WorldWideScience

Sample records for public health private

  1. 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....

  2. Water privatization and public health in Latin America.

    Science.gov (United States)

    Mulreany, John P; Calikoglu, Sule; Ruiz, Sonia; Sapsin, Jason W

    2006-01-01

    This study had two objectives: (1) to determine what the public health and development literature has found regarding the public health outcomes of water privatization in Latin America and (2) to evaluate whether the benefits of water privatization, if any, outweigh the equity and justice concerns that privatization raises. Using a standard set of terms to search several databases, the authors identified and reviewed articles and other materials from public health and development sources that were published between 1995 and 2005 and that evaluated the public health effects of water privatizations in Latin America from 1989 to 2000, based on (1) access to water by the poor and/or (2) improvements in public health. Next, the authors examined the experiences of three cities in Bolivia (Cochabamba, El Alto, and La Paz) in order to illuminate further the challenges of water privatization. Finally, the authors considered the equity and justice issues raised by the privatization of water. The literature review raised persistent concerns regarding access to water by the poor under privatization. The review also suggested that the public sector could deliver public health outcomes comparable to those of the private sector, as measured by access rates and decreasing child mortality rates. In terms of social equity and justice, privatization marked a troubling shift away from the conception of water as a "social good" and toward the conception of water--and water management services--as commodities. Our results indicated there is no compelling case for privatizing existing public water utilities based on public health grounds. From the perspective of equity and justice, water privatization may encourage a minimalist conception of social responsibility for public health that may hinder the development of public health capacities in the long run.

  3. Public versus Private: Evidence on Health Insurance Selection

    Science.gov (United States)

    Pardo, Cristian; Schott, Whitney

    2012-01-01

    This paper models health insurance choice in Chile (public versus private) as a dynamic, stochastic process, where individuals consider premiums, expected out-of pocket costs, personal characteristics and preferences. Insurance amenities and restrictions against pre-existing conditions among private insurers introduce asymmetry to the model. We confirm that the public system services a less healthy and wealthy population (adverse selection for public insurance). Simulation of choices over time predicts a slight crowding out of private insurance only for the most pessimistic scenario in terms of population aging and the evolution of education. Eliminating the restrictions on pre-existing conditions would slightly ameliorate the level (but not the trend) of the disproportionate accumulation of less healthy individuals in the public insurance program over time. PMID:22374192

  4. 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.

  5. Educating the future public health workforce: do schools of public health teach students about the private sector?

    Science.gov (United States)

    Rutkow, Lainie; Traub, Arielle; Howard, Rachel; Frattaroli, Shannon

    2013-01-01

    Recent surveys indicate that approximately 40% of graduates from schools of public health are employed within the private sector or have an employer charged with regulating the private sector. These data suggest that schools of public health should provide curricular opportunities for their students--the future public health workforce--to learn about the relationship between the private sector and the public's health. To identify opportunities for graduate students in schools of public health to select course work that educates them about the relationship between the private sector and public health. We systematically identified and analyzed data gathered from publicly available course titles and descriptions on the Web sites of accredited schools of public health. Data were collected in the United States. The sample consisted of accredited schools of public health. Descriptions of the number and types of courses that schools of public health offer about the private sector and identification of how course descriptions frame the private sector relative to public health. We identified 104 unique courses with content about the private sector's relationship to public health. More than 75% of accredited schools of public health offered at least 1 such course. Nearly 25% of identified courses focused exclusively on the health insurance industry. Qualitative analysis of the data revealed 5 frames used to describe the private sector, including its role as a stakeholder in the policy process. Schools of public health face a curricular gap, with relatively few course offerings that teach students about the relationship between the private sector and the public's health. By developing new courses or revising existing ones, schools of public health can expose the future public health workforce to the varied ways public health professionals interact with the private sector, and potentially influence students' career paths.

  6. The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths.

    Science.gov (United States)

    Lister, Cameron; Payne, Hannah; Hanson, Carl L; Barnes, Michael D; Davis, Siena F; Manwaring, Todd

    2017-01-01

    Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

  7. Public and private donor financing for health in developing countries.

    Science.gov (United States)

    Howard, L M

    1991-06-01

    Among the many variables that influence the outcome of national health status in both developed and developing countries, the availability and efficiency of financing is critical. For 148 developing countries, annual public and private expenditures from domestic sources (1983) were estimated to be approximately $100 billion. For the United States alone, annual public and private costs for medical care are almost five times larger ($478 billion, 1988). In contrast to domestic expenditures, the total flow of donor assistance for health in 1986 was estimated to be $4 billion, approximately 5% of total current domestic expenditures by developing countries. Direct donor assistance for development purposes by the United States Government approximates 0.5% of the US federal budget (1988). Approximately 10% of all United States development assistance is allocated for health, nutrition, and population planning purposes. While the total health sector contribution is on the order of $500 million annually, the US contribution represents about 13% of health contributions by all external donors. In sub-Saharan Africa, all donor health allocations only reach 3.4% of total development assistance. While available data suggest that private and voluntary organizations contribute approximately 20% of total global health assistance, data reporting methods from private agencies are not sufficiently specific to provide accurate global estimates. Clearly, developing countries as a whole are dependent on the efficient use of their own resources because external financing remains a small fraction of total domestic financing. Nevertheless, improvement in health sector performance often depends on the sharing of western experience and technology, services available through external donor cooperation. In this effort, the available supply of donor financing for health is not restricted entirely by donor policy, but also by the official demand for external financing as submitted by developing

  8. Ethics in public health research: masters of marketing: bringing private sector skills to public health partnerships.

    Science.gov (United States)

    Curtis, Valerie A; Garbrah-Aidoo, Nana; Scott, Beth

    2007-04-01

    Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public-Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships.

  9. 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...

  10. 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...

  11. Private well water in Colorado: collaboration, data use, and public health outreach.

    Science.gov (United States)

    Brown, Eric M; Van Dyke, Mike; Kuhn, Stephanie; Mitchell, Jane; Dalton, Hope

    2015-01-01

    As a result of participating in the Centers for Disease Control and Prevention's Private Well Initiative and Environmental Public Health Tracking Network (Tracking), the Colorado Department of Public Health and Environment was able to inventory private well water quality data, prioritize potential health concerns associated with drinking water from these wells, and create a Web portal for sharing public health information regarding private well water. The Colorado Department of Public Health and Environment collaborated with a local health department to pilot the project prior to a public implementation. Approximately 18 data sets were identified and inventoried. The Colorado Department of Public Health and Environment also participated in development and pilot testing of best practices for display of well water quality data with other Tracking states. Available data sets were compiled and summarized, and the data made available on the Colorado Tracking portal using geographic information system technology to support public health outreach regarding private wells.

  12. Rethinking the private-public mix in health care: analysis of health reforms in Israel during the last three decades.

    Science.gov (United States)

    Filc, Dani; Davidovitch, Nadav

    2016-10-01

    To analyse the process of health care privatization using the case of Israeli health care reforms during the last three decades. We used mixed methods including quantitative analysis of trends in health expenditures in Israel and qualitative critical analysis of documents describing the main health reforms. Israel epitomizes how boundaries between the private and public sector become blurred when health care services are subject to privatization, both of finance and supply. Additionally, the continuous growth of public-private relationships in health care results in systems that lack both equity and efficiency. More than three decades of experience show that such private-public partnerships increase both inequality and inefficiency. While most discussion surrounding the private-public mix in health care focuses on financing infrastructure, in Israel, the public-private mix has become a central way of financing and delivering services, making its damaging influence more pervasive. © The Author(s) 2016.

  13. Public and private health insurance in Germany: the ignored risk selection problem.

    Science.gov (United States)

    Grunow, Martina; Nuscheler, Robert

    2014-06-01

    We investigate risk selection between public and private health insurance in Germany. With risk-rated premiums in the private system and community-rated premiums in the public system, advantageous selection in favor of private insurers is expected. Using 2000 to 2007 data from the German Socio-Economic Panel Study (SOEP), we find such selection. While private insurers are unable to select the healthy upon enrollment, they profit from an increase in the probability to switch from private to public health insurance of those individuals who have experienced a negative health shock. To avoid distorted competition between the two branches of health care financing, risk-adjusted transfers from private to public insurers should be instituted.

  14. 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.

  15. 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…

  16. Measuring the effects of reducing subsidies for private insurance on public expenditure for health care.

    Science.gov (United States)

    Cheng, Terence Chai

    2014-01-01

    This paper investigates the effects of reducing subsidies for private health insurance on public sector expenditure for hospital care. An econometric framework using simultaneous equation models is developed to analyse the interrelated decisions on the intensity and type of health care use and private insurance. The framework is applied to the context of the mixed public-private system in Australia. The simulation projections show that reducing premium subsidies is expected to generate net cost savings. This arises because the cost savings achieved from reducing subsidies are larger than the potential increase in public expenditure on hospital care. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. [The role of private insurance in public health care systems: conceptual framework and policies].

    Science.gov (United States)

    Rodríguez, M

    2001-01-01

    The structure of the health care system ans specifically the type and amount of the public and private mix is not a closed issue. This article provides and update of the arguments that justify public intervention in health, and emphasizes the failures of the private insurance market that call for mandatory universal health insurance, although that does not necessarily mean that state has to be the insurer. The relationship between both sectors and the variables determining the relative level of expenditure in both are also analyzed. Following the literature on the public provision of private goods, the level of expenditure in a democracy is seen to depend on the preferences of the median voter, where private insurance usually tops up public insurance. The key variable determining the decision to buy additional private insurance is the difference in quality, defined broadly, between both sectors. Concerning policies, the appropriateness of fiscal incentives to promote the uptake of private insurance is discussed and it is concluded that there is no clear evidence of its suitability. Also, it is argued that models in which the public and private sectors appear totally segregated or totally integrated are preferable to intermediate models, in which both sectors appear combined. Medical coverage bought by an informed agent in exchange for a capitation payment seems a better way to integrate the private sector than through a system of vouchers.

  18. 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

  19. Differences in public and private health services in a rural district of Malaysia.

    Science.gov (United States)

    Aljunid, S M; Zwi, A B

    1996-12-01

    A cross-sectional study, comparing the nature of services in 15 private clinics and 6 public health facilities, was undertaken in a rural district of Malaysia. Semi-structured interviews and observations using check-lists were employed. Public health facilities were run by younger doctors (mean age = 31.1 years), supported mostly by trained staff. The private clinics were run by older doctors (mean age = 41.2 years) who had served the district for much longer (8.9 years vs 1.5 years) but were supported by less well trained staff. The curative services were the main strength of the private clinics but their provision of preventive care was less comprehensive and of inferior quality. Private clinics were inclined to provide more expensive diagnostic services than the public facilities. 'Short hours' private clinics had very restricted opening hours and offered limited range of services.

  20. Barriers and Enablers to Clinical Fieldwork Education in Rural Public and Private Allied Health Practice

    Science.gov (United States)

    Maloney, Phoebe; Stagnitti, Karen; Schoo, Adrian

    2013-01-01

    There is a need to maximise rural clinical fieldwork placement to build health workforce capacity. This study investigated allied health professionals' (AHPs) experience of supervising students as part of work-integrated learning in public and private rural health settings. An anonymous postal questionnaire with 30 questions was used to collect…

  1. 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.

  2. 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.

  3. Public vs private administration of rural health insurance schemes: a comparative study in Zhejiang of China.

    Science.gov (United States)

    Zhou, Xiaoyuan; Mao, Zhengzhong; Rechel, Bernd; Liu, Chaojie; Jiang, Jialin; Zhang, Yinying

    2013-07-01

    Since 2003, China has experimented in some of the country's counties with the private administration of the New Cooperative Medical Scheme (NCMS), a publicly subsidized health insurance scheme for rural populations. Our study compared the effectiveness and efficiency of private vs public administration in four counties in one of China's most affluent provinces in the initial stage of the NCMS's implementation. The study was undertaken in Ningbo city of Zhejiang province. Out of 10 counties in Ningbo, two counties with private administration for the NCMS (Beilun and Ninghai) were compared with two others counties with public administration (Zhenhai and Fenghua), using the following indicators: (1) proportion of enrollees who were compensated for inpatient care; (2) average reimbursement-expense ratio per episode of inpatient care; (3) overall administration cost; (4) enrollee satisfaction. Data from 2004 to 2006 were collected from the local health authorities, hospitals and the contracted insurance companies, supplemented by a randomized household questionnaire survey covering 176 households and 479 household members. In our sample counties, private administration of the NCMS neither reduced transaction costs, nor improved the benefits of enrollees. Enrollees covered by the publicly administered NCMS were more likely to be satisfied with the insurance scheme than those covered by the privately administered NCMS. Experience in the selected counties suggests that private administration of the NCMS did not deliver the hoped-for results. We conclude that caution needs to be exercised in extending private administration of the NCMS.

  4. Public-private partnerships and responsibility under international law: a global health perspective

    NARCIS (Netherlands)

    L. Clarke

    2014-01-01

    Partnerships between the public and private sectors are an increasingly accepted method to deal with pressing global issues, such as those relating to health. Partnerships, comprised of states and international organizations (public sector) and companies, non-governmental organizations, research ins

  5. 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...

  6. 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...

  7. Factors Influencing the Choice of a Public or Private Health Institution for Childbirth in Chandigarh

    Directory of Open Access Journals (Sweden)

    Trusty Khumukcham

    2015-03-01

    Full Text Available Background: Knowledge of factors affecting the choice of place for delivery may help in developing a user friendly maternity program. Hence, this study aimed at finding out factors influencing women’s choice about the type of health institutions for delivery. Materials and methods: A cross sectional study was conducted in selected communities of Chandigarh city in India during 2010-11. A consecutive sample of 300 women (150 in public and 150 in private institutions who had delivered a baby in previous three months were interviewed using a pre-tested interview schedule. Chi square test was used to find association of socio-demographic, maternal, and institutional factors with the type of institution selected for delivery. Results: Women from lower socio-economic status delivered more frequently in public sector institutions (47.3% than in private institutions (16.7%  (p<0.01. In private institutions 30% of the women were delivered through Caesarean Section compared to 17.3% in public institutions (p<0.05. Physical infrastructure was better in private institutions. Cost was lower in public (Rs. 4,630 than in private institutions (Rs 21,676. Most women were satisfied with quality of care received in public and private institutions. However, some reported that public institution staff needs to be more polite. Quality of infrastructure in health facility, quality of care, and socio-economic status were associated with the choice of institution for delivery. Conclusions: Public sector health institutions are a major source of maternity care in Chandigarh, hence, care providers should be trained in handling clients gently. Regulations for adherence to protocols, e.g., indications for Caesarean Section and fee structure etc. need to be implemented in private institutions.

  8. 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.

  9. [On the issue of development of state-private partnership in public health of Russia].

    Science.gov (United States)

    2012-01-01

    The article considers possible directions of development of organizational technologies of state-private partnership in public health of Russia. Such directions are emphasized as management of operational activities of medical institutions, development of infrastructure of population medical care system, implementation of innovative technologies, organization of interaction with international clinical institutions, joint development of legal and low decisions in the area of interactions oa state and business relating to public health. The factors interfering with development of effective state-private partnership are demonstrated and possible ways of overcoming are proposed.

  10. Utilization of dental health services by Danish adolescents attending private or public dental health care systems

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Petersen, Poul Erik; Bastholm, Annelise

    2002-01-01

    The objectives of the study were: 1) to describe the choice of dental care system among 16-year-olds, 2) to describe the utilization of dental services among 16-17-year-olds enrolled in either public or private dental care systems, and to compare the dental services provided by the alternative...... systems. The study comprised 1,245 adolescents from 3 municipalities; the historical cohort study design was applied; and data were collected from dental records (public dental service) and dental claims (private practice). At age 16, 12% preferred being enrolled in the private practice system, while 88......% remained in the public dental care system. During the 2-year study period the attendance rate was 99% for the public system, while 90% attended the private practice system (Pdental services were provided more frequently by the public than the private system (P

  11. The cyclical behaviour of public and private health expenditure in China.

    Science.gov (United States)

    Chen, Gang; Inder, Brett; Lorgelly, Paula; Hollingsworth, Bruce

    2013-09-01

    This paper studies short-run cyclical behaviour of public (government and social) and private health expenditure and GDP using both time series and panel data techniques. First, national time series data have been used within a multivariate Beveridge-Nelson decomposition framework to construct the permanent and cyclical components. The correlation analysis results for the cyclical components suggest that current public health expenditure is pro-cyclical while there is no clear evidence of a correlation between cycles in private health expenditure and in GDP growth. Next, using an instrumental variable method and the generalised method of moments estimator, provincial-level panel data analyses confirm pro-cyclical impacts of government spending on health. The provincial analysis also suggests that private health expenditure in urban China has a pro-cyclical association with GDP growth, but a lack of good instruments makes it difficult to identify a clear causal link between cycles in income growth and private health expenditure. The results suggest two policy recommendations relevant to public health expenditure, in line with China's current health reforms. Copyright © 2013 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

    Cappellaro, Giulia; Longo, Francesco

    2011-04-19

    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 a comparative analysis of the reasons for the adoption of institutional PPPs and the governance and managerial features necessary to establish them as appropriate arrangements for public-health services provisions. A qualitative analysis is carried out on experiences of institutional PPPs within the Italian National Health Service (Sistema Sanitario Nazionale, SSN). The research question is addressed through a contextual and comparative embedded case study design, assuming the entire population of PPPs (4) currently in force in one Italian region as the unit of analysis: (i) a rehabilitation hospital, (ii), an orthopaedic-centre, (iii) a primary care and ambulatory services facility, and (iv) a health- and social-care facility. Internal validity is guaranteed by the triangulation of sources in the data collection phase, which included archival and interview data. Four governance and managerial issues were found to be critical in determining the positive performance of the case examined: (i) a strategic market orientation to a specialised service area with sufficient potential demand, (ii) the allocation of public capital assets and the consistent financial involvement of the private partner, (iii) the adoption of private administrative procedures in a regulated setting while guaranteeing the respect of public administration principles, and (iv) clear regulation of the workforce to align the contracts with the organisational culture. Findings suggests that institutional PPPs enable national health

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

    Directory of Open Access Journals (Sweden)

    Longo Francesco

    2011-04-01

    Full Text Available 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 a comparative analysis of the reasons for the adoption of institutional PPPs and the governance and managerial features necessary to establish them as appropriate arrangements for public-health services provisions. Methods A qualitative analysis is carried out on experiences of institutional PPPs within the Italian National Health Service (Sistema Sanitario Nazionale, SSN. The research question is addressed through a contextual and comparative embedded case study design, assuming the entire population of PPPs (4 currently in force in one Italian region as the unit of analysis: (i a rehabilitation hospital, (ii, an orthopaedic-centre, (iii a primary care and ambulatory services facility, and (iv a health- and social-care facility. Internal validity is guaranteed by the triangulation of sources in the data collection phase, which included archival and interview data. Results Four governance and managerial issues were found to be critical in determining the positive performance of the case examined: (i a strategic market orientation to a specialised service area with sufficient potential demand, (ii the allocation of public capital assets and the consistent financial involvement of the private partner, (iii the adoption of private administrative procedures in a regulated setting while guaranteeing the respect of public administration principles, and (iv clear regulation of the workforce to align the contracts with the organisational culture. Conclusions Findings

  14. Public private partnerships

    NARCIS (Netherlands)

    Miranda Sarmento, J.J.

    2014-01-01

    Public-private partnerships (PPPs) are increasing in number worldwide and are used to build and manage large public infrastructure projects. In PPPs, the private sector plays a role in developing and maintaining public infrastructure and services, which is usually a public sector responsibility. Des

  15. Public private partnerships

    NARCIS (Netherlands)

    Miranda Sarmento, J.J.

    2014-01-01

    Public-private partnerships (PPPs) are increasing in number worldwide and are used to build and manage large public infrastructure projects. In PPPs, the private sector plays a role in developing and maintaining public infrastructure and services, which is usually a public sector responsibility.

  16. Public private partnerships

    NARCIS (Netherlands)

    Miranda Sarmento, J.J.

    2014-01-01

    Public-private partnerships (PPPs) are increasing in number worldwide and are used to build and manage large public infrastructure projects. In PPPs, the private sector plays a role in developing and maintaining public infrastructure and services, which is usually a public sector responsibility. Des

  17. Public and private roles in plant health management

    NARCIS (Netherlands)

    Oude Lansink, A.G.J.M.

    2011-01-01

    World-wide, government institutions play an important role in the management of plant health. This paper develops a conceptual framework in which suppliers and demanders jointly determine the optimal level of plant health in a hypothetical market. Next this paper argues that this market falls short

  18. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services

    Science.gov (United States)

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    Background A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. Methods This is a sub-analysis of a national population-based survey of postpartum women entitled “Birth in Brazil”, performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Results Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk–adjusted OR of 2.3 (CI 1.5–3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1–2.3) for women of high obstetric risk. Conclusion The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care. PMID:27196102

  19. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    Science.gov (United States)

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3) for women of high obstetric risk. The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

  20. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Leal

    Full Text Available A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk.This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services.Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8% when compared to the ones receiving public services (rate of 2.4%, regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6 for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3 for women of high obstetric risk.The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

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

    Science.gov (United States)

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

    2016-01-01

    Introduction Health services quality has been the most important criteria of judging, and its improvement causes people’s satisfaction of health systems. In a health system, public and private sectors provide services and typically have been effective in promoting health services quality of community. The aim of this study was to compare the quality of health services in both public and private sectors from the perspective of residents in Qazvin (Iran). Methods This cross-sectional study was conducted in 2014. The study population included all residents of Qazvin Province, and the sample size was estimated to 1002. The research tool was a perceptions of services quality standard questionnaire. Data were collected by trained interviewers visiting homes and were analyzed by IBM-SPSS software version 22 and t-test and linear regression. Cronbach’s alpha coefficient was 0.91 and test–re-test coefficient was 83%. Results 741 people (74%) in their last visit to receive services were referred to the public sector. Between the perception of people participating in the study about medical equipment and supplies, welfare facilities, competence and experience of doctor, waiting time, rapid reception, and access to doctor in public and private sectors, significant differences were observed (p < 0.05). In the tangible realm in perception of health services, there was a significant difference in quality between the public and private sectors (p < 0.05). In addition, place of receiving services, waiting time, education, occupation, and type of received services were affecting factors in regards to perceptions of health services from the perspective of Iran’s population (p < 0.05). Conclusion The results showed the importance of a tangible realm on people’s satisfaction of health services. It seems that the public sector should pay more attention to this issue. PMID:27790347

  2. Private outlets for public limitations: the rise of commercial health insurance in Israel.

    Science.gov (United States)

    Cohen, M A; Barnea, T

    1992-01-01

    In recent years, dissatisfaction with aspects of the Israeli health care system has grown. Labor conflict and unrest, long waits for elective surgery, increases in out-of-pocket payments for health care, and declining government investment have given rise to a new phenomenon: the increasing use of private services. This has led consumers to seek financing sources for their private care and created opportunities for commercial insurers and sick funds to offer new insurance packages to meet this demand. As a result, over the last five years more than twenty commercial health policies and four mandatory supplemental policies provided by the sick funds are currently on the market. The market for these policies is small but growing, with consequences for the cost and quality of care, access, the level and composition of national expenditures, and the allocation of resources to both the public and private health systems. As the balance between private and public financing changes, so too do the trade-offs between differing objectives. Greater private pluralism and competition at the financing level have many advantages but also make it more difficult for government to manage the tradeoffs that occur. Thus, a changed emphasis in government regulation and policy-making is required.

  3. Provision of Private Care by Doctors Employed in Public Health Institutions: Ethical Considerations and Implications for Clinical Training.

    Science.gov (United States)

    Benbassat, Jochanan

    2015-06-01

    This paper summarizes the difficulties that may emerge when the same care-provider attends to private and public patients within the same or different clinical settings. First, I argue that blurring the boundaries between public and private care may start a slippery slope leading to "black" under-the-table payments for preferential patient care. Second, I question whether public hospitals that allow their doctors to attend to private patients provide an appropriate learning environment for medical students and residents. Finally, I propose a way to both maintain the advantages of private care and avoid its negative consequences: complete separation between the public and the private health care systems.

  4. [Public-private relations in the Colombian health system from 1991 to 2015].

    Science.gov (United States)

    Cárdenas, William Iván López; Pereira, Adelyne Maria Mendes; Machado, Cristiani Vieira

    2017-07-27

    The case of Colombia's health system exemplifies the neoliberal reforms conducted in Latin America, characterized by the private sector's broad participation in the administration of resources and provision of health services. The system includes a set of benefits for persons that can afford to pay and a package of basic services with state financing for poor persons. This study aimed to analyze the public-private arrangements in the Colombian health system from 1991 and 2015, including the dimensions of insurance and financing. A case study was performed that included a literature review and analysis of documents and secondary data. The results suggest that the 1993 reform conceived of health as a public service to be provided by the market. There were changes in the state's role, delegating health care functions to the private sector through regulatory and contractual measures. Beginning in 2000, incremental reforms included instrumental changes in the system, while other initiatives aimed to expand the state's responsibilities in guaranteeing the right to health. In terms of health insurance, the main advances were the expansion of insurance coverage and harmonization of baskets of benefits between different insurance systems (although late). As for financing, there are important inequities in per capita spending between the different insurance systems and inefficiency in the financial intermediation. The Colombian case underscores the limits of structuring health systems with heavy market participation, and the study contributes to the debate on the challenges for social protection in health in Latin American countries.

  5. School health services and its practice among public and private primary schools in Western Nigeria.

    Science.gov (United States)

    Kuponiyi, Olugbenga Temitope; Amoran, Olorunfemi Emmanuel; Kuponiyi, Opeyemi Temitola

    2016-04-06

    Globally the number of children reaching school age is estimated to be 1.2 billion children (18% of the world's population) and rising. This study was therefore designed to determine the school health services available and its practices in primary schools in Ogun state, Western Nigeria. The study was a comparative cross-sectional survey of private and public primary schools in Ogun state using a multi-stage sampling technique. Participants were interviewed using a structured, interviewer administered questionnaire and a checklist. Data collected was analyzed using the SPSS version 15.0. A total of 360 head teachers served as respondents for the study with the overall mean age of 45.7 ± 9.9 years. More than three quarters of the respondents in both groups could not correctly define the school health programme. There were no health personnel or a trained first aider in 86 (47.8%) public and 110 (61.1%) private schools but a nurse/midwife was present in 57 (31.7%) and 27 (15.0%) public and private schools. (χ(2) = 17.122, P = 0.002). In about 95% of the schools, the teacher carried out routine inspection of the pupils while periodic medical examination for staff and pupils was carried out in only 13 (7.2%) public and 31 (17.2%) private schools (χ(2) = 8.398, P = 0.004). A sick bay/clinic was present in 26 (14.4%) and 67 (37.2%) public and private schools respectively (χ(2) = 24.371, P = 0.001). The practice of school health programme was dependent on the age (χ(2) = 12.53, P = 0.006) and the ethnicity of the respondents (χ(2) = 6.330, P = 0.042). Using multivariate analysis only one variable (type of school) was found to be a predictor of school health programme. (OR 4.55, CI 1.918-10.79). The study concludes that the practice of the various components of school health services was poor but better in private primary schools in Nigeria. Routine inspection by teachers was the commonest form of health appraisal. This may suggest that more health personnel need to

  6. Public/private financing in the Greek health care system: implications for equity.

    Science.gov (United States)

    Liaropoulos, L; Tragakes, E

    1998-02-01

    The 1983 health reforms in Greece were indirectly aimed at increasing equity in financing through expansion of the role of the public sector and restriction of the private sector. However, the rigid application of certain measures, the failure to change health care financing mechanisms, as well as growing dissatisfaction with publicly provided services actually increased the private share of health care financing relative to that of the public share. The greatest portion of this increase involved out-of-pocket payments, which constitute the most regressive form of financing, and hence resulted in reduced equity. The growing share of private insurance financing, though as yet quite small, has also contributed to reducing equity. Within public funding, while a small shift has occurred in favor of tax financing, it is questionable whether this has contributed to increased equity in view of widespread tax evasion. On balance, it is most unlikely that the 1983 health care reforms have led to increased equity; it is rather more likely that the system in operation today is more inequitable from the point of view of financing than the highly inequitable system that was in place in the early 1980s.

  7. [The contracting process and outsourcing in health: the scenario for dispute between public and private interests].

