  16. [President Obama's health care reform: lessons to and from the Israeli health care system].

    Science.gov (United States)

    Balicer, Ran D; Shadmi, Efrat

    2011-08-01

    In March 2010 the United States enacted the most significant health care reform in several decades. The Patient Protection and Affordable Care Act, amongst other provisions, addresses two of the main current shortcomings of the U.S. health system: the large portion of the population that are uninsured and the high percentage of hsealth expenditures (mostly private] which amounts to about 16% of the GDP. Changes to the current structure and financing of the U.S. health system will have implications for other health systems, for science (e.g., through enhanced federal funding for comparative effectiveness research), and for technological advance (e.g., through accelerated development and use of electronic health records). There are several lessons from the reform, and the factors leading to its implementation, for the Israeli health system. Firstly, the basic principles of the Israeli health system are a source of pride, and undermining its main values can have deleterious effects. Overreliance on private, out-of-pocket, spending and lack of support for public practice of medicine (in community and hospital settings) will weaken the public sector, strengthen the private sector, and could result in a tiered lower quality and less accessible public system with greater widening of gaps in health and health care utilization. This paper reviews the main provisions of the U.S. health care reform and the potential implications for the IsraeLi health system. PMID:21939111

  17. Glosario crítico EN-ES de términos que figuran en la "Health Insurance Portability and Accountability Act (HIPAA)", en la "Patient Protection and Affordable Care Act (PPACA)" y en la legislación conexa en materia sanitaria de los Estados Unidos

    OpenAIRE

    Juan Manuel Martín Arias

    2012-01-01

    La "Health Insurance Portability and Accountability Act (HIPAA)" y la "Patient Protection and Affordable Care Act (PPACA)" son actualmente las dos leyes más importantes de los EE. UU. en materia de asistencia sanitaria. En este glosario crítico hemos recogido los términos de traducción difícil o engañosa que aparecen en estas dos leyes y en otras de menor importancia, que, juntas, constituyen el entramado jurídico-administrativo del sistema sanitario de los EE. UU. El glosario se ha elaborado...

  18. The Affordable Care Act and the Labor Market

    OpenAIRE

    Aaronson, Daniel; Lubotsky, Darren

    2014-01-01

    In 2010, Congress passed the Affordable Care Act (ACA), the largest expansion of health insurance since the advent of Medicaid and Medicare roughly a half century ago. Because the law is being phased in slowly and many provisions are still years away from being launched, the law’s impact on employment, wages, job mobility, retirement, self-employment, economic efficiency, and overall well-being remains contentious.

  19. Affordability Approaches for Human Space Exploration

    Science.gov (United States)

    Holladay, Jon; Smith, David Alan

    2012-01-01

    The design and development of historical NASA Programs (Apollo, Shuttle and International Space Station), have been based on pre-agreed missions which included specific pre-defined destinations (e.g., the Moon and low Earth orbit). Due to more constrained budget profiles, and the desire to have a more flexible architecture for Mission capture as it is affordable, NASA is working toward a set of Programs that are capability based, rather than mission and/or destination specific. This means designing for a performance capability that can be applied to a specific human exploration mission/destination later (sometime years later). This approach does support developing systems to flatter budgets over time, however, it also poses the challenge of how to accomplish this effectively while maintaining a trained workforce, extensive manufacturing, test and launch facilities, and ensuring mission success ranging from Low Earth Orbit to asteroid destinations. NASA Marshall Space Flight Center (MSFC) in support of Exploration Systems Directorate (ESD) in Washington, DC has been developing approaches to track affordability across multiple Programs. The first step is to ensure a common definition of affordability: the discipline to bear cost in meeting a budget with margin over the life of the program. The second step is to infuse responsibility and accountability for affordability into all levels of the implementing organization since affordability is no single person s job; it is everyone s job. The third step is to use existing data to identify common affordability elements organized by configuration (vehicle/facility), cost, schedule, and risk. The fourth step is to analyze and trend this affordability data using an affordability dashboard to provide status, measures, and trends for ESD and Program level of affordability tracking. This paper will provide examples of how regular application of this approach supports affordable and therefore sustainable human space exploration

  20. At the Crossroads: Hazard Assessment and Reduction of Health Risks from Arsenic in Private Well Waters of Northeastern United States and Atlantic Canada

    OpenAIRE

    Zheng, Yan; Ayotte, Joseph D.

    2014-01-01

    This special issue contains 12 papers that report on new understanding of arsenic hydrogeochemistry, performance of household well water treatment systems, and testing and treatment behaviors of well users in several states of the northeastern region of the United States and Nova Scotia, Canada. The responsibility to ensure water safety of private wells falls on well owners. In the U.S., 43 million Americans, mostly from rural areas, use private wells. In order to reduce As exposure in rural ...

  1. Public-Private Substitution Among Medicaid Adults...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Few adult Medicaid enrollees in Ohio voluntarily replace their private coverage with Medicaid. In 2008, only 2.9 percent of new Medicaid adults voluntarily...

  2. Private Solutions for Infrastructure in Cambodia : A Country Framework Report

    OpenAIRE

    Public-Private Infrastructure Advisory Facility

    2002-01-01

    Infrastructure plays a crucial role in supporting Cambodia's growth and development. Improving access to efficient and affordable water, electricity, transport, and telecommunications services has a major impact on the living standards of individual households. This Country Framework Report (CFR) is one of a series of country reviews aimed at improving the environment for the private secto...

  3. Health of women.

    Science.gov (United States)

    1997-01-01

    This article discusses the problems that women face in social, health, and nutritional areas in India. India's 135th ranking in the Human Development Index reflects the marginalization of women, the aged, the poor, the disabled, lower castes, and other neglected groups. The sex ratio has declined. Maternal mortality is high. 84% of rural women and 42% of urban women rely on untrained persons during childbirth. The systems of education, religion, health care, law, employment, and the mass media promote gender discrimination. Patriarchal structures resist efforts to build a gendered perspective and to provide gender sensitivity within health care and development. Women experience deficits in educational development, rest, food, recreation, and freedom of movement and action. Girls lack sufficient breast feeding and health care from a health system that is 80% private. 40% of the population is poor and needs access to affordable health services. Inadequate diets and nutrition have long term health consequences. Women's health deteriorates due to early marriage and childbearing. Adequate nutrition is exacerbated by high food prices, limits in the Public Distribution System, and the shift to non-edible cash crops. The family planning program focuses on women, despite the prevailing belief that women are not in a position to make decisions. Responsible use of modern contraception requires adequate health infrastructure, personnel, and gender sensitivity. The new emphasis on reproductive health must address the issues of unsafe abortion, reproductive tract infections, women's domestic burden, violence, and mental health. PMID:12293894

  4. 76 FR 41929 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

    Science.gov (United States)

    2011-07-15

    ... E--Health Insurance Issuer Standards Related to the Transitional Reinsurance Program F. Subpart F... July 15, 2011 Part III Department of Health and Human Services 45 CFR Part 153 Patient Protection and... OF HEALTH AND HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care...

  5. "Out in the Rural: A Health Center in Mississippi"

    OpenAIRE

    Carolyn Chu

    2006-01-01

    Prior to the 1960s, most health care in the United States had been delivered privately to those who could afford it or administered via church-based “charity” systems to those who could not. When President Lyndon B. Johnson and the federal government declared a “war on poverty” via the Economic Opportunity Act of 1964, medical and civil rights activists seized the opportunity to create public health systems that could reduce disparities in wealth and health. At the time H. Jack Geiger was a y...

  6. Quantitative analysis of privatization

    CERN Document Server

    Vahabi, M

    2008-01-01

    In recent years, the economic policy of privatization, which is defined as the transfer of property or responsibility from public sector to private sector, is one of the global phenomenon that increases use of markets to allocate resources. One important motivation for privatization is to help develop factor and product markets, as well as security markets. Progress in privatization is correlated with improvements in perceived political and investment risk. Many emerging countries have gradually reduced their political risks during the course of sustained privatization. In fact, most risk resolution seems to take place as privatization proceeds to its later stage. Alternative benefits of privatization are improved risk sharing and increased liquidity and activity of the market. One of the main methods to develop privatization is entering a new stock to the markets for arising competition. However, attention to the capability of the markets to accept a new stock is substantial. Without considering the above st...

  7. Private Water Districts

    Data.gov (United States)

    California Department of Resources — Private Water District boundaries are areas where private contracts provide water to the district in California. This database is designed as a regions polygon...

  8. Smoking Bans in Affordable Housing Benefit All

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160501.html Smoking Bans in Affordable Housing Benefit All: Study Secondhand exposure ... researchers found. At properties with only indoor smoking bans, there was actually an increase in outdoor secondhand ...

  9. Private Equity Business Model

    OpenAIRE

    Miškovič, Branislav

    2008-01-01

    The aim of this bachelors' thesis is to introduce a private equity business model. Private equity investments are a growing segment of the market with high potential returns to the investors. The thesis contains introduction to the forms of private equity investments, the methods used based on the stage of the investee company. It also describes the profit making process and characterizes European and US private equity markets. At the very end it briefly talks about valuation methodology in p...

  10. Private opportunity, public benefit?

    OpenAIRE

    John Hall

    1998-01-01

    The newly elected Labour government has pledged to ‘reinvigorate the Private Finance Initiative’, as part of the new emphasis on ‘public/private partnerships’ in the delivery of core public services. This article assesses the merits of using private finance to deliver public services against three criteria: whether it will lead to additional investment in social infrastructure, whether it represents good value for the taxpayer’s money and whether the use of private finance will reduce the pub...

  11. Privatization in Economic Theory

    OpenAIRE

    Drakić Maja

    2007-01-01

    In reality privatization has never occurred according to the handbook rules of ordinary market transactions. Not even in advanced market economies can privatization transactions be described by the Walrasian or Arrowian, or Leontiefian equilibrium models, or by the equilibrium models of the game theory. In these economies transactions of privatization take place in a fairly organic way – which means that those are driven by the dominance of private property rights and in a market economy. But...

  12. BANKING PRIVATIZATION IN TURKEY

    OpenAIRE

    Ersoy, İmre

    2015-01-01

    It seems impossible to drive a general rule concerning the outcomes of privatization that would be applicable to each country or sector. Privatization may lead to better use of resources but also to extraction of profit overseas and growing industrial concentration. Privatization of banking is more delicate an issue because of the potential to undermine confidence in the system. Moreover, there is the problem of obtaining data on bank privatization as public banks have always been an importan...

  13. Rethinking Affordable Housing Delivery: An Analytical Insight

    OpenAIRE

    Olanrewaju Abdullateef; Yeow Seong; Lim Lee

    2016-01-01

    Malaysia currently has a housing shortage of 12 million units. Towards the year 2020, this would require an annual supply of a minimum of 2 million homes. With the current production rate, the deficits will remain over the next 100 years. The crisis will lead to poor standards of living, un-affordable rental price, high mortgage payment, abandonment, and dilapidation of the existing housing stock. Lack of affordable housing is already a source of concern among many Malaysians. The middle and ...