    Science.gov (United States)

    Albuquerque, Maria do Socorro Veloso; Morais, Heloísa Maria Mendonça de; Lima, Luci Praciano

    2015-06-01

    This research analyzed the public-private composition in the municipal health network and aspects of the contracting/outsourcing process for services over the period from 2001 to 2008. The research method used was a case study with documentary research and interviews. The interviewees were former secretaries of health, directors of regulation and district managers. The categories of analysis used were public funds, care networks and public control. The results showed that the contracting was restricted to philanthropic units. With respect to the other private establishments linked to the public care network, non-compliance with programmatic aspects was detected, such as the lack of regulation of bidding processes required for contracting. Management authorities did not actively pursue building up state public services, or the formation of care networks. The contracted establishments conducted their activities without effective external and internal control mechanisms, which are paramount for the proper use of public resources. The authors conclude that the contracting process does not significantly alter the standard of buying and selling of services and indeed does not enhance the empowering process of the role of the public domain.

  8. [Public-private partnerships (PPPs) in the health sector: global processes and national dynamics].

    Science.gov (United States)

    Almeida, Celia

    2017-10-02

    This essay addresses several dimensions that promote and consolidate the growing participation by private stakeholders in the decision-making process in health, emphasizing international and domestic factors that have facilitated and sustained the persistence of the neoliberal political and ideological perspective over the course of nearly thirty years (since the 1990s). The article emphasizes the role of intergovernmental organizations in this process, highlighting public-private interactions at the global and domestic levels, with a specific focus on so-called public-private partnerships (PPPs). The working premise is that such linkages alter the power relations in policy formulation and implementation, with a predominance of private stakeholders. The article presents an overview of the development of PPPs in Europe, Latin America, and Brazil, identifying their specific origins and the simultaneity of triggering events. The text reiterates the importance of not overlooking the power of these actors in dislodging them from this political position, whether in multilateral organizations or national health systems. The aim is to emphasize the importance of more in-depth reflection on the subject, backing debates within the sector. This entire dynamic requires rethinking strategies of resistance to preserve the rights won through centuries of struggle.

  9. Insurance coverage and socioeconomic differences in patient choice between private and public health care providers in China.

    Science.gov (United States)

    Wang, Qing; Zhang, Donglan; Hou, Zhiyuan

    2016-12-01

    The private health care sector has become an increasingly important complement to China's health care system. During the health care reform in 2009, China's central government established multiple initiatives to relax constraints on the growth of the private health care sector. However, private health services have not been growing as rapidly as private health care facilities. Using data from the China Health and Retirement Longitudinal Study collected between 2011 and 2013, this study investigated patient choice between private and public providers for outpatient care and estimated its relationship with health insurance and socioeconomic status (SES). The Heckman sample selection model was applied to address the problem of selection bias caused by a lack of awareness of provider ownership. We found that 82.1% of the outpatient care users were aware of their provider's ownership, and 23.8% chose private health care providers. Although patients with health insurance and higher SES were more likely to be aware of their provider's ownership, they preferred public providers over private providers. For example, having Urban Employee Basic Medical Insurance was associated with a 16.5% lower probability of choosing private providers than no health insurance. Respondents with the highest level of household expenditure had a 7.5% lower probability of choosing private providers than those with the lowest level of expenditure. The probability of choosing private providers were significantly lower by 4.0% among respondents with an education level of junior high school and above than those with no formal education. For private providers to play an effective role in the health care system, policies that have constrained the growth of the private sector should be changed, and more effort should be directed toward equalizing health insurance coverage for both types of providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. 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.

  11. A NEW PUBLIC HEALTH ISSUE: CONTAMINATION WITH ARSENIC OF PRIVATE WATER SOURCES

    Directory of Open Access Journals (Sweden)

    ANCA ELENA GURZAU

    2012-03-01

    Full Text Available A new public health issue: contamination with arsenic of private water sources. Known since the early ‘40s, the natural contamination with arsenic of depth water in Bihor and Arad areas continues to incite interest, especially since the rural localities still use depth water as the main source of drinking water. Arsenic concentrations measured in the water sources in the area range between 0-176 μg/L, and it is estimated that over 45,000 people are exposed via drinking water to arsenic concentrations above 10 μg/L. The present study proposed the measurement of arsenic concentrations from old public sources and individual private water sources from recent wells located in five localities in Arad County, samples being collected during 2010-2011. The results showed that public water sources declared or not non-potable contain arsenic above the maximum allowable concentration of 10 μg/L. Individual water sources recently drilled as an alternative for the population to the lack of access to safe water from public water systems, presented high concentrations of arsenic in most cases, even higher than the concentrations of the public sources declared by authorities as non-potable. In the absence of informing and counseling the population regarding the natural uneven distribution of arsenic in the depth water and its potential carcinogenicity, human exposure continues and it is even more intense. The significance of the problem in terms of public health becomes even more important as for the private water sources quality is not monitored by the authorities according to law, water analysis being performed on request and for a fee.

  12. 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?

  13. Demand for Private Health Insurance Where Public Health Services are Free: The Case of Malawi

    Science.gov (United States)

    Makoka, Donald; Kaluwa, Ben; Kambewa, Patrick

    This study assesses the determinants of demand for private health insurance among formal sector employees in Malawi using a multinomial logit. We examine membership in the three different schemes of Medical Aid Society of Malawi`s (MASM), which was the only health insurance provider at the time of the study. The results indicate that formal sector employees prefer to receive medical treatment from private health facilities, but lack of access to information prevents many from becoming insured. Further, the probability of enrolling in any of MASM`s schemes increases with income and with age for the top and minimum schemes. More children and good health status reduce the probability of enrolling into the two lower schemes. Policies that improve access to information and income among the target group are likely to increase demand for MASM schemes.

  14. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Fox, Mary A., E-mail: mfox9@jhu.edu [Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 407, Baltimore, MD 21205 (United States); Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 429, Baltimore, MD 21205 (United States); Nachman, Keeve E. [Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 407, Baltimore, MD 21205 (United States); Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 429, Baltimore, MD 21205 (United States); Center for a Livable Future, Johns Hopkins University, 615 North Wolfe Street, Room W7010, Baltimore, MD 21205 (United States); Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205 (United States); Anderson, Breeana [Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 429, Baltimore, MD 21205 (United States); Department of Pharmacology and Molecular Sciences, The Johns Hopkins University School of Medicine, 725 North Wolfe Street, Baltimore, MD 21205 (United States); Lam, Juleen [Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 407, Baltimore, MD 21205 (United States); Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Room 429, Baltimore, MD 21205 (United States); University of California at San Francisco, Department of Obstetrics, Gynecology & Reproductive Sciences, Mailstop 0132, 550 16th Street, 7th Floor, San Francisco, CA 94143 (United States); and others

    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. - Highlights: • About 43 million Americans use federally unregulated private wells for drinking water. • Private wells may be contaminated with naturally occurring and man-made chemicals. • Protecting well water requires an “infrastructure for stewardship”. • Recommendations to advance private well protection are offered.

  16. A study on the public-private partnership to global health issues in Korea.

    Science.gov (United States)

    Lee, Hyun Sook

    2013-12-01

    To find the fit that is most apt for the current situation in Korea and to find new ways of identifying potential partners for the purpose of public-private partnership (PPP). The research was conducted using domestic and international literature where the concept and definition of PPP was stated, and cases of PPP reported by the World Health Organization and cases in developed countries were investigated. Data were collected from 237 PPP potential partner organization, government agencies, and the government under a special law, local governments, businesses, hospitals, and private organizations through their internet webpage. The Delphi questionnaire was given to relevant institutions and questionnaire was surveyed general hospitals. Groups that were likely to realize most of the partnership were nonprofit or nongovernmental organizations, the central government, the private sector, public healthcare services, and products. In order to secure the position of exceptional comparative advantage of international expertise in the field of healthcare, we must implement PPP strategy that is in ordinance of domestic situation.

  17. Gender blind? An analysis of global public-private partnerships for health.

    Science.gov (United States)

    Hawkes, Sarah; Buse, Kent; Kapilashrami, Anuj

    2017-05-12

    The Global Public Private Partnerships for Health (GPPPH) constitute an increasingly central part of the global health architecture and carry both financial and normative power. Gender is an important determinant of health status, influencing differences in exposure to health determinants, health behaviours, and the response of the health system. We identified 18 GPPPH - defined as global institutions with a formal governance mechanism which includes both public and private for-profit sector actors - and conducted a gender analysis of each. Gender was poorly mainstreamed through the institutional functioning of the partnerships. Half of these partnerships had no mention of gender in their overall institutional strategy and only three partnerships had a specific gender strategy. Fifteen governing bodies had more men than women - up to a ratio of 5:1. Very few partnerships reported sex-disaggregated data in their annual reports or coverage/impact results. The majority of partnerships focused their work on maternal and child health and infectious and communicable diseases - none addressed non-communicable diseases (NCDs) directly, despite the strong role that gender plays in determining risk for the major NCD burdens. We propose two areas of action in response to these findings. First, GPPPH need to become serious in how they "do" gender; it needs to be mainstreamed through the regular activities, deliverables and systems of accountability. Second, the entire global health community needs to pay greater attention to tackling the major burden of NCDs, including addressing the gendered nature of risk. Given the inherent conflicts of interest in tackling the determinants of many NCDs, it is debatable whether the emergent GPPPH model will be an appropriate one for addressing NCDs.

  18. Analysis of a unique global public-private partnership to promote oral health.

    Science.gov (United States)

    Pine, Cynthia M; Dugdill, Lindsey

    2011-08-01

    Partnerships for health promotion are between two or more partners to work co-operatively towards a set of shared health outcomes; few public-private partnerships in oral health promotion have been established. To undertake a detailed analysis of a unique global public-private partnership to promote oral health between a global company, Unilever and the Féderation Dentaire International (FDI), a membership organisation representing more than one million dentists worldwide. Qualitative and quantitative, including: collating and analysing a wide range of partnership documents (n =164); reviewing film and pictorial records; undertaking structured interviews (n=34) with people who had a critical role in establishing and delivering the aims of the partnership, and external experts; and site visits to selected global projects active at the time of the evaluation. Over 1 million people have been reached directly through their engagement with 39 projects in 36 countries; an oral health message about the benefits of twice daily tooth brushing has appeared with the authority of the FDI logo on billions of packs of Unilever Oral Care's toothpastes worldwide; many individual members of National Dental Associations have participated in health promotion activities within their communities for the first time; some organisational challenges during the development and delivery of the partnership were recognised by both partners. The first phase of this unique global partnership has been successful in making major progress towards achieving its goals; lessons learned have ensured that the next phase of the partnership has significant potential to contribute to improving oral health globally. © 2011 FDI World Dental Federation.

  19. Public-Private Partnerships

    DEFF Research Database (Denmark)

    Helby Petersen, Ole

    This PhD dissertation studies national similarities and differences in policy and regulation of public-private partnerships (PPPs), with an empirical focus on Denmark and Ireland. The starting point and motivation for the study is the observation that whereas PPPs are often depicted in the academic...

  20. 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...

  1. 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...

  2. 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.

  3. Mental health leadership and patient access to care: a public-private initiative in South Africa.

    Science.gov (United States)

    Szabo, Christopher Paul; Fine, Jennifer; Mayers, Pat; Naidoo, Shan; Zabow, Tuviah

    2017-01-01

    Mental health leadership is a critical component of patient access to care. More specifically, the ability of mental health professionals to articulate the needs of patients, formulate strategies and engage meaningfully at the appropriate level in pursuit of resources. This is not a skill set routinely taught to mental health professionals. A public-private mental health leadership initiative, emanating from a patient access to care programme, was developed with the aim of building leadership capacity within the South African public mental health sector. The express aim was to equip health care professionals with the requisite skills to more effectively advocate for their patients. The initiative involved participants from various sites within South Africa. Inclusion was based on the proposal of an ongoing "project", i.e. a clinician-initiated service development with a multidisciplinary focus. The projects were varied in nature but all involved identification of and a plan for addressing an aspect of the participants' daily professional work which negatively impacted on patient care due to unmet needs. Six such projects were included and involved 15 participants, comprising personnel from psychiatry, psychology, occupational therapy and nursing. Each project group was formally mentored as part of the initiative, with mentors being senior professionals with expertise in psychiatry, public health and nursing. The programme design thus provided a unique practical dimension in which skills and learnings were applied to the projects with numerous and diverse outcomes. Benefits were noted by participants but extended beyond the individuals to the health institutions in which they worked and the patients that they served. Participants acquired both the skills and the confidence which enabled them to sustain the changes that they themselves had initiated in their institutions. The initiative gave impetus to the inclusion of public mental health as part of the curriculum

  4. Public and Private Sector in the Health Care System of the Federation Bosnia and Herzegovina: Policy and Strategy

    Science.gov (United States)

    Slipicevic, Osman; Malicbegovic, Adisa

    2012-01-01

    In Bosnia and Herzegovina citizens receive health care from both public and private providers. The current situation calls for a clear government policy and strategy to ensure better position and services from both parts. This article examines how health care services are delivered, particularly with respect to relationship between public and private providers. The paper notes that the public sector is plagued by a number of weaknesses in terms of inefficiency of services provision, poorly motivated staff, prevalent dual practice of public employees, poor working conditions and geographical imbalances. Private sector is not developing in ways that address the weaknesses of the public sector. Poorly regulated, it operates as an isolated entity, strongly profit-driven. The increasing burdens on public health care system calls for government to abandon its passive role and take action to direct growth and use potential of private sector. The paper proposes a number of mechanisms that can be used to influence private as well as public sector, since actions directed toward one part of the system will inevitable influence the other. PMID:23678309

  5. 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.

  6. 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.

  7. eHealth Search Patterns: A Comparison of Private and Public Health Care Markets Using Online Panel Data.

    Science.gov (United States)

    Schneider, Janina Anne; Holland, Christopher Patrick

    2017-04-13

    Patient and consumer access to eHealth information is of crucial importance because of its role in patient-centered medicine and to improve knowledge about general aspects of health and medical topics. The objectives were to analyze and compare eHealth search patterns in a private (United States) and a public (United Kingdom) health care market. A new taxonomy of eHealth websites is proposed to organize the largest eHealth websites. An online measurement framework is developed that provides a precise and detailed measurement system. Online panel data are used to accurately track and analyze detailed search behavior across 100 of the largest eHealth websites in the US and UK health care markets. The health, medical, and lifestyle categories account for approximately 90% of online activity, and e-pharmacies, social media, and professional categories account for the remaining 10% of online activity. Overall search penetration of eHealth websites is significantly higher in the private (United States) than the public market (United Kingdom). Almost twice the number of eHealth users in the private market have adopted online search in the health and lifestyle categories and also spend more time per website than those in the public market. The use of medical websites for specific conditions is almost identical in both markets. The allocation of search effort across categories is similar in both the markets. For all categories, the vast majority of eHealth users only access one website within each category. Those that conduct a search of two or more websites display very narrow search patterns. All users spend relatively little time on eHealth, that is, 3-7 minutes per website. The proposed online measurement framework exploits online panel data to provide a powerful and objective method of analyzing and exploring eHealth behavior. The private health care system does appear to have an influence on eHealth search behavior in terms of search penetration and time spent per

  8. [Work regulation in the context of new public versus private relations in health].

    Science.gov (United States)

    Barbosa, Nelson Bezerra

    2010-08-01

    This work discusses the management of the work relations in the context of the new systems of public vs. private relation in health, having as reference the experience of the habilitation of Social Organizations (SO), responsible for the administration of a group of hospitals in the state of São Paulo. The urgency in this kind of management supported on the legal figure of the SO has implications in the management of Human Resources in Health (HRH) through the adoption of flexibilization mechanisms which include ways of selection, hiring and dismissal, payment rules and functional progression similar to the actions adopted by the market. The establishment of this sort of administration refers to the new paradigm proposed by the managerial administrative reform which suggests the exhaustion of the bureaucratic model to promote adjustment of the public administration to the transformations originated in the new stage of internationalization of the economy and its unfolding in the work world, as well as to the new standards of requirements of performance of the public field. Aspects related to the management of HHR are approached in the two ruling modalities in the Secretaria de Estado da Saúde de São Paulo: Direct Administration Hospitals (DAH) and units organized under the SO model (SOH).

  9. Good governance of animal health systems and public-private partnerships: an Australian case study.

    Science.gov (United States)

    Black, P F

    2012-08-01

    The animal health system in Australia has evolved over more than 100 years and includes innovative public-private partnership arrangements. The establishment in 1996 of Animal Health Australia (AHA), a not-for-profit company, was a crucial development which formalised arrangements for shared decision-making and funding across both government and industry stakeholders. However, Federal and State governments retain legislative authority for animal health control. Accordingly, all programmes must recognise that the public sector remains an executive arm of government, accountable for its actions. Hence, much effort has been invested in ensuring that the governance arrangements within AHA are lawful and transparent. The Emergency Animal Disease Response Agreement (EADRA) is a very good example of governance arrangements that are sustainably financed, widely available, provided efficiently, without waste or duplication, and in a manner that is transparent and free of fraud or corruption. The benefits of EADRA include certainty and greater transparency of funding; greater efficiency through increased probability of a rapid response to an occurrence of any of 65 diseases; and industry participation in the management and financing of such a response.

  10. Rotavirus vaccines contribute towards universal health coverage in a mixed public-private healthcare system.

    Science.gov (United States)

    Loganathan, Tharani; Jit, Mark; Hutubessy, Raymond; Ng, Chiu-Wan; Lee, Way-Seah; Verguet, Stéphane

    2016-11-01

    To evaluate rotavirus vaccination in Malaysia from the household's perspective. The extended cost-effectiveness analysis (ECEA) framework quantifies the broader value of universal vaccination starting with non-health benefits such as financial risk protection and equity. These dimensions better enable decision-makers to evaluate policy on the public finance of health programmes. The incidence, health service utilisation and household expenditure related to rotavirus gastroenteritis according to national income quintiles were obtained from local data sources. Multiple birth cohorts were distributed into income quintiles and followed from birth over the first five years of life in a multicohort, static model. We found that the rich pay more out of pocket (OOP) than the poor, as the rich use more expensive private care. OOP payments among the poorest although small are high as a proportion of household income. Rotavirus vaccination results in substantial reduction in rotavirus episodes and expenditure and provides financial risk protection to all income groups. Poverty reduction benefits are concentrated amongst the poorest two income quintiles. We propose that universal vaccination complements health financing reforms in strengthening Universal Health Coverage (UHC). ECEA provides an important tool to understand the implications of vaccination for UHC, beyond traditional considerations of economic efficiency. © 2016 John Wiley & Sons Ltd.

  11. Assessment of health care needs and utilization in a mixed public-private system: the case of the Athens area

    Directory of Open Access Journals (Sweden)

    Niakas Dimitris

    2006-11-01

    Full Text Available Abstract Background Given the public-private mix of the Greek health system, the purpose of this study was to assess whether variations in the utilisation of health services, both primary and inpatient care, were associated with underlying health care needs and/or various socio-economic factors. Methods Data was obtained from a representative sample (N = 1426 residing in the broader Athens area (response rate 70.6%. Perceived health-related quality of life (HRQOL, as measured by the physical and mental summary component scores of the SF-36 Health Survey, was used as a proxy of health care need. Health care utilization was measured by a last-month visits to public sector physicians, b last-month visits to private sector physicians, c last-year visits to hospital emergency departments and d last-year hospital admissions. Statistical analysis involved the implementation of logistic regression models. Results Health care need was the factor most strongly associated with all measures of health care utilization, except for visits to public physicians. Women, elderly, less wealthy and individuals of lower physical health status visited physicians contracted to their insurance fund (public sector. Women, well educated and those once again of lower physical health status were more likely to visit private providers. Visits to hospital emergency departments and hospital admissions were related to need and no socio-economic factor was related to the use of those types of care. Conclusion This study has demonstrated a positive relationship between health care need and utilisation of health services within a mixed public-private health care system. Concurrently, interesting differences are evident in the utilization of various types of services. The results have potential implications in health policy-making and particularly in the proper allocation of scarce health resources.

  12. Antimalarial drug prescribing practice in private and public health facilities in South-east Nigeria: a descriptive study

    Directory of Open Access Journals (Sweden)

    Okebe Joseph

    2007-05-01

    Full Text Available Abstract Background Nigeria's national standard has recently moved to artemisinin combination treatments for malaria. As clinicians in the private sector are responsible for attending a large proportion of the population ill with malaria, this study compared prescribing in the private and public sector in one State in Nigeria prior to promoting ACTs. Objective To assess prescribing for uncomplicated malaria in government and private health facilities in Cross River State. Method Audit of 665 patient records at six private and seven government health facilities in 2003. Results Clinicians in the private sector were less likely to record history or physical examination than those in public facilities, but otherwise practice and prescribing were similar. Overall, 45% of patients had a diagnostic blood slides; 77% were prescribed monotherapy, either chloroquine (30.2%, sulphadoxine-pyrimethamine (22.7% or artemisinin derivatives alone (15.8%. Some 20.8% were prescribed combination therapy; the commonest was chloroquine with sulphadoxine-pyrimethamine. A few patients (3.5% were prescribed sulphadoxine-pyrimethamine-mefloquine in the private sector, and only 3.0% patients were prescribed artemisinin combination treatments. Conclusion Malaria treatments were varied, but there were not large differences between the public and private sector. Very few are following current WHO guidelines. Monotherapy with artemisinin derivatives is relatively common.

  13. 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.

  14. Comparison of the effects of public and private health expenditures on the health status: a panel data analysis in eastern mediterranean countries.

    Science.gov (United States)

    Homaie Rad, Enayatollah; Vahedi, Sajad; Teimourizad, Abedin; Esmaeilzadeh, Firooz; Hadian, Mohamad; Torabi Pour, Amin

    2013-08-01

    Health 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). In 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. The 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. The 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.

  15. 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.

  16. Principles for building public-private partnerships to benefit food safety, nutrition, and health research.

    Science.gov (United States)

    Rowe, Sylvia; Alexander, Nick; Kretser, Alison; Steele, Robert; Kretsch, Molly; Applebaum, Rhona; Clydesdale, Fergus; Cummins, Deborah; Hentges, Eric; Navia, Juan; Jarvis, Ashley; Falci, Ken

    2013-10-01

    The present article articulates principles for effective public-private partnerships (PPPs) in scientific research. Recognizing that PPPs represent one approach for creating research collaborations and that there are other methods outside the scope of this article, PPPs can be useful in leveraging diverse expertise among government, academic, and industry researchers to address public health needs and questions concerned with nutrition, health, food science, and food and ingredient safety. A three-step process was used to identify the principles proposed herein: step 1) review of existing PPP guidelines, both in the peer-reviewed literature and at 16 disparate non-industry organizations; step 2) analysis of relevant successful or promising PPPs; and step 3) formal background interviews of 27 experienced, senior-level individuals from academia, government, industry, foundations, and non-governmental organizations. This process resulted in the articulation of 12 potential principles for establishing and managing successful research PPPs. The review of existing guidelines showed that guidelines for research partnerships currently reside largely within institutions rather than in the peer-reviewed literature. This article aims to introduce these principles into the literature to serve as a framework for dialogue and for future PPPs.

  17. Private and public patients in public hospitals in Australia.

    Science.gov (United States)

    Shmueli, Amir; Savage, Elizabeth

    2014-04-01

    The nature of the private-public mix in health insurance and in health care is a major issue in most health systems. To compare the hospitalization characteristics of private and public patients hospitalized in public hospitals. We focused on planned, overnight and same-day admissions, discharged during 2004-2005 from the public New South Wales hospitals, and run fixed-effects regressions in order to identify the effect of accommodation status (private/public) on the hospitalization characteristics. Private patients have one third less waiting days than public patients, and they are assigned higher urgency of admission. Length of stay and length of visit are both unrelated to the accommodation status, however, private patients tend to have more hours in ICU and more procedures performed during the hospitalization. In-hospital mortality and the number of transfers (wards) are not affected by the accommodation status. Private patients are treated differently than public patients in public hospitals, reinforcing the private health insurance-related inequity in inpatient care identified by others. Two health policy issues emerge from the findings: the role of private health insurance in the Australian socialized medicine system, and in particular, in the public hospitals; and the way public hospitals are reimbursed for private patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

    Ben-Zeev, Dror

    2016-06-06

    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

  19. 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

    Aim As in many countries, medical and surgical specialists in New Zealand have the opportunity of working in the public sector, the private sector or both. This study aimed to explore the level and sources of satisfaction and dissatisfaction of specialists in New Zealand with working in the two s...

  20. Publicprivate '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.

  1. Dedicated Doctors: Public and Private Provision of Health Care with Altruistic Physicians

    NARCIS (Netherlands)

    J. Delfgaauw (Josse)

    2007-01-01

    textabstractPhysicians are supposed to serve patients' interests, but some are more inclined to do so than others. This paper studies how the system of health care provision affects the allocation of patients to physicians when physicians differ in altruism. We show that allowing for private provisi

  2. Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh

    OpenAIRE

    Sikder, Shegufta S; Labrique, Alain B.; Ali, Hasmot; Hanif, Abu AM; Klemm, Rolf DW; Mehra, Sucheta; Keith P. West; Christian, Parul

    2015-01-01

    Background Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access...

  3. Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh

    OpenAIRE

    Sikder, Shegufta S.; Labrique, Alain B; Ali, Hasmot; Hanif, Abu AM; Klemm, Rolf DW; Mehra, Sucheta; West, Keith P; Christian, Parul

    2015-01-01

    Background Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access...

  4. Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh.

    Science.gov (United States)

    Sikder, Shegufta S; Labrique, Alain B; Ali, Hasmot; Hanif, Abu A M; Klemm, Rolf D W; Mehra, Sucheta; West, Keith P; Christian, Parul

    2015-01-31

    Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access to healthcare and key constraints to EmOC provision. Using data from a large population-based community trial, we identified and surveyed the 14 health facilities (7 public, 7 private) most frequently visited for obstetric complications and near misses as reported by women. Availability of EmOC was based on provision of medical services, assessed through clinician interviews and record review. Levels of EmOC availability were defined as basic or comprehensive. Readiness for EmOC provision was based on scores in four categories: staffing, equipment, laboratory capacity, and medicines. Readiness scores were calculated using unweighted averages. Costs of C-section procedures and geographic locations of facilities were described. Textual analysis was used to identify key constraints. The seven surveyed private facilities offered comprehensive EmOC compared to four of the seven public facilities. With 100% representing full readiness, mean EmOC readiness was 81% (range: 63%-91%) among surveyed private facilities compared to 67% (range: 48%-91%) in public facilities (p = 0.040). Surveyed public clinics had low scores on staffing and laboratory capacity (69%; 50%). The mean cost of the C-section procedure in private clinics was $77 (standard deviation: $16) and free in public facilities. The public sub-district facilities were the only facilities located in rural areas, with none providing comprehensive EmOC. Shortages in specialized staff were listed as the main barrier to EmOC provision in

  5. Quality of private and public ambulatory health care in low and middle income countries: systematic review of comparative studies.

    Directory of Open Access Journals (Sweden)

    Sima Berendes

    2011-04-01

    Full Text Available BACKGROUND: In developing countries, the private sector provides a substantial proportion of primary health care to low income groups for communicable and non-communicable diseases. These providers are therefore central to improving health outcomes. We need to know how their services compare to those of the public sector to inform policy options. METHODS AND FINDINGS: We summarised reliable research comparing the quality of formal private versus public ambulatory health care in low and middle income countries. We selected studies against inclusion criteria following a comprehensive search, yielding 80 studies. We compared quality under standard categories, converted values to a linear 100% scale, calculated differences between providers within studies, and summarised median values of the differences across studies. As the results for for-profit and not-for-profit providers were similar, we combined them. Overall, median values indicated that many services, irrespective of whether public or private, scored low on infrastructure, clinical competence, and practice. Overall, the private sector performed better in relation to drug supply, responsiveness, and effort. No difference between provider groups was detected for patient satisfaction or competence. Synthesis of qualitative components indicates the private sector is more client centred. CONCLUSIONS: Although data are limited, quality in both provider groups seems poor, with the private sector performing better in drug availability and aspects of delivery of care, including responsiveness and effort, and possibly being more client orientated. Strategies seeking to influence quality in both groups are needed to improve care delivery and outcomes for the poor, including managing the increasing burden of non-communicable diseases.

  6. Pharmaceutical Public-Private Partnerships

    DEFF Research Database (Denmark)

    Bagley, Constance; Tvarnø, Christina D.

    2014-01-01

    This article provides a game theory and law-and-management analysis of for- profit pharmaceutical public-private partnerships, a complex type of legal arrangement in the highly regulated pharmaceutical industry. A pharmaceutical public-private partnership (PPPP) agreement is a legally binding con...

  7. Factors associated to Caesarean delivery in public and private health care systems.

    Science.gov (United States)

    Oliveira, Rosana Rosseto de; Melo, Emiliana Cristina; Novaes, Elisiane Soares; Ferracioli, Patrícia Louise Rodrigues Varela; Mathias, Thais Aidar de Freitas

    2016-01-01

    Identifying factors associated to Caesarean sections among the residents of Maringá-PR, according to the financing source for delivery. A cross-sectional study with data from 920 postpartum women interviewed between October 2013 and February 2014. Association analysis was performed by logistic regression. Caesarean section rates were 55.5% in the Unified Healthcare System (SUS) and 93.8% in the private system. Factors associated with Caesarean section in the SUS were: previous Caesarean section (OR=8.9; CI=4.6-16.9), desire for Caesarean section early in pregnancy (OR=2.0; CI=1.1-3.6), pregestational overweight/obesity (OR=1.8; CI=1.1-2.8), and per capita family income higher than one minimum wage (OR=2.1; CI=1.3-3.4). In the private system, desire for Caesarean section early in pregnancy (OR=25.3) and a previous Caesarean section (OR=11.3) were strongly associated to its performance. It is necessary to properly orientate all pregnant women who desire a Caesarean delivery, from both the SUS and the private system, about the inherent risks of the surgical procedure without indication. In the public health sector, guidelines should be focused on pregnant women with previous Caesarean delivery, with a per capita income higher than one minimum wage and those who are overweight or obese, as these women are more likely to have a Caesarean section. Identificar fatores associados à cesárea entre residentes de Maringá-PR, segundo a fonte de financiamento do parto. Estudo transversal com dados de 920 puérperas entrevistadas entre outubro de 2013 e fevereiro de 2014. A análise de associação foi feita por regressão logística. A taxa de cesariana foi de 55,5% e 93,8% no Sistema Único de Saúde (SUS) e no sistema privado, respectivamente. Associou-se à cesárea no SUS: realização de cesárea anterior (OR=8,9; IC=4,6-16,9), desejo pela cesárea no início da gestação (OR=2,0; IC=1,1-3,6), sobrepeso/obesidade pré-gestacional (OR=1,8; IC=1,1-2,8), e renda familiar

  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

    and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Conclusion Sources of job satisfaction......Aim As in many countries, medical and surgical specialists in New Zealand have the opportunity of working in the public sector, the private sector or both. This study aimed to explore the level and sources of satisfaction and dissatisfaction of specialists in New Zealand with working in the two...... of satisfaction and 9 sources of dissatisfaction according to a 5-point Likert scale. Means and standard deviations were calculated for the total sample, and for procedural and non-procedural specialties. Differences between the means of each source of satisfaction and dissatisfaction were also calculated...

  9. Value Chains of Public and Private Health-care Services in a Small EU Island State: A SWOT Analysis

    Science.gov (United States)

    Buttigieg, Sandra C.; Schuetz, Marcus; Bezzina, Frank

    2016-01-01

    The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state’s health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta. PMID:27683658

  10. Value Chains of Public and Private Health-care Services in a Small EU Island State: A SWOT Analysis.

    Science.gov (United States)

    Buttigieg, Sandra C; Schuetz, Marcus; Bezzina, Frank

    2016-01-01

    The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state's health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta.

  11. Public Sector Unions and Privatization

    DEFF Research Database (Denmark)

    Foged, Søren Kjær; Aaskoven, Lasse

    2016-01-01

    to substantially and significantly less privatization through the voucher market. By comparison, the estimated relationship between the relative number of public workers and privatization does not reach statistical significance. Features of the voucher market and qualitative evidence suggest that the union...

  12. Value chains of public and private health care services in a small EU Island State: A SWOT analysis

    Directory of Open Access Journals (Sweden)

    Sandra C. Buttigieg

    2016-09-01

    Full Text Available The global financial and macro-economic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically in health care, governments started to explore ways of establishing collaborations between the public and private healthcare sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care, as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health care systems in Malta, a small EU island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains and this was followed by an analysis of strengths, weaknesses, opportunities and threats (SWOT. The latter revealed several strengths and opportunities, which can better equip health policy makers in the quest to maximize provision of health care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that unless addressed, may threaten the state’s health care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health care services in Malta.

  13. Private Health Insurance Exchanges

    Science.gov (United States)

    Buttorff, Christine; Nowak, Sarah; Syme, James; Eibner, Christine

    2017-01-01

    Abstract Private health insurance exchanges offer employer health insurance, combining online shopping, increased plan choice, benefit administration, and cost-containment strategies. This article examines how private exchanges function, how they may affect employers and employees, and the possible implications for the Affordable Care Act's (ACA's) Small Business Health Options Program (SHOP) Marketplaces. The authors found that private exchanges could encourage employees to select less-generous plans. This could expose employees to higher out-of-pocket costs, but premium contributions would drop substantially, so net spending would decrease. On the other hand, employee spending may increase if, in moving to private exchanges, employers decrease their health insurance contributions. Most employers can avoid the ACA's “Cadillac tax” by reducing the generosity of the plans they offer, regardless of whether they move to a private exchange. There is not yet enough evidence to determine whether the private exchanges will become prominent in the insurance market and how they will affect employers and their employees. PMID:28845340

  14. Privatization and the Public Good

    Science.gov (United States)

    Lambert, Matthew T.

    2015-01-01

    After two centuries of public higher education in the United States, the covenant between public colleges and universities and the public that created and funded them is under strain. In a time of scarce resources and changing policy in many corners of the country and around the globe, privatization has emerged as a possible replacement for the…

  15. Coverage of emergency obstetric care and availability of services in public and private health facilities in Bangladesh.

    Science.gov (United States)

    Alam, Badrul; Mridha, Malay K; Biswas, Taposh K; Roy, Lumbini; Rahman, Maksudur; Chowdhury, Mahbub E

    2015-10-01

    To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric services in Bangladesh. In a national health facility assessment performed between November 2007 and July 2008, all public EmOC facilities and private facilities providing obstetric services in the 64 districts of Bangladesh were mapped. The performance of EmOC services in these facilities during the preceding month was investigated using a semi-structured questionnaire completed through interviews of managers and service providers, and record review. In total, 8.6 (2.1 public and 6.5 private) facilities per 500000 population offered obstetric care services. Population coverage by obstetric care facilities varied by region. Among 281 public facilities designated for comprehensive EmOC, cesarean delivery was available in only 215 (76.5%) and blood transfusion services in 198 (70.5%). In the private sector (for profit and not for profit), these services were available in more than 80% of facilities. In all facility types, performance of assisted vaginal delivery (range 12.2%-48.4%) and use of parenteral anticonvulsants to treat pre-eclampsia/eclampsia (range 48.6%-80.8%) were low. The main reason for non-availability of EmOC services was a lack of specialist/trained providers. Bangladesh needs to increase the availability of EmOC services through innovative public-private partnerships. In the public sector, additional trained manpower supported by an incentivized package should be deployed. Copyright © 2015. Published by Elsevier Ireland Ltd.

  16. Quantifying Differences in Health Care Consumption for the Management of Multiple Sclerosis Within Privately and Publicly Insured Health Care Programs.

    Science.gov (United States)

    Livingston, Terrie; Fay, Monica; Iyer, Ravi; Wells, Wendy; Pill, Michael W

    2016-12-01

    Multiple sclerosis (MS) is a chronic and debilitating disease of the central nervous system that affects more than 570,000 persons in the United States and 2.3 million worldwide. Since most individuals experience initial symptoms between the ages of 20 and 40 years, MS can have a significant effect on health care consumption, quality of life, productivity, and employment over the long-term disease course. Opportunities exist to better understand how benefit design and other nonclinical factors can affect health care delivery and associated costs. To observe and report variances in health care consumed for the treatment of MS in patients enrolled in privately (commercial) and publicly (Medicaid) funded health insurance programs. In a retrospective analysis using Havas Gemini's proprietary MS Benchmarks Disease-Modeling Process and IMS LifeLink Health Plan Claims and Longitudinal Prescriptions databases, integrated medical and pharmacy claims data were analyzed to select patients with a diagnosis of MS during the 2012 calendar year. Comorbidities were determined using ICD-9-CM codes present on medical claims. Prescription drug use was evaluated by pharmacy claims and drug-specific billing codes. 19,984 patients with MS were identified-18,269 from commercial payers and 1,715 from Medicaid. Although total annual costs related to the care of MS for the groups reflected a relatively small difference ($31,107 commercial; $33,344 Medicaid), costs associated with specific service categories varied greatly. Pharmacy costs were considerably less in the Medicaid group; however, inpatient and emergency room costs were as much as 5 times higher. Overall use of disease-modifying treatments (DMTs) in the Medicaid group was seen in 32.5% of patients and 52.1% in the commercial patient group. Thus, lower pharmacy costs in the Medicaid group were possibly related to lesser use of DMTs among that group of patients. This analysis illustrates that notable variances exist in consumption

  17. 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

  18. Blurring of the public/private divide: the Canadian chapter.

    Science.gov (United States)

    Flood, Colleen M; Thomas, Bryan

    2010-06-01

    Blurring of public/private divide is occurring in different ways around the world, with differential effects in terms of access and equity. In Canada, one pathway towards privatization has received particular attention: duplicative private insurance, allowing those with the financial means to bypass queues in the public system. We assess recent legal and policy developments on this front, but also describe other trends towards the blurring of public and private in Canada: the reliance on mandated private insurance for pharmaceutical coverage; provincial governments' reliance on public-private partnerships to finance hospitals; and the incorporation of for-profit clinics within the public health care system.

  19. 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 work (p work-related permanent disabilities (p working lives that need improvement; priority expectations in the 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.

  20. Private Money, Public Good

    Science.gov (United States)

    Kelly, Andrew P.; McShane, Michael Q.

    2013-01-01

    It's no secret that states and the federal government have found themselves in a financial pinch when it comes to higher education. After years of recession and sluggish recovery, states have slashed per-pupil public spending on higher education by 14.6 percent since 2008. At the federal level, though money for Pell Grants has more than doubled…

  1. Private Money, Public Good

    Science.gov (United States)

    Kelly, Andrew P.; McShane, Michael Q.

    2013-01-01

    It's no secret that states and the federal government have found themselves in a financial pinch when it comes to higher education. After years of recession and sluggish recovery, states have slashed per-pupil public spending on higher education by 14.6 percent since 2008. At the federal level, though money for Pell Grants has more than doubled…

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

    Science.gov (United States)

    Vieira Machado, Alessandra A; Estevan, Anderson Oliveira; Sales, Antonio; Brabes, Kelly Cristina da Silva; Croda, Júlio; Negrão, Fábio Juliano

    2014-09-01

    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.

  4. 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

  5. Managing the work-life roller-coaster: private stress or public health issue?

    Science.gov (United States)

    Bryson, Lois; Warner-Smith, Penny; Brown, Peter; Fray, Leanne

    2007-09-01

    Although research has established the importance for health of a sense of personal control at work, the implications of this for women have not been adequately studied. Using quantitative data from the Australian Longitudinal Study on Women's Health and qualitative data from an associated study, here we examine women's health and sense of control in relation to family and employment commitments. In line with other research, 'demand over-load' is found to be important for sense of control, but both 'over-load' and 'control' prove complex, as illustrated by the finding that good mental health is associated with satisfaction with, rather than actual, hours of employment. In the contemporary western context of longer working hours, increasing time strain, and gender relations shaped within a neo-liberal, individualised social environment, the findings suggest that as life speeds up, 'control' and the health effects of 'busyness', need to be understood not merely as personal matters, but rather as potentially important public health issues.

  6. Public-private Partnerships

    DEFF Research Database (Denmark)

    Hodge, Graeme A.; Greve, Carsten; Boardman, Anthony E.

    2017-01-01

    Infrastructure PPPs are now main-stream. Both partnership language and its contractual forms have evolved over the past few decades, though. Compared to early optimistic promises, we now have a more nuanced and balanced view of what PPPs are and what they can achieve. Indeed, modern PPPs are tied...... experience in this context, particularly through the global financial crisis. It concludes that PPP can become an integrated part of infrastructure development around the world, assuming learning occurs from past experience. It presents several lessons on deepening partnerships; on the multiplicity...... of the PPP ‘model’ and its ingredients; on policy learning and on governing infrastructure in the medium term. And it also concludes that not only does the PPP brand today still offer manifold possibilities, even more public policy experimentation is currently warranted....

  7. Georgia's Cancer Awareness and Education Campaign: combining public health models and private sector communications strategies.

    Science.gov (United States)

    Parker, Demetrius M

    2004-07-01

    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 dollars, the first year of the campaign focuses on breast and cervical cancer screening and early detection.

  8. Portugal's experience with public-private partnerships

    NARCIS (Netherlands)

    Miranda Sarmento, J.J.; Renneboog, L.D.R.; Akintoye, A.; Beck, M.; Kumaraswamy, M.

    2015-01-01

    This paper documents the Portuguese experience in Public-Private Partnerships (PPPs). Since 1993, Portugal has been using PPPs intensively, mainly for highway construction and in the health sector. This has enabled the country to close the infrastructure gap and avoid the budget constraints at the

  9. Brazil's Mixed Public and Private Hospital System.

    Science.gov (United States)

    Lewis, Maureen; Penteado, Evandro; Malik, Ana Maria

    2015-01-01

    Brazil's hospital sector is vibrant and growing. Under the 1988 Brazilian constitution all citizens have the right to health care, anticipating the global commitment to Universal Health Care. Brazil's public sector prides itself on having one of the world's largest single payer health care systems, but complementing that is a significant and larger private sector that is seeing big increase in investment, utilization and prices. This article outlines the structure of the hospital system and analyzes the nature and direction of private health sector expansion. Twenty-six percent of Brazilians have private health insurance and although coverage is concentrated in the urban areas of the Southeastern part of the country, it is growing across the nation. The disease burden shift to chronic diseases affects the nature of demand and the directly affects overall health care costs, which are rising rapidly outstripping national inflation by a factor of 3. Increasingly costs will have to be brought under control to maintain the viability of the private sector. Adaption of integrated care networks and strengthening of the public reimbursement system represent important areas for improvement.

  10. 77 FR 30351 - Sec. 221 Public Private Partnerships Public Meeting

    Science.gov (United States)

    2012-05-22

    ... such a program be based on public- private partnership (PPP) principles and maximize the use of private... effective public-private partnership equipage incentive program. This notice is for the initial meeting. A...

  11. 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

  12. Public-private partnerships improve health outcomes in individuals with early stage Alzheimer's disease.

    Science.gov (United States)

    Galvin, James E; Tolea, Magdalena I; George, Nika; Wingbermuehle, Cheryl

    2014-01-01

    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. 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. 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. PLM was successful in improving detection of incident cases of dementia in the community and in connecting patients and their families with needed services. Our findings support the use of state agencies and community service partners to detect dementia. Early implementation of psychosocial interventions could have significant impact in improving patient- and family-centered outcomes, potentially providing a cost-efficient alternative to pharmacotherapy.

  13. [Disease monitoring and surveillance systems and the role of public and private animal health agents: the experience of Africa].

    Science.gov (United States)

    Roger, F; Thonnat, J; Hendrikx, P; Domenech, J

    2004-04-01

    The current importance of animal diseases, and their emergence or re-emergence, show that surveillance is crucial for defining suitable control measures. Surveillance systems rely on networks of different people, whose activities include collecting, transmitting, analysing and disseminating disease information. These activities can be distributed among both the public and private sectors. However, nowadays it is essential to clearly define the different roles of the public and private sectors. In Africa, where budget cuts for state Veterinary Services over a number of years have promoted the growth of private veterinary medicine, the tasks of public officials (veterinarians, technicians, etc.) and private sector workers (veterinarians, livestock farmers) must be clearly determined and harmonised. This article presents and comments upon a number of different experiments that various sub-Saharan African countries have conducted in this field.

  14. Balancing Public and Private Regulation

    Directory of Open Access Journals (Sweden)

    Martijn Scheltema

    2016-01-01

    Full Text Available Voluntary Sustainability Standards (VSS might develop into a viable alternative to public regulation. However, it turns on the (regulatory circumstances whether that holds true in practice. If public regulation on CSR topics is lacking, governments are unable to agree upon certain topics on a global level or diverging public regulation exists, VSS can be helpful to set global standards. Obviously, private standards will especially be helpful if they are commensurate with local public legislation (and e.g. treaties and/or are accepted by local governments. If one neglects this, numerous domestic structures might exist that frustrate VSS. Furthermore, governments have to remain vigilant as to whether these private regimes do not result in market disruption, consumer detriment or hamper trade. VSS might also compete with public arrangements which might limit the uptake of VSS. However, if public regulation exists VSS might be a viable alternative if compliance with not too compelling public norms by market participants is rather poor and the public policymaker is aiming to incentivize the better performing part of the market to embark on higher standards and thus only desires to regulate the less performing part of the market. However, of paramount importance is the effectiveness of VSS in order to be a viable alternative to public regulation. The effectiveness of VSS should be assessed using an integrated multi-disciplinary (comparative approach entailing legal, impact-assessment, legitimacy, governance and behavioural aspects. Only effective VSS in the aforementioned sense are a true alternative to public regulation.Beyond that, the legal perspective in connection with (the effectiveness of VSS is discussed, featuring FSC and UTZ Certified as an example. It is important from this perspective that VSS have a clear and sufficiently selective objective and sufficiently specific norms, are regularly evaluated, entail ‘conflict of law rules’ and

  15. Balancing Public and Private Regulation

    Directory of Open Access Journals (Sweden)

    Martijn Scheltema

    2016-01-01

    Full Text Available Voluntary Sustainability Standards (VSS might develop into a viable alternative to public regulation. However, it turns on the (regulatory circumstances whether that holds true in practice. If public regulation on CSR topics is lacking, governments are unable to agree upon certain topics on a global level or diverging public regulation exists, VSS can be helpful to set global standards. Obviously, private standards will especially be helpful if they are commensurate with local public legislation (and e.g. treaties and/or are accepted by local governments. If one neglects this, numerous domestic structures might exist that frustrate VSS. Furthermore, governments have to remain vigilant as to whether these private regimes do not result in market disruption, consumer detriment or hamper trade. VSS might also compete with public arrangements which might limit the uptake of VSS. However, if public regulation exists VSS might be a viable alternative if compliance with not too compelling public norms by market participants is rather poor and the public policymaker is aiming to incentivize the better performing part of the market to embark on higher standards and thus only desires to regulate the less performing part of the market. However, of paramount importance is the effectiveness of VSS in order to be a viable alternative to public regulation. The effectiveness of VSS should be assessed using an integrated multi-disciplinary (comparative approach entailing legal, impact-assessment, legitimacy, governance and behavioural aspects. Only effective VSS in the aforementioned sense are a true alternative to public regulation.Beyond that, the legal perspective in connection with (the effectiveness of VSS is discussed, featuring FSC and UTZ Certified as an example. It is important from this perspective that VSS have a clear and sufficiently selective objective and sufficiently specific norms, are regularly evaluated, entail ‘conflict of law rules’ and

  16. 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.

  17. Public and private maternal health service capacity and patient flows in Southern Tanzania: using a geographic information system to link hospital and national census data.

    Science.gov (United States)

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M E; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health programming. Inclusive partnerships could increase

  18. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    Directory of Open Access Journals (Sweden)

    Patrik Tabatabai

    2014-01-01

    Full Text Available Background: Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective: To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design: A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6 in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds, provider-fees for obstetric services and patient turnover (antenatal care, births. Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results: The contribution of faith-based organizations (FBOs to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions: We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising

  19. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    Science.gov (United States)

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M. E.; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Background Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health

  20. Public-private partnerships in Denmark

    DEFF Research Database (Denmark)

    Esbjerg, Lars; Grunert, Klaus G.; Bruun, Peter

    2004-01-01

    element of this project, this report presents an inventory of public-private partnerships in Denmark. More specifically, it provides an inventory of past, present and proposed research projects related to food quality and food safety involving both public and private partners. Furthermore it points...... to a number of opportunities for developing public-private partnerships....

  1. Privatizing health care in times of new public management: Investigating the role of psychological empowerment using cluster analysis.

    Science.gov (United States)

    Hansen, Niklas; Baraldi, Stephan; Berntson, Erik; Andersson, Håkan

    2013-12-01

    Although privatization within health care is usually justified using arguments based on efficiency and productivity, the empirical investigations underpinning such arguments are few and ambiguous in their results. Presenting a new theoretical and analytical approach to this research field, we argue that psychological empowerment, reflecting individuals' intrinsic change motivation state, is a crucial prerequisite for the transformation of a nonprofit health care organization to a for-profit one. The general aims of this study were to explore empowerment cognitions during a privatization, to relate these to a selection of key work-related outcome variables, and to identify the effects of privatization in terms of individual level changes in empowerment after privatization. A sample of health care workers (n = 210) provided survey longitudinal data that were analyzed using cluster analysis. Eight clusters were identified at both pre- and postprivatization with each cluster mirroring specific empowerment patterns: Empowered, In Control, Quasi-Empowered, Competent/Normed, Reference, Underused, Misfit, and Powerless. The clusters discriminated on positive work attitudes, mental health complaints, and turnover intentions. The analysis also revealed the complexity of privatization in that a homogenization as well as a differentiation tendency was observed, thereby implicating both socio-structural equality and inequality effects. The results highlighted the relevance of allocating importance to health care workers' psychological empowerment during the privatization process, and of viewing such organizational transformations not as simple shifts in the state of affairs, but as nonlinear processes involving dynamic changes in individual perceptions over time.

  2. Blurring the boundaries between public and private health care services as an alternative explanation for the emergence of black medicine: the Israeli case.

    Science.gov (United States)

    Filc, Dani; Cohen, Nissim

    2015-07-01

    Black medicine represents the most problematic configuration of informal payments for health care. According to the accepted economic explanations, we would not expect to find black medicine in a system with a developed private service. Using Israel as a case study, we suggest an alternative yet a complimentary explanation for the emergence of black medicine in public health care systems - even though citizens do have the formal option to use private channels. We claim that when regulation is weak and political culture is based on 'do it yourself' strategies, which meant to solve immediate problems, blurring the boundaries between public and private health care services may only reduce public trust and in turn, contribute to the emergence of black medicine. We used a combined quantitative and qualitative methodology to support our claim. Statistical analysis of the results suggested that the only variable significantly associated with the use of black medicine was trust in the health care system. The higher the respondents' level of trust in the health care system, the lower the rate of the use of black medicine. Qualitatively, interviewee emphasized the relation between the blurred boundaries between public and private health care and the use of black medicine.

  3. Factors Associated with Treatment Delay among Pulmonary Tuberculosis Patients in Public and Private Health Facilities in Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Getinet Shewaseged Adenager

    2017-01-01

    Full Text Available Background. Early detection and diagnosis of tuberculosis (TB and the timely commencement of antituberculosis (anti-TB treatment are the parts of efficient tuberculosis prevention and control program. Delay in the commencement of anti-TB treatment worsens the prognosis and increases the risk of death and the chance of transmission in the community and among health care workers. Objective. To assess tuberculosis treatment delay and associated factors among pulmonary TB patients in Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted in 10 public and 10 private health facilities that provide TB treatment. The data were collected from 425 newly registered pulmonary TB patients using pretested structured questionnaire from April to June 2012. Data were entered in EPI info version 3.5.1 and analyzed using SPSS version 16.0. Findings. The median durations of a patient, health care system, and total treatment delays were 17, 9, and 35 days, respectively. Overall 179 (42.1%, 233 (54.8%, and 262 (61.6% of patients experienced patient delay, health care system delay, and total treatment delay, respectively. Distance more than 2.5 km from TB treatment health facility [AOR = 1.6, 95% CI (1.1–2.5] and the presence of TB-associated stigma [AOR = 2.1, 95% CI (1.3, 3.4] indicate higher odds of patient delay, whereas, being unemployed, patients with the hemoptysis symptom complain indicated lower odds of health care system delay [AOR = 0.41, 95% CI (0.24, 0.70] and [AOR = 0.61 (0.39, 0.94], respectively. Conclusions. A significant proportion of clients experienced patient and health care system delay. Thus, there is a need for designing and implementing appropriate strategies to decrease the delays. Efforts to reduce delays should give focus on integrating prevention programs such as active case detection and expanding access to TB care.

  4. HRM in public private partnerships: working in a health production system

    OpenAIRE

    Bishop, Simon

    2011-01-01

    This study explores the changing nature of employment and employment management within multi-organisational public services ‘partnerships’. In line with international trends, a major feature of the 1997-2010 New Labour government’s public policy was encouraging partnerships between organisations of all sectors to run public services. Within healthcare, central government has increasingly been seen as taking on a role of market regulator, with organisations from all sectors allowed to plan as ...

  5. Balancing authority, deference and trust across the public-private divide in health care: tuberculosis health visitors in western Maharashtra, India.

    Science.gov (United States)

    Kielmann, Karina; Datye, Vinita; Pradhan, Anagha; Rangan, Sheela

    2014-01-01

    While concepts such as 'partnership' are central to the terminology of private-public mix (PPM), little attention has been paid to how social relations are negotiated among the diverse actors responsible for implementing these inter-sectoral arrangements. India's Revised National Tuberculosis Control Programme (RNTCP) has used intermediary agents to facilitate the involvement of private providers in the expansion of Directly Observed Therapy, Short-Course (DOTS). We examine the roles of tuberculosis health visitors (TB HVs) in mediating working relationships among private providers, programme staff and patients that underpin a PPM-DOTS launched by the RNTCP in western Maharashtra. In addition to observations and informal interactions with the programme and participating health providers, researchers conducted in-depth interviews with senior programme officers and eight TB HVs. Framed by a political discourse of clinical governance, working relationships within the PPM are structured by the pluralistic context, social and professional hierarchies and paternalism of health care in India. TB HVs are at the nexus of these relationships, yet remain undervalued partly because accountability is measured through technical rather than social outcomes of the 'partnership'. Close attention to the dynamics of power relations in working practices within the health system can improve accountability and sustainability of partnerships.

  6. Health care privatization in Latin America: comparing divergent privatization approaches in Chile, Colombia, and Mexico.

    Science.gov (United States)

    Bustamante, Arturo Vargas; Méndez, Claudio A

    2014-08-01

    The public-private mix in Chile, Colombia, and Mexico was very similar until the early 1980s when Chile undertook health care privatization as part of comprehensive health care reform. Since then, health care privatization policies have diverged in these countries. In this study we characterize health care privatization in Latin America and identify the main factors that promoted and hindered privatization by comparing the experiences of these countries. We argue that policy elites took advantage of specific policy environments and the diffusion of privatization policies to promote health care privatization while political mobilization against privatization, competing policy priorities, weak market and government institutions, and efforts to reach universal health insurance hindered privatization. The privatization approaches of Chile and Colombia were classified as "big-bang," since these countries implemented health care privatization more rapidly and with a wider scope compared with the case of Mexico, which was classified as gradualist, since the privatization path followed by this country adopted a slower pace and became more limited and focalized over time. We conclude that the emphasis on policy-driven privatization diminished in the 1990s and 2000s because of increased public health care financing and a shift in health care reform priorities. Health care privatization in the region, however, continued as a consequence of demand-driven privatization.

  7. Message framing in the context of the national menu-labelling policy: a comparison of public health and private industry interests.

    Science.gov (United States)

    Shelton, Rachel C; Colgrove, James; Lee, Grace; Truong, Michelle; Wingood, Gina M

    2017-04-01

    We conducted a content analysis of public comments to understand the key framing approaches used by private industry v. public health sector, with the goal of informing future public health messaging, framing and advocacy in the context of policy making. Comments to the proposed menu-labelling policy were extracted from Regulations.gov and analysed. A framing matrix was used to organize and code key devices and themes. Documents were analysed using content analysis with Dedoose software. Recent national nutrition-labelling regulations in the USA provide a timely opportunity to understand message framing in relation to obesity prevention and policy. We examined a total of ninety-seven documents submitted on behalf of organizations (private industry, n 64; public health, n 33). Public health focused on positive health consequences of the policy, used a social justice frame and supported its arguments with academic data. Industry was more critical of the policy; it used a market justice frame that emphasized minimal regulation, depicted its members as small, family-run businesses, and illustrated points with humanizing examples. Public health framing should counter and consider engaging directly with non-health-related arguments made by industry. Public health should include more powerful framing devices to convey their messages, including metaphors and humanizing examples.