  14. Understanding the adoption dynamics of medical innovations: affordances of the da Vinci robot in the Netherlands.

    Science.gov (United States)

    Abrishami, Payam; Boer, Albert; Horstman, Klasien

    2014-09-01

    This study explored the rather rapid adoption of a new surgical device - the da Vinci robot - in the Netherlands despite the high costs and its controversial clinical benefits. We used the concept 'affordances' as a conceptual-analytic tool to refer to the perceived promises, symbolic meanings, and utility values of an innovation constructed in the wider social context of use. This concept helps us empirically understand robot adoption. Data from 28 in-depth interviews with diverse purposively-sampled stakeholders, and from medical literature, policy documents, Health Technology Assessment reports, congress websites and patients' weblogs/forums between April 2009 and February 2014 were systematically analysed from the perspective of affordances. We distinguished five interrelated affordances of the robot that accounted for shaping and fulfilling its rapid adoption: 'characteristics-related' affordances such as smart nomenclature and novelty, symbolising high-tech clinical excellence; 'research-related' affordances offering medical-technical scientific excellence; 'entrepreneurship-related' affordances for performing better-than-the-competition; 'policy-related' affordances indicating the robot's liberalised provision and its reduced financial risks; and 'communication-related' affordances of the robot in shaping patients' choices and the public's expectations by resonating promising discourses while pushing uncertainties into the background. These affordances make the take-up and use of the da Vinci robot sound perfectly rational and inevitable. This Dutch case study demonstrates the fruitfulness of the affordances approach to empirically capturing the contextual dynamics of technology adoption in health care: exploring in-depth actors' interaction with the technology while considering the interpretative spaces created in situations of use. This approach can best elicit real-life value of innovations, values as defined through the eyes of (potential) users. PMID

  15. Motivational Affordance and Risk-Taking Across Decision Domains.

    Science.gov (United States)

    Zou, Xi; Scholer, Abigail A

    2016-03-01

    We propose a motivational affordance account to explain both stability and variability in risk-taking propensity in major decision domains. We draw on regulatory focus theory to differentiate two types of motivation (prevention, promotion) that play a key role in predicting risk-taking. Study 1 demonstrated that prevention motivation is negatively associated with risk-taking across six key decision domains, including health/safety, ethics, recreation, gambling, investment, and social. In contrast, promotion motivation is positively associated with risk-taking in the social and investment domains. Study 2 replicated the same pattern and provided direct evidence that promotion motivation is a strong predictor of risk-taking only in domains where there is true potential for gains. Study 3 manipulated promotion (vs. prevention) motivation experimentally to demonstrate that motivational affordance is a critical mechanism for understanding risk-taking behaviors. PMID:26802189

  16. Private Equity Spring

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    The first group of 50 private equity fund management in- stitutions reeeived their private equity fund lieenses in Mareh of 2014. The State Couneil later issued the Several Opinions on Further Promoting the Healthy Development of Capital Markets and initiated the important decision to "cultivate the private equity market."

  17. A FEW FOR-PROFIT BUSINESSES’ BATTLE OVER THE AFFORDABLE CARE ACT’S PREVENTATIVE SERVICES MANDATE

    Directory of Open Access Journals (Sweden)

    Leigh Argentieri Coogan

    2014-07-01

    Full Text Available Normal 0 false false false EN-US JA X-NONE Under the Patient Protection and Affordable Care Act (ACA, employers are required to provide employees with health plans, which must include FDA, approved contraceptives with no cost sharing. While Health and Humans Services (HHS revised the regulation to allow for a compromise among religious organizations and non-profits run by religious organizations, private for profit businesses must comply with the ACA even if the business asserts to be founded on religious principles. Several for profit business have sued in district court for an injunction against the requirements. However, a circuit split exists among courts granting preliminary injunctions against the ACA pending a granting of appeal. This note will focus on whether the federal government can compel secular, for profit organizations to provide employee health plans that include contraceptives, the morning after pill and sterilization under the Religious Freedom Restoration Act. Unless the statute or regulation changes, the Supreme Court will likely need to grant certiorari to resolve the issue.

  18. Discussion on sports teaching in private universities based on the concept of the health quotient%基于健商理念下的民办高校体育教学探讨

    Institute of Scientific and Technical Information of China (English)

    陈科全; 廖月荣

    2013-01-01

    In recent years, the private education of our country has obtained the fast development, and gradually become an important part of higher education system, however, private universities has not attracted enough attention to the sports teaching, teaching concept is lay behind, and social cohesion is fewer, is not conducive to a comprehensive training of physical and mental quality of college students and the sustainable development. This paper, based on the concept of health quotient and the necessity of introducing sports teaching in private colleges and universities, discusses the effective strategies of sports teaching in private universities under the concept of health quotient.%  近年来,我国的民办教育获得了快速的发展,并且逐渐成为高等教育体系的重要组成部分,然而民办高校对体育教学却并没有引起足够的重视,存在教学理念落后,与社会衔接较少等问题,不利于大学生身心素质的全面培养与可持续发展。对此,本文基于健商理念的概念及其在民办高校体育教学中引入的必要性分析,探讨了健商理念下民办高校体育教学的有效策略。

  19. Economic Public Private Partnerships for Development

    Science.gov (United States)

    Taylor, Thomas C.; Kistler, Walter P.; Citron, Bob

    2008-01-01

    Space transportation has evolved to entrepreneurs offering affordable transportation services to LEO. Society expects space tourism to produce low costs quickly, but entrepreneurs need the larger commercial transportation markets to raise the private money to build the orbital vehicles. Early heavy cargo is the logistics model of remote bases on Earth and is likely to be similar for off planet remote bases. Public Private Partnerships (PPP), (Norment, 2006) and other alliances with governments offer new transportation markets and combines private funding with government markets to accelerate the movement of mankind into space, (Kistler, 2004a). Entrepreneurs bring change like a multitude of innovation, changes to the traditional aerospace industry status quo, commercial market forces and the lowering of the cost of transportation to orbit. Within PPPs, government stretches space budgets, increases vehicle innovation without cost and gains cost advantages of larger markets. Examples of PPPs show some opportunity for change in space commerce is possible, (Stainback, 2000 and Spekman, 2000). Some of the items entrepreneurs bring include innovation in hardware, a maturing of the normal market forces such as the pressures from buyers and sellers rather than those from government planners or from regulation. Launch costs are high, society wants orbital hotels and current/future markets are not emerging because of high transportation costs. The paper proposes a new approach with examples, because mankind has taken a long time to transition from expendable launch vehicles to newer more affordable launch innovation and may require the introduction of new innovative approaches.

  20. Labor Redundancy, Retraining, and Outplacement during Privatization : The Experience of Brazil's Federal Railway

    OpenAIRE

    Estache, Antonio; Schmitt de Azevedo, Jose Antonio; Sydenstricker, Evelyn

    2000-01-01

    One of the most complex challenges of infrastructure privatization is its impact on employment. Often (but not always) private operators' main approach to cost-cutting is labor reduction. Private operators cannot afford the low levels of labor productivity typical in public companies if they are to be competitive and to deliver on their contractual obligations to provide cheaper, more reliable infrastructure services. But labor issues are so sensitive that government's early, direct involveme...

  1. Affordable care act: comparison of healthcare indicators among different insurance beneficiaries with new coverage eligibility

    OpenAIRE

    Hong, Young Rock; Holcomb, Derek; Bhandari, Michelyn; Larkin, Laurie

    2016-01-01

    Background Health coverage in the United States will be increased to nearly universal levels under the Affordable Care Act (ACA). In order to better understand the impact of the type of health insurance and health outcomes, there is a need to examine health disparities and inequalities between the insured and the uninsured based on their eligibility for coverage. Methods The current study used the data from the Medical Expenditure Panel Survey 2012 (MEPS). Selected health characteristics and ...

  2. Mechanism Research on Standardized Development of Rural Private Finance

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    In generalizing the researching conditions of researchers on private finance,the paper introduces the connoted meaning of rural private finance broadly and narrowly.The paper states the forms of rural private finance(including private loaning,private bank,rural private collecting,financing organizations,cooperatives,NGO,small loaning organizations and so on),the relations between rural private finance and rural economic relations,pointing out that it is the combination of the strong and the weak,which may generate benefits with the operation of marketing mechanisms.The paper analyzes the historical causes,supervision causes and cultural causes of rural private finance,discussing mechanisms of standardized development of rural private finance:firstly,standardize the organization management mechanisms,including scaled controlling mechanisms and bank management mechanisms;secondly,complete finance supervision mechanisms;thirdly,moderate government intervention,including affording liberal policy environment and reducing the improper intervention;fourthly,upgrading qualities mechanisms,including cultivating the rural credit culture and improving the quality of regulatory personnel.

  3. The political economy of healthcare reform in China: negotiating public and private.

    Science.gov (United States)

    Daemmrich, Arthur

    2013-01-01

    China's healthcare system is experiencing significant growth from expanded government-backed insurance, greater public-sector spending on hospitals, and the introduction of private insurance and for-profit clinics. An incremental reform process has sought to develop market incentives for medical innovation and liberalize physician compensation and hospital finance while continuing to keep basic care affordable to a large population that pays for many components of care out-of-pocket. Additional changes presently under consideration by policymakers are likely to further restructure insurance and the delivery of care and will alter competitive dynamics in major healthcare industries, notably pharmaceuticals, medical devices, and diagnostic testing. This article describes the institutional history of China's healthcare system and identifies dilemmas emerging as the country negotiates divisions between public and private in healthcare. Building on this analysis, the article considers opportunities for public-private partnerships and greater systems integration to reconcile otherwise incommensurable approaches to rewarding innovation and improving access. The article concludes with observations on the public function of health insurance and its significance to further development of China's healthcare system. PMID:24052932

  4. Food Access, Availability, and Affordability in 3 Los Angeles Communities, Project CAFE, 2004-2006

    OpenAIRE

    Vallianatos, Mark; Azuma, Andrea Misako; Gilliland, Susan; Gottlieb, Robert

    2010-01-01

    Introduction Racial/ethnic minority communities are at increasingly high risk for chronic diseases related to obesity. Access to stores that sell affordable, nutritious food is a prerequisite for adopting a healthful diet. The objective of this study was to evaluate food access, availability, and affordability in 3 nonoverlapping but similar low-income communities in urban Los Angeles, California. Methods Using a community-based participatory research approach, we trained community members to...

  5. 民办幼儿园园长心理健康状况及应对策略论析%Discussion and Analysis of Private Kindergarten Directors Mental Health Status and Countermeasures

    Institute of Scientific and Technical Information of China (English)

    黄俊官

    2012-01-01

    学前教育是基础教育的基础。随着我国民办学前教育发展以及竞争的加剧,民办幼儿园团长这一特殊群体心理问题日趋严重。本研究旨在通过问卷调查以及访谈法的方式调查研究民办园团长心理健康状况,探讨影响民办园园长心理健康的主要成因及应对策略。%Pre--school education is the foundation of elementary education As private pre--school education development in our country, as well as competition intensifies, private kindergarten directors" psychological problem is becoming more serious. This study,by means of a questionnaire and interview kindergarten directors,aims to explore the main causes affecting the private kindergarten, director mental health and countermeasures.

  6. Cavinkare Private Limited: Serving Low Income Consumers

    OpenAIRE

    Anand Kumar Jaiswal; Pingali Venugopal

    2008-01-01

    This case deals with the strategies adopted by CavinKare Private Limited to serve the low income consumers in India. Chik brand of CavinKare established its leadership in rural markets and emerged as the second largest selling shampoo brand. The factors contributing to the success of CavinKare were (a) keen understanding of rural markets, (b) focus on innovation, (c) development of affordable products, (d) low cost operations, and (e) extensive distribution and access. The study of CavinKare ...