  8. Biosecurity in public and private office.

    Science.gov (United States)

    Garbin, Artênio José Isper; Garbin, Cléa Adas Saliba; Arcieri, Renato Moreira; Crossato, Michel; Ferreira, Nelly Foster

    2005-06-01

    Biosecurity is currently a concern for all health-related services, including dentistry, since infection control has a relevant importance. In dental practice, health-related occupations have contact with a great number of individuals who are potentially capable to transmit pathogens. This study comprised a descriptive evaluation of the universal precaution measures for infection control adopted by dental practitioners working at public and private offices in the city of Araçatuba, SP. Data collection was performed by a quiz with questions about individual and collective protection equipments. The results showed that the use of caps was reported by 55% of the professionals working at the public sector and 90% for the private sector. The use of masks and gloves was reported by all professionals surveyed; nevertheless, glove change between patients was not reported by 40% of professionals working at the public sector. There were more flaws in public offices as to the use of protective barriers, since except for the use of gloves, gowns and masks, the frequency of use of those barriers was smaller than at private offices.

  9. Public and private sector interactions: an economic perspective.

    Science.gov (United States)

    Maynard, A

    1986-01-01

    The debate about the public-private mix for health care has been dominated by rhetoric and the failure to evaluate the characteristics of the outcomes of public and private health care systems and to relate these to policy targets. After a brief analysis of the competing, liberal (conservative) and collectivist (socialist), objectives, the nature of the private health care sector in Britain is described and it is shown that growth has faltered due to cost containment problems. This outcome is the product of characteristics of the private health care system, paralleled precisely in the NHS: asymmetry information, monopoly power, moral hazard and third party pays. The final section discusses briefly some remedies for the inefficient and inequitable outcomes which are seen in all health care markets and it is argued that competition within public and private health care systems may enable each system type to achieve its own particular objectives more efficiently.

  10. PRIVATE OR PUBLIC PENSION INSURANCE?

    Directory of Open Access Journals (Sweden)

    Bogomil Manov

    2013-03-01

    Full Text Available The most recent trends in population dynamics and increased longevity risk have provoked a rigorous debate whether the private or the public pension insurance system should be predominant. The public pension insurance is dominated by the state that guarantees its stability, but is often compared to a pyramid or a Ponzi scheme. The private pension insurance provides personal retirement accounts and proper ownership of the accumulated funds, but its sustainability during prolonged market crises and inadequate risk sharing are often questioned. In order to address the issue, this study analyzes and compares a large set of arguments and popular opinions in favour and against both pension models. As a result of the study, a conclusion is drawn stating that both types of pension insurance, despite of their positive and negative features have their essential role nowadays. This study is part of a growing set of articles on the feasibility of using a proper combination of the two pension models and will contribute to future research on the topic and might benefit policymakers in taking an appropriate decision.

  11. The Privatization of Public University Research Libraries

    Science.gov (United States)

    Franklin, Brinley

    2007-01-01

    Are we witnessing the privatization of public university research libraries? There is convincing evidence that, in an era of decreasing state support for public higher education, public universities have begun to resemble private universities, particularly in their sources of revenue. A number of indicators demonstrate that public universities,…

  12. The Challenge of Public-Private Partnerships

    DEFF Research Database (Denmark)

    Hodge, Graeme; Greve, Carsten

    . "The Challenge of Public - Private Partnerships" advances recent thought on PPPs in the areas of risk transfer, financial implications, contractual matters, politics, management and accountability. International case studies are presented from the United Kingdom, Europe, the US and Australasia......Public - Private Partnerships (PPPs) - co-operative institutional arrangements between public and private sector actors - are now an increasingly relevant and globally popular public policy option. The authors argue that even though PPPs are still evolving, there is now sufficient research to bring...

  13. Availability and price of malaria rapid diagnostic tests in the public and private health sectors in 2011: results from 10 nationally representative cross-sectional retail surveys.

    Science.gov (United States)

    Poyer, Stephen; Shewchuk, Tanya; Tougher, Sarah; Ye, Yazoume; Mann, Andrea G; Willey, Barbara A; Thomson, Rebecca; Amuasi, John H; Ren, Ruilin; Wamukoya, Marilyn; Taylor, Mark; Nguah, Samuel Blay; Mberu, Blessing; Kalolella, Admirabilis; Juma, Elizabeth; Festo, Charles; Johanes, Boniface; Diap, Graciela; Bruxvoort, Katia; Ansong, Daniel; Hanson, Kara; Arnold, Fred; Goodman, Catherine

    2015-06-01

    To describe the state of the public and private malaria diagnostics market shortly after WHO updated its guidelines for testing all suspected malaria cases prior to treatment. Ten nationally representative cross-sectional cluster surveys were conducted in 2011 among public and private health facilities, community health workers and retail outlets (pharmacies and drug shops) in nine countries (Tanzania mainland and Zanzibar surveyed separately). Eligible outlets had antimalarials in stock on the day of interview or had stocked antimalarials in the past 3 months. Three thousand four hundred and thirty-nine rapid diagnostic test (RDT) products from 39 manufacturers were audited among 12,197 outlets interviewed. Availability was typically highest in public health facilities, although availability in these facilities varied greatly across countries, from 15% in Nigeria to >90% in Madagascar and Cambodia. Private for-profit sector availability was 46% in Cambodia, 20% in Zambia, but low in other countries. Median retail prices for RDTs in the private for-profit sector ranged from $0.00 in Madagascar to $3.13 in Zambia. The reported number of RDTs used in the 7 days before the survey in public health facilities ranged from 3 (Benin) to 50 (Zambia). Eighteen months after WHO updated its case management guidelines, RDT availability remained poor in the private sector in sub-Saharan Africa. Given the ongoing importance of the private sector as a source of fever treatment, the goal of universal diagnosis will not be achievable under current circumstances. These results constitute national baselines against which progress in scaling-up diagnostic tests can be assessed. © 2015 John Wiley & Sons Ltd.

  14. Utilization of public or private health care providers by febrile children after user fee removal in Uganda

    Directory of Open Access Journals (Sweden)

    Peterson Stefan

    2009-03-01

    Full Text Available Abstract Background Despite investments in providing free government health services in Uganda, many caretakers still seek treatment from the drug shops/private clinics. The study aimed to assess determinants for use of government facilities or drug shops/private clinics for febrile illnesses in children under five. Methods Structured questionnaires were administered to caretakers in 1078 randomly selected households in the Iganga – Mayuge Demographic Surveillance site. Those with children who had had fever in the previous two weeks and who had sought care from outside the home were interviewed on presenting symptoms and why they chose the provider they went to. Symptoms children presented with and reasons for seeking care from government facilities were compared with those of drug shops/private clinics. Results Of those who sought care outside the home, 62.7% (286/456 had first gone to drug shops/private clinics and 33.1% (151/456 first went to government facilities. Predictors of having gone to government facilities with a febrile child were child presenting with vomiting (OR 2.07; 95% CI 1.10 – 3.89 and perceiving that the health providers were qualified (OR 10.32; 95% CI 5.84 – 18.26 or experienced (OR 1.93; 95% CI 1.07 – 3.48. Those who took the febrile child to drug shops/private clinics did so because they were going there to get first aid (OR 0.20; 95% CI 0.08 – 0.52. Conclusion Private providers offer 'first aid' to caretakers with febrile children. Government financial assistance to health care providers should not stop at government facilities. Multi-faceted interventions in the private sector and implementation of community case management of febrile children through community medicine distributors could increase the proportion of children who access quality care promptly.

  15. [Oral health in 12 year-old students from public and private schools in the city of Goiânia, Brazil].

    Science.gov (United States)

    Freire, Maria do Carmo Matias; Reis, Sandra Cristina Guimaraes Bahia; Gonçalves, Michele Martins; Balbo, Patrícia Lima; Leles, Cláudio Rodrigues

    2010-08-01

    To compare 12-year-old students from public and private schools in the city of Goiânia, Brazil, in terms of the prevalence of caries, periodontal conditions, dentofacial anomalies, and fluorosis. In 2003, the 2002-2003 Oral Health Conditions in the Brazilian Population project (SB Brasil) was expanded to Goiânia as a cross-sectional study, as described in the present article. The sample included 1 947 students from urban schools: 1 790 (91.9%) attended public schools and 157 (8.1%) attended private schools. Data on the following oral conditions were collected through clinical examination: dental caries (decayed, missing, or filled teeth index, DMFT), periodontal condition (Community Periodontal Index, CPI), dentofacial anomaly (Dental Aesthetics Index, DAI), and dental fluorosis (Dean index). The groups were compared using the chi-square and Mann-Whitney U tests. There were differences between the public and private schools for all the variables. DMFT, CPI, and DAI indexes were higher in children from public schools (P private schools (P school was associated with the oral health condition of the children in this sample. Investments in actions and services to mitigate this inequality and its effects should be made as part of the policies to promote oral health.

  16. Comparing demographics, clinical presentation, treatments and outcome between systemic lupus erythematosus patients treated in a public and private health system in Santa Fe, Argentina.

    Science.gov (United States)

    Schmid, María Marcela; Roverano, Susana Graciela; Paira, Sergio Oscar

    2014-01-01

    The study includes 159 SLE patients seen between 1987 and 2011, of whom 116 were treated in the public health system and 43 in private practice. In the comparison between both groups, it was shown that patients in the public health system were younger at first consultation and at the onset of SLE, and that the mean duration of their disease prior to nephropathy was statistically significantly shorter. They also presented with more SLE activity (measured by Systemic Lupus Erythematosus Activity Index) such as fever, lower levels of C4, and elevated erythrocyte sedimentation rate. Although cyclophosphamide was administered more frequently to patients in the public health system group, there were no statistically significant differences in renal histological findings. A second renal biopsy was performed on 20 patients due to the presence of persistent proteinuria, peripheral edema, urinary casts, or because of previous defective renal specimens. The overall 10-year survival of the patients in the public health system was 78% compared to a survival rate of 91% for the patients in private practices. When survival was evaluated at 15 years, however, no differences were found (log rank test: 0.65). Patients from both public and private groups attended medical specialist practices and received early diagnoses and close follow-ups.

  17. 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.

  18. Differentially Private Trajectory Data Publication

    CERN Document Server

    Chen, Rui; Desai, Bipin C

    2011-01-01

    With the increasing prevalence of location-aware devices, trajectory data has been generated and collected in various application domains. Trajectory data carries rich information that is useful for many data analysis tasks. Yet, improper publishing and use of trajectory data could jeopardize individual privacy. However, it has been shown that existing privacy-preserving trajectory data publishing methods derived from partition-based privacy models, for example k-anonymity, are unable to provide sufficient privacy protection. In this paper, motivated by the data publishing scenario at the Societe de transport de Montreal (STM), the public transit agency in Montreal area, we study the problem of publishing trajectory data under the rigorous differential privacy model. We propose an efficient data-dependent yet differentially private sanitization algorithm, which is applicable to different types of trajectory data. The efficiency of our approach comes from adaptively narrowing down the output domain by building...

  19. 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

  20. Is Canada odd? A comparison of European and Canadian approaches to choice and regulation of the public/private divide in health care.

    Science.gov (United States)

    Flood, Colleen M; Haugan, Amanda

    2010-07-01

    Choice is often touted as a means for change within health care systems. Yet 'choice', in this context, takes at least three distinct forms: choice between providers within a publicly funded health care system; choice between competing insurers within a universal plan; and, lastly, choice as between privately financed health care and universal public coverage. In Canada, it is this last form of choice that is under active debate; particularly in light of the Supreme Court of Canada's decision in Chaoulli, which found a regulation banning private health insurance for medically necessary care was unconstitutional. The argument is frequently made that Canada is an outlier from other countries in having regulation that effectively precludes this kind of choice. This issue is likely to become of concern again in upcoming constitutional challenges where applicants are looking to overturn through judicial challenges Canada's medicare system. This article tests that argument of whether Canada truly is 'odd' from a comparative policy perspective by exploring regulation of choice of privately financed health care in several European countries - the Netherlands, Germany, Sweden, England and France. We highlight commonalities as well as differences, showing the extent to which these countries employ regulation to fetter growth of a large privately financed sector. The article's thesis is that Canada, in employing more intrusive forms of regulation, is not an outlier per se but at one point in a regulatory spectrum.

  1. Public Private Partnerships Applicability to Defence Procurement

    Science.gov (United States)

    2001-09-01

    Public Private Partnerships Applicability to Defence Procurement Jonathan Barnes KPMG Corporate Finance Report Documentation Page Report Date...25SEP2001 Report Type N/A Dates Covered (from... to) 25SEP2001 - 27SEP2001 Title and Subtitle Public Private Partnerships Applicability to Defence...unclassified Classification of Abstract unclassified Limitation of Abstract UU Number of Pages 6 kpmg Aim Provide an appreciation of: n Public Private Partnerships

  2. Comparing public and private sector switchers

    DEFF Research Database (Denmark)

    Frederiksen, Anders; Hansen, Jesper Rosenberg; Bozeman, Barry

    are related to sector switching and the pattern of sector switch, public to private versus private to public. We propose a life stage model arguing that people's needs change in different life stages of their lives. We further suggest that this can help explain why they switch sector. We use unique Danish...... labor market data that include information on all employees in Denmark (both private and public sector). The data are for the period 1980 to 2006, and this longitudinal database includes abundant information about job changes, including sector switching. Our findings indicate mixed support....... Finally, we find that people with more education are likely to switch from private to public sector....

  3. Patterns of case management and chemoprevention for malaria-in-pregnancy by public and private sector health providers in Enugu state, Nigeria

    Directory of Open Access Journals (Sweden)

    Onwujekwe Ogochukwu C

    2012-07-01

    Full Text Available Abstract Background Malaria in pregnancy (MIP is a major disease burden in Nigeria and has adverse consequences on the health of the mother, the foetus and the newborn. Information is required on how to improve its prevention and treatment from both the providers’ and consumers’ perspectives. Methods The study sites were two public and two private hospitals in Enugu, southeast Nigeria. Data was collected using a pre-tested structured questionnaire. The respondents were healthcare providers (doctors, pharmacists and nurses providing ante-natal care (ANC services. They consisted of 32 respondents from the public facilities and 20 from the private facilities. The questionnaire elicited information on their: knowledge about malaria, attitude, chemotherapy and chemoprophylaxis using pyrimethamine, chloroquine proguanil as well as IPTp with sulphadoxine-pyrimethamine (SP. The data was collected from May to June 2010. Results Not many providers recognized maternal and neonatal deaths as potential consequences of MIP. The public sector providers provided more appropriate treatment for the pregnant women, but the private sector providers found IPTp more acceptable and provided it more rationally than public sector providers (p  Conclusions There is sub-optimal level of knowledge about current best practices for treatment and chemoprophylaxis for MIP especially in the private sector. Also, IPTp was hardly used in the public sector. Interventions are required to improve providers’ knowledge and practices with regards to management of MIP.

  4. Clients satisfaction of antenatal care services in public and private ...

    African Journals Online (AJOL)

    ... to be effective and educating pregnant women about planning for safe birth. ... Methods: A descriptive cross-sectional comparative study design was used to ... in public and private health facilities in Surulere local government, Lagos state.

  5. Public-Private Partnerships for Transport Infrastructure

    DEFF Research Database (Denmark)

    Figueroa, Maria Josefina; Greve, Carsten

    The provision of transport infrastructure and services creates fundamental value to society. With traditional sources of transport public funding running short, governments around the world are increasingly turning to public-private finance (PPPs) as a promising tool of public infrastructure...... of the public but of the private actor as well, to act perhaps motivated by corporate social responsibility, committing to bringing innovation and transparency in their efforts for advancing sustainability....

  6. [Organization of the drug supply chain in state health services: potential consequences of the public-private mix].

    Science.gov (United States)

    López-Moreno, Sergio; Martínez-Ojeda, Rosa Haydeé; López-Arellano, Oliva; Jarillo-Soto, Edgar; Castro-Albarrán, Juan Manuel

    2011-01-01

    To assess the consequences of private outsourcing on the overall supply and filling of prescriptions in state health services. The research was conducted using quantitative and qualitative techniques in 13 states. The information was collected through interviews and direct observation. The interviews were carried on staff of state health services related to the drug supply chain and users of health services. The quantitative approach examined the percentage of stocked full recipes in a sample of users. States that have opted for the fully outsourced model, and properly monitored this choice, have increased the supply of drugs to their users and guaranteed the supply in the care units in charge. Other states with the outsourced model have multiple problems: direct purchase of drugs not included in the basic drugs catalogue, failure of suppliers and shortage of supplies in the laboratories that provide the company. The main disadvantages identified in all models were: the subordination of the medical criteria to administrative criteria, insufficient planning based on local care needs, heterogeneous procedures, insufficient knowledge of regulations and lack of normativity. The results indicate that the incorporation of private providers in the drug supply chain may not be the solution to bring down the shortage faced by health services, especially at the hospital level. The shift to outsourcing models has developed without incorporating evaluation mechanisms and the consequences that this transition can have on state health systems must be investigated more deeply.

  7. The rise of private health insurande in Denmark

    DEFF Research Database (Denmark)

    Dejgaard, Thomas Engel

    2011-01-01

    The Danish healthcare system has since the early 1970s been tax financed and with free and equal access to health care. It still is, but within the last decade there has been an exponential growth in the number of private health insurances – from less than 50.000 in 2002 to approximately 1.......1 million in 2010. These private health insurances to great extent cover the same kind of treatments that can be obtained through the public tax financed system, but without the waiting lists that has been the an unsolvable problem for the public health care system over the past two decades. The rise...... of 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...

  8. Public Incentives for Conservation on Private Land

    OpenAIRE

    Suter, Jordan; Sahan, Dissanayake; Lynne, Lewis

    2014-01-01

    Habitat destruction and fragmentation resulting from land development has motivated considerable public and private expenditures on land conservation initiatives. In addition to direct expenditures related to the procurement of conservation land, legislators have also put in place incentives aimed at encouraging private landowners to voluntarily donate conservation easements. Many landowners have taken advantage of these incentives, as private land held under conservation easement increased n...

  9. Public or private? The role of the state and civil society in health and health inequalities across nations.

    Science.gov (United States)

    Olafsdottir, Sigrun; Bakhtiari, Elyas; Barman, Emily

    2014-12-01

    Social scientists have long recognized that macro-level factors have the potential to shape the health of populations and individuals. Along these lines, they have theorized about the role of the welfare state in creating more equal opportunities and outcomes and how this intervention may benefit health. More recently, scholars and policymakers alike have pointed out how the involvement of civil society actors may replace or complement any state effort. Using data from the World Values Surveys and the European Values Study, combined with national-level indicators for welfare state and civil society involvement, we test the impact of each sector on health and health inequalities in 25 countries around the world. We find that both have a statistically significant effect on overall health, but the civil society sector may have a greater independent influence in societies with weaker welfare states. The health inequalities results are less conclusive, but suggest a strong civil society may be particularly beneficial to vulnerable populations, such as the low income and unemployed. Our paper represents an early step in providing empirical evidence for the impact of the welfare state and civil society on health and health inequalities.

  10. Public and private responsibility for health: a comparative analysis of attitudes towards financing and the right for health care.

    NARCIS (Netherlands)

    Abel, T.; Zee, J. van der

    1995-01-01

    The present study focuses on values that directly relate to issues of health care. It will observe specific patterns of health values and compare their distribution across selected social groups within and across four European nations. Studying these issues, new insights are expected into Eurpean we

  11. Public-private partnership in theory

    Directory of Open Access Journals (Sweden)

    Blaž Vrhnjak

    2007-07-01

    Full Text Available Background: In political and other debates much of attention is paid to publicprivate partnerships (PPPs. These partnerships are perceived as a tool of meeting public demand by private supply. In theory there are at least four different forms of contract partnerships according to the amount of risks transferred to the private sector.Conclusions: Publicprivate partnerships are neither the only neither the preferred way of providing public service. On one hand they tend to lower financial burden of the public sector but on the other hand PPPs require complex ways of management and monitoring. It is highly important to consider specific circumstances of individual projects in question.

  12. Reputational Sanctions in Private and Public Regulation

    NARCIS (Netherlands)

    J.G. van Erp (Judith)

    2008-01-01

    textabstractThis article analyses how reputation functions as a mechanism for social control in private and public regulation. It discusses three cases of private markets where reputation is a powerful and effective mechanism for social control. From the case studies, four characteristics of markets

  13. Privatization in a public leadership mixed duopoly

    Science.gov (United States)

    Ferreira, Fernanda A.; Ferreira, Flávio

    2016-06-01

    We consider domestic and international competitions with one public leader firm and one follower private firm, producing complementary goods and competing on prices. We compare the results obtained in both models. Furthermore, we examine the impacts of privatization on consumer surplus and on social welfare.

  14. Respondents report survey Public Private Partnerships

    NARCIS (Netherlands)

    E-H. Klijn (Erik-Hans); J.F.M. Koppenjan (Joop); N. de Boer (Noortje)

    2014-01-01

    markdownabstract__Abstract__ Public private partnerships (PPP) have become a popular policy instrument in many Western European countries. Governments assume that the involvement of private actors in the provision of services, or in the realization of policy goals will increase quality and provide

  15. USAID Public-Private Partnerships Database

    Data.gov (United States)

    US Agency for International Development — This dataset brings together information collected since 2001 on PPPs that have been supported by USAID. For the purposes of this dataset a Public-Private...

  16. Conflicting logics in Public Private Innovation

    DEFF Research Database (Denmark)

    Nissen, Helle Aarøe

    The article explores the interplay between conflicting logics, when private firms interact with potential public customers, as the firms aim to commercialize welfare innovations developed through Public Private Innovation (PPI) projects. Commercialization of welfare innovations in healthcare may ...... as there is an expressed need for these within the healthcare system. As such, the article contributes to institutional logics theory by addressing the call for research in conflicting logics.......The article explores the interplay between conflicting logics, when private firms interact with potential public customers, as the firms aim to commercialize welfare innovations developed through Public Private Innovation (PPI) projects. Commercialization of welfare innovations in healthcare may...... that they are faced with a NIH logic which is in conflict with their own market logic involving intensions to commercialize broadly within the healthcare system. The firms experience difficulties in commercializing and thus diffusing welfare innovations, which, for them, seem to be counter intuitive...

  17. Renegotiating Public-Private Partnerships

    NARCIS (Netherlands)

    Miranda Sarmento, J.J.; Renneboog, Luc

    2017-01-01

    The renegotiations of public–private partnership (PPP) contracts are commonly considered to be one of the pitfalls of PPPs, as they tend to undermine their (ex ante) efficiency. A renegotiation occurs when specific events change the conditions of a concession, frequently leading to a financial claim

  18. Renegotiating Public-Private Partnerships

    NARCIS (Netherlands)

    Miranda Sarmento, J.J.; Renneboog, Luc

    2017-01-01

    The renegotiations of public–private partnership (PPP) contracts are commonly considered to be one of the pitfalls of PPPs, as they tend to undermine their (ex ante) efficiency. A renegotiation occurs when specific events change the conditions of a concession, frequently leading to a financial claim

  19. Public Schools: Make Them Private.

    Science.gov (United States)

    Friedman, Milton

    1997-01-01

    A voucher system enabling parents to choose freely the schools their children attend is the most feasible way to improve education. Vouchers will encourage privatization. That will unleash the drive, imagination, and energy of competitive free enterprise to revolutionize the education process. Government schools will be forced to improve to retain…

  20. Blogging how our private thoughts went public

    CERN Document Server

    Wolfe, Kristin Roeschenthaler

    2014-01-01

    Public vs. private is an ongoing concern in communication. This book examines this phenomenon through self-representational writing and the philosophical lens of Hannah Arendt's public vs. private theory, the Boundary Management theory, and the Parasocial Framework theory to examine the first social networking platform: personal blogs. By starting with a look back at self-representational writing, the book also examines how much information individuals have shared with each other through this format historically.

  1. The Challenge of Public-Private Partnerships

    DEFF Research Database (Denmark)

    Hodge, Graeme; Greve, Carsten

    Public - Private Partnerships (PPPs) - co-operative institutional arrangements between public and private sector actors - are now an increasingly relevant and globally popular public policy option. The authors argue that even though PPPs are still evolving, there is now sufficient research to bring....... "The Challenge of Public - Private Partnerships" advances recent thought on PPPs in the areas of risk transfer, financial implications, contractual matters, politics, management and accountability. International case studies are presented from the United Kingdom, Europe, the US and Australasia...... international challenges for future PPPs. Re-examining the myriad meanings and definitions given to PPPs, and presenting a range of theories and frameworks to improve understanding of PPP events and outcomes, this book will be of great interest to those involved in public administration and public policy-making....

  2. Developing public private partnerships in Denmark

    DEFF Research Database (Denmark)

    Buser, Martine; Koch, Christian

    2005-01-01

    The establishment of private public partnerships in Denmark in relation to construction has been a long and reluctant process. In the spring of 2004 however the government launched an action plan and PPP arrangements are now emerging. A first wave of PPP arrangements started flourishing however...... these various sectors in producing present public services. The paper analyse the emergent network and the metagovernance frame. Examples of Danish PPP are given highlighting the role of the construction firms. The experiences illustrate the importance of recognizing public private partnerships as emergent...... of networking, learning and establishing of institutions. Drawing on new public management perspectives it is argued that the future model of public services is the network of a mixed set of players (private, voluntary and public). Such networks might be strong in combining forces and strength from...

  3. Public by Day, Private by Night: Examining the Private Lives of Kenya's Public Universities

    Science.gov (United States)

    Wangenge-Ouma, Gerald

    2012-01-01

    This article examines the emergence of the public university in Kenya as a key provider of private higher education, characterised mainly by the phenomenon of the "private public university student." It probes the broader socio-economic reforms circumscribing the privatisation of Kenya's public universities and the local and global forces…

  4. Public by Day, Private by Night: Examining the Private Lives of Kenya's Public Universities

    Science.gov (United States)

    Wangenge-Ouma, Gerald

    2012-01-01

    This article examines the emergence of the public university in Kenya as a key provider of private higher education, characterised mainly by the phenomenon of the "private public university student." It probes the broader socio-economic reforms circumscribing the privatisation of Kenya's public universities and the local and global…

  5. Signal functions for emergency obstetric care as an intervention for reducing maternal mortality: a survey of public and private health facilities in Lusaka District, Zambia.

    Science.gov (United States)

    Tembo, Tannia; Chongwe, Gershom; Vwalika, Bellington; Sitali, Lungowe

    2017-09-06

    Zambia's maternal mortality ratio was estimated at 398/100,000 live births in 2014. Successful aversion of deaths is dependent on availability and usability of signal functions for emergency obstetric and neonatal care. Evidence of availability, usability and quality of signal functions in urban settings in Zambia is minimal as previous research has evaluated their distribution in rural settings. This survey evaluated the availability and usability of signal functions in private and public health facilities in Lusaka District of Zambia. A descriptive cross sectional study was conducted between November 2014 and February 2015 at 35 public and private health facilities. The Service Availability and Readiness Assessment tool was adapted and administered to overall in-charges, hospital administrators or maternity ward supervisors at health facilities providing maternal and newborn health services. The survey quantified infrastructure, human resources, equipment, essential drugs and supplies and used the UN process indicators to determine availability, accessibility and quality of signal functions. Data on deliveries and complications were collected from registers for periods between June 2013 and May 2014. Of the 35 (25.7% private and 74.2% public) health facilities assessed, only 22 (62.8%) were staffed 24 h a day, 7 days a week and had provided obstetric care 3 months prior to the survey. Pre-eclampsia/ eclampsia and obstructed labor accounted for most direct complications while postpartum hemorrhage was the leading cause of maternal deaths. Overall, 3 (8.6%) and 5 (14.3%) of the health facilities had provided Basic and Comprehensive EmONC services, respectively. All facilities obtained blood products from the only blood bank at a government referral hospital. The UN process indicators can be adequately used to monitor progress towards maternal mortality reduction. Lusaka district had an unmet need for BEmONC as health facilities fell below the minimum UN standard

  6. Private and public decisions in social dilemmas

    DEFF Research Database (Denmark)

    Houser, Daniel; Montinari, Natalia; Piovesan, Marco

    2012-01-01

    Are selfish impulses less likely to be pursued when decisions are publicly observable? Is the presence of peers a potential solution to social dilemmas? In this paper we report data on the self-control decisions of children aged 6 to 11 who participated in games that require one to resist a selfish...... impulse for several minutes in order to benefit others. In Public Condition children make decisions in public view of the group of other participants, while in Private Condition they have the possibility to decide privately. We find that children aged 9 and higher are better able to resist selfish...... impulses in public environments. Younger children, however, display no such effect. Further, we find self-control substantially impacted by group size. When decisions are public, self-control is better in larger groups, while in private condition the opposite holds....

  7. Health literacy, health information seeking behaviors and internet use among patients attending a private and public clinic in the same geographic area.

    Science.gov (United States)

    Gutierrez, Natalia; Kindratt, Tiffany B; Pagels, Patti; Foster, Barbara; Gimpel, Nora E

    2014-02-01

    Despite the growing body of health information available online, patients with limited health literacy may lack either internet access or skills necessary to utilize this information. Nonetheless, patients at all health literacy levels may prefer other primary sources to obtain health information. We conducted a cross-sectional study to measure health literacy of patients attending two clinics in Dallas, TX and determine associations between health literacy, health information access and internet usage before and after controlling for confounders. Patients from both clinics (county N = 265; private N = 233) completed a brief survey which included sociodemographics, internet patterns, confidence in filling out medical forms and a self-administered Newest Vital Sign to measure health literacy. In the county clinic, most patients (61.5 %) were Hispanic, had low income (literacy (68.5 %). In the private clinic, participants were mostly black (40.4 %) or white (38.6 %), had higher incomes (≥$46,000), higher education (technical college or college) and adequate health literacy (75.1 %). The primary source of obtaining health information in both clinics was their health care professional (50.6 % county; 40.1 % private). In multivariate analyses to determine differences by health literacy level, there were no statistically significant differences between patients with limited and adequate health literacy and their primary information source. Regardless of health literacy, patients rely on their health care providers to obtain health information. These results showcase the importance of providers' effective communication with patients to make shared decisions about their health regardless of other factors.

  8. What's public? What's private? Policy trade-offs and the debate over mandatory annual influenza vaccination for health care workers.

    Science.gov (United States)

    Mah, Catherine L

    2008-01-01

    Policy decisions about public health services differ from those for personal health services. Both require trade-offs between such policy goals as liberty, security, efficiency, and equity. In public health, however, decisions about who will approve, pay for, and deliver services are often accompanied by decisions on when and how to compel individual behaviour. Policy becomes complex because different stakeholders interpret evidence differently: stakeholders may assign different weights to policy goals and may even define the same goals differently. In the debate over mandatory annual influenza vaccination for health care workers, for example, proponents as well as opponents of mandatory vaccination may convey arguments in security terms. Those in favour of mandatory vaccination emphasize subclinical infections and duty of care (public security) while those opposed emphasize risk of adverse events (personal security). Proponents assert less worker absenteeism (efficiency) while opponents stress coercion and alternate personal infection control measures (liberty and individual rights/responsibilities). Consequently, stakeholders talk past each other. Determining the place of mandatory influenza vaccination for health care workers thus demands reconciling policy trade-offs and clarifying the underlying disputes hidden in the language of the policy debate.

  9. 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.

  10. Developing public private partnerships in Denmark

    DEFF Research Database (Denmark)

    Buser, Martine; Koch, Christian

    2005-01-01

    these various sectors in producing present public services. The paper analyse the emergent network and the metagovernance frame. Examples of Danish PPP are given highlighting the role of the construction firms. The experiences illustrate the importance of recognizing public private partnerships as emergent...

  11. Motivating the Private vs. Public Sector Managers.

    Science.gov (United States)

    Khojasteh, Mak

    1993-01-01

    A questionnaire on intrinsic/extrinsic rewards received 362 responses from 380 managers. Pay and security were greater motivators for private than for public sector managers. Recognition had higher motivating potential in the public sector. Both groups were motivated by achievement and advancement. (SK)

  12. PRIVATIZATION OF PUBLIC ENTERPRISES: WHICH WAY NIGERIA?

    Directory of Open Access Journals (Sweden)

    Daniel Eseme GBEREVBIE

    2015-08-01

    Full Text Available Governments exist among others to implement policies for the enhancement of the living standard of citizens. To accomplish this goal, public enterprises are established to provide goods and services. With the use of secondary data, the paper examines privatization policy in Nigeria. It observed government interference, lack of transparency and accountability as the major hindrances to the successful implementation of the policy. The paper therefore recommends that for privatization to achieve its goals, government should stop interfering in the implementation of the policy and appoint people of credible character to manage the implementing agency of privatization in Nigeria.

  13. [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

  14. Research using blogs for data: public documents or private musings?

    Science.gov (United States)

    Eastham, Linda A

    2011-08-01

    Nursing and other health sciences researchers increasingly find blogs to be valuable sources of information for investigating illness and other human health experiences. When researchers use blogs as their exclusive data source, they must discern the public/private aspects inherent in the nature of blogs in order to plan for appropriate protection of the bloggers' identities. Approaches to the protection of human subjects are poorly addressed when the human subject is a blogger and the blog is used as an exclusive source of data. Researchers may be assisted to protect human subjects via a decisional framework for assessing a blog author's intended position on the public/private continuum.

  15. Privatization: The Challenge Ahead for Public Higher Education.

    Science.gov (United States)

    DeAngelo, Linda

    This paper discusses privatization of public higher education, noting that some form of it exists on almost every college campus and that it is part of the wider movement toward less government. Four models of privatization are defined: public production with public finance; public production with private finance; private production with public…

  16. Comparing public and private sector switchers

    DEFF Research Database (Denmark)

    Frederiksen, Anders; Hansen, Jesper Rosenberg; Bozeman, Barry

    are related to sector switching and the pattern of sector switch, public to private versus private to public. We propose a life stage model arguing that people's needs change in different life stages of their lives. We further suggest that this can help explain why they switch sector. We use unique Danish......Sector switching is a new rising research area. Little is known about the motives and behaviors of those switching sectors. Using Person-Environment (P-E) fit theory, we seek to determine whether familiar demographic characteristics, including age, gender, having children and length of education...... labor market data that include information on all employees in Denmark (both private and public sector). The data are for the period 1980 to 2006, and this longitudinal database includes abundant information about job changes, including sector switching. Our findings indicate mixed support...

  17. Modern aspects of public private partnership

    Directory of Open Access Journals (Sweden)

    Sladjana Benkovic

    2009-12-01

    Full Text Available Development of infrastructure is essential presumption for growth and development of relevant economic entities. The empirical evidence of private initiative importance and potentials in the establishment of cooperation with the public sector in infrastructure projects financing and operation refocused professional and academic attention on the studies of this phenomenon. The realm of the public private partnership (PPP became scientifically treated as an interdisciplinary skill based mostly on project financing, whilst practically it became almost mandatory method for economic prosperity. Practical problems in implementation appeared due to lack of knowledge and nonsystematic approach in researches of private public partnership. This paper presents theoretical and practical directions for actors in this cooperation, scoping for mobilization of assets and energy for development and facilitation, and advancing of project investments efficiency.

  18. Markets & Myths: Autonomy in Public & Private Schools

    Directory of Open Access Journals (Sweden)

    Sandra Rubin Glass

    1997-01-01

    Full Text Available

    School choice is the most controversial education policy issue of the 1990s. John Chubb and Terry Moe's Politics, Markets and America's Schools stimulated this investigation. They concluded that teacher and administrator autonomy was the most important influence on student achievement. They assumed that the organization of private schools offered greater autonomy resulting in higher student achievement and that the bureaucracy of public schools stifles autonomy limiting student achievement. The research undertaken here elaborates, elucidates, and fills in the framework of teacher and principal autonomy in public and private secondary schools. Interviews of more than thirty teachers and administrators in six high schools, observations, field notes, and analysis of documents collected in the field form the empirical base of this work. The sites included three private, independent, nondenominational secondary schools which are college preparatory and three public secondary schools noted for high graduation rates and offering numerous advanced placement courses.

    The feelings expressed by both public and private school participants in this study testify to equally high degrees of autonomy. Issues that emerged from data analysis in this study which mitigate and shape autonomy include the following: conflicting and contradictory demands, shared beliefs, layers of protection, a system of laws, funding constraints and matters of size of the institution. These issues challenge oversimplified assertions that differences of any importance exist between the autonomy experienced by professionals in public and private high schools. This study reveals the complexity of the concept of autonomy and challenges the myth that teachers and principals in private schools enjoy autonomy and freedom from democratic bureaucracy that their public school counterparts do not.

  19. Theorising Public and Private Spheres

    Directory of Open Access Journals (Sweden)

    Sima Remina

    2016-12-01

    Full Text Available The 19th century saw an expression of women’s ardent desire for freedom, emancipation and assertion in the public space. Women hardly managed to assert themselves at all in the public sphere, as any deviation from their traditional role was seen as unnatural. The human soul knows no gender distinctions, so we can say that women face the same desire for fulfillment as men do. Today, women are more and more encouraged to develop their skills by undertaking activities within the public space that are different from those that form part of traditional domestic chores. The woman of the 19th century felt the need to be useful to society, to make her contribution visible in a variety of domains. A woman does not have to become masculine to get power. If she is successful in any important job, this does not mean that she thinks like a man, but that she thinks like a woman. Women have broken through the walls that cut them off from public life, activity and ambition. There are no hindrances that can prevent women from taking their place in society.

  20. Private Goods and Public Bads

    Science.gov (United States)

    Renshaw, Edward F.

    1975-01-01

    The author of this article has developed a simple economic growth model which suggests that public concern for the environment increases as the quality of the environment, for any number of reasons, becomes worse. Using this model, the author believes that Earth Day, 1970, could have been predicted. (MA)

  1. Private Funds for Public Schools.

    Science.gov (United States)

    Addonizio, Michael F.

    2000-01-01

    Discusses sources of nontraditional revenue for public school systems: the result of donor activities (the solicitation of goods, services, and money via direct and indirect donations); enterprise activities (the selling or leasing of services or facilities); and shared or cooperative activities (pooling functions with other agencies or…

  2. Legal issues in governing genetic biobanks: the Italian framework as a case study for the implications for citizen's health through public-private initiatives.

    Science.gov (United States)

    Piciocchi, Cinzia; Ducato, Rossana; Martinelli, Lucia; Perra, Silvia; Tomasi, Marta; Zuddas, Carla; Mascalzoni, Deborah

    2017-09-18

    This paper outlines some of the challenges faced by regulation of genetic biobanking, using case studies coming from the Italian legal system. The governance of genetic resources in the context of genetic biobanks in Italy is discussed, as an example of the stratification of different inputs and rules: EU law, national law, orders made by authorities and soft law, which need to be integrated with ethical principles, technological strategies and solutions. After providing an overview of the Italian legal regulation of genetic data processing, it considers the fate of genetic material and IP rights in the event of a biobank's insolvency. To this end, it analyses two case studies: a controversial bankruptcy case which occurred in Sardinia, one of the first examples of private and public partnership biobanks. Another case study considered is the Chris project: an example of partnership between a research institute in Bolzano and the South Tyrolean Health System. Both cases seem to point in the same direction, suggesting expediency of promoting and improving public-private partnerships to manage biological tissues and biotrust to conciliate patent law and public interest.

  3. Public And Private Leadership And Performance Management

    Directory of Open Access Journals (Sweden)

    Christine (Mihaescu Demeter

    2013-05-01

    Full Text Available The aim of this article is to make a comparing between the private and public leadership. We analyze (1 whether there are differences between public and private sector leadership based on some variables related to job complexity of a manager (including the managerial behaviour, job autonomy, and job clarity, decision-making vs policymaking process and the stakeholders vs political influence, and (2 to assess the degree of their effects on the managerial competences and performance management. Our study is conducted from the Romanian perspective on public organizations. As the methodology used, in order to identify the perception on political influence in Romanian public administration we conducted a survey among civil servants at central and local level. Our research is based on the empirical analysis of the relevant literature in public administration, leadership and organizational performance.

  4. Public health

    NARCIS (Netherlands)

    Berg, van den A.E.

    2007-01-01

    Agnes van den Berg wrote an essay about human health and nature, establishing that subject as an important policy argument in developing (urban) nature in the Netherlands. She studied the public balance of fear and fascination for nature, summarising benefits on human health. In this chapter, she ad

  5. Public health

    NARCIS (Netherlands)

    Berg, van den A.E.

    2007-01-01

    Agnes van den Berg wrote an essay about human health and nature, establishing that subject as an important policy argument in developing (urban) nature in the Netherlands. She studied the public balance of fear and fascination for nature, summarising benefits on human health. In this chapter, she

  6. Health Care Disparities Among English-Speaking and Spanish-Speaking Women With Pelvic Organ Prolapse at Public and Private Hospitals: What Are the Barriers?

    Science.gov (United States)

    Alas, Alexandriah N; Dunivan, Gena C; Wieslander, Cecelia K; Sevilla, Claudia; Barrera, Biatris; Rashid, Rezoana; Maliski, Sally; Eilber, Karen; Rogers, Rebecca G; Anger, Jennifer Tash

    The objective of this study was to compare perceptions and barriers between Spanish-speaking and English-speaking women in public and private hospitals being treated for pelvic organ prolapse (POP). Eight focus groups, 4 in English and 4 in Spanish, were conducted at 3 institutions with care in female pelvic medicine and reconstructive surgery. Standardized questions were asked regarding patients' emotions to when they initially noticed the POP, if they sought family support, and their response to the diagnosis and treatment. Transcripts were analyzed using grounded theory qualitative methods. Thirty-three women were Spanish-speaking and 25 were English-speaking. Spanish speakers were younger (P = 0.0469) and less likely to have a high school diploma (P speaking women had more concerns that the bulge or treatments could lead to cancer, were more resistant to treatment options, and were less likely to be offered surgery. Women in the private hospital desired more information, were less embarrassed, and were more likely to be offered surgery as first-line treatment. The concept emerged that patient care for POP varied based on socioeconomic status and language and suggested the presence of disparities in care for underserved women with POP. The discrepancies in care for Spanish-speaking women and women being treated at public hospitals suggest that there are disparities in care for POP treatment for underserved women. These differences may be secondary to profit-driven pressures from private hospitals or language barriers, low socioeconomic status, low health literacy, and barriers to health care.

  7. Availability and provision of emergency obstetric care under a public-private partnership in three districts of Gujarat, India: lessons for Universal Health Coverage.

    Science.gov (United States)

    Iyer, V; Sidney, K; Mehta, R; Mavalankar, D

    2016-01-01

    The state of Gujarat in India (population 60 million) has implemented a public-private partnership (PPP) with private obstetricians called the Chiranjeevi Yojana (CY) since 2006. This study investigated the adequacy of basic and comprehensive emergency obstetric care (BEmOC and CEmOC) services through the public and private sectors with reference to the United Nations (UN) guidelines. A cross-sectional facility survey was conducted in three districts. A total of 300 facilities, 151 public and 149 private, had provided obstetric services to a total of 53 896 births in the past 6 months. Nearly half, 135 facilities (104 public and 31 private), individually reported EmOC facilities. All the three districts exceeded the UN recommendation for EmOC availability by 3.3 to 11.3 times. Free provision, through both public and PPP facilities, ranged from 1.42 to 3.43. The actual performance was nearly double the recommendation for CEmOC but inadequate for BEmOC. Public sector EmOC availability and provision is negligible. Private sector availability is well beyond the recommended UN norms. The CY programme has resulted in increased availability and provision of EmOC services. However, the overall provision of EmOC is compromised due to the poor performance of BEmOC functions and clustering of private facilities in towns.

  8. Commodity Administrative Manual. Public and Private Schools.

    Science.gov (United States)

    California State Dept. of Education, Sacramento.

    This manual was developed for agencies receiving food commodities distributed to eligible schools and noneducational organizations by the U.S. Department of Agriculture (USDA) through the California State Department of Education's Office of Surplus Property. It covers rules, regulations, and forms for recipients who are public or private schools…

  9. Capturing Value from Public-Private Collaborations

    NARCIS (Netherlands)

    Reypens, C.; Lievens, A.; Blazevic, V.

    2016-01-01

    Although public-private collaborations offer opportunities to create unique value for a wide range of stakeholders, participating organizations often struggle to capture value from them. We focus on this challenge using a practice perspective and aim to understand how organizations attempt to captur

  10. Public-private partnerships for the unemployed

    NARCIS (Netherlands)

    Sol, E.

    2010-01-01

    Under new dimensions of individualisation, decentralisation and particularly marketisation, new forms of public-private partnerships between the actors involved in the employment services for the unemployed have emerged. This is because for-profit providers have now entered the arena of welfare to w

  11. Public/Private Partnerships for New Construction.

    Science.gov (United States)

    Adams, Matthew C.

    1999-01-01

    Discusses how colleges can finance new construction projects during lean financial times by employing public/private partnerships in an off-balance sheet financing format. Construction planning of a new school parking deck is used to illustrate the process. Benefits of savings in operating costs, management fees, and other line-item expenses are…

  12. The private initiative in public infrastructure and public utilities concessions

    Directory of Open Access Journals (Sweden)

    Juan Carlos Expósito Vélez

    2010-06-01

    Full Text Available Given the renewed and growing importance of the initiative of the private sector in developing public infrastructure and public utilities, especially as a consequence of the incentives created by the law, this study intends to address the various aspects of the new legal framework for the formation of concession contracts as a result of a particular initiative or idea and not as a product of the needs defined by the Administration, with a particular emphasis on the requirements for the formation of public works concessions, but without forgetting how the mechanism of private initiative applies to public utilities when they require a concession contract to be provided.

  13. The Private Value of Public Pensions

    OpenAIRE

    Konstantin Petrichev; Susan Thorp

    2007-01-01

    Individual retirement savings accounts are replacing or supplementing public basic pensions. However at decumulation, replacing the public pension with an equivalent private sector income stream may be costly. We value the Australian basic pension by calculating the wealth needed to generate an equivalent payment stream using commercial annuities or phased withdrawals, but still accounting for investment and longevity risks. At age 65, a retiree needs an accumulation of about 8.5 years earnin...

  14. The Portuguese Experience with Public-Private Partnerships

    NARCIS (Netherlands)

    Miranda Sarmento, J.; Renneboog, L.D.R.

    2014-01-01

    Abstract: This paper documents the Portuguese experience in Public-Private Partnerships (PPPs). Since 1993, Portugal has been using PPPs intensively, mainly for highway construction and in the health sector. This has enabled the country to close the infrastructure gap and avoid the budget constraint

  15. The Portuguese Experience with Public-Private Partnerships

    NARCIS (Netherlands)

    Miranda Sarmento, J.; Renneboog, L.D.R.

    2014-01-01

    Abstract: This paper documents the Portuguese experience in Public-Private Partnerships (PPPs). Since 1993, Portugal has been using PPPs intensively, mainly for highway construction and in the health sector. This has enabled the country to close the infrastructure gap and avoid the budget

  16. Portugal’s experience with public-private partnerships

    NARCIS (Netherlands)

    Renneboog, Luc; Miranda Sarmento, J.J.; Akintoye, Akintola; Beck, Matthias; Kumaraswamy, Mohan

    2015-01-01

    This paper documents the Portuguese experience in Public-Private Partnerships (PPPs). Since 1993, Portugal has been using PPPs intensively, mainly for highway construction and in the health sector. This has enabled the country to close the infrastructure gap and avoid the budget constraints at the m

  17. The Portuguese Experience with Public-Private Partnerships

    NARCIS (Netherlands)

    Miranda Sarmento, J.; Renneboog, L.D.R.

    2014-01-01

    Abstract: This paper documents the Portuguese experience in Public-Private Partnerships (PPPs). Since 1993, Portugal has been using PPPs intensively, mainly for highway construction and in the health sector. This has enabled the country to close the infrastructure gap and avoid the budget constraint

  18. 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

  19. The quality of private and public primary health care management of children with diarrhoea and acute respiratory infections in Tlaxcala, Mexico.

    Science.gov (United States)

    Bojalil, R; Guiscafré, H; Espinosa, P; Martínez, H; Palafox, M; Romero, G; Gutiérrez, G

    1998-09-01

    In Tlaxcala, Mexico, 80% of the children who died from diarrhoea or acute respiratory infections (ARI) in 1992-1993 received medical care; in more than 70% of cases it was provided by a private general practitioner (GP). The present study evaluated the quality of case management by private and public GPs to children under five years of age with diarrhoea and ARI. During the clinical observation, the treatment and counselling given to the mother were assessed with the WHO guidelines as reference standard. A total of 41 private and 40 public GPs were evaluated for the management of diarrhoea, and 59 private and 40 public GPs for the management of ARI. For diarrhoea, half of the private GPs gave inadequate rehydration therapy, 63% gave incorrect advice on diet, 66% and 49% made an incorrect correct decision in the prescription of antimicrobial and symptomatic drugs, respectively. Public GPs generally performed better in diarrhoea management: 7% gave inadequate rehydration therapy, 13% gave wrong advice on diet, 3% made a wrong decision in the prescription of symptomatic drugs and 28% gave a wrong decision in antimicrobial prescription. In the management of ARI, 66% and 58% of private GPs made a wrong decision in the prescription of antimicrobial and symptomatic drugs, respectively, compared to 30% and 20% of public GPs, respectively. Counselling to the mother given by both private and public GPs was considered inadequate in most cases of diarrhoea and ARI. These results clearly show that private doctors, as important providers of medical care, need to be included in the strategies to improve the quality of care of children with diarrhoea and ARI. Future research needs to address the determinants of the clinical practice of private doctors in countries like Mexico.

  20. Organizational climate: Comparing private and public hospitals within professional roles

    Directory of Open Access Journals (Sweden)

    Diana Rojas

    2014-11-01

    Full Text Available This study compares the organizational climate differences within professional roles in private and public hospitals. We focused on how physicians, administrative, healthcare and non-healthcare staff either in the public or in the private perceived their work environment and each organizational climate dimension. Data came from organizational-climate questionnaires administered in 2010 and 2012 to 19616 and 1276 health employees in public and private hospitals in the Tuscany Region respectively. We applied exploratory factoranalysis to verify the validity and internal consistency between items in the questionnaire and t-test, one-way analysis of variance to compare mean perceptions regarding to the dimensions across different groups of respondents. We measured four dimensions: “training opportunities”, “managerial tools”, “organization” and “management & leadership style” and overall job satisfaction. Hospital status in the professional roles was found significant in the staff's perceptions (p≤0.05.

  1. INVESTING OPPORTUNITIES THROUGH PUBLIC-PRIVATE PARTNERSHIP IN MOLDAVIAN ECONOMY

    Directory of Open Access Journals (Sweden)

    Daniela POPA

    2013-01-01

    Full Text Available The paper studied the impact of a public-private partnership objectives and scope that are more beneficial for the community's private profit and social welfare for the public, in order to determine the next task: defining, identifyingfeatures and principles of public-private partnerships, identifying criteria for their classification, identification of objectives and benefits they can get a public private partnership, public private partnership development analysis inthe Republic of Moldova the importance of implementing this and proposed projects, identify gaps in regulation andproposing public private partnership for achieving performance in this direction.

  2. Public-Private Partnership in the EU Public Procurement Regime

    DEFF Research Database (Denmark)

    My PhD research focuses on the relationship between the formation and operation of a Public-Private Partnership (PPP) and public procurement law as a legal framework for the award of the PPP contract. The complex nature of PPP projects including long term high value contracts, long award process...... to apply when awarding a Public-Private Partnership contract, as well as to analyse if a deregulation of PPP’s award framework could potentially resolve these potential legal challenges. The latter consideration of deregulation of PPP award framework is based on comparison of highly regulated European...

  3. Channel One: When Private Interests and the Public Interest Collide

    Science.gov (United States)

    Blokhuis, Jason C.

    2008-01-01

    If the notion of public and private spheres seems somehow quaint or old-fashioned, the distinction between public and private corporations will be that much more obscure. Yet Channel One broadcasts in a public school classroom are indisputably the result of a contract between a private corporation (Alloy Media + Marketing) and a public corporation…

  4. Is the corporate transformation of hospitals creating a new hybrid health care space? A case study of the impact of co-location of public and private hospitals in Australia.

    Science.gov (United States)

    Brown, Laurie; Barnett, J Ross

    2004-01-01

    A common feature of health reforms in western nations has been the transformation or (re)construction of health and health care as both a commodity and product. In the hospital sector, this transformation has become increasingly evident in the growth of for-profit involvement in service delivery. Investor-owned hospitals are now prominent providers of hospital care in Australia. This paper examines the changing nature of health care space through the changing portrayal and meaning of hospitals as represented by and encoded in the built environment. Public hospitals once occupied 'pride of place'. In contrast, up to the early 1980s, the private sector was seen as a cottage industry. However, increased levels of state subsidisation and government incentives and pro-market policies, combined with market-based opportunities for profit generation, have seen the emergence of large private hospital chains with a new corporate image to hospital care and the blurring of 'public' and 'private'. A significant factor in the reconstruction of hospital space in Australia has been the co-location of private and public hospitals. Co-location is a popular strategy proffered by State governments and one that has been quickly acted on by corporate providers. Using Mayne Health Ltd, Australia's largest for-profit hospital chain, and four specific case studies, this paper explores four variants of co-location. Each of these examples represent a different public and private hospital space. The growth of for-profit hospital chains signifies a new phase in the delivery of health care in Australia but also importantly the creation of a new hybridised 'health care' space. This space is neither private nor public but a reflection of the economic, political and social processes underlying this transformation.

  5. PUBLIC-PRIVATE DISTINCTIONS AND STRATEGIC MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Ioan NICOLAE

    2007-01-01

    Full Text Available Public organizations are no longer synonymous with governmental agencies but include many for-profit service organizations as well as the third sector, which is made up of the private NPOs. Such diverse organizations. meet the publicness criterion to the extent that they cannot ignore publicness when dealing with development of strategy. Competitive models of strategic management have little use in organizations with significant degrees of publicness. Instead, a strategy should be sought which enhances cooperation and collaboration. Strategic management in public settings must identify the beliefs and demands of key stakeholders and deal with elaborate fictions held by these individuals to premise development and guide implementation. Strategic managers must carefully collaborate with their oversight body as they fashion a strategy.

  6. Nineteenth Century Public And Private Spheres

    Directory of Open Access Journals (Sweden)

    SIMA REMINA

    2014-12-01

    Full Text Available The aim of this paper is to illustrate the public and private spheres. The former represents the area in which each of us carries out their daily activities, while the latter is mirrored by the home. Kate Chopin and Charlotte Perkins Gilman are two salient nineteenth-century writers who shape the everyday life of the historical period they lived in, within their literary works that shed light on the areas under discussion.

  7. The Basic Public Finance of Public-Private Partnerships

    OpenAIRE

    Engel, Eduardo M. R. A.; Fischer, Ronald D.; Galetovic, Alexander

    2007-01-01

    Public-private partnerships (PPPs) have been justified because they release public funds or save on distortionary taxes. However, the resources saved by a government that does not finance the upfront investment are offset by giving up future revenue flows to the concessionaire. If a PPP can be justified on efficiency grounds, the PPP contract that optimally balances demand risk, userfee distortions and the opportunity cost of public funds has a minimum revenue guarantee and a revenue cap. The...

  8. The Basic Public Finance of Public-Private Partnerships

    OpenAIRE

    Eduardo M.R.A. Engel; Ronald D. Fischer; Galetovic, Alexander

    2007-01-01

    Public-private partnerships (PPPs) have been justified because they release public funds or save on distortionary taxes. However, the resources saved by a government that does not finance the upfront investment are offset by giving up future revenue flows to the concessionaire. If a PPP can be justified on efficiency grounds, the PPP contract that optimally balances demand risk, userfee distortions and the opportunity cost of public funds has a minimum revenue guarantee and a revenue cap. The...

  9. PROJECT BONDS IN FINANCING PUBLIC-PRIVATE PARTNERSHIPS IN UKRAINE

    Directory of Open Access Journals (Sweden)

    I. Ovsiannykova

    2014-12-01

    Full Text Available The theoretical principles concerning the financing of public private partnership' projects are deepened and practical recommendations for improving the procedure of raising funds for projects of public-private partnerships through the use project bonds are substantiated.

  10. PROJECT BONDS IN FINANCING PUBLIC-PRIVATE PARTNERSHIPS IN UKRAINE

    OpenAIRE

    2014-01-01

    The theoretical principles concerning the financing of public private partnership' projects are deepened and practical recommendations for improving the procedure of raising funds for projects of public-private partnerships through the use project bonds are substantiated.