  7. Privatization in economic theory

    Directory of Open Access Journals (Sweden)

    Drakić Maja

    2007-01-01

    Full Text Available In reality privatization has never occurred according to the handbook rules of ordinary market transactions. Not even in advanced market economies can privatization transactions be described by the Walrasian or Arrowian, or Leontiefian equilibrium models, or by the equilibrium models of the game theory. In these economies transactions of privatization take place in a fairly organic way – which means that those are driven by the dominance of private property rights and in a market economy. But despite this fact Western privatization also some peculiar features as compared to ordinary company takeovers, since the state as the seller may pursue non – economic goals. Changes in the dominant form of property change positions and status of many individuals and groups in the society. That’s why privatization can even less be explained by ordinary market mechanisms in transition countries where privatizing state-owned property have happened in a mass scale and where markets and private property rights weren't established at the time process of privatization began. In this paper I’ll discuss and analyze the phenomenon of privatization in context of different economic theories arguing that empirical results go in favor of the public choice theory (Buchanan, 1978, theory of "economic constitution" (Brennan and Buchanan 1985, (Buchanan and Tullock, 1989, and theory of "collective action" (Olson, 1982. These theories argues that transition from one economic system into another, for example transition from collectivistic, socialistic system into capitalism and free market economy with dominant private property, will not happen through isolated changes of only few economic institutions, no matter how deep that changes would be. In other words privatization can not give results if it's not followed by comprehensive change of economic system because privatized companied wouldn't be able to operate in old environment.

  8. Affordances for robots: a brief survey

    Directory of Open Access Journals (Sweden)

    Thomas E. Horton

    2012-12-01

    Full Text Available In this paper, we consider the influence of Gibson's affordance theory on the design of robotic agents. Affordance theory (and the ecological approach to agent design in general has in many cases contributed to the development of successful robotic systems; we provide a brief survey of AI research in this area. However, there remain significant issues that complicate discussions on this topic, particularly in the exchange of ideas between researchers in artificial intelligence and ecological psychology. We identify some of these issues, specifically the lack of a generally accepted definition of "affordance" and fundamental differences in the current approaches taken in AI and ecological psychology. While we consider reconciliation between these fields to be possible and mutually beneficial, it will require some flexibility on the issue of direct perception.

  9. Affordances and the musically extended mind.

    Science.gov (United States)

    Krueger, Joel

    2014-01-01

    I defend a model of the musically extended mind. I consider how acts of "musicking" grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of "musical affordances" and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances - via soliciting different forms of entrainment - enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I argue that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea. PMID:24432008

  10. Affordances in Mobile Augmented Reality Applications

    Directory of Open Access Journals (Sweden)

    Tor Gjøsæter

    2014-10-01

    Full Text Available This paper explores the affordances of augmented reality content in a mobile augmented reality application. A user study was conducted by performing a multi-camera video recording of seven think aloud sessions. The think aloud sessions consisted of individual users performing tasks, exploring and experiencing a mobile augmented reality (MAR application we developed for the iOS platform named ARad. We discuss the instrumental affordances we observed when users interacted with augmented reality content, as well as more complex affordances rising from conventions from media content, AR and the traditional WIMP paradigm. We find that remediation of traditional newspaper content through the MAR medium can provide engaging, pleasing and exciting user experiences. However, the some of the content still suffers from being shoveled onto the MAR platform without adapting it properly. Finally, we discuss what content was most successfully mediated to the user and how the content impacts the user experience.

  11. The impact of competitive environment on the service marketing mix strategy of health organisations in developing countries : Jordanian private sector hospital senior managers perspective

    OpenAIRE

    Ahmad, Ala'eddin Mohamad Khalaf.

    2007-01-01

    The environment of Jordanian private hospitals has never been so complex and challenging as at present. There are huge influences on these hospitals in the current climate. Managers in these hospitals are finding themselves, more than ever before, confronted by increasing pressures and demands which they must seek to understand and respond to in their service marketing mix strategy in order to achieve effective strategic marketing in terms of their choice of service marketing m...

  12. The Transformation of Ergonomic Affordances into Cultural Affordances: The Case of the Alnuset System

    Science.gov (United States)

    Chiappini, Giampaolo

    2012-01-01

    Is it possible to study the ergonomic affordances offered by a system designed for educational aims and their transformation into cultural affordances? To this purpose, what references can we adopt? This work describes the theoretical framework used to realise this study referring to AlNuSet, a system realised within the EC ReMath project to…

  13. At the crossroads: Hazard assessment and reduction of health risks from arsenic in private well waters of the northeastern United States and Atlantic Canada.

    Science.gov (United States)

    Zheng, Yan; Ayotte, Joseph D

    2015-02-01

    This special issue contains 12 papers that report on new understanding of arsenic (As) hydrogeochemistry, performance of household well water treatment systems, and testing and treatment behaviors of well users in several states of the northeastern region of the United States and Nova Scotia, Canada. The responsibility to ensure water safety of private wells falls on well owners. In the U.S., 43 million Americans, mostly from rural areas, use private wells. In order to reduce As exposure in rural populations that rely on private wells for drinking water, risk assessment, which includes estimation of population at risk of exposure to As above the EPA Maximum Contaminant Level, is helpful but insufficient because it does not identify individual households at risk. Persistent optimistic bias among well owners against testing and barriers such as cost of treatment mean that a large percentage of the population will not act to reduce their exposure to harmful substances such as As. If households are in areas with known As occurrence, a potentially large percentage of well owners will remain unaware of their exposure. To ensure that everyone, including vulnerable populations such as low income families with children and pregnant women, is not exposed to arsenic in their drinking water, alternative action will be required and warrants further research. PMID:25466685

  14. At the Crossroads: Hazard Assessment and Reduction of Health Risks from Arsenic in Private Well Waters of Northeastern United States and Atlantic Canada

    Science.gov (United States)

    Zheng, Yan; Ayotte, Joseph D.

    2014-01-01

    This special issue contains 12 papers that report on new understanding of arsenic hydrogeochemistry, performance of household well water treatment systems, and testing and treatment behaviors of well users in several states of the northeastern region of the United States and Nova Scotia, Canada. The responsibility to ensure water safety of private wells falls on well owners. In the U.S., 43 million Americans, mostly from rural areas, use private wells. In order to reduce As exposure in rural populations that rely on private wells for drinking water, risk assessment, which includes estimation of population at risk of exposure to As above the EPA Maximum Contaminant Level, is helpful but insufficient because it does not identify individual households at risk. Persistent optimism bias among well owners against testing and barriers such as cost of treatment mean that a large percentage of the population will not act to reduce their exposure to harmful substances such as As. If households are in areas with known As occurrence, a potentially large percentage of well owners will remain unaware of their exposure. To ensure that everyone, including vulnerable populations such as low income families with children and pregnant women, is not exposed to arsenic in their drinking water, alternative action will be required and warrants further research. PMID:25466685

  15. The Affordable Care Act and orthopaedic trauma.

    Science.gov (United States)

    Issar, Neil M; Jahangir, A Alex

    2014-10-01

    The Affordable Care Act has resulted in a dramatic governmental restructuring of the healthcare insurance market and delivery system. Orthopaedic traumatologists must be aware of the law's impact on their clinical practice, finances, and overall business model. This includes the effect of accountable care organizations, the Independent Payment Advisory Board, and the Physician Value-Based Payment Modifier program, as well as the impact of the Affordable Care Act's grace period provision, medical device excise tax, and cuts to funding for the Disproportionate Share Hospital program. PMID:25229683

  16. Affordance Templates for Shared Robot Control

    Science.gov (United States)

    Hart, Stephen; Dinh, Paul; Hambuchen, Kim

    2014-01-01

    This paper introduces the Affordance Template framework used to supervise task behaviors on the NASA-JSC Valkyrie robot at the 2013 DARPA Robotics Challenge (DRC) Trials. This framework provides graphical interfaces to human supervisors that are adjustable based on the run-time environmental context (e.g., size, location, and shape of objects that the robot must interact with, etc.). Additional improvements, described below, inject degrees of autonomy into instantiations of affordance templates at run-time in order to enable efficient human supervision of the robot for accomplishing tasks.

  17. Availability, price and affordability of cardiovascular medicines: A comparison across 36 countries using WHO/HAI data

    Directory of Open Access Journals (Sweden)

    Cameron Alexandra

    2010-06-01

    Full Text Available Abstract Background The global burden of cardiovascular disease (CVD continues to rise. Successful treatment of CVD requires adequate pharmaceutical management. The aim was to examine the availability, pricing and affordability of cardiovascular medicines in developing countries using the standardized data collected according to the World Health Organization/Health Action International methodology. Methods The following medicines were included: atenolol, captopril, hydrochlorothiazide, losartan and nifedipine. Data from 36 countries were analyzed. Outcome measures were percentage availability, price ratios to international reference prices and number of day's wages needed by the lowest-paid unskilled government worker to purchase one month of chronic treatment. Patient prices were adjusted for inflation and purchasing power, procurement prices only for inflation. Data were analyzed for both generic and originator brand products and the public and private sector and summarized by World Bank Income Groups. Results For all measures, there was great variability across surveys. The overall availability of cardiovascular medicines was poor (mean 26.3% in public sector, 57.3% private sector. Procurement prices were very competitive in some countries, whereas others consistently paid high prices. Patient prices were generally substantially higher than international references prices; some countries, however, performed well. Chronic treatment with anti-hypertensive medication cost more than one day's wages in many cases. In particular when monotherapy is insufficient, treatment became unaffordable. Conclusions The results of this study emphasize the need of focusing attention and financing on making chronic disease medicines accessible, in particular in the public sector. Several policy options are suggested to reach this goal.

  18. The production of critical theories in Health Systems Research and Education. An epistemological approach to emancipating public research and education from private interests

    OpenAIRE

    Jean-Pierre Unger; Pierre De Paepe; Patrick Van Dessel; Alicia Stolkiner

    2011-01-01

    This paper aims at offering alternative methodological perspectives in health systems research, to produce critical, theoretical knowledge in domains such as health policy and management of health care, organization of disease control, political economy of health and medical practice.We first examined the reasons to believe that worldwide economic agents have driven publicly funded schools of public health to adopt their preferred policies and to orient their priority research topics. We then...

  19. Private finance. Oz trials.

    Science.gov (United States)

    West, P

    1999-08-19

    Privatization of a public sector general hospital in Adelaide, Australia, five years ago has revealed the strengths of the model and the difficulties of contracting with the private sector. Managers believe the new model has reduced overstaffing and increased local management. There have been continual contracting problems and the hospital has made losses, almost from the start. Private finance initiative contracts may always be difficult to negotiate and sustain. PMID:10662311

  20. Medical loss ratio regulation under the Affordable Care Act.

    Science.gov (United States)

    Harrington, Scott E

    2013-01-01

    The minimum medical loss ratio (MLR) regulations in the Affordable Care Act guarantee that a specific percentage of health insurance premiums is spent on medical care and specified activities to improve health care quality. This paper analyzes the regulations' potential unintended consequences and incentive effects, including: higher medical costs and premiums for some insurers; less innovation to align consumer, provider, and health plan incentives, less consumer choice and increased market concentration; and the risk that insurers will pay rebates if claim costs are lower than projected when premiums are established, despite the regulations' permitted "credibility adjustments." The paper discusses modifications and alternatives to the MLR regulations to help achieve their stated goals with less potential for adverse effects. PMID:23720876

  1. Costs and benefits of private finance initiative schemes.

    Science.gov (United States)

    Gittoes, Paula; Trim, Joanna

    The private finance initiative (PFI) is the biggest building programme in the history of the NHS. It aims to raise the quality of health care facilities by utilising the skills and expertise of companies in the private sector. This article outlines what PFI involves, how it works and the benefits to the NHS in raising the quality of health care facilities. PMID:16315802

  2. The Emergence of Personalized Health Technology.

    Science.gov (United States)

    Allen, Luke Nelson; Christie, Gillian Pepall

    2016-01-01

    Personalized health technology is a noisy new entrant to the health space, yet to make a significant impact on population health but seemingly teeming with potential. Devices including wearable fitness trackers and healthy-living apps are designed to help users quantify and improve their health behaviors. Although the ethical issues surrounding data privacy have received much attention, little is being said about the impact on socioeconomic health inequalities. Populations who stand to benefit the most from these technologies are unable to afford, access, or use them. This paper outlines the negative impact that these technologies will have on inequalities unless their user base can be radically extended to include vulnerable populations. Frugal innovation and public-private partnership are discussed as the major means for reaching this end. PMID:27165944

  3. Affordances and distributed cognition in museum exhibitions

    DEFF Research Database (Denmark)

    Achiam, Marianne; May, Michael; Marandino, Martha

    2014-01-01

    history museum. We show how differences in exhibit characteristics give rise to differences in the interpretive strategies used by visitors in their meaning-making process, and conclude by discussing how the notions of affordance and distributed cognition can be used in an exhibit design perspective....