  11. Publicprivate partnership : A critical discussion

    Directory of Open Access Journals (Sweden)

    Johans Tveit Sandvin

    2015-03-01

    Full Text Available Public-private partnerships have long been highly valued in Western welfare states, and the valuation of such cooperation has become even stronger in light of last year’s economic turbulence, particularly with voluntary non-profit organizations (VNPOs. At the same time, the voluntary sector is changing. The broad popular movements have generally declined in favour of more individual interests as the basis for forming VNPOs, and those organisations still involved in the provision of social services are becoming more and more similar to public service, due to requirements placed on them by the public sector. This is believed to have consequences for the value of such cooperation. If voluntary organisations in public services – or other private organisations for the matter – are becoming copies of public services, there is not much value to be gained from such cooperation, except for some financial gain.In this article, we argue that this conclusion is based on a rather narrow perception of public-voluntary cooperation. Research and debate on such cooperation are mainly preoccupied by what we call supplementary relations, in which voluntary organizations are assessed according to whether they can deliver cheaper or better services than the public sector. Based on an example of public-voluntary cooperation in preventive social work among young adults in Norway, the article show that public-voluntary collaboration can be truly valuable when it is based on a complimentary relation, in which parties collaborate because they command different resources equally important to the task at hand.

  12. Public-Private Partnership in the EU Public Procurement Regime

    DEFF Research Database (Denmark)

    My PhD research focuses on the relationship between the formation and operation of a Public-Private Partnership (PPP) and public procurement law as a legal framework for the award of the PPP contract. The complex nature of PPP projects including long term high value contracts, long award process......, poses legal challenges for the procurement of PPP contracts. The overall research objective of my doctoral thesis is to analyse, clarify and discuss potential legal challenges resulting from European Union public procurement law - provided in Directive 2004/18/EC – which a public authority is obliged...... to apply when awarding a Public-Private Partnership contract, as well as to analyse if a deregulation of PPP’s award framework could potentially resolve these potential legal challenges. The latter consideration of deregulation of PPP award framework is based on comparison of highly regulated European...

  13. The Public-Private Partnership in ECEC Provision in Norway

    Science.gov (United States)

    Haug, Peder

    2014-01-01

    This article seeks to answer three central questions pertaining to public-private partnership in early childhood education and care (ECEC provision) in Norway: How has public-private partnership developed during the last four decades? How is public-private partnership understood in Norwegian ECEC policy? What seem to be the future challenges in…

  14. Interactions: trade policy and healthcare reform after Chaoulli v. Quebec: is it time for Canada to acknowledge the fragile boundary between health and trade policies and strengthen the separation between private and public health insurance?

    Science.gov (United States)

    Crawford, Mark

    2006-01-01

    The insulation of Canada's healthcare system from trade treaty obligations is crucial to the legitimacy of Canada's trade policy. Legal analysis has suggested, however, that competitive and for-profit delivery of the kind contemplated by the Kirby Report and some provinces may make healthcare more vulnerable to challenges under NAFTA and GATS. The Government of Canada has tried to counter this interpretation by stressing the importance of public financing as the principal criterion for exemption of healthcare from trade treaties, but now the potential for private financing of essential medical services indicated by the Supreme Court's decision in Chaoulli v. Quebec has made that line of argument look risky as well. It is apparent that Canada failed to anticipate the possible interactions of domestic, international and constitutional law when it made commitments in the area of private health insurance at the WTO in 1997. Accordingly, the time has come to acknowledge the fragility of the boundary between health and trade policies, to take the risks and costs associated with trade treaty obligations fully into account when undertaking healthcare reform and to strengthen the separation between private and public health insurance.

  15. Public-private partnership models in France and in Europe.

    Science.gov (United States)

    Demotes-Mainard, Jacques; Canet, Emmanuel; Segard, Lionel

    2006-01-01

    The workshop entitled "Public-Private partnerships models in Europe-- comparison between France and European countries" brought together representatives of academia and industry, of national or European health research programs, of regional or national public-private partnership (PPP) initiatives, and of biotechnology with the following objectives: sharing a common vision on the needs, expectations and challenges of public-private partnership, based on the analysis of actual and original cases, and of new initiatives on public-private partnership, drawing conclusions and identifying key success factors, identifying trails for progress and drawing recommendations. The major event in this field is a European public-private partnership initiative between pharmaceutical industry (European Federation of Pharmaceultical Industry and Associations, EFPIA) and the European Commission (DG Research--health priority) resulting in the European Technology Platform project "Innovative Medicines Initiative" (IMI). Its architecture is based on the identification of the main bottlenecks to the development of innovative treatments (predictive pharmacology and toxicology, identification and validation of biomarkers, patients' recruitment, risk evaluation, and cooperation with the regulatory authorities). Simultaneously, initiatives both at the national and regional levels also foster PPP in the therapeutic field. Regional competitivity clusters acting in the biomedical sector, and national PPP calls such as the ANR (National Research Agency) RIB (Research and Innovation in Biotechnology) call are incentives for PPP projects. These regional and national PPP levels help public and private partners to further build consortia able to compete for EU-level calls, thus acting as incubators for EU PPP projects. In spite of incentives and of the regional and national structuring of PPP, weaknesses in the French system are linked to its fragmentation--multiple transfer agencies, multiple

  16. Private security, public/private sector partnership, crime prevention, police, public safety

    Directory of Open Access Journals (Sweden)

    Juan Ricardo Gómez Hecht

    2014-12-01

    Full Text Available The current security environment in El Salvador is characterized by high levels of insecurity and criminality. Public authorities confronting this problem need to resort to new alternatives for solving or at least managing the situation. One of these alternatives is the public/private sector partnership in crime prevention which is a promising option. Research has analyzed the current state of the public/private sector partnership between the National Civil Police and Private Security Services in El Salvador, revealing among other things that this relationship is at an incipient stage, but has promising results.DOI: http://dx.doi.org/10.5377/rpsp.v4i2.1759

  17. Dead public spaces - live private corners: (Recontextualization of musically public and private

    Directory of Open Access Journals (Sweden)

    Jakovljević Rastko

    2009-01-01

    Full Text Available The expressions of private and public musical life and experience are mostly discussed separately. This article joins these two concepts into one scope and surveys the identity of both. In ideal (utopian? traditional context between private and public music experience (life, the context shows ideal vitality and consistence, while in an 'irregular' context these two concepts begin to distance themselves, opening space for marginality or so called 'errors'. This article studies bagpipe tradition in Serbia, at different stages of its development and in different periods, specifically focusing on rural and urban contexts in diverse sociopolitical conditions. Although bagpipe tradition still exists in Serbia it is far removed from what it once was, and the idea is to represent the contexts of that process, private and public, sociopolitical, and marginal aspects, from the 19th century (or hypothetically before then until today.

  18. Public and Private Activity in Commercial TV Broadcasting

    OpenAIRE

    Hansen, Bodil O.; Keiding, Hans

    2006-01-01

    We consider a model of commercial television market, where private broadcasters coexist with a public television broadcaster. Assuming that the public TV station follows a policy of Ramsey pricing whereas the private stations are profit maximizers, we consider the equilibria in this market and compare with a situation where the public station is privatized and acts as another private TV broadcaster. A closer scrutiny of the market for commercial television leads to a distinction between targe...

  19. Evaluation of international case studies within 'Live.Learn.Laugh.': a unique global public-private partnership to promote oral health.

    Science.gov (United States)

    Dugdill, Lindsey; Pine, Cynthia M

    2011-08-01

    The partnership between the Féderation Dentaire International (FDI), and Unilever Oral Care, aims to raise awareness of oral health globally; to enable FDI member associations to promote oral health; and to increase the visibility of the FDI and authority of Unilever oral care brands worldwide. Country Projects between National Dental Associations (NDAs), the member associations of FDI, and Unilever Oral Care local companies have been established as a key strand of the partnership. This paper reports on the evaluation of an in-depth sample of Country Projects (n=5) to determine their potential to impact on oral health. Five country sites were selected as being indicative of different programme delivery types. Each site received a two-day visit during Spring-Summer 2009, which enabled the evaluators to audit what was delivered in practice compared with the original written project briefs and to undertake interviews of study site staff. 39 projects in 36 countries have been initiated. In those examined by site visits, clear evidence was found of capacity building to deliver oral health. In some countries, widespread population reach had been prioritised. Effectiveness of partnership working varied depending on the strength of the relationship between the NDA and local Unilever Oral Care representatives and alignment with national marketing strategy. The quality of internal evaluation varied considerably. Over a million people had been reached directly by Country Projects and this public-private partnership has made a successful start. To move towards improving oral health rather than only awareness raising; future Country Projects would benefit from being limited to certain evidence-based intervention designs, and using an agreed core indicator set in order to allow cross-country comparison of intervention outcomes. © 2011 FDI World Dental Federation.

  20. Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh

    National Research Council Canada - National Science Library

    Sikder, Shegufta S; Labrique, Alain B; Ali, Hasmot; Hanif, Abu A M; Klemm, Rolf D W; Mehra, Sucheta; West, Jr, Keith P; Christian, Parul

    2015-01-01

    Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC...

  1. Private finance for adaptation: do private realities meet public ambitions?

    NARCIS (Netherlands)

    Pauw, W.P.; Klein, R.J.T.; Vellinga, P.; Biermann, F.

    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

  2. The privatepublic law divide

    DEFF Research Database (Denmark)

    Gyldenløve Jeppesen-de Boer, Christina; Kronborg, Annette; Svendsen, Idamarie Leth

    2013-01-01

    to a particular societal institution. Marriage as an institution has been individualized and the goodness of the family has to relate to the well-being of the individuals instead. This article shows that within this historical development the private-public law divide has not been seriously challenged......In a Scandinavian perspective, the family and the individual have changed places during the 20th Century. Today, the law takes its starting point in the individual - not in the family. A consequence of this development is that it is no longer legally possible to relate the good family...

  3. Public private partnerships for emergency obstetric care: Lessons from Maharashtra

    OpenAIRE

    Sarika Chaturvedi; Bharat Randive

    2011-01-01

    Background: The National Rural Health Mission of India advocates public private partnerships (PPPs) to meet its "service guarantee" of Emergency obstetric care (EmOC) provision. The Janani Suraksha Yojana (JSY) has a provision of Rs. 1500 for contracting in obstetric specialists. Objectives: The study aimed to understand the issues in the design and implementation of the PPPs for EmOC under the JSY in Maharashtra and how they affect the availability of EmOC services to women. Materials and Me...

  4. 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.

  5. Public versus Private University Presidents Pay Levels and Structure

    Science.gov (United States)

    Monks, James

    2007-01-01

    Existing studies examine the determinants of private university presidents' compensation, but ignore recent earnings differentials between public and private university presidents. This paper estimates that public university presidents earn approximately 50 percent less than comparable private university presidents. This salary discount is robust…

  6. Unwinding the State subsidisation of private health insurance in Ireland.

    Science.gov (United States)

    Turner, Brian

    2015-10-01

    Ireland's private health insurance market provides primarily supplementary health insurance for hospital services, operating alongside a public hospital system to which residents have universal access entitlements, subject to some copayments for those without a medical card. The State subsidises the purchase of private health insurance through measures including tax relief on premiums and not charging the full economic cost for private beds in public hospitals. Furthermore, privately insured patients occupying public beds in public hospitals did not, until 2014, incur charges for such accommodation, apart from modest statutory charges. In the Budget in October 2013, a number of measures were announced that began to unwind these subsidies. Although it was initially feared that these measures would add to premium inflation, leading in turn to further discontinuation of health insurance, the evidence suggests that premium inflation has eased and take-up has stabilised, although some of this may have been due to the introduction of lifetime community rating in May 2015. Nevertheless, it would appear that the restriction on the subsidisation of private health insurance has not had a significant adverse effect on the market, while it has reduced an inequitable cross-subsidy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Public versus Private Education in Hawaii

    Directory of Open Access Journals (Sweden)

    Antonina Espiritu

    2001-10-01

    Full Text Available This study presents a time-series evidence on the timing and degree of feedback relationship between participation in education and income growth in Hawaii. Using the unrestricted vector autoregression approach and two related measures of linear dependence and feedback, the results suggest that across all educational levels, i.e., K-12 and tertiary, participation in public education could be a good predictor of income growth in Hawaii. However, decomposing the feedback effect by frequency suggests that the dominance of public education over private education in explaining the variation in income growth to be concentrated mainly on the short-run to medium-run for tertiary level and long-run to permanent effect for K-12 level. Hawaii state legislature and educators should perhaps take these results as a motivation not to ignore the problems plaguing Hawaii's public schools but should work towards greater improvement and support for public education given its predicted significant overall contribution to the Hawaiian economy.

  8. Comparing public and private hospitals in China: evidence from Guangdong.

    Science.gov (United States)

    Eggleston, Karen; Lu, Mingshan; Li, Congdong; Wang, Jian; Yang, Zhe; Zhang, Jing; Quan, Hude

    2010-03-23

    The literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care. We analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes. Compared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation). Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix. In combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital performance and protect vulnerable patients, regardless of

  9. Comparing public and private hospitals in China: Evidence from Guangdong

    Directory of Open Access Journals (Sweden)

    Yang Zhe

    2010-03-01

    Full Text Available Abstract Background The literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care. Methods We analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes. Results Compared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation. Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix. Conclusions In combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital

  10. Public Private Partnership Benefits in Delivering Public Facilities in Malaysia

    Directory of Open Access Journals (Sweden)

    Sapri M.

    2016-01-01

    Full Text Available The development of infrastructure in developing country such as Malaysia was increasingly founded by the Public–Private Partnership (PPP scheme. Collaboration with private sector has become popular as a means to improve the delivery of public facilities. Yet, empirical evidence on how PPP initiative has benefits the delivery of public facilities within Malaysia context is lagging. The purpose of this paper is to identify and assess the perception of stakeholders on the benefits of adopting PPP in delivering public facilities in Malaysia. Literature review was carried out to identify PPP benefits, which were then incorporated into the questionnaire. The mean score and mean score ranking was conducted to assess the agreement level of stakeholders towards the PPP benefits. The overall findings show that the implementation of PPP has benefitted the delivery of public facilities in both financial and non-financial aspects. From the analysis, improvement in service quality is perceived as the top advantage followed by innovation in design and transfer of risk. The findings provide more informed basis on the rationale of PPP implementation and its potential in improving the delivery of public facilities within Malaysia context.

  11. Evolutionary Game Analysis of the Supervision Behavior for Public-Private Partnership Projects with Public Participation

    OpenAIRE

    Congdong Li; Xiaoli Li; Yu Wang

    2016-01-01

    The public can directly or indirectly participate in the PPP (public-private partnership) projects and then has an impact on the project profit and public or private behavior. To explore the influence of the public participation of the PPP projects supervision behavior, this paper analyzes the mutual evolutionary regularity of the private sector and government supervision department and the influence of public participation level on public and private behavior based on evolutionary game theor...

  12. Institutionalising of public health.

    Science.gov (United States)

    Karkee, R

    2014-01-01

    Though public health situation in Nepal is under-developed, the public health education and workforce has not been prioritised. Nepal should institutionalise public health education by means of accrediting public health courses, registration of public health graduates in a data bank and increasing job opportunities for public health graduates in various institutions at government sector.

  13. Nirvana Neighborhood: Public/private tensions

    Directory of Open Access Journals (Sweden)

    Verónica Ardenghi

    2011-01-01

    Full Text Available Our object of study is the neighborhood called Nirvana [in City Bell, district of La Plata], and our aim is to describe the traces left by the landscape dynamics which mark different historical periods, and to relate the concept of landscape with this neighborhood's current territorial configuration. Framed in Cultural Geography, we go back to Milton Santos, Paul Claval and Mario Margulis' perspective, from the category of landscape. The methodology used was qualitative, and it entailed observation and photographic records of the area, informal talks with neighbors, compilation of documents and journalistic material about the area, all of which allowed us to dig deep into what is "public" and what is "private" in this neighborhood, where and how the "outside" and the "inside" are established and to decide whether its aim is being an open and including landscape or if what they are actually after is pushing strangers away by means of invisible barriers

  14. Public, private and personal: qualitative research on policymakers' opinions on smokefree interventions to protect children in 'private' spaces.

    Science.gov (United States)

    Rouch, Gareth; Thomson, George; Wilson, Nick; Hudson, Sheena; Edwards, Richard; Gifford, Heather; Lanumata, Tolotea

    2010-12-31

    Governments use law to constrain aspects of private activities for purposes of protecting health and social wellbeing. Policymakers have a range of perceptions and beliefs about what is public or private. An understanding of the possible drivers of policymaker decisions about where government can or should intervene for health is important, as one way to better guide appropriate policy formation. Our aim was to identify obstacles to, and opportunities for, government smokefree regulation of private and public spaces to protect children. In particular, to seek policymaker opinions on the regulation of smoking in homes, cars and public parks and playgrounds in a country with incomplete smokefree laws (New Zealand). Case study, using structured interviews to ask policymakers (62 politicians and senior officials) about their opinions on new smokefree legislation for public and private places. Supplementary data was obtained from the Factiva media database, on the views of New Zealand local authority councillors about policies for smokefree outdoor public places. Overall, interviewees thought that government regulation of smoking in private places was impractical and unwise. However, there were some differences on what was defined as 'private', particularly for cars. Even in public parks, smoking was seen by some as a 'personal' decision, and unlikely to be amenable to regulation. Most participants believed that educative, supportive and community-based measures were better and more practical means of reducing smoking in private places, compared to regulation. The constrained view of the role of regulation of smoking in public and private domains may be in keeping with current political discourse in New Zealand and similar Anglo-American countries. Policy and advocacy options to promote additional smokefree measures include providing a better voice for childrens' views, increasing information to policymakers about the harms to children from secondhand smoke and the

  15. Homeschooling, Virtual Learning, and the Eroding Public/Private Binary

    Science.gov (United States)

    Saiger, Aaron

    2016-01-01

    Regulators ubiquitously dichotomize schooling into two discrete sectors: "public" and "private". Although homeschooling is regulated in some contexts as a third sector, the general approach is to treat it as a species of private education by subjecting it to public regulation while simultaneously denying it public funds. But…

  16. Private versus Public Feedback - The Incentive Effects of Symbolic Awards

    DEFF Research Database (Denmark)

    Gerhards, Leonie; Siemer, Neele

    We experimentally compare the incentive effects of rewarding individuals for outstanding performance publicly versus privately. We implement two real-effort tasks, which differ in how prestigious subjects perceive working on them. In both tasks private and public feedback similarly enhances...... experiment at a secondary school we furthermore compare the incentive effects of different forms of public recognition....

  17. Innovation embedded in entrepreneurs’ networks in private and public spheres

    DEFF Research Database (Denmark)

    Schøtt, Thomas; Cheraghi, Maryam; Rezaei, Shahamak;

    2014-01-01

    Global studies have found tendencies: traditional culture promotes entrepreneurs' networking in the private sphere, impeding innovation, whereas secular-rational culture facilitates networking in the public sphere, benefiting innovation. This embeddedness is here scrutinised in contrasting...... is negatively affected by private sphere networking and positively affected by public sphere networking, but innovation is less promoted by public sphere networking in China than in Denmark....

  18. Are Private Firms Really More Tax Aggressive Than Public Firms ?

    OpenAIRE

    Pierk, Jochen

    2016-01-01

    This paper tests the notion that private firms are more tax aggressive than public firms. Tax avoidance measures, e.g. effective tax rates, cannot be used to compare private and public firms when private and public firms have different levels of importance on financial accounting earnings (Hanlon and Heitzman 2010). To disentangle financial reporting incentives from tax aggressiveness, I use the fact that European groups must prepare two sets of financial statements: first, gro...

  19. 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

    2004-04-01

    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 for addressing their students' mental health needs. Understanding that need requires data to guide the services and programs a school may put in place. Having data helps inform those services, and comparative data from other schools provides feedback and perspective. This project surveyed type and frequency of mental health problems experienced by students who received a formal evaluation at 11 private schools in Connecticut during academic year 2001-2002.

  20. Leveraging public private partnerships to innovate under challenging budget times.

    Science.gov (United States)

    Portilla, Lili M; Rohrbaugh, Mark L

    2014-01-01

    The National Institutes of Health (NIH), academic medical centers and industry have a long and productive history in collaborating together. Decreasing R&D budgets in both the private and public sector have made the need for such collaborations paramount to reduce the risk of further declines in the number of innovative drugs reaching the market to address pressing public health needs. Doing more with less has forced both industry and public sector research institutions (PSRIs) to leverage resources and expertise in order to de-risk projects. In addition, it provides an opportunity to envision and implement new approaches to accomplish these goals. We discuss several of these innovative collaborations and partnerships at the NIH that demonstrate how the NIH and industry are working together to strengthen the drug development pipeline.

  1. Privatizing responsibility: public sector reform under neoliberal government.

    Science.gov (United States)

    Ilcan, Suzan

    2009-08-01

    In light of public sector reforms in Canada and elsewhere, this paper focuses on the shift of emphasis from social to private responsibilities and raises new questions about the forces of private enterprise and market-based partnerships. Under neoliberal governmental agendas, privatizing responsibility links to three main developments: the reconsideration of the relations of public and private; the mobilization of responsible citizenship; and the formation of a cultural mentality of rule that works alongside these developments. The research for this article is based on extensive analysis of policy documents and public sector reform initiatives, as well as interviews with Canadian federal public service employees.

  2. Private Schools and Public Benefit: Fees, Fee Remissions, and Subsidies

    Science.gov (United States)

    Davies, Peter

    2011-01-01

    The level of fee remissions offered by private schools bears upon the scope for relying on private schools to provide public benefit. Analyses of education voucher systems have generally ignored the possibility that they will partially crowd out school-financed fee remissions. Moreover, variation in fee remissions between private schools may be…

  3. Prioritizing lean management practices in public and private hospitals.

    Science.gov (United States)

    Hussain, Matloub; Malik, Mohsin

    2016-05-16

    Purpose - The purpose of this paper is to prioritize 21 healthcare wastes in public and private hospitals of United Arab Emirates (UAE). Design/methodology/approach - Seven healthcare wastes linked with lean management are further decomposed in to sub-criteria and to deal with this complexity of multi criteria decision-making process, analytical hierarchical process (AHP) method is used in this research. Findings - AHP framework for this study resulted in a ranking of 21 healthcare wastes in public and private hospitals of UAE. It has been found that management in private healthcare systems of UAE is putting more emphasis on the inventory waste. On the other hand, over processing waste has got highest weight in public hospitals of UAE. Research limitations/implications - The future directions of this research would be to apply a lean set of tools for the value stream optimization of the prioritized key improvement areas. Practical implications - This is a contribution to the continuing research into lean management, giving practitioners and designers a practical way for measuring and implementing lean practices across health organizations. Originality/value - The contribution of this research, through successive stages of data collection, measurement analysis and refinement, is a set of reliable and valid framework that can be subsequently used in conceptualization, prioritization of the waste reduction strategies in healthcare management.

  4. Public and Private Activity in Commercial TV Broadcasting

    DEFF Research Database (Denmark)

    Olai Hansen, Bodil; Keiding, Hans

    2006-01-01

    We consider a model of commercial television market, where private broadcasters coexist with a public television broadcaster. Assuming that the public TV station follows a policy of Ramsey pricing whereas the private stations are profit maximizers, we consider the equilibria in this market...... and compare with a situation where the public station is privatized and acts as another private TV broadcaster. A closer scrutiny of the market for commercial television leads to a distinction between target rating points, which are the prime unit of account in TV advertising, and net coverage, which...... is the final goal of advertisers. Working with net coverage as the fundamental concept, we exploit the models of competition between public and private price and quantity in order to show that privatization of the public TV station entails a welfare loss and results in TV advertising becoming more expensive...

  5. 78 FR 1918 - Public-Private Partnerships Public Meeting and Request for Comment

    Science.gov (United States)

    2013-01-09

    ... on what should be included or excluded from such model public-private partnership (P3) contracts. The... Federal Highway Administration Public-Private Partnerships Public Meeting and Request for Comment AGENCY...: The USDOT/FHWA is tasked by MAP-21 to develop ``standard public-private partnership transaction...

  6. 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.

  7. How a new 'public plan' could affect hospitals' finances and private insurance premiums.

    Science.gov (United States)

    Dobson, Allen; DaVanzo, Joan E; El-Gamil, Audrey M; Berger, Gregory

    2009-01-01

    Two key health reform bills in the House of Representatives and Senate include the option of a "public plan" as an additional source of health coverage. At least initially, the plan would primarily be structured to cover many of the uninsured and those who now have individual coverage. Because it is possible, and perhaps even likely, that this new public payer would pay less than private payers for the same services, such a plan could negatively affect hospital margins. Hospitals may attempt to recoup losses by shifting costs to private payers. We outline the financial pressures that hospitals and private payers could experience under various assumptions. High uninsured enrollment in a public plan would bolster hospital margins; however, this effect is reversed if the privately insured enter a public plan in large proportions, potentially stressing the hospital industry and increasing private insurance premiums.

  8. The fantasy world of private finance for transport via public private partnerships

    OpenAIRE

    Shaoul, Jean; Stafford, Anne; Stapleton, Pam

    2012-01-01

    In 1993, the British government turned to the private sector to finance much needed investment in public infrastructure and manage services under its Public Private Partnerships (PPP) policy (Edwards et al., 2004), with transport forming by far the largest component by value of the PPP programme. (...)

  9. The fantasy world of private finance for transport via public private partnerships

    OpenAIRE

    Shaoul, Jean; Stafford, Anne; Stapleton, Pam

    2012-01-01

    In 1993, the British government turned to the private sector to finance much needed investment in public infrastructure and manage services under its Public Private Partnerships (PPP) policy (Edwards et al., 2004), with transport forming by far the largest component by value of the PPP programme. (...)

  10. Cream skimming and hospital transfers in a mixed public-private system.

    Science.gov (United States)

    Cheng, Terence C; Haisken-DeNew, John P; Yong, Jongsay

    2015-05-01

    The increasing prominence of the private sector in health care provision has generated considerable interest in understanding its implications on quality and cost. This paper investigates the phenomenon of cream skimming in a mixed public-private hospital setting using the novel approach of analysing hospital transfers. We analyse hospital administrative data of patients with ischemic heart disease from the state of Victoria, Australia. The data set contains approximately 1.77 million admission episodes in 309 hospitals, of which 132 are public hospitals, and 177 private hospitals. We ask if patients transferred between public and private hospitals differ systematically in the severity and complexity of their medical conditions; and if so, whether utilisation also differs. We find that patients with higher disease severity are more likely to be transferred from private to public hospitals whereas the opposite is true for patients transferred to private hospitals. We also find that patients transferred from private to public hospitals stayed longer and cost more than private-to-private transfer patients, after controlling for patients' observed health conditions and personal characteristics. Overall, the evidence is suggestive of the presence of cream skimming in the Victorian hospital system, although we cannot conclusively rule out other mechanisms that might influence hospital transfers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Public-Private Partnerships in Chronic Disease Prevention-Part 6

    Centers for Disease Control (CDC) Podcasts

    2009-04-06

    This podcast is the sixth of a seven part series discussing public health partnerships with the private sector. In this segment, CDC's Elizabeth Majestic and Georgia State University's Michael Eriksen discuss whether the tobacco industry has forfeited its opportunity to participate in traditional public-private partnerships.  Created: 4/6/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/6/2009.

  12. Living ‘private life in the public gaze’

    DEFF Research Database (Denmark)

    Singla, Rashmi

    and the next generation. Profound implications of these findings for psychosocial services for mixed couples and their children are lastly discussed. *Singla, R. (2015) “Intermarriage, Mixed Parenting, Promoting mental health and wellbeing: Crossover Love Basingstoke, Palgrave Macmillan......Living ‘private life in the public gaze’: Multiethnic/visibly ethnically mixed couples in Denmark This paper deals with the subjective experiences of the mixed couples’ lives, both in the country of native partner and in the diasporic spouse’s country of origin. Despite increasing numbers...

  13. Social Justice and Education in the Public and Private Spheres

    Science.gov (United States)

    Power, Sally; Taylor, Chris

    2013-01-01

    This paper explores the complex relationship between social justice and education in the public and private spheres. The politics of education is often presented as a battle between left and right, the state and the market. In this representation, the public and the private spheres are neatly aligned on either side of the line of battle, and…

  14. An Excursion Into The Public-Private Partnership Jungle

    DEFF Research Database (Denmark)

    Stelling, Christiane

    2014-01-01

    While the Private Finance Initiative (PFI) is doubtless the most visible Public-Private Partnership (PPP) in the public debate it is by no means the only one. A number of scholars have outlined the ambiguity of the PPP concept beyond PFIs and pointed to the multiplicity of differing types...

  15. STRATEGY OF PUBLIC-PRIVATE PARTNERSHIPS DEVELOPMENT IN CRISIS

    Directory of Open Access Journals (Sweden)

    Nataliya BYKOVA

    2014-02-01

    Full Text Available The role of strategy of public-private partnerships development through information is examined. The informational nature measures, the implementation of which help to promote Ukrainian innovative products on foreign markets, are identified. The urgency of implementing the strategy of public-private partnerships to intensify foreign trade with innovative products in crisis period is substantiated.

  16. Anatomy of public-private partnerships : Creation, financing, and renegotiations

    NARCIS (Netherlands)

    Miranda Sarmento, J.J.; Renneboog, Luc

    2016-01-01

    This paper presents the main reasons why public-private partnerships (PPPs) are adopted as well as the possible disadvantages for the public and private sectors. By means of two case studies on bridge construction and railway infrastructure (Fertagus and Lusoponte), we elucidate how a PPP is structu

  17. Understanding Public-Private Collaboration Configurations for International Information Infrastructures

    NARCIS (Netherlands)

    Klievink, A.J.

    2015-01-01

    Collaboration between the public and the private sector is seen as an instrument to make governance smarter, more effective, and more efficient. However, whereas there is literature on public-private collaboration, very little of it addresses how these collaborations can be shaped to make use of the

  18. Public Private Partnerships: deciphering meaning message and phenomenon

    NARCIS (Netherlands)

    E-H. Klijn (Erik-Hans)

    2010-01-01

    markdownabstract__Abstract__ There is no doubt that Public private partnerships have been a dominant issue in governmental rhetoric’s but also in governmental practice. In many countries governments have turned to the idea of public private partnerships, or partnerships in general, as a vehicle

  19. Teachers’ organisational behaviour in public and private funded schools

    NARCIS (Netherlands)

    Honingh, M.E.; Oort, F.J.

    2009-01-01

    Purpose - The purpose of this paper is to compare teachers' organisational behaviour in publicly- and privately-funded schools in the Dutch Vocational Education and Training (VET) sector. Design/methodology/approach - A percentage of all middle managers in publicly and privately funded schools (72

  20. Teachers’ organisational behaviour in public and private funded schools

    NARCIS (Netherlands)

    Honingh, M.E.; Oort, F.J.

    2009-01-01

    Purpose - The purpose of this paper is to compare teachers' organisational behaviour in publicly- and privately-funded schools in the Dutch Vocational Education and Training (VET) sector. Design/methodology/approach - A percentage of all middle managers in publicly and privately funded schools (72 p

  1. Anatomy of public-private partnerships : Creation, financing, and renegotiations

    NARCIS (Netherlands)

    Miranda Sarmento, J.J.; Renneboog, Luc

    2016-01-01

    This paper presents the main reasons why public-private partnerships (PPPs) are adopted as well as the possible disadvantages for the public and private sectors. By means of two case studies on bridge construction and railway infrastructure (Fertagus and Lusoponte), we elucidate how a PPP is

  2. Public Private Partnerships: deciphering meaning message and phenomenon

    NARCIS (Netherlands)

    E-H. Klijn (Erik-Hans)

    2010-01-01

    markdownabstract__Abstract__ There is no doubt that Public private partnerships have been a dominant issue in governmental rhetoric’s but also in governmental practice. In many countries governments have turned to the idea of public private partnerships, or partnerships in general, as a vehicle to

  3. Anatomy of public-private partnerships : Creation, financing, and renegotiations

    NARCIS (Netherlands)

    Miranda Sarmento, J.J.; Renneboog, Luc

    2016-01-01

    This paper presents the main reasons why public-private partnerships (PPPs) are adopted as well as the possible disadvantages for the public and private sectors. By means of two case studies on bridge construction and railway infrastructure (Fertagus and Lusoponte), we elucidate how a PPP is structu

  4. The "Big Bang" in Public and Private Faculty Salaries

    Science.gov (United States)

    Rippner, Jennifer A.; Toutkoushian, Robert K.

    2015-01-01

    The gap between average faculty salaries at public and private institutions has been growing wider over the past 40 years, yet little is known about the nature and causes of the gap. This study uses data on more than 1,000 institutions to examine institutional average faculty salaries and how they have changed for public and private institutions.…

  5. Comparing Administrative Satisfaction in Public and Private Universities.

    Science.gov (United States)

    Volkwein, James Fredericks; Parmley, Kelli

    2000-01-01

    Examined levels of administrator satisfaction at public and private institutions, using national data on university characteristics, state characteristics, and administrative satisfaction. Found hypothesized differences in satisfaction between administrators at public/private institutions were related only to extrinsic rewards. In both sectors,…

  6. Private Placement Debt Financing for Public Entities

    Science.gov (United States)

    Holman, Lance S.

    2010-01-01

    Private placement financing is a debt or capital lease obligation arranged between a municipality or a 501(c) (3) not-for-profit organization and a single sophisticated institutional investor. The investor can be a bank, insurance company, finance company, hedge fund, or high-net worth individual. Private placement financing is similar to…

  7. Public and Private Sector IT Governance: Identifying Contextual Differences

    Directory of Open Access Journals (Sweden)

    John Campbell

    2010-01-01

    Full Text Available This paper highlights systemic contextual differences and the unique IT Governance issues that might arise in public and private sector organizations. Public sector organizations constitute a significant component of economic activity in most countries. Like their private sector counterparts, many public sector agencies are struggling to cope with reduced or inadequate IT budgets and are continuously looking for ways to extract maximum value from IT resources. While both sectors face similar managerial-level IT issues and challenges, we argue that there are systemic differences between private and public sector organizations suggesting that a one size fits all approach to IT Governance may not apply.

  8. Corruption and ethical issues regarding public-private partnership

    OpenAIRE

    2005-01-01

    The paper raises general questions about  ethical problems that taint public-private  partnership. Everybody talks about the  economical benefits of encouraging firms  to invest in the community using different  incentives offered by the public institutions.  In the same time, every day, newspapers  bring to our attention cases of misuse of  public resources for private gain or cases  of private investors who give bribes in order  to get a contract with a public institution.  The purpose of t...

  9. Umbilical cord blood banks. Ethical aspects. Public versus private banks.

    Science.gov (United States)

    Aznar Lucea, Justo

    2012-01-01

    The creation of umbilical cord blood (UCB) banks raises interesting medical, social, economic and ethical issues. This paper reviews the ethical problems specifically. In this respect, it evaluates: a) whether there are advantages to the use of UCB compared to bone marrow, b) whether or not it is ethical to create UCB banks, c) whether their creation is ethically acceptable in terms of their clinical usefulness or d) the use made of them for therapeutic purposes, and finally e) whether their creation is ethically justified from a cost/profitability point of view. We focus primarily on evaluating the ethical controversy between public and private banks, particularly on whether it is ethical to bank autologous blood in private UCB banks, on the basis of its limited possibilities for use by the cord blood donor. We can conclude that, from an ethical point of view, autologous blood banks have limited acceptance among specialised researchers, scientific societies and other public institutions. Therefore, we believe that it is ethically more acceptable to support the creation of public UCB banks for medical and social reasons and, above all, based on the principle of justice and human solidarity. Nevertheless, there is no definitive ethical argument why a couple, according to their autonomy and freedom, cannot bank their child's UCB in a private bank. An equally acceptable solution could be the creation of mixed banks, such as that proposed by the Virgin Health Bank or like the Spanish system where autologous samples can be stored in public banks but with the proviso that if at any time the stored sample is required by any person other than the donor, it would have to be given to them.

  10. Athletic Trainer Services in Public and Private Secondary Schools.

    Science.gov (United States)

    Pike, Alicia M; Pryor, Riana R; Vandermark, Lesley W; Mazerolle, Stephanie M; Casa, Douglas J

    2017-01-01

     The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored.  To compare the level of AT services in public and private secondary schools.  Concurrent mixed-methods study.  Public and private secondary schools in the United States.  A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private).  School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis.  A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators.  Both public and private secondary schools lacked ATs, but higher percentages of total AT services and full-time services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector.

  11. Small Public Private Partnerships: The answer to local public and private needs, yet an ugly duckling?

    DEFF Research Database (Denmark)

    Koch, Christian; Jensen, Jesper Ole

    2009-01-01

    Public Private Partnerships (PPP) are frequently mobilized as a purchasing form suitable for large infrastructure projects. And it is commonly assumed that transaction costs linked to the establishment of PPP make them prohibitive in small sizes. In a Danish context this has been safeguarded...... by the authorities, which recommend sizes over 13,5 million € (100 million DKr). PPP is here understood as Design, Build, Finance and Operate projects. The paper shows, when looking at Germany, Italy and United Kingdom, that small PPP (below 13,5 million €) are widespread in two investigated countries; United...

  12. Small Public Private Partnerships: The answer to local public and private needs, yet an ugly duckling?

    DEFF Research Database (Denmark)

    Koch, Christian; Jensen, Jesper Ole

    2009-01-01

    Public Private Partnerships (PPP) are frequently mobilized as a purchasing form suitable for large infrastructure projects. And it is commonly assumed that transaction costs linked to the establishment of PPP make them prohibitive in small sizes. In a Danish context this has been safeguarded...... businesses and represent operable units for the clients and citizens. Cases are focused within education and healthcare. The analysis suggests that another type of economy apparently is in play. It is thus characteristic within education projects in UK that the largest portion of small PPPs are of a size...

  13. Impact of Performance Management in Public and Private Organizations

    DEFF Research Database (Denmark)

    Hvidman, Ulrik; Andersen, Simon Calmar

    2014-01-01

    Recent theoretical developments suggest that management actions have different impacts on outcomes in public and private organizations. This proposition is important to public organizations’ widespread import of private sector management tools such as performance management. This article examines...... how performance management influences performance outcomes in otherwise similar public and private organizations. Showing that the factors expected to diminish the impact of performance management parallel the organizational characteristics of public organizations, we hypothesize that this type...... of management is less effective in public organizations. A difference-in-differences model based on survey data on management in Danish public and private schools, combined with administrative data of students’ test scores, confirms the hypothesis. The results have important implications for the transfer...

  14. Insights in Public Health

    Science.gov (United States)

    Hayes, Donald K; Calhoun, Candice R; Joseph, Lin; Farnsworth, JoAnn Y; Arakaki, Kimberly B

    2016-01-01

    The Hawai‘i Maternal and Infant Health Collaborative, founded in 2013, is a public-private partnership committed to improving birth outcomes and reducing infant mortality. The Collaborative was developed in partnership with the Executive Office on Early Learning Action Strategy with help from the Department of Health and National Governor's Association. The Action Strategy provides Hawai‘i with a roadmap for an integrated and comprehensive early childhood system, spanning preconception to third grade. The Collaborative helps advance goals within the Action Strategy by focusing on ensuring that children have the best start in life by being healthy and welcomed. The Collaborative has completed a strategic plan and accompanying Logic Model, The First 1,000 Days, aimed at achieving the outcomes of 8% reduction in preterm births and 4% reduction in infant mortality. To date over 120 people across Hawai‘i have been involved in the Collaborative. These members include physicians and clinicians, public health planners and providers, insurance providers and health care administrators. The work is divided into three primary areas and coordinated by a cross sector leadership team. Work is specific, outcome driven, informed by data and primarily accomplished in small work groups. PMID:27738566

  15. Public private partnerships for emergency obstetric care: Lessons from Maharashtra

    Directory of Open Access Journals (Sweden)

    Sarika Chaturvedi

    2011-01-01

    Full Text Available Background: The National Rural Health Mission of India advocates public private partnerships (PPPs to meet its "service guarantee" of Emergency obstetric care (EmOC provision. The Janani Suraksha Yojana (JSY has a provision of Rs. 1500 for contracting in obstetric specialists. Objectives: The study aimed to understand the issues in the design and implementation of the PPPs for EmOC under the JSY in Maharashtra and how they affect the availability of EmOC services to women. Materials and Methods: A cross-sectional study using the rapid assessment approach was conducted in Ahmednagar district of Maharashtra spanning 1-year duration ending in June 2009. Primary data were obtained through interviews with women, providers, and administrators at various levels. Data were analyzed thematically. Results: The PPP scheme for EmOC is restricted to deliveries by Caesarean section. The administrators prefer subsidization of costs for services in private facilities to contracting in. There are no PPPs executed in the study district. This study identifies barriers to women in accessing the benefit and the difficulties faced by administrators in implementing the scheme. Conclusion: The PPPs for EmOC under the JSY have minimally influenced the out-of-pocket payments for EmOC. Infrastructural inadequacies and passive support of the implementers are major barriers to the implementation of contracting-in model of PPPs. Capacities in the public health system are inadequate to design and manage PPPs.

  16. Public private partnerships for emergency obstetric care: lessons from maharashtra.

    Science.gov (United States)

    Chaturvedi, Sarika; Randive, Bharat

    2011-01-01

    The National Rural Health Mission of India advocates public private partnerships (PPPs) to meet its "service guarantee" of Emergency obstetric care (EmOC) provision. The Janani Suraksha Yojana (JSY) has a provision of Rs. 1500 for contracting in obstetric specialists. The study aimed to understand the issues in the design and implementation of the PPPs for EmOC under the JSY in Maharashtra and how they affect the availability of EmOC services to women. A cross-sectional study using the rapid assessment approach was conducted in Ahmednagar district of Maharashtra spanning 1-year duration ending in June 2009. Primary data were obtained through interviews with women, providers, and administrators at various levels. Data were analyzed thematically. The PPP scheme for EmOC is restricted to deliveries by Caesarean section.The administrators prefer subsidization of costs for services in private facilities to contracting in. There are no PPPs executed in the study district. This study identifies barriers to women in accessing the benefit and the difficulties faced by administrators in implementing the scheme. The PPPs for EmOC under the JSY have minimally influenced the out-of-pocket payments for EmOC. Infrastructural inadequacies and passive support of the implementers are major barriers to the implementation of contracting-in model of PPPs. Capacities in the public health system are inadequate to design and manage PPPs.

  17. PUBLIC ACCESS TO PRIVATE LAND IN SCOTLAND

    Directory of Open Access Journals (Sweden)

    David L Carey Miller

    2012-08-01

    Full Text Available This article attempts to understand the radical reform of Scottish land law in its provision for a general right of public access to private land introduced in 2003 as part of land reform legislation, an important aspect of the initial agenda of the Scottish Parliament revived in 1999. The right is to recreational access for a limited period and the right to cross land. Access can be taken only on foot or by horse or bicycle. As a starting point clarification of the misunderstood pre-reform position is attempted. The essential point is that Scots common law does not give civil damages for a simple act of trespass (as English law does but only a right to obtain removal of the trespasser. Under the reforms the longstanding Scottish position of landowners allowing walkers access to the hills and mountains becomes a legal right. A critical aspect of the new right is that it is one of responsible access; provided a landowner co-operates with the spirit and system of the Act access can be denied on the basis that it is not being exercised responsibly. But the onus is on the landowner to show that the exercise of the right is not responsible.Although the right applies to all land a general exception protects the privacy of a domestic dwelling. Early case law suggests that the scope of this limit depends upon particular circumstances although reasonable 'garden ground' is likely to be protected. There are various particular limits such as school land.Compliance with the protection of property under the European Convention on Human Rights is discussed. The article emphasises the latitude, open to nations, for limitations to the right of ownership in land in the public interest. The extent of the Scottish access inroad illustrates this. This leads to the conclusion that 'land governance' – the subject of the Potchefstroom Conference at which the paper was initially presented – largely remains a matter for domestic law; the lex situs concept is alive

  18. Gender wage differentials in private and public sector jobs.

    Science.gov (United States)

    Zweimuller, J; Winter-ebmer, R

    1994-07-01

    "In this study gender wage differentials in private and public sector jobs in Austria are calculated. Occupational attainment is considered as endogenous by the use of an ordered response model. Results show that wage discrimination is also present in the public sector, though on a lower level. Both in private firms and for public servants a substantial part of this unwarranted differential is due to unequal professional advancement." excerpt

  19. Do Private Schools Provide Competition for Public Schools?

    OpenAIRE

    Caroline Minter Hoxby

    1994-01-01

    Arguments in favor of school choice depend on the idea that competition between schools improves the quality of education. However, we have almost no empirical evidence on whether competition actually affects school quality. In this study, I examine the effects of inter-school competition on public schools by using exogenous variation in the availability and costs of private school alternatives to public schools. Because low public school quality raises the demand for private schools as subst...

  20. Characteristics of the Public and Private Property Right

    OpenAIRE

    Titus CORLATEAN; Popescu-Cruceru, Anca; Aurel ASMARANDEI

    2012-01-01

    The national law contains provisions for both public property and private property. Public property belongs to the state or public administration units. Public property is also named state property. The definition of the property right must take into account both the general and specific aspects of this real right.

  1. PUBLIC AND PRIVATE PARTENERSHIP IN INFRASTRUCTURE DEVELOPMENT: ESSENCE, EXPERIENCE, PROBLEMS

    Directory of Open Access Journals (Sweden)

    Alexander E. Lantsov

    2014-01-01

    Full Text Available Infrastructure is of high importance for human society, so the state pay great attention to it. Characteristics inherent to infrastructure, its development, maintenance and consumption don’t always explain only the state involvement in the sector.The article considers preconditions and basis of private sector involvement in the process of infrastructure supply, experience of different countries, public and private sectors relationships in the matter and private sector effectiveness in infrastructure supply.

  2. PUBLIC AND PRIVATE PARTENERSHIP IN INFRASTRUCTURE DEVELOPMENT: ESSENCE, EXPERIENCE, PROBLEMS

    OpenAIRE

    Alexander E. Lantsov

    2014-01-01

    Infrastructure is of high importance for human society, so the state pay great attention to it. Characteristics inherent to infrastructure, its development, maintenance and consumption don’t always explain only the state involvement in the sector.The article considers preconditions and basis of private sector involvement in the process of infrastructure supply, experience of different countries, public and private sectors relationships in the matter and private sector effectiveness in infrast...

  3. Corruption and ethical issues regarding public-private partnership

    Directory of Open Access Journals (Sweden)

    Bianca COBÂRZAN

    2005-10-01

    Full Text Available The paper raises general questions about ethical problems that taint public-private partnership. Everybody talks about the economical benefits of encouraging firms to invest in the community using different incentives offered by the public institutions. In the same time, every day, newspapers bring to our attention cases of misuse of public resources for private gain or cases of private investors who give bribes in order to get a contract with a public institution. The purpose of this paper is to synthesize our understanding of the entrepreneurial movement and analyze its implications for potential problems of corruption that can arise in the relation between the public and the private sector.a

  4. Corruption and Ethical Issues Regarding Public-Private Partnership

    Directory of Open Access Journals (Sweden)

    Bianca COBÂRZAN

    2005-10-01

    Full Text Available The paper raises general questions about  ethical problems that taint public-private  partnership. Everybody talks about the  economical benefits of encouraging firms  to invest in the community using different  incentives offered by the public institutions.  In the same time, every day, newspapers  bring to our attention cases of misuse of  public resources for private gain or cases  of private investors who give bribes in order  to get a contract with a public institution.  The purpose of this paper is to synthesize  our understanding of the entrepreneurial  movement and analyze its implications for  potential problems of corruption that can  arise in the relation between the public and the private sector.

  5. Project Management in Development Aid Industry – Public vs. Private

    Directory of Open Access Journals (Sweden)

    Simović Dragana

    2015-02-01

    Full Text Available This article examines the relationship between the type of a development aid implementing organisation (public or private and the quality of project management in development aid. The author begins with main public administration considerations - how public aid administration is different from private and furthermore, how particular sectoral characteristics of organisations influence the quality of the management process. The article combines empirical findings on the differences between the public and private sector with a complex setting of development aid and main success factors in development aid activity, in order to determine whether for-profit or public companies are more likely to achieve better project management processes. The article identifies some indices that favorise private companies, and outlines further necessary steps that should be taken in order to broaden the argumentation and confirm or reject this assertion

  6. Eliminating canine rabies: the role of public-private partnerships.

    Science.gov (United States)

    Taylor, Louise

    2013-05-01

    Canine rabies has been eliminated from industrialized countries, but infected dogs remain the principal source of human infections in the developing world. Despite the availability of effective tools for prevention and post-exposure prophylaxis, canine rabies inflicts a heavy burden on the poorest people of Africa, Asia and Latin America, resulting in more than 60,000 deaths each year. Public-private partnerships offer a new approach to the challenge of eliminating canine rabies in the developing world, by bringing together stakeholders to share responsibilities and reduce costs. The leading partnership for rabies control, the Partners for Rabies Prevention, is an informal international group that includes representatives of major health organizations (WHO, PAHO, FAO, OIE), the European Commission, universities, nongovernmental organizations, the human and animal health industries, and private global health institutions. This article describes how the Partners for Rabies Prevention is working toward the global elimination of canine rabies. It forms part of a symposium in Antiviral Research on the elimination of canine rabies.

  7. Twitter and public health.

    Science.gov (United States)

    Bartlett, Catherine; Wurtz, Rebecca

    2015-01-01

    Twitter can serve as a powerful communication modality to both "push" and "pull" public health data; each user is a potential public health sensor and actor. However, in 2012, only 8% of local health departments had Twitter accounts. We outline how Twitter works, describe how to access public tweets for public health surveillance purposes, review the literature on Twitter's current and potential role supporting public health's essential services, summarize Twitter's limitations, and make recommendations for health department use.

  8. Working together: public law enforcement and private security.

    Science.gov (United States)

    Jones, Harold T

    2010-01-01

    Private security forces, including hospital security professionals, provide a vast largely untapped resource for public law enforcement in a number of critical areas affecting society, the author points out. At the same time, police agencies in some communities have programs which can be used to provide additional training for private security officers.

  9. Privatization of Public Education: Panacea or Pandora's Box?

    Science.gov (United States)

    Stevenson, Kenneth R.

    1999-01-01

    The drive for privatizing public education comes from two different movements: load-shedding and outsourcing. Districts hope to reduce perceived labor problems, avoid managing "uninteresting" services, save money, and/or buy quick-fix education reform. Privatization of charter schools is becoming big business, but its cost-effectiveness…

  10. Achievement in Public and Private Secondary Education in the Netherlands

    NARCIS (Netherlands)

    van Laarhoven, Peter; Bakker, Bart; Dronkers, Jaap; Schijf, Hubert

    1987-01-01

    Recent research has claimed that American private high schools are more effective than public high schools. Two critical aspects of this research are at the center of this article: a) whether the short-term benefits of private schools which were found to exist persist over an extended period of

  11. Achievement in Public and Private Secondary Education in the Netherlands

    NARCIS (Netherlands)

    van Laarhoven, Peter; Bakker, Bart; Dronkers, Jaap; Schijf, Hubert

    1987-01-01

    Recent research has claimed that American private high schools are more effective than public high schools. Two critical aspects of this research are at the center of this article: a) whether the short-term benefits of private schools which were found to exist persist over an extended period of time

  12. Public and Private Schools: Evidence on Tuition Tax Credits.

    Science.gov (United States)

    Catterall, James S.; Levin, Henry M.

    1982-01-01

    Discusses the conclusion reached by Coleman, Hoffer and Kilgore in their report "Public and Private Schools" that tuition tax credits would increase minority and low-income family participation in private, secondary schools. The implications of estimates of enrollment changes from tuition tax credits are analyzed. (AM)

  13. Evaluation of Public Sector Contributions to Public-Private Partnership Projects

    OpenAIRE

    Mackie, Peter; Nellthorp, John; Laird, James

    2005-01-01

    The Bank requires that any public sector contribution to a collaborative effort between the public sector and private enterprises in the transport sector be analyzed and justified in economic terms. This Note will set out the basis for making such an analysis. The general principles underlying this analysis are that: 1) public contributions to public-private partnership (PPP) projects sho...

  14. Response of Foreign Private Investment to Public Debt in Nigeria

    Directory of Open Access Journals (Sweden)

    Emenike Kalu O.

    2015-06-01

    Full Text Available The study investigates the long-term relationship and dynamic short-term impact of public debt on foreign private investment for a developing country – Nigeria during the period 1962 to 2012. The paper deploys cointegration model to examine long-term relationship between the variables. The study also examines dynamic short-term impact and causality between public debt and foreign private investment using the VECM and Granger causality test. The study further examines the response paths of foreign private investment variable due to public debts shocks using variance decomposition. The results confirm absence of long-term relationship between public debt and foreign private investment in Nigeria. The results also show that external debt has negative impact on foreign private investment in the short-term. Finally, the results show that there is no causality between foreign private investment and public debt. The major economic implication of these findings is for debt management authorities to be conscious of growing external debts as it discourages foreign private investments into Nigeria.

  15. Private public diplomacy. The end of public hegemony over international relations

    Directory of Open Access Journals (Sweden)

    Luis Melgar

    2014-09-01

    We could be witnessing a completely new model: a private public diplomacy that would be based on a sovereign states definitive withdrawal from their monopoly on international relations in favour of the private sector.

  16. 8 CFR 299.4 - Reproduction of Public Use Forms by public and private entities.

    Science.gov (United States)

    2010-01-01

    ... or private entity. Forms printed or reproduced by public or private entities shall be: (1) In black... be replicated to mirror the authorized agency form. Each item must be printed on the same page in...

  17. Health Reforms and Public Health in Georgia

    Directory of Open Access Journals (Sweden)

    Raminashvili, D.

    2012-07-01

    Full Text Available BACKGROUND: Starting from 90‘th, the Government of Georgia (GoG made several attempts to transform Georgian health care system into one with improved efficiency, accessibility, and quality services. Mandatory social health insurance which was introduced in the 1990s was abolished and private health insurance has been promoted as its replacement. The main principle of health care reform since 2006 was the transition towards complete marketization of the health care sector: private provision, private purchasing, liberal regulation, and minimum supervision.This paper aims to analyze an impact of ongoing reforms on public health and population health status.MATERIALS AND METHODS: A systematic review of the available literature was conducted through national and international organization reports; key informant interviews were conducted with major stakeholders. RESULTS: The country has attained critical achievements in relation to improved maternal and child health, national responses to HIV, TB and Malaria. Life expectancy has increased from 70.3 years in 1995 to 75.1 years in 2010. Under-5 mortality indicator has improved from 45.3 to 16.4 per 1000 live birth in 2005-2010 meaning a 64% decrease. However, Georgia is still facing a number of critical challenges securing better health for the population. Cardiovascular diseases are by far the largest cause of mortality, respiratory diseases are the leading cause of morbidity and have doubled during last decade. Georgia has one of the highest rates of male smoking in the world (over 50%.CONCLUSION: Governmental efforts in health promotion and disease prevention can have significant impact on health status by preventing chronic diseases and detecting health problems at a treatable stage. Government should consider increasing funding for public health and prevention programmes with the focus on prevention of the main risk factors affecting the population’s health: tobacco and drug use and unsafe

  18. BETWEEN PUBLIC AND PRIVATE. WOMEN RULE MUNICIPALITIES IN TLAXCALA, MEXICO

    Directory of Open Access Journals (Sweden)

    Verónica Vázquez-García

    2012-01-01

    Full Text Available For public / private dichotomy in Western thought, the power is exercised in the public while private space is maintained as a domestic, apolitical and non-theorized. By contrast, for feminists it is an area of power that must be studied. The aim of this paper is to analyze the link between the public and private sphere from depth interviews with 14 mayors from Tlaxcala, Mexico. It discusses the various pressures to which women are subjected to assume public office and their slim chances of a far-reaching political career. We conclude that the social relations of private sector are vital to facilitate the participation of women in the audience, making it necessary to include in the definition of democracy.

  19. PUBLIC-PRIVATE PARTNERSHIP AS EFFECTIVE MECHANISM OF SPORTS INFRASTRUCTURE

    Directory of Open Access Journals (Sweden)

    D. P. Moskvin

    2012-01-01

    Full Text Available The article discusses the current state of sports infrastructure in Russia and also explores the experience of using public-private partnership at Olympic facilities construction in Sochi.