  4. Options for Affordable Fission Surface Power Systems

    International Nuclear Information System (INIS)

    Fission surface power systems could provide abundant power anywhere on the surface of the moon or Mars. Locations could include permanently shaded regions on the moon and high latitudes on Mars. To be fully utilized, however, fission surface power systems must be safe, have adequate performance, and be affordable. This paper discusses options for the design and development of such systems. (authors)

  5. Delivering affordable cancer care in high-income countries.

    Science.gov (United States)

    Sullivan, Richard; Peppercorn, Jeffrey; Sikora, Karol; Zalcberg, John; Meropol, Neal J; Amir, Eitan; Khayat, David; Boyle, Peter; Autier, Philippe; Tannock, Ian F; Fojo, Tito; Siderov, Jim; Williamson, Steve; Camporesi, Silvia; McVie, J Gordon; Purushotham, Arnie D; Naredi, Peter; Eggermont, Alexander; Brennan, Murray F; Steinberg, Michael L; De Ridder, Mark; McCloskey, Susan A; Verellen, Dirk; Roberts, Terence; Storme, Guy; Hicks, Rodney J; Ell, Peter J; Hirsch, Bradford R; Carbone, David P; Schulman, Kevin A; Catchpole, Paul; Taylor, David; Geissler, Jan; Brinker, Nancy G; Meltzer, David; Kerr, David; Aapro, Matti

    2011-09-01

    The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies

  6. Private Speech in Ballet

    Science.gov (United States)

    Johnston, Dale

    2006-01-01

    Authoritarian teaching practices in ballet inhibit the use of private speech. This paper highlights the critical importance of private speech in the cognitive development of young ballet students, within what is largely a non-verbal art form. It draws upon research by Russian psychologist Lev Vygotsky and contemporary socioculturalists, to…

  7. Setting up virtual private network

    International Nuclear Information System (INIS)

    Setting up virtual private network for business enterprise provides a low cost network foundation, increases enterprise's network function and enlarges its private scope. The text introduces virtual private network's principal, privileges and protocols that use in virtual private network. At last, this paper introduces several setting up virtual private network's technologies which based on LAN

  8. Setting up virtual private network

    International Nuclear Information System (INIS)

    Setting up virtual private network for business enterprise provides a low cost network foundation, increases enterprise network function and enlarges its private scope. This text introduces virtual private network principal, privileges and protocols applied in virtual private network. At last, this paper introduces several setting up virtual private network technologies which is based on LAN

  9. Affordability for sustainable energy development products

    International Nuclear Information System (INIS)

    Highlights: • Clean cookstoves that also generate electricity improve affordability. • Excel spreadsheet model to assist stakeholders to choose optimum technology. • Presents views for each stakeholder villager, village and country. • By adding certain capital costs, affordability and sustainability are improved. • Affordability is highly dependent on carbon credits and social understandings. - Abstract: Clean burning products, for example cooking stoves, can reduce household air pollution (HAP), which prematurely kills 3.5 million people each year. By careful selection of components into a product package with micro-finance used for the capital payment, barriers to large-scale uptake of products that remove HAP are reduced. Such products reduce smoke from cooking and the lighting from electricity produced, eliminates smoke from kerosene lamps. A bottom-up financial model, that is cognisant of end user social needs, has been developed to compare different products for use in rural areas of developing countries. The model is freely available for use by researchers and has the ability to assist in the analysis of changing assumptions. Business views of an individual villager, the village itself and a country view are presented. The model shows that affordability (defined as the effect on household expenses as a result of a product purchase) and recognition of end-user social needs are as important as product cost. The effects of large-scale deployment (greater that 10 million per year) are described together with level of subsidy required by the poorest people. With the assumptions given, the model shows that pico-hydro is the most cost effective, but not generally available, one thermo-acoustic technology option does not require subsidy, but it is only at technology readiness level 2 (NASA definition) therefore costs are predicted and very large investment in manufacturing capability is needed to meet the cost target. Thermo-electric is currently the only

  10. Synergies between veterinarians and para-professionals in the public and private sectors: organisational and institutional relationships that facilitate the process of privatising animal health services in developing countries.

    Science.gov (United States)

    Woodford, J D

    2004-04-01

    The delivery of veterinary services in most developing countries was, until recently, considered to be the responsibility of the public sector. However, over the past four decades, economic constraints and the imposition of structural adjustment policies (SAPs) have led to a gradual decline in public sector investment in real terms and thus a reduction in the quality and quantity of services available to livestock keepers. Many governments acknowledged that they were no longer able to provide services that were essentially of a 'private good' nature and introduced radical policy changes which sought to introduce the concepts of a market orientated approach towards agriculture and livestock production in particular. The role of government, in the future, would be to provide a reduced range of essential 'public good' services and to create a favourable environment in which the private sector could become established as a provider of 'private good' services and at the same time act as a partner in carrying out certain public functions under contract or 'sanitary mandates'. In almost all developing countries, however, these policy changes were not accompanied by appropriate development strategies. The reasons for this are complex. Firstly, SAPs may be considered to have been foisted upon governments by donors and are thus perceived by many policy-makers as the cause of financial problems, rather than a solution to them. Secondly, most animal health senior policy-makers in the public sector have been trained as veterinarians and lack the required management skills to plan change effectively. Furthermore, as regards clinical veterinary service delivery, especially in rural or more remote areas, the solution fostered by donor investment, which involves deregulation and the deployment of privately operating para-professionals, is often perceived as a threat to the veterinary profession and might result in limiting access to international markets for the trade of livestock

  11. Radon in private drinking water wells

    International Nuclear Information System (INIS)

    At least 10 % of inhabitants in the Czech Republic are supplied with water from private sources (private wells, boreholes). With the increasing cost of water, the number of people using their own sources of drinking water will be likely to increase. According to the Decree of the State Office for Nuclear Safety about the Radiation Protection 307/2002 as amended by Decree 499/2005, the guideline limit for the supplied drinking water ('drinking water for public supply') for radon concentration is 50 Bq.l-1. This guideline does not apply to private sources of drinking water. Radon in water influences human health by ingestion and also by inhalation when radon is released from water during showering and cooking. This paper presents results of measurements of radon concentrations in water from private wells in more than 300 cases. The gross concentration of alpha-emitting radionuclides and the concentrations of radium and uranium were also determined. (authors)

  12. An Affordable Open-Source Turbidimeter

    Directory of Open Access Journals (Sweden)

    Christopher D. Kelley

    2014-04-01

    Full Text Available Turbidity is an internationally recognized criterion for assessing drinking water quality, because the colloidal particles in turbid water may harbor pathogens, chemically reduce oxidizing disinfectants, and hinder attempts to disinfect water with ultraviolet radiation. A turbidimeter is an electronic/optical instrument that assesses turbidity by measuring the scattering of light passing through a water sample containing such colloidal particles. Commercial turbidimeters cost hundreds or thousands of dollars, putting them beyond the reach of low-resource communities around the world. An affordable open-source turbidimeter based on a single light-to-frequency sensor was designed and constructed, and evaluated against a portable commercial turbidimeter. The final product, which builds on extensive published research, is intended to catalyze further developments in affordable water and sanitation monitoring.

  13. Affordances and the musically extended mind

    Directory of Open Access Journals (Sweden)

    Joel eKrueger

    2014-01-01

    Full Text Available I defend a model of the musically extended mind. I consider how acts of musicking grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of musical affordances and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances—via soliciting different forms of entrainment—enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I suggest that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea.

  14. Refining Grasp Affordance Models by Experience

    DEFF Research Database (Denmark)

    Detry, Renaud; Kraft, Dirk; Buch, Anders Glent;

    2010-01-01

    We present a method for learning object grasp affordance models in 3D from experience, and demonstrate its applicability through extensive testing and evaluation on a realistic and largely autonomous platform. Grasp affordance refers here to relative object-gripper configurations that yield stable...... visual model of the object they characterize. We explore a batch-oriented, experience-based learning paradigm where grasps sampled randomly from a density are performed, and an importance-sampling algorithm learns a refined density from the outcomes of these experiences. The first such learning cycle is...... bootstrapped with a grasp density formed from visual cues. We show that the robot effectively applies its experience by downweighting poor grasp solutions, which results in increased success rates at subsequent learning cycles. We also present success rates in a practical scenario where a robot needs to...

  15. System Concepts for Affordable Fission Surface Power

    Science.gov (United States)

    Mason, Lee; Poston, David; Qualls, Louis

    2008-01-01

    This paper presents an overview of an affordable Fission Surface Power (FSP) system that could be used for NASA applications on the Moon and Mars. The proposed FSP system uses a low temperature, uranium dioxide-fueled, liquid metal-cooled fission reactor coupled to free-piston Stirling converters. The concept was determined by a 12 month NASA/DOE study that examined design options and development strategies based on affordability and risk. The system is considered a low development risk based on the use of terrestrial-derived reactor technology, high efficiency power conversion, and conventional materials. The low-risk approach was selected over other options that could offer higher performance and/or lower mass.

  16. Examining Affordability Issues in Northern Ireland

    OpenAIRE

    Brown, L.; S. McGreal; Gibb, K.; Joe Frey; Frey, J.

    2007-01-01

    The paper explores the relationship between house price growth, income levels, investor activity and the effects on entrants to the housing market. It concentrates on the area of first time buyers to the market and the issues of affordability which are now becoming increasingly apparent in Northern Ireland. House prices in Northern Ireland have experienced unprecedented growth particularly in the last 12 months (37% in 2006 alone according to the University of Ulster Quarterly House Price Ind...

  17. Heavy fuel oil: acceptable? available? affordable?

    International Nuclear Information System (INIS)

    Increasingly stringent environmental legislation on emissions limits poses problems for large industrial energy users, causing them to re-examine their choice of fuel source. Choice of fuel must be made flexibly, preferably in the form of a dual fuel strategy, it is argued here. This article examines the relationship between the 1995 Environment Act, the 1990 Environmental Protection Act, and the likely future of heavy fuel oils in terms of acceptability, availability and affordability. (UK)

  18. Private sector joins family planning effort.

    Science.gov (United States)

    1989-12-01

    Projects supported by the Directorate for Population (S&T/POP) of the U.S. Agency for International Development and aimed at increasing for-profit private sector involvement in providing family planning services and products are described. Making products commercially available through social-marketing partnerships with the commercial sector, USAID has saved $1.1 million in commodity costs from Brazil, Dominican Republic, Ecuador, Indonesia, and Peru. Active private sector involvement benefits companies, consumers, and donors through increased corporate profits, healthier employees, improved consumer access at lower cost, and the possibility of sustained family planning programs. Moreover, private, for-profit companies will be able to meet service demands over the next 20 years where traditional government and donor agency sources would fail. Using employee surveys and cost-benefit analyses to demonstrate expected financial and health benefits for businesses and work forces, S&T/POP's Technical Information on Population for the Private Sector (TIPPS) project encourages private companies in developing countries to invest in family planning and maternal/child health care for their employees. 36 companies in 9 countries have responded thus far, which examples provided from Peru and Zimbabwe. The Enterprise program's objectives are also to increase the involvement of for-profit companies in delivering family planning services, and to improve the efficiency and effectiveness of private volunteer organizations in providing services. Projects have been started with mines, factories, banks, insurance companies, and parastatals in 27 countries, with examples cited from Ghana and Indonesia. Finally, the Social Marketing for Change project (SOMARC) builds demand and distributes low-cost contraceptives through commercial channels especially to low-income audiences. Partnerships have been initiated with the private sector in 17 developing countries, with examples provided from

  19. The production of critical theories in Health Systems Research and Education. An epistemological approach to emancipating public research and education from private interests

    Directory of Open Access Journals (Sweden)

    Jean-Pierre Unger

    2011-10-01

    Full Text Available This paper aims at offering alternative methodological perspectives in health systems research, to produce critical, theoretical knowledge in domains such as health policy and management of health care, organization of disease control, political economy of health and medical practice.We first examined the reasons to believe that worldwide economic agents have driven publicly funded schools of public health to adopt their preferred policies and to orient their priority research topics. We then studied whether this hidden leadership has also contributed to shape research methodologies, which we contrasted with the epistemological consequences of a quest for intellectual independence, that is, the researcher’s quest to critically understand the state of health systems and generalize results of related action-research. To do so, we applied concepts of what could be named the ‘French School of Critical Sociology’ to qualitative research methodologies in descriptive health systems research. To do so, we applied concepts of what could be named the ‘French School of Critical Sociology’ to qualitative research methodologies in descriptive health systems research.

  20. Private Sector Involvement in Healthcare and UHC : An Assessment in Light of the Right to the Highest Attainable Standard of Health

    NARCIS (Netherlands)

    Toebes, Brigit; Hallo de Wolf, Antenor

    2015-01-01

    The goal of UHC (Universal Health Coverage) is to ‘ensure that all people obtain the health services they need without suffering financial hardship when paying for them’. There are many dense connections between the goal of UHC, and the State’s legal obligation to realize the human right to the high

  1. Essential drugs in AIDS care: issues of availability and affordability.

    Science.gov (United States)

    Kaur, S R

    1996-01-01

    Several antiretroviral drugs against HIV/AIDS have been developed in recent years. These drugs, reverse transcriptase inhibitors and protease inhibitors, inhibit the reproduction of HIV, but do not eliminate the presence of HIV in the body. The cost of drugs to treat one person with HIV/AIDS easily runs into the thousands of US dollars per year. These new drugs are therefore routinely used in developed countries, but not among the masses in developing countries. Many of the drugs needed to treat the opportunistic infections present during advanced HIV infection and AIDS are also prohibitively expensive for both developing countries and most individuals in those countries. The imposition of World Bank and International Monetary Fund structural adjustment programs together with decreased household purchasing power during the 1990s has led to increased demand for public sector services amid reduced public expenditure. The private sector is increasingly taking over the drug supply in developing countries, driving the cost of drugs out of the range of affordability for the vast majority of the poor. One strategy to contain the cost of drugs is for governments to develop and implement an integrated national drug policy based upon the concept of essential drugs and their rational use. PMID:12292110

  2. Support grows for privatization

    International Nuclear Information System (INIS)

    Issues relating to the privatization of Ontario Hydro were discussed in light of the Corporation's first ever indication of being in favour of privatization in its January 26, 1996 submission to the Macdonald Committee, which is studying electric sector reform options for the Ontario government. In the course of the Committee hearings a majority of the interested parties were in favour of some form of privatization, except the labour union, which was, and continues to be, opposed. While welcoming the apparent change in attitude, IPPSO believes that Ontario Hydro's new proposal would, in fact,lessen competition, rather than increase it. It was stated that what Ontario Hydro is asking is to be granted commercial rights, which some experts describe as absolute freedom without meaningful regulation or competition for an indefinite period of time. Details of Ontario Hydro's submission to the Committee, and the basis of the objection of the privatization supporters were explained

  3. Islamic Private Equity

    OpenAIRE

    Chatti, Mohamed Ali; Yousfi, Ouidad

    2010-01-01

    The Islamic private equity (IPE) market has grown dramatically over the last few years. There are some similarities between venture capital (VC) and some traditional methods in Islamic financing. In medieval Islamic societies it is hard to pinpoint the starting of IPE but there were partnership arrangements similar to those practiced in conventional private equity (PE). But both academicians and professionals argue that the VC activity started in 1946 when General Doriot, a French born and a ...

  4. Audits of private firms

    OpenAIRE

    Langli, John Christian; Svanström, Tobias

    2013-01-01

    Private and public firms differ across a number of important dimensions. Public firms are under scrutiny by stock exchanges, regulators, and market participants and they share the feature of separation of ownership and control. Private firms, in contrast, are much less regulated, the nature of their agency problems is different, they are less exposed to market forces, litigation and publicity, and they operate in a much more opaque information environment. The greater heterogeneit...

  5. Ireland: a private patriarchy?

    OpenAIRE

    E Mahon

    1994-01-01

    Ireland has recently been characterised as a country dominated by private patriarchy. One indicator of private patriarchy is the incidence of women engaged in full-time 'home duties' rather than in paid employment. The participation of women in the Irish labour force has been comparatively very low because the majority of married women in Ireland are full-time housewives. Persistently high fertility rates -- in 1987 the highest in Europe -- and a state ideology which enshrined women's positio...

  6. Privatization in Mexico

    OpenAIRE

    Chong, Alberto; Lopez-de-Silanes, Florencio

    2004-01-01

    Over the last 20 years, Mexico redefined the role of the state in its economy through an ambitious program to liberalize trade, promote efficiency and reduce the size and scope of the state-owned sector. In Mexico, privatization led to a significant improvement in firm performance, as profitability increased 24 percentage points and converged to levels similar to those of private firms. From this increase, at most 5 percent can be attributed to higher prices and 31 percent to transfers from w...

  7. Insight private equity

    OpenAIRE

    Gill, Andrej; Visnjic, Nikolai

    2013-01-01

    We are able to shed light on the black box of restructuring tools private equity investors use to improve the operational performance of their portfolio companies. By building on previous work considering performance evaluation of PE backed companies, we analyze whether private equity improves operating efficiency and which of the typical restructuring tools are the main performance drivers. Using a set of over 300 international leveraged buyout transactions of the last thirty years, we find ...

  8. New Zealand consumers’ perceptions of private insurance for pharmaceuticals

    OpenAIRE

    Ragupathy, Rajan; Babar, Zaheer-Ud-Din; Mirza, Wasif; Daiya, Mitali; Chandra, Himesh; Yousif, Ali; Girn, Maninder

    2014-01-01

    Private insurance plays a minor role in paying for pharmaceuticals in New Zealand, despite controversy about access through the public health system. The present study examines New Zealand consumers’ perceptions of private insurance for pharmaceuticals. A self-administered questionnaire was completed by 433 consumers at thirty pharmacies. The questionnaire included 18 questions on demographics, insurance status, perceptions of private insurance for pharmaceuticals and confidence in the public...

  9. Macroeconomic Impacts of Privatization: The Case of Turkey

    OpenAIRE

    ÖZATA, Erkan

    2013-01-01

    State owned enterprises and privatization have long been a major economic concern for Turkey. The main philosophy of privatization is to confine the role of the state in the economy in the areas like health, basic education, social security, national defense, large scale infrastructure investments; provide legal and structural environment for free enterprise to operate and thus to increase the productivity and the value added to the economy. Originally the privatization ideology was based on ...

  10. Municipal household solid waste collection strategies in an African megacity: analysis of public private partnership performance in Lagos.

    Science.gov (United States)

    Aliu, Ibrahim Rotimi; Adeyemi, Oluwagbemiga Ezekiel; Adebayo, Adeolu

    2014-09-01

    Managing municipal solid waste is a pervasive urban problem globally. While several strategies have been applied for efficient municipal solid waste management in developing economies, their performance level has not been critically investigated. Among these strategies, the public private partnership has widest appeal. This study examines the performance of public private partnership in household solid waste collection in Lagos, Nigeria. We collected primary data using a municipal solid waste survey in three residential density areas of Lagos megacity. Descriptive and inferential statistics were used to analyse the data. Two indexes of service performance, namely the service reliability index and operational quality index, were created to produce evidence on public private partnership performance in municipal solid waste collection in Lagos. Results show that the average amount of household solid waste generation per week ranges between 22.75 kg in the medium residential density area and 30.39 kg in the high residential density region of the city. The estimated per capita waste generated in Lagos Megacity is 0.95 kg day(-1). Regression models indicate that the public private partnership performance is significantly influenced by economic status, affordability, flexibility, consistency, cleanliness, coverage and accessibility, as well as number of waste collection vehicles, vehicle maintenance, capacity, trip rate, frequency, number of personnel and quality of personnel. Findings from this study reveal that Lagos residents have strong positive perception of public private partnership as a waste collection policy framework. The study has important policy and practical implications for urban waste management, public health and sustainability in developing economies. PMID:25193926

  11. Public Supervision over Private Relationships : Towards European Supervision Private Law?

    NARCIS (Netherlands)

    Cherednychenko, O.O.

    2014-01-01

    The rise of public supervision over private relationships in many areas of private law has led to the development of what, in the author’s view, could be called ‘European supervision private law’. This emerging body of law forms part of European regulatory private law and is made up of contract-rela

  12. 基于股份制的民营社区卫生服务管理模式的SWOT分析(待续)%SWOT Analysis of Private Community Health Service in Joint Stock System

    Institute of Scientific and Technical Information of China (English)

    蒋羽萍; 王馨; 刘永谊; 张齐苑; 王家骥; 周志衡

    2012-01-01

    在社区卫生服务领域引入竞争机制,可有效促进其市场结构和企业组织结构的优化.民营股份制社区卫生服务管理模式是有效筹集资金,调动社会力量举办社区卫生服务机构的一种模式.本研究以广东省广州市黄埔区红山街社区卫生服务中心为例,运用SWOT分析法对此模式的优势和劣势、机遇和风险进行系统的分析,并提出建议,从而充分利用内部优势和外部机遇,避免内部劣势和外部风险,达到完善此模式的目的.%It is an inevitable choice and the most powerful means for government to introduce competition into community health service. Only based on fair competition in the industry, can the market structure and enterprise organizations improve and maintain healthy and continuing development. In this paper,we analyze the strengthening and weaknesses,opportunities and risks of community health service in private share mode by SWOT analysis with a case study of one typical private share CHS center in Guangzhou. Some suggestions are proposed sp as to make full use of the internal strengthening and external opportunity,and to a-void the internal weakness and external threat, achieving the purpose to improve the mode.

  13. Building Affordable Rental Housing in Unaffordable Cities: A Canadian Low-Income Housing Tax Credit

    OpenAIRE

    Marion Steele; Francois Des Rosiers

    2009-01-01

    Many Canadian cities are short of affordable rental housing. Waiting lists for low-income housing are years in length, and new-build construction of rental housing has fallen over the last two decades. This study proposes a better way to build more low-income housing in expensive Canadian cities. A made-in-Canada Low-Income Housing Tax Credit (LIHTC) could leverage private sector expertise in site location, building, and management to build more and better low-income rental housing.

  14. Saúde suplementar no Brasil: abordagens sobre a articulação público/privada na assistência à saúde Salud suplementaria en Brasil: enfoques sobre la vertebración pública/privada en la asistencia a la salud Private health insurance in Brazil: approaches to public/private patterns in healthcare

    Directory of Open Access Journals (Sweden)

    Lígia Bahia

    2013-05-01

    estricto como foco de la discusión sobre salud suplementaria. Por ello, es evidente que la comprensión de la vertebración pública/privada en la salud requiere el desarrollo de una sólida base empírica, analizada fundamentándose en presupuestos teóricos adecuados al grado de complejidad inherente de la línea divisoria en la vertebración entre lo público y lo privado en el ámbito de la asistencia a la salud.This article draws on a previous review of 270 articles on private health plans published from 2000 to 2010 and selects 17 that specifically address the issue of the relationship between the public and private healthcare sectors. Content analysis considered the studies' concepts and terms, related theoretical elements, and predominant lines of argument. A reading of the argumentative strategies detected the existence of a critical view of the modus operandi in the public/private relationship based on Social Medicine and the theoretical tenets of the Brazilian Health Reform Movement. The study also identified contributions based on neoliberal business approaches that focus strictly on economic issues to discuss private health insurance. Understanding the public/private link in healthcare obviously requires the development of a solid empirical base, analyzed with adequate theoretical assumptions due to the inherent degree of complexity in the public/private healthcare interface.

  15. Perceiving Affordances for Different Motor Skills

    Science.gov (United States)

    Cole, Whitney G.; Chan, Gladys L. Y.; Vereijken, Beatrix; Adolph, Karen E.

    2013-01-01

    We examined several factors that affect people’s ability to perceive possibilities for action. In Experiment 1, 24 participants crossed expanses of various sizes in three conditions: leaping, a familiar, launching action system; arm-swinging on monkey bars, an unpracticed skill that uses the arms rather than the legs; and crawling on hands and knees, a disused skill that involves all four limbs. Before and after performing each action, participants gave verbal judgments about the largest gap they could cross. Participants scaled initial judgments to their actual abilities in all three conditions. But they considerably underestimated their abilities for leaping, a launching action, and for arm-swinging when it was performed as a launching action; judgments about crawling, a non-launching action, and arm-swinging when it was performed as a non-launching action were more accurate. Thus, launching actions appear to produce a deficit in perceiving affordances that is not ameliorated by familiarity with the action. However, after performing the actions, participants partially corrected for the deficiency and more accurately judged their abilities for launching actions—suggesting that even brief action experience facilitates the perception of affordances. In Experiment 2, we confirmed that the deficit was due to the launching nature of the leaping and arm-swinging actions in Experiment 1. We asked an additional 12 participants to cross expanses using two non-launching actions using the legs (stepping across an expanse) and the arms (reaching across an expanse). Participants were highly accurate when judging affordances for these actions, supporting launching as the cause of the underestimation reported in Experiment 1. PMID:23411672

  16. Improved malaria case management in formal private sector through public private partnership in Ethiopia: retrospective descriptive study

    OpenAIRE

    Argaw, Mesele D.; Woldegiorgis, Asfawesen GY.; Abate, Derebe T.; Abebe, Mesfin E.

    2016-01-01

    Background Malaria is a major public health problem and still reported among the 10 top causes of morbidity and mortality in Ethiopia. More than one-third of the people sought treatment from the private health sector. Evaluating adherences of health care providers to standards are paramount importance to determine the quality and the effectiveness of service delivery. Therefore, the aim of this study was to evaluate the contribution of public private mix (PPM) approach in improving quality of...

  17. The housing bust and housing affordability in New England

    OpenAIRE

    Robert Clifford

    2010-01-01

    This discussion paper updates the Center's 2006 housing affordability working paper, drawing on housing market data through 2008 to provide an in-depth analysis of housing affordability after the recent housing market bust. The paper looks at affordability in the New England states, their largest metropolitan areas, competitor metropolitan areas, and for the nation. The results show that as New England's housing prices have declined, affordability has been returning to the pre-housing crisis ...

  18. Experiments on affordance in the journal "ecological psychology"

    DEFF Research Database (Denmark)

    Trettvik, Johan

    2009-01-01

    There are two general aims: 1) to review how the concept of affordance is construed, in theory as well as in practice/experiments, and 2) to review the experiments on affordances.......There are two general aims: 1) to review how the concept of affordance is construed, in theory as well as in practice/experiments, and 2) to review the experiments on affordances....

  19. Casemix perspectives for clinicians in the private sector.

    Science.gov (United States)

    Maxwell, C N

    1998-10-19

    All private hospitals and clinics must now supply deidentified data, using AN-DRG classification, on all admitted patients to the Private Hospitals Data Bureau. Contracts between health funds and hospitals must also be described on the basis of AN-DRGs, which will enable funds to undertake hospital variance analysis. These data provide the foundation for nationally developed clinical pathways and utilisation reviews which could modify clinical practice, improve standards and reduce health costs. Clinicians must understand and participate in these changes, and adequate safeguards are needed to protect them against loss of their clinical integrity, and against inappropriate discretionary control by private hospitals, healthcare corporations and health insurers. PMID:9830414

  20. Where Does My Private Data Go?

    DEFF Research Database (Denmark)

    Khajuria, Samant; Sørensen, Lene Tolstrup

    2015-01-01

    Privacy has become a leading concern for manyusers using online services of any kind: social media activities, health care or shopping. As a consequence, targeted services offer information visualizations of private data for users on a browser or app level. This paper focuses on comparing existing...

  1. The Patient Protection and Affordable Care Act: The Role of the School Nurse. Position Statement

    Science.gov (United States)

    Combe, Laurie G.; Sharpe, Susan; Feeser, Cynthia Jo; Ondeck, Lynnette; Fekaris, Nina

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) serves a vital role in the delivery of health care to our nation's students within the healthcare system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as…

  2. Awareness, Perceptions, and Communication Needs about the Affordable Care Act across the Life Span

    Science.gov (United States)

    Bergeron, Caroline D.; Friedman, Daniela B.; Sisson, Diana C.; Tanner, Andrea; Kornegay, Vance L.; Owens, Otis L.; Weis, Megan A.; Patterson, Lee L.

    2016-01-01

    Background: By March 2014, all U.S. citizens were required to have health insurance according to the Affordable Care Act (ACA). Purpose: Study objectives were to explore individuals' opinions, perceptions, and communication sources and needs about the ACA and to assess differences by age group. Methods: In November 2013, 10 1-hour focus groups (5…

  3. 77 FR 17219 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

    Science.gov (United States)

    2012-03-23

    ... health insurance premium stabilization programs (that is, reinsurance, risk corridors, and risk... and the RFC, where relevant. On July 15, 2011, we published in the Federal Register (76 FR 41950-41956... Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment; Final Rule...

  4. South African private security contractors active in armed conflicts: citizenship, prosecution and the right to work

    OpenAIRE

    Maritz, M.; Bosch, S.

    2011-01-01

    South Africa has adopted two pieces of legislation since 1998 aimed at restricting one of the fastest growing sectors of the global economy: the private security industry. Not only is this legislation completely unique, but it appears wholly at odds with international opinion. In this article we place private security contractors (PSCs) under the microscope of international law, exploring the role they play in armed conflicts, and the status afforded them by international humanitarian law (IH...

  5. 42 CFR 440.80 - Private duty nursing services.

    Science.gov (United States)

    2010-10-01

    ... nursing services. Private duty nursing services means nursing services for recipients who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing... 42 Public Health 4 2010-10-01 2010-10-01 false Private duty nursing services. 440.80 Section...

  6. 76 FR 77392 - Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan...

    Science.gov (United States)

    2011-12-13

    ... bring meaningful resolution to the lack of consumer choice in the health insurance market. The commenter... program (CO-OP) to foster the creation of new consumer-governed, private, nonprofit health insurance issuers. In addition to improving consumer choice and plan accountability, the CO- OP program also...

  7. Immunologic protection afforded by sunscreens in vitro.

    Science.gov (United States)

    Davenport, V; Morris, J F; Chu, A C

    1997-06-01

    Several studies have suggested a lack of correlation between sunscreen sun protection factor and protection of the skin immune system, potentially allowing greater damage to the skin by removing the natural protective erythemal response to sun exposure. Despite this, routine testing of immune protection afforded by sunscreens is not performed by industry. Current laboratory methods for investigating the efficacy of sunscreen protection of epidermal immune function use the induction of contact hypersensitivity or epidermal cell alloantigen presentation. Animal models, cell culture systems, and in vivo human studies are commonly employed, but all these systems have significant drawbacks for use in routine testing. The purpose of this study was to develop an in vitro system for testing the immunologic protection afforded by sunscreens in human skin. Five test sunscreens plus a vehicle control were tested in a "blind" fashion for their in vitro level of immune protection. Creams were applied in a standard manner to human whole skin explants and were irradiated over a range of physiologic doses using an Oriel solar simulator. A mixed epidermal lymphocyte reaction was used to quantify epidermal alloantigen-presenting capacity, in the presence or absence of test cream, for five explants. Results consistently demonstrated that all the test sunscreens protected beyond their designated sun protection factors, whereas the vehicle conferred no protection. The explant-mixed epidermal lymphocyte reaction system gave consistent, reproducible results and may prove useful for the allocation of an immune protection factor to all sunscreens. PMID:9182811

  8. SunShot Prize: America's Most Affordable Rooftop Solar: A Competition To Spur Low-Cost Rooftop Solar Installations Across The Nation (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2012-06-01

    The SunShot Prize encourages novel public-private partnerships, original business models, and innovative approaches to installing clean, renewable solar energy. The sustainable business strategies developed by participants will provide transferable lessons that can be applied nationwide to hasten America's transition to affordable clean energy in a post-subsidy market.

  9. How to Think About Changes in Higher Education Affordability

    OpenAIRE

    Robert B. Archibald; Feldman, David H.

    2008-01-01

    Many have argued that because the cost of attending college has increased more rapidly than family income, college has become less affordable. In this paper, we argue that this is not the correct way to think about affordability. Goods and services are more or less affordable if the consumer can or cannot afford to purchase the market basket of goods and services in the second time period he or she could afford in the first period. The measure of whether an increase in tuition and fees has in...

  10. The Affordable Care Act: the ethical call to transform the organizational culture.

    Science.gov (United States)

    Piper, Llewellyn E

    2014-01-01

    The Patient Protection and Affordable Care Act will require health care leaders and managers to develop strategies and implement organizational tactics for their organization to survive and thrive under the federal mandates of this new health care law. Successful health care organizations and health care systems will be defined by their adaptability in the new value-based marketplace created by the Affordable Care Act. The most critical underlining challenge for this success will be the effective transformation of the organizational culture. Transformational value-based leadership is now needed to answer the ethical call for transforming the organizational culture. This article provides a model and recommendations to influence change in the most difficult leadership duty-transforming the organizational culture. PMID:25068882

  11. Housing Affordability in Czech Regions and Demographic Behaviour – Does Housing Affordability Impact Fertility?

    Czech Academy of Sciences Publication Activity Database

    Kostelecký, Tomáš; Vobecká, Jana

    2009-01-01

    Roč. 45, č. 6 (2009), s. 1191-1213. ISSN 0038-0288 R&D Projects: GA MMR WD-05-07-3 Institutional research plan: CEZ:AV0Z70280505 Keywords : housing affordability * fertility * Czech regions Subject RIV: AO - Sociology, Demography Impact factor: 0.562, year: 2009

  12. LIFTing Corporate Governance in Public Private Partnerships

    OpenAIRE

    Mutvalli, Raaqib

    2006-01-01

    The last twenty years has seen a significant shift on two inter-related ideas within the Public Sector. The introduction of more market-based mechanisms as part of the New Public Management reforms has seen an increasing role for the private sector in the public services arena. The second major change has been a greater awareness of the public sectors need to be accountable to its stakeholders leading to the use of governance mechanisms usually seen in the private sector. The health sector ha...

  13. European private company

    OpenAIRE

    Bednářová, Tereza

    2014-01-01

    This bachelor's thesis focuses on the statute of a European private company (SPE)- a new European limited liability company intended for small and medium sized enterprises. In the thesis there is a summary of all the initiatives prior to the proposal for the Council regulation on the Statute for a European private company. There is also a summary of the proposal itself and the main characteristics of the company followed by a summary of a number of compromise proposals trying to find a suitab...

  14. THE MANAGEMENT OF CORPORATE REPUTATION IN HEALTH CARE INSTITUTIONS: A RESEARCH STUDY FOR MEASURING THE PERCEPTION ABOUT CORPORATE REPUTATION OF EMPLOYEES WORKING IN PUBLIC AND PRIVATE HOSPITALS

    OpenAIRE

    ARACI, Mehtap; Genç, Emine

    2015-01-01

    That being one of the most important values of the institutions, the management of reputation, with its feature that cannot be imitated by its competitors, has become one of the crucial management tools in recent years. That it is one and perhaps the most important of the institution having vital importance in terms of trust, communication and behavior in social responsibility for its internal and external stakeholders, it becomes necessary for health care sector to deal with the issue of cor...

  15. NASA's Space Launch System: Affordability for Sustainability

    Science.gov (United States)

    May, Todd A.; Creech, Stephen D.

    2012-01-01

    The National Aeronautics and Space Administration's (NASA) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center, is charged with delivering a new capability for human exploration beyond Earth orbit in an austere economic climate. But the SLS value is clear and codified in United States (U.S.) budget law. The SLS Program knows that affordability is the key to sustainability and will provide an overview of initiatives designed to fit within the funding guidelines by using existing engine assets and hardware now in testing to meet a first launch by 2017 within the projected budget. It also has a long-range plan to keep the budget flat, yet evolve the 70-tonne (t) initial lift capability to 130-t lift capability after the first two flights. To achieve the evolved configuration, advanced technologies must offer appropriate return on investment to be selected through the competitive process. For context, the SLS will be larger than the Saturn V that took 12 men on 6 trips for a total of 11 days on the lunar surface some 40 years ago. Astronauts train for long-duration voyages on platforms such as the International Space Station, but have not had transportation to go beyond Earth orbit in modern times, until now. To arrive at the launch vehicle concept, the SLS Program conducted internal engineering and business studies that have been externally validated by industry and reviewed by independent assessment panels. In parallel with SLS concept studies, NASA is now refining its mission manifest, guided by U.S. space policy and the Global Exploration Roadmap, which reflects the mutual goals of a dozen member nations. This mission planning will converge with a flexible heavy-lift rocket that can carry international crews and the air, water, food, and equipment they need for extended trips to asteroids and Mars. In addition, the SLS capability will accommodate very large science instruments and other payloads, using a series of modular fairings and

  16. What Does Mental Health Parity Really Mean for the Care of People with Serious Mental Illness?

    Science.gov (United States)

    Bartlett, John; Manderscheid, Ron

    2016-06-01

    Parity of mental health and substance abuse insurance benefits with medical care benefits, as well as parity in their management, are major ongoing concerns for adults with serious mental illness (SMI). The Mental Health Parity and Addiction Equity Act of 2008 guaranteed this parity of benefits and management in large private insurance plans and privately managed state Medicaid plans, but only if the benefits were offered at all. The Patient Protection and Affordable Care Act of 2010 extended parity to all persons receiving insurance through the state health insurance marketplaces, through the state Medicaid Expansions, and through new individual and small group plans. This article presents an analysis of how accessible parity has become for adults with SMI at both the system and personal levels several years after these legislative changes have been implemented. PMID:27216906

  17. Perceptions and utilization of primary health care services in Iraq: findings from a national household survey

    Directory of Open Access Journals (Sweden)

    Burnham Gilbert

    2011-12-01

    Full Text Available Abstract Background After many years of sanctions and conflict, Iraq is rebuilding its health system, with a strong emphasis on the traditional hospital-based services. A network exists of public sector hospitals and clinics, as well as private clinics and a few private hospitals. Little data are available about the approximately 1400 Primary Health Care clinics (PHCCs staffed with doctors. How do Iraqis utilize primary health care services? What are their preferences and perceptions of public primary health care clinics and private primary care services in general? How does household wealth affect choice of services? Methods A 1256 household national survey was conducted in the catchment areas of randomly selected PHCCs in Iraq. A cluster of 10 households, beginning with a randomly selected start household, were interviewed in the service areas of seven public sector PHCC facilities in each of 17 of Iraq's 18 governorates. A questionnaire was developed using key informants. Teams of interviewers, including both males and females, were recruited and provided a week of training which included field practice. Teams then gathered data from households in the service areas of randomly selected clinics. Results Iraqi participants are generally satisfied with the quality of primary care services available both in the public and private sector. Private clinics are generally the most popular source of primary care, however the PHCCs are utilized more by poorer households. In spite of free services available at PHCCs many households expressed difficulty in affording health care, especially in the purchase of medications. There is no evidence of informal payments to secure health services in the public sector. Conclusions There is widespread satisfaction reported with primary health care services, and levels did not differ appreciably between public and private sectors. The public sector PHCCs are preferentially used by poorer populations where they are

  18. Implementing the Affordable Care Act: Promoting Competition in the Individual Marketplaces.

    Science.gov (United States)

    Cusano, David; Lucia, Kevin

    2016-02-01

    A main goal of the Affordable Care Act is to provide Americans with access to affordable coverage in the individual market, achieved in part by pro­moting competition among insurers on premium price and value. One primary mechanism for meeting that goal is the establishment of new individual health insurance marketplaces where consumers can shop for, compare, and purchase plans, with subsidies if they are eligible. In this issue brief, we explore how the Affordable Care Act is influencing competition in the individual marketplaces in four states--Kansas, Nevada, Rhode Island, and Washington. Strategies include: educating consumers and providing coverage information in one place to ease decision-making; promoting competition among insurers; and ensuring a level playing field for premium rate development through the rate review process. PMID:26910926

  19. Visual Descriptor Learning for Predicting Grasping Affordances

    DEFF Research Database (Denmark)

    Thomsen, Mikkel Tang

    2016-01-01

    feature space consisting of surface features was performed. Dimensions in the visual space were varied and the effects were evaluated with the task of grasping unknown object. The evaluation was performed using a novel probabilistic grasp prediction approach based on neighbourhood analysis. The resulting...... success-rates for predicting grasps were between 75% and 90% depending on the object class. The investigations also provided insights into the importance of selecting a proper visual feature space when utilising it for predicting affordances. As a consequence of the gained insights, a semi-local surface...... for creating a hierarchical representation of visual surface descriptors in SE(3). The mechanism provides a generic way of creating a hierarchical representation of N layers using pairs of descriptors. The created hierarchies were evaluated on the task of grasping unknown objects and the resulting...

  20. Affordances of form in stanzaic narrative poetry

    Directory of Open Access Journals (Sweden)

    B. McHale

    2010-07-01

    Full Text Available This article develops the notion that poetry is crucially distinguished from other forms of verbal art by its foregrounding of segmentivity, the spacing of language. If a measure is regarded as the smallest unit of resistance to meaning, measure determines where gaps open up in a poetic text. Poetry is, however, not only measured, but typically countermeasured and narrative in poetry can also be countermeasured against the segmentation that is specific to narrative. The present article investigates segmentivity in one particular type of narrative poem, namely poems in discontinuous stanzaic forms. The concept of affordances (referring to different potentials for use is applied to the stanzaic form in Edmund Spenser’s “The faerie queene” (1590; 1596 and to the “ottava rima” stanza, as exemplified by Kenneth Koch’s postmodernist narrative poem, “Seasons on earth” (1960; 1977; 1987.

  1. Affordable Hybrid Heat Pump Clothes Dryer

    Energy Technology Data Exchange (ETDEWEB)

    TeGrotenhuis, Ward E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Butterfield, Andrew [Jabil, St. Petersburg, FL (United States); Caldwell, Dustin D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Crook, Alexander [Jabil, St. Petersburg, FL (United States)

    2016-06-30

    This project was successful in demonstrating the feasibility of a step change in residential clothes dryer energy efficiency by demonstrating heat pump technology capable of 50% energy savings over conventional standard-size electric dryers with comparable drying times. A prototype system was designed from off-the-shelf components that can meet the project’s efficiency goals and are affordable. An experimental prototype system was built based on the design that reached 50% energy savings. Improvements have been identified that will reduce drying times of over 60 minutes to reach the goal of 40 minutes. Nevertheless, the prototype represents a step change in efficiency over heat pump dryers recently introduced to the U.S. market, with 30% improvement in energy efficiency at comparable drying times.

  2. Assessing the Role of TRIPS Agreement for Inaccessibility and Un-affordability of Essential Medicines in Nigeria

    OpenAIRE

    Umar Abubakar Dubagari

    2015-01-01

    Intellectual property rights (IPRs) protection was not recognised in Nigeria and essential medicines were accessible and affordable to all but reverse is the case with the implementation of TRIPS agreement on IPRs. This resulted in inordinate policy formulation and implementation that exacerbates the public health care despite Nigeria’s endowment with enormous human and natural resources. This paper argues that patents protection hinders access and affordability to essential medicines in Ni...

  3. Public-Private Partnerships

    DEFF Research Database (Denmark)

    Weihe, Gudrid

    There is a great deal of confusion about the meaning of the concept public-private partnership (PPP). Much is written on the subject but only rarely do authors give an adequate account of what they mean when they talk about PPP, nor do they acknowledge that there exist qualitatively different PPP...

  4. Clans in Private Economy

    Institute of Scientific and Technical Information of China (English)

    ZhaoHongmei,; ZhuShida; DavidKelly

    2004-01-01

    In traditional China, clans were dominant segments of society. Clan ideology is widespread in China, where private firms generally choose clan operation as their business form. Greater trust in family or clan members and resources distribution in terms of human affinity are all manifestations of the influence of the clan ideology on economic life.

  5. Public-Private Partnerships

    DEFF Research Database (Denmark)

    Lehmann, Martin; Jeppesen, S.

    2006-01-01

    Public-private partnerships in the environmental field have emerged as one option in the pursuit of sustainable development. So-called ‘Green Networks’, ‘Cleaner Production Centres’, ‘Waste Minimisation Clubs’ are among others highlighted as alternatives to governmental regulation. While being...

  6. Private Floating World.

    OpenAIRE

    Clay, Allyson

    1998-01-01

    The tondi in the series "Private Floating World" show three views of a particular location in Disneyland. Rather, they show the same view with the only difference being distance from the image. Paradoxically, nothing more is revealed in the image offering the closest view. 

  7. At private den

    DEFF Research Database (Denmark)

    Winther, Ida

    2006-01-01

    club (teens between 12-16 years) in Denmark will be presented. The teens are always situated end located when they use the cell phone. When they use it, temporary personal reserves are created, in which they do territorial demands. As the most obvious they forget themselves and ?go private?. It has...

  8. Private Airlines Take Off

    Institute of Scientific and Technical Information of China (English)

    ISABELDING

    2005-01-01

    OKAY Airways, the first wholly private airline in China, took off from the Tianjin Binhai International Airport on March Ⅱ. Carrying a total of 80 passengers, the 189-seat Boeing 737-900 leased from Korea Airlines was bound for Kunming, capital of Yunnan Province, via Changsha,

  9. PUBLIC-PRIVATE PARTNERSHIPS IN LOCAL DISASTER MANAGEMENT: A PANACEA TO ALL LOCAL DISASTER MANAGEMENT ILLS?

    Directory of Open Access Journals (Sweden)

    Angela van der Berg

    2015-11-01

    Full Text Available It is anticipated that the occurrence and intensity of disasters will increase globally and in South Africa where typical disasters include droughts, floods, extreme hailstorms, gales, fires and earthquakes, as well as sinkholes arising from mining activity in dolomitic areas. Disasters such as these result in human suffering and damage to the resources and infrastructure on which South Africans rely for their survival and the maintenance of their quality of life. Section 24 of the Constitution of the Republic of South Africa, 1996 affords to everyone the right to an environment that is not harmful to his or her health and well-being. It may be argued that a person's sense of environmental security in relation to the potential risks and dangers of disaster falls within the scope of the protection provided by section 24. The responsibility to intervene for the protection of the interests inherent in the constitutional environmental right lies with the government of South Africa. Disaster management specifically is a functional area of competence of national and provincial government, but practice has shown that the actual implementation of and planning for disaster management happens in the local government sphere. Against the backdrop of these introductory discussions and, given the fact that several municipalities in South Africa are under-resourced, this article very specifically aims to critically discuss and describe from a legal perspective the potential and function of public-private partnerships (PPPs between local government (municipalities and the private sector (such as industries in fulfilling the legally entrenched disaster management mandate of municipalities. Through a critical evaluation of some existing PPPs, this article illustrates that the private sector has a key role to play in assisting municipalities to fulfil their legally entrenched disaster management mandate.

  10. 公私医疗卫生支出与经济增长关系的实证分析%An Empirical Study of the Relationship between Public and Private Health Spending and Economic growth

    Institute of Scientific and Technical Information of China (English)

    钟晓敏; 杨六妹

    2016-01-01

    It’s well-known that health care spending is not only related to the planning of a national social welfare policy, but also plays an important role in the nation’s economic growth.However, the existing literature holds different opinions on the relationship between health spending and economic growth.In view of this, the paper divides the health expenditures into government health spending and residential health care spending, and establishes a two-way fixed effects model to analyze the impact of public and private health care spending on economic growth in.The results are as follows:on national average, when the government health care spending grows by 100%, it will promote economic growth by 12.08%; when the residential health care spending grows by 100%, it can promote eonomic growth by 15.85%;but at the same time, taking into account the difference in regional economic development, we find vast discrepancies between the effects of government health care spending and residential health care spending on economic growth--the government health care spending has an “inverted U-shaped” effect on economic growth while the residential health care spending shows a “ladder-type” effect on economic growth.%众所周知,医疗卫生支出不仅关系到一个国家社会福利政策的规划,还对经济增长具有不可忽略的促进作用。然而,现有文献对于医疗卫生支出与经济增长关系之间的研究结论却是众说纷纭。鉴于此,本文根据医疗卫生支出的支付主体,将其分为政府医疗卫生支出和居民医疗卫生支出,并通过建立双向固定效应模型对公私医疗卫生支出对经济增长的影响进行分析。结果显示:从全国平均水平来看,政府医疗卫生支出每增长100%,带动经济增长12.08%,居民医疗卫生支出每增长100%,带动经济增长15.85%;但与此同时,考虑到不同地区的经济发展非均衡化时,政府医疗卫生支

  11. Private finance for adaptation: do private realities meet public ambitions?

    OpenAIRE

    Pauw, W.P.; Klein, R.J.T.; Vellinga, P.; Biermann, F. (Friedhelm)

    2016-01-01

    The private sector’s role in climate finance is increasingly subject to political and scientific debate. Yet there is poor empirical evidence of private engagement in adaptation and its potential contribution to the industrialised countries’ mobilisation of USD 100 billion of annual climate finance from 2020 onwards to support developing countries to address climate change. This paper analysed 101 case studies of private sector adaptation under the Private Sector Initiative (PSI) of the UNFCC...

  12. A Agência Nacional de Saúde e a política de saúde mental no contexto do sistema suplementar de assistência à saúde: avanços e desafios The Brazilian National Health Agency and the mental health policy in the context of the private health system: developments and challenges

    Directory of Open Access Journals (Sweden)

    Rachel Torres Salvatori

    2012-03-01

    Full Text Available O presente estudo trata das políticas de saúde mental conduzidas pela Agência Nacional de Saúde Suplementar - ANS, no cenário da assistência dispensada pelos planos privados de assistência à saúde. Dessa forma, analisa o modelo de regulação econômica e assistencial do setor suplementar, a forma de atuação da ANS como organismo regulador e o tratamento dispensado à assistência à saúde mental nos normativos emanados pela Agência. Concluiu-se que, apesar de avanços como a obrigatoriedade de cobertura para todas as doenças listadas na CID-10, a inclusão do tratamento das tentativas de suicídio e das lesões autoinfligidas, o atendimento por uma equipe multiprofissional, a ampliação do número de sessões com psicólogo, com terapeuta ocupacional e de psicoterapia, e a inclusão do hospital-dia na rede credenciada da operadora, a assistência à saúde mental ainda é pouco normatizada pelos regramentos vigentes no sistema de atenção à saúde suplementar, existindo muitas lacunas a serem preenchidas. A regulamentação dos mecanismos de coparticipação e franquia, a coparticipação crescente como limitador da internação psiquiátrica sem o repensar em uma rede substitutiva e a limitação do número de sessões de psicoterapia de crise são alguns dos desafios colocados para a ANS, no sentido de que esta cumpra realmente o seu papel institucional de promoção da defesa do interesse público na assistência suplementar à saúde.This work analyses the mental health policy-making activity of the Brazilian National Health Agency (ANS, responsible for controlling health insurance companies. Three points are discussed: a the framework of an economic and private health assistance regulatory activity, b the ANS and its regulation activity and c the rules produced by ANS in the mental health care field. It was concluded that, despite advances like the legal obligation to ensure medical treatment to all the diseases listed in

  13. Theoretical Framework of Fair Distribution of Affordable Housing in China

    Directory of Open Access Journals (Sweden)

    Tao Zhang

    2011-08-01

    Full Text Available Urbanization and industrialization in China result in dramatic growth of population in urban areas. The housing price rises so high that low-income people living in urban cannot afford to buy their own houses. In order to alleviate their housing plight, affordable housing has been built in mainland China. However, unfair distribution of affordable housing failed to accomplish the goal of this program. The paper firstly introduces the current situation and problem of affordable housing distribution. It then discusses the rationale of Theory of Justice from John Rawl, and puts forward a systematic legal framework, which consists of affordable housing legislation, enforcement, judiciary and sanction, to safeguard the justice of affordable housing distribution.

  14. Medicaid Expansion under the Affordable Care Act. Implications for Insurance-related Disparities in Pulmonary, Critical Care, and Sleep

    OpenAIRE

    Lyon, Sarah M.; Douglas, Ivor S.; Cooke, Colin R.

    2014-01-01

    The Affordable Care Act was intended to address systematic health inequalities for millions of Americans who lacked health insurance. Expansion of Medicaid was a key component of the legislation, as it was expected to provide coverage to low-income individuals, a population at greater risk for disparities in access to the health care system and in health outcomes. Several studies suggest that expansion of Medicaid can reduce insurance-related disparities, creating optimism surrounding the pot...

  15. Deregulation, privatization and the Ontario power failure

    International Nuclear Information System (INIS)

    The Canadian Union of Public Employees (CUPE) has examined the history of deregulation of the electricity industry in the United States and presents lessons that could be learned from the California electricity crisis, the collapse of Enron, and the massive blackout that occurred in August 2003 across Ontario and northeastern United States. Unlike the United States, Canada's electricity system is mostly publicly owned and operated. This report emphasized that the need for public investment in the electricity system is greater than ever, and offers suggestions on how to strengthen the Canadian electricity system. It examines the attempts made to deregulate and privatize the electricity system in Ontario, Alberta, New Brunswick and British Columbia and exposes the reality of price caps and the debt of public utilities. It demonstrates that privatization has failed to provide a safe, reliable, affordable and adequate supply of electricity. The report claims that profit-seeking power producers want to keep supply and demand in their favour to sell electricity at the highest possible price. In addition to emphasizing the need for public investment in the electricity system, this report emphasizes the need for Canadian electricity cooperation, with particular mention of the large energy supplies in Manitoba and Quebec. 37 refs

  16. Financial Private Regulation and Enforcement

    OpenAIRE

    Miller, Geoffrey

    2011-01-01

    This paper has been delivered within the context of the research project "Transnational Private Regulatory Regimes: Constitutional foundations and governance design". This paper considers the topic of private regulation and enforcement for internationally active financial services firms. The paper documents the following types of regulation and enforcement that involve significant private input: house rules, contracts, internal compliance, management-based regulation, private standard-sett...

  17. Rethinking Space Design Standards Toward Quality Affordable Housing In Malaysia

    OpenAIRE

    Ishak Nor Haniza; Mohd Ariffin Ati Rosemary; Sulaiman Raha; Mohd Zailani Muhammad Najib

    2016-01-01

    Provision of affordable housing is important to low- and middle-income population. A fit form of house will not only fulfil a basic human need for shelter, but it also contributes to physical and psychological well-being of the occupants. Excellent quality and affordable housing is an indication of a high quality of life. While writings exist on various aspects of the quality of affordable housing in Malaysia, discussion regarding space and design standards has scarcely been given any serious...

  18. A ratio or budget benchmark for comparing affordability across countries?

    OpenAIRE

    Heylen, Kristof; Haffner, Marietta

    2013-01-01

    In this article, the methodological strengths and weaknesses of two common housing affordability indicators - the expenditure-to-income ratio and the residual income - are discussed, using data for the Belgian region of Flanders and the Netherlands. Affordability standards are used in order to distinguish the group facing affordability problems. In case of residual income, we use minimum budget standards – excluding housing - that allow for decent participation in society. For the expenditur...

  19. Integrating risk adjustment and enrollee premiums in health plan payment.

    Science.gov (United States)

    McGuire, Thomas G; Glazer, Jacob; Newhouse, Joseph P; Normand, Sharon-Lise; Shi, Julie; Sinaiko, Anna D; Zuvekas, Samuel H

    2013-12-01

    In two important health policy contexts - private plans in Medicare and the new state-run "Exchanges" created as part of the Affordable Care Act (ACA) - plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). PMID:24308878

  20. Contracting with Private Rewards

    OpenAIRE

    Rene Kirkegaard

    2015-01-01

    I extend the canonical moral hazard model to allow the agent to face endogenous and non-contractible uncertainty. The agent works for the principal and simultaneously pursues private rewards. I establish conditions under which the first-order approach remains valid. The model adds to the literature on intrinsic versus extrinsic motivation. Specifically, to induce higher effort at work the contract may offer higher rewards but flatter incentives. The contract change makes the agent reevaluate ...