  20. Determinants of Job Hopping Experience among Private and Public ...

    African Journals Online (AJOL)

    Determinants of Job Hopping Experience among Private and Public Sector ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL ... This study investigated perceived organizational justice, job stress and job ...

  1. Comparing public and private hospital care service quality.

    Science.gov (United States)

    Camilleri, D; O'Callaghan, M

    1998-01-01

    The study applies the principles behind the SERVQUAL model and uses Donabedian's framework to compare and contrast Malta's public and private hospital care service quality. Through the identification of 16 service quality indicators and the use of a Likert-type scale, two questionnaires were developed. The first questionnaire measured patient pre-admission expectations for public and private hospital service quality (in respect of one another). It also determined the weighted importance given to the different service quality indicators. The second questionnaire measured patient perceptions of provided service quality. Results showed that private hospitals are expected to offer a higher quality service, particularly in the "hotel services", but it was the public sector that was exceeding its patients' expectations by the wider margin. A number of implications for public and private hospital management and policy makers were identified.

  2. Implementation of a public-private partnership in local government ...

    African Journals Online (AJOL)

    Implementation of a public-private partnership in local government in Ghana: A study of Ga West ... Open Access DOWNLOAD FULL TEXT ... selected from the two study areas and primary data collected using one-on-one indepth interviews.

  3. Innovation embedded in entrepreneurs’ networks in private and public spheres

    DEFF Research Database (Denmark)

    Schøtt, Thomas; Cheraghi, Maryam; Rezaei, Shahamak

    2014-01-01

    Global studies have found tendencies: traditional culture promotes entrepreneurs' networking in the private sphere, impeding innovation, whereas secular-rational culture facilitates networking in the public sphere, benefiting innovation. This embeddedness is here scrutinised in contrasting...

  4. MARKETING FUNCTION IN THE DEVELOPMENT OF PUBLIC-PRIVATE PARTNERSHIP

    Directory of Open Access Journals (Sweden)

    Ljubiša Ćosić

    2012-01-01

    Full Text Available Marketing function of an economicentity involves the usage of various marketing subfunctionssuch as marketing research, marketingapproach in product development, marketingplanning, marketing management, etc. Themarketing orientation of the economic entity isdirected by using those functions, eitherindividually or jointly. In terms of our public sectorand institutions, introduction and application ofmarketing as a kind of business philosophy are notyet enough widespread and used. This paper posesas imperative introduction of a marketing conceptand corresponding marketing sub-functions inpublic institutions, mainly in the field of public -private partnership. The direct relation andcooperation between public and private sector inthe projects of general and social interest that areimplemented by private partner in cooperation withpublic institution in the framework of private-publicpartnership reflects the significance of marketingfunction of public sector in this field.

  5. Public and Private Investment and Economic Growth in Namibia ...

    African Journals Online (AJOL)

    to a redefinition of its role in the development process in many countries, under the guiding ...... Private Investment in Latin America, Economic Development and Cultural .... Does public investment enhance productivity growth in Mexico? A.

  6. 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.

  7. Who's that sleeping in my bed? Potential and actual utilization of public and private in-patient beds in Irish acute public hospitals.

    Science.gov (United States)

    O'Reilly, Jacqueline; Wiley, Miriam

    2010-10-01

    To examine the impact of the unusual public/private mix on public and private in-patient bed utilization within Irish acute public hospitals. Data from the Department of Health and Children and the Hospital In-Patient Enquiry were used to estimate and compare potential and actual utilization of public and private designated in-patient beds in 54 acute public hospitals from 2000 to 2004. Private in-patients used more bed days than were potentially available to them in 14.1% of hospital-year observations. The equivalent figure for public in-patients was 12.6%. Although the prevalence of excess utilization of private beds was relatively small, it did increase over the study period. Hospitals with excess private utilization were characterized by a relatively low proportion of private- or non-designated beds despite their patient profile being broadly similar to that of hospitals where there was no excess private utilization. Despite policies designed to limit private practice in Irish acute public hospitals, some hospitals have apparently been able to overcome these restrictions. In a system where financial incentives to treat private patients exist both for consultants and hospitals, it is not clear whether this excess private practice in public hospitals reflects a more efficient utilization of resources (when demand from public patients is low) or the displacement of public patients in favour of private patients. However, that a smaller number on hospital waiting lists possess private health insurance provides some support for the displacement hypothesis. Thus, it appears that policy-makers may need to reconsider attempts to ensure an appropriate division of acute public hospital resources between public and private patients.

  8. Some Salient Features of Guatemala's Public and Private School Sectors

    Directory of Open Access Journals (Sweden)

    Carlos R. Ruano

    2003-07-01

    Full Text Available The purpose of this article is to analyze the formulation and implementation of educational policy processes in relation to private schools in Guatemala. Specifically, how bilingual education is defined and implemented in the private education sector in Guatemala City where the largest number of privately run establishments exist. Given the great deficits in the provision of educational coverage in the public sector, there has been an explosive expansion of private institutions which have very different levels of quality. Through an analysis of the administrative processes within the Guatemalan Government in general and its Education Ministry in particular as well as of the governance arrangements existing in the private school sector, an overall view of the curricular and policy decisions taken by private schools in the formulation and implementation of bilingual education is presented. This study was based on a sample of six private schools which cater to higher income segments of Guatemala City’s student population. Some of the relevant findings of this study include, the existence of a situation of quasi autonomous institutional functioning of the private sector, extreme differentials in the quality of services provided, inadequate levels of teacher and school administrator’s training as well as lack of cooperation between public and private sector schools.

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

    Science.gov (United States)

    Morgan, Rosemary; Ensor, Tim; Waters, Hugh

    2016-08-06

    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.

  10. Private vs. public self-consciousness and self-discrepancies

    OpenAIRE

    2015-01-01

    Background We studied the relationships of self-discrepancies with private and public self-consciousness. It was postulated that private self-consciousness is more strongly related to actual–ideal discrepancy than to actual–ought discrepancy, and that the latter is more strongly related to public self-consciousness. Participants and procedure The sample consisted of 71 students aged 19-25, who completed the Self-Consciousness Scale and the DRP procedure for measuring self-...

  11. After the reform : Change in Dutch public and private organizations

    NARCIS (Netherlands)

    Nieto Morales, F.; Wittek, R.P.M.; Heyse, L.

    Proponents of new public management (NPM) expect public organizations to become more flexible and adaptive after administrative reforms, effectively showing convergence with patterns of organizational change in the private sector. This "convergence argument" is tested with a sample of 61 public and

  12. After the reform : Change in Dutch public and private organizations

    NARCIS (Netherlands)

    Nieto Morales, F.; Wittek, R.P.M.; Heyse, L.

    2013-01-01

    Proponents of new public management (NPM) expect public organizations to become more flexible and adaptive after administrative reforms, effectively showing convergence with patterns of organizational change in the private sector. This "convergence argument" is tested with a sample of 61 public and

  13. Private medical services in the Italian public hospitals: the case for improving HRM.

    Science.gov (United States)

    De Pietro, Carlo

    2006-08-22

    This study explores how Italian public hospitals can use private medical activities run by their employed physicians as a human resources management (HRM) tool. It is based on field research in two acute-care hospitals and a review of Italian literature and laws. The Italian National Health Service (NHS) allows employed physicians to run private, patient-funded activities ("private beds", surgical operations, hospital outpatient clinics, etc.). Basic regulation is set at the national level, but it can be greatly improved at the hospital level. Private activities, if poorly managed, can damage efficiency, equity, quality of care, and public trust in the NHS. On the other hand, hospitals can also use them as leverage to improve HRM, with special attention to three issues: (1) professional evaluation, development, and training; (2) compensation policies; (3) competition for, and retention of, professionals in short supply. The two case studies presented here show great differences between the two hospitals in terms of regulation and organizational solutions that have been adopted to deal with such activities. However, in both hospitals, private activities do not seem to benefit HRM. Private activities are not systematically considered in compensation policies. Moreover, private revenues are strongly concentrated in a few physicians. Hospitals use very little of the information provided by the private activities to improve knowledge management, career development, or training planning. Finally, hospitals do not use private activities management as a tool for competing in the labor market for health professionals who are in short supply.

  14. Contracepção hormonal: uma comparação entre pacientes das redes pública e privada de saúde Hormonal contraception: a comparison between patients of the private and public health network

    Directory of Open Access Journals (Sweden)

    Patrícia Delage Gomes

    2011-05-01

    Full Text Available O objetivo deste artigo é avaliar o perfil de pacientes usuárias de contraceptivos hormonais no setor público e fazer a comparação com o serviço privado de saúde, bem como verificar a frequência de efeitos colaterais e a aderência ao tratamento. Realizou-se um estudo de corte transversal com 240 pacientes, sendo 120 da rede privada e 120 da rede pública de saúde. No grupo privado, a dosagem hormonal mais frequentemente prescrita foi a de 15 ou 20 microgramas de etinil-estradiol (EE, associados a gestodeno, desogestrel ou levonogestrel (36,7%. No grupo público, a combinação de 30 microgramas de EE associados a gestodeno, levonogestrel ou desogestrel (48,3% foi a principal medicação contraceptiva prescrita. Não houve diferença entre a frequência dos efeitos colaterais nos dois grupos pesquisados (p>0,05. A aderência ao tratamento foi maior nas pacientes do grupo privado (pThe aim of this paper is to assess the profile of patients using hormonal contraceptives in the public health network and a comparison with the private health service, as well as the frequency of side effects and adherence to treatment. A cross-sectional study was conducted with 240 patients, namely 120 patients from the private health service and 120 patients from the public health network. The most commonly prescribed hormonal dosage on the private group (36.7% was 15 or 20 micrograms of ethinyl estradiol (EE, associated with gestodene, desogestrel or levonorgestrel. On the other hand, the prescribed hormonal dosage in the public group was a combination of 30 micrograms of EE associated with gestodene, levonorgestrel or desogestrel (48.3%. There was no difference between the frequency of side effects in both groups surveyed (p>0.05. Meanwhile, adherence to treatment was higher in patients of the private group. The authors concluded that the most widely used contraceptive method was a low oral dose of ethinyl estradiol and there is no difference between the

  15. 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.

  16. 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

  17. Public-private provision of protection measures against natural hazards

    Science.gov (United States)

    Gruber, M.

    2009-04-01

    Natural hazards threaten human lives as well as economic values of a society. Due to an increasing population density, augmenting property holdings in congested areas as well as higher frequencies of catastrophic events, the damage potential associated with natural hazards is growing. In order to safeguard societal assets against this threat, active and passive protection measures can be established. While passive protection measures provide for this type of risk by means of thorough land use planning, active protection measures aim at improving safety through technical or biological protective systems and structures. However, these provisions are costly and need to be handled prudentially. In most European countries protection measures against natural hazards are provided by the public. Specific governmental funds have been set up for the establishment of preventive systems as well as for damage compensation payments after the occurrence of catastrophic events. Though, additional capital is urgently needed in order to facilitate the realisation of all necessary projects in this field and to provide for maximal safety. One potential solution for such financial deficiencies can be found in Public Private Partnerships (PPP). PPPs have been implemented as attractive concepts for the funding of diverse projects in the fields of e.g. road construction, municipal, health and social services. In principle, they could also provide alternative funding solutions for the establishment of crucial protective infrastructure in respect of natural hazards, adding private financial means to the currently available public funds. Thereby, the entire capacities for catastrophe funding could be enhanced. Beside PPPs, also alternative funding mechanisms such as the emission of catastrophe bonds, contingent credit lines or leasing arrangements may enhance available capacities for the financing of protection measures. This contribution discusses innovative solutions for the funding of

  18. Market Positioning of Public and Private Universities:Students Perspective

    Directory of Open Access Journals (Sweden)

    Abdul-Kahar ADAM

    2014-06-01

    Full Text Available This paper concentrates on universities strategies for admitting students and the rate at which private sector universities expand in today’s higher educational setups. This paper answers the following question: to what extend are the public universities different from the private universities? In an attempt to find the answers, the whole study is developedtowards students’ perception of the universities positioning in terms of what they are offering to the customers, through what they prompt people to apply for admission? Therefore, thispaper looks at the prevailing admission strategies and potential students’ entry requirements at both public and private universities to determine the theoretical systems that are used by these universities in competition for customers (students. A quantitative survey of students in both public and private universities in Ghana was undergone In all, a total number of 255 questionnaires were printed. Only 187 were answered and returned out of 200 distributed questionnaires to the public sector universities whereas 55 questionnaires were distributed to the private sector students and 51 were answered and returned. This research was based on sampling data collection methods. The findings show that there are three categories of universities such as Publicly/Fully Independent Chartered Universities, Privately Owned Universities and Personal/Sole Proprietorship University Colleges. All these affect students’ choices for admission application. The findings clearly indicate that both public and private universitiespurposes are related using Pearson’s Product Moment Correlation Coefficient formulae to that of the sole proprietorship colleges. Also, the admission requirement strategies differ between public and private universities.

  19. Public-private interactions in global food safety governance.

    Science.gov (United States)

    Lin, Ching-Fu

    2014-01-01

    In response to an apparent decline in global food safety, numerous public and private regulatory initiatives have emerged to restore public confidence. This trend has been particularly marked by the growing influence of private regulators such as multinational food companies, supermarket chains and non-governmental organizations (NGOs), who employ private standards, certification protocols, third-party auditing, and transnational contracting practices. This paper explores how the structure and processes of private food safety governance interact with traditional public governance regimes, focusing on Global Good Agricultural Practices (GlobalGAP) as a primary example of the former. Due to the inefficiency and ineffectiveness of public regulation in the face of global problems, private governance in food safety has gradually replaced states' command-and-control regulation with more flexible, market-oriented mechanisms. The paper concludes by emphasizing the importance of constructive regime interaction instead of institutional boundary building to global food safety governance. Public and private ordering must each play a role as integral parts of a larger, dynamic and evolving governance complex.

  20. Role of public-private partnership in micronutrient food fortification.

    Science.gov (United States)

    Mannar, M G Venkatesh; van Ameringen, Marc

    2003-12-01

    Iron, iodine, and vitamin A deficiencies prevent 30% of the world's population from reaching full physical and mental potential. Fortification of commonly eaten foods with micronutrients offers a cost-effective solution that can reach large populations. Effective and sustainable fortification will be possible only if the public sector (which has the mandate and responsibility to improve the health of the population), the private sector (which has experience and expertise in food production and marketing), and the social sector (which has grass-roots contact with the consumer) collaborate to develop, produce, and promote micronutrient-fortified foods. Food fortification efforts must be integrated within the context of a country's public health and nutrition situation as part of an overall micronutrient strategy that utilizes other interventions as well. Identifying a set of priority actions and initiating a continuous dialogue between the various sectors to catalyze the implementation of schemes that will permanently eliminate micronutrient malnutrition are urgently needed. The partners of such a national alliance must collaborate closely on specific issues relating to the production, promotion, distribution, and consumption of fortified foods. Such collaboration could benefit all sectors: National governments could reap national health, economic, and political benefits; food companies could gain a competitive advantage in an expanding consumer marketplace; the scientific, development, and donor communities could make an impact by achieving global goals for eliminating micronutrient malnutrition; and by demanding fortified foods, consumers empower themselves to achieve their full social and economic potential.

  1. Trends in Health Care Spending by the Private Sector

    Science.gov (United States)

    1997-04-01

    trends in employment-based premiums. One such study by Jon Gabel and colleagues compared results from the Peat Marwick/Wayne State University 1993 survey...shift from indemnity to managed care plans during that period. 18. Jon Gabel and others, "The Health Insurance Picture in 1993: Some Rare Good News...Jonathan M. Gruber , Does Public Insurance Crowd Out Private Insurance? Working Paper No. 5082 (Cambridge, Mass.: National Bureau of Economic Research

  2. Living ‘private life in the public gaze’

    DEFF Research Database (Denmark)

    Singla, Rashmi

    Living ‘private life in the public gaze’: Multiethnic/visibly ethnically mixed couples in Denmark This paper deals with the subjective experiences of the mixed couples’ lives, both in the country of native partner and in the diasporic spouse’s country of origin. Despite increasing numbers...... in the present study. The former is illustrated through an awareness of the discrimination processes they face in different social domains such as the labour market, the stereotypical views of family members, negative attitudes of personnel in the children’s day care institutions, curious questions, while...... and the next generation. Profound implications of these findings for psychosocial services for mixed couples and their children are lastly discussed. *Singla, R. (2015) “Intermarriage, Mixed Parenting, Promoting mental health and wellbeing: Crossover Love Basingstoke, Palgrave Macmillan...

  3. Public-Private Partnerships in Chronic Disease Prevention-Part 1

    Centers for Disease Control (CDC) Podcasts

    2009-04-06

    This podcast is the first of a seven part series discussing public health partnerships with the private sector. In this segment, CDC's Elizabeth Majestic and University of North Carolina's Gene Matthews talk about the history of public health partnerships with the for profit sector.  Created: 4/6/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/6/2009.

  4. Financing and planning of public and private not-for-profit hospitals in the European Union.

    Science.gov (United States)

    Thompson, Ceri R; McKee, Martin

    2004-03-01

    While much has been written about health care financing in Europe in recent years, discussion has almost entirely focused on revenue. In contrast, there has been remarkably little written on financing of capital investment in European health care systems. Yet major changes are underway in several countries, in particular involving new forms of public-private partnerships (PPP). At the same time, there is growing recognition of the way in which the inherited structure of the health care delivery system constrains the system's ability to adapt to changing circumstances. This paper reports the results of a survey undertaken among key informants in the member states of the European Union to begin to ascertain existing practices and future plans in relation to hospital planning and financing amongst public and private not-for-profit hospitals. The locus of hospital planning decisions reflect the constitutional framework of the country involved, and thus the emphasis on national or local plans. There has been an expansion of private sector involvement, with four basic models identified: private loans direct to the hospital; private loans to a regional health body; a PPP where the private sector's role is to build, design and operate the non-clinical functions of the hospital; and, finally, a PPP, where the private sector's involvement also includes management of the clinical functions of the hospital. It is too early to say whether these approaches will be more successful than the models they are replacing.

  5. Entre o público e o privado: a saúde hoje no Brasil Between public and private: health in Brazil today

    Directory of Open Access Journals (Sweden)

    Maria Helena Oliva Augusto

    1999-10-01

    Full Text Available O artigo analisa a política governamental de saúde, no período 1995-1998, focalizando as principais decisões relativas à organização e financiamento do Sistema Único de Saúde (SUS. São apontadas e discutidas, entre outras decisões do governo federal no setor saúde: a regulamentação dos critérios de transferência de recursos federais para estados e municípios, com a conseqüente definição de modalidades de gestão local do sistema de saúde; a estratégia de reorganização da atenção básica à saúde, via incentivos especiais ao Programa de Agentes Comunitários de Saúde (PACS e ao Programa de Saúde da Família (PSF; a instituição da Contribuição Provisória sobre Movimentação Financeira (CPMF como fonte específica de recursos para ações de saúde; e a regulamentação dos seguros e planos privados de assistência à saúde.The article analyses the Government Health Policy, in the 1995-1998 period, focusing the main decisions related to the SUS (Single Health System organization and financing. It points out and discusses some among several federal government decisions: the regulation of the federal resources transference criteria to states and municipalities and the resulting definition of the different kinds of local health system administration; the basic health care reorganization strategy via special incentives to the PACS (Health Community Agents Program and to the PSF (Family Health Program; the establishment of the CPMF (Temporary Contribution on Financial Transactions as an specific source of health services; the regulation of private health care plans and insurance.

  6. High rates of adherence and treatment success in a public and public-private HIV clinic in India: potential benefits of standardized national care delivery systems

    Directory of Open Access Journals (Sweden)

    Heylen Elsa

    2011-10-01

    Full Text Available Abstract Background The massive scale-up of antiretroviral treatment (ART access worldwide has brought tremendous benefit to populations affected by HIV/AIDS. Optimising HIV care in countries with diverse medical systems is critical; however data on best practices for HIV healthcare delivery in resource-constrained settings are limited. This study aimed to understand patient characteristics and treatment outcomes from different HIV healthcare settings in Bangalore, India. Methods Participants from public, private and public-private HIV healthcare settings were recruited between 2007 and 2009 and were administered structured interviews by trained staff. Self-reported adherence was measured using the visual analogue scale to capture adherence over the past month, and a history of treatment interruptions (defined as having missed medications for more than 48 hours in the past three months. In addition, CD4 count and viral load (VL were measured; genotyping for drug resistance-associated mutations was performed on those who were in virological failure (VL > 1000 copies/ml. Results A total of 471 individuals were included in the analysis (263 from the public facility, 149 from the public-private facility and 59 from the private center. Private facility patients were more likely to be male, with higher education levels and incomes. More participants reported ≥ 95% adherence among public and public-private groups compared to private participants (public 97%; private 88%; public-private 93%, p Conclusions Adherence and treatment success was significantly higher among patients from public and public-private settings compared with patients from private facilities. These results suggest a possible benefit of the standardized care delivery system established in public and public-private health facilities where counselling by a multi-disciplinary team of workers is integral to provision of ART. Strengthening and increasing public-private partnerships can

  7. Private Arbitration of Incidental Public Law Issues

    DEFF Research Database (Denmark)

    Werlauff, Erik

    2009-01-01

     The article discusses the incidental public law issues which can arise in an arbitration case, e.g. concerning power, heating, natural gas and other public facility legislation, national or Community legal restrictive trade practices law, and rules on state administration approval of the terms...... by arbitration, and where the award is nullifiable only if its findings are in violation of public policy, the ordre public. The article relies on UNCITRAL's Model Arbitration Law, the new Danish arbitration act (DAA), national European case law, and literature and case law of the European Court....

  8. The Role of Boundary Objects in Public-Private Innovation Networks

    DEFF Research Database (Denmark)

    Scheuer, John Damm

    2010-01-01

    The aim of the contribution is to describe and analyze the process through which a health school was established and to show how involved actors inability to construct an attractive boundary object may explain the lack of further public-private collaboration around the health school (it was devel...... was developed, tested out for a short period and then closed)....

  9. Provider performance measures in private and public programs: achieving meaningful alignment with flexibility to innovate.

    Science.gov (United States)

    Higgins, Aparna; Veselovskiy, German; McKown, Lauren

    2013-08-01

    In recent years there has been a significant expansion in the use of provider performance measures for quality improvement, payment, and public reporting. Using data from a survey of health plans, we characterize the use of such performance measures by private payers. We also compare the use of these measures among selected private and public programs. We studied twenty-three health plans with 121 million commercial enrollees--66 percent of the national commercial enrollment. The health plans reported using 546 distinct performance measures. There was much variation in the use of performance measures in both private and public payment and care delivery programs, despite common areas of focus that included cardiovascular conditions, diabetes, and preventive services. We conclude that policy makers and stakeholders who seek less variability in the use of performance measures to increase consistency should balance this goal with the need for flexibility to meet the needs of specific populations and promote innovation.

  10. Análise econômica da interação entre a infraestrutura da saúde pública e privada no Brasil Economic analysis of the Brazilian public and private health infrastructure

    Directory of Open Access Journals (Sweden)

    Marislei Nishijima

    2010-12-01

    Full Text Available Este artigo analisa de que forma a interação entre o setor público e privado de saúde da economia brasileira, avaliando como a sua estrutura produtiva, aliada ao aparato legal referente ao período anterior à regulação da Agência Nacional de Saúde Suplementar, pode ter causado um impacto negativo sobre o acesso dos brasileiros de baixa renda aos bens públicos de saúde. Para dar suporte aos argumentos apresentados, foram utilizados os microdados do suplemento saúde da PNAD de 1998, analisados por meio de modelos logit e probit tendo em vista o caráter qualitativo da variável dependente. Os resultados sugerem evidências favoráveis à hipótese proposta.This article analyses how the last Brazilian Constitution - which regulates the universal rights of public health care - has negatively impacted the distribution of health care in terms of the access that Brazilians with lower incomes have to public health care. The specific way that the public and private sectors of health care functions has caused this to happen. This phenomenon was indirectly tested using supplementary health economics survey data, together with a traditional household survey, the "Pesquisa Nacional de Amostra por Domicílio" (PNAD, from 1998. Logit and probit models were used to analyze the data, and the results supported the proposed hypothesis.

  11. Private versus Public Feedback - The Incentive Effects of Symbolic Awards

    DEFF Research Database (Denmark)

    Gerhards, Leonie; Siemer, Neele

    subjects' performance compared to the control treatment. Also high ability and a positive interim feedback increase performance. Competitive preferences matter only in the less prestigious task. Subjects' gender and overconfidence can in neither of the tasks explain performance. In a supplementary field......We experimentally compare the incentive effects of rewarding individuals for outstanding performance publicly versus privately. We implement two real-effort tasks, which differ in how prestigious subjects perceive working on them. In both tasks private and public feedback similarly enhances...... experiment at a secondary school we furthermore compare the incentive effects of different forms of public recognition....

  12. Public-Private Partnership for Regional Development of Renewable Energy

    Directory of Open Access Journals (Sweden)

    Andreea ZAMFIR

    2011-11-01

    Full Text Available This study investigates the public-private partnership as a possible solution for regional development of renewable energy. Firstly, the study reveals the strong connection between renewable energy and sustainable regional development, and secondly, the study discloses some reasons for developing renewable energy through public-private partnerships in Romania’s regions. The findings of this study reveal that there is a strong need for a renewable energy partnership between public authorities, business community and civil society in order to achieve the regional development of renewable energy. The results of this study may be used for upcoming research in the area of implementing renewable energy projects through public-private partnerships in order to achieve sustainable regional development.

  13. Oral health care for children in countries using dental therapists in public, school-based programs, contrasted with that of the United States, using dentists in a private practice model.

    Science.gov (United States)

    Mathu-Muju, Kavita R; Friedman, Jay W; Nash, David A

    2013-09-01

    The United States faces a significant problem with access to oral health care, particularly for children. More than 50 countries have developed an alternative dental provider, a dental therapist, practicing in public, school-based programs, to address children's access to care. This delivery model has been demonstrated to improve access to care and oral health outcomes while providing quality care economically. We summarize elements of a recent major review of the global literature on the use of dental therapists, "A Review of the Global Literature on Dental Therapists: In the Context of the Movement to Add Dental Therapists to the Oral Health Workforce in the United States." We contrast the success of a school-based model of caring for children by dental therapists with that of the US model of dentists providing care for children in private practices.

  14. Private market PPP versus innovative public market procurement practices

    NARCIS (Netherlands)

    Korthals Altes, W.K.

    2014-01-01

    Public contracts between contracting authorities and economic operators take place in a context in which initiative rests with a contracting authority publishing a contract notice defining content and scope of the contract. Many innovative contracting practices, described as public-private partnersh

  15. Privatization and 'Agentification' of Public Services Delivery in Africa ...

    African Journals Online (AJOL)

    seriane.camara

    2009-05-14

    May 14, 2009 ... Council for the Development of Social Science Research in Africa, 2008 .... between public and private sector organizations in public services delivery .... assets. Land survey. Municipal land. Sanitation. Town cleaning .... depending on circumstance and may include executive share ..... DOL Contract No.

  16. Democracy, redistributive taxation and the private provision of public goods

    DEFF Research Database (Denmark)

    Markussen, Thomas

    2011-01-01

    The paper studies in a simple, Downsian model of political competition the private provision of public goods embedded in a system of democracy and redistributive taxation. Results show that the positive effect of inequality on production of public goods, to which Olson (1965) pointed, is weakened...

  17. Democracy, Redistributive Taxation and the Private Provision of Public Goods

    DEFF Research Database (Denmark)

    Markussen, Thomas

    The paper studies in a simple, Downsian model of political competition how the private provision of public goods is affected when it is embedded in a system of democracy and redistributive taxation. Results show that the positive effect of inequality on public goods production, which Olson (1965...

  18. Oferta pública y privada de servicios sanitarios por comunidades autónomas Public and private supply of health services by autonomous communities in Spain

    Directory of Open Access Journals (Sweden)

    Beatriz González

    2004-05-01

    Full Text Available El presente artículo resume las desigualdades territoriales en la oferta de servicios sanitarios, y discute sus implicaciones sobre las desigualdades en el acceso y la utilización. En el ámbito de la atención primaria, destacan las diferencias regionales en el proceso de implantación de la reforma y en la dotación de servicios complementarios a los tradicionales, que conviven con desigualdades territoriales significativas en la cobertura y el acceso a algunos programas asistenciales. Por su parte, la oferta de camas sigue siendo desigual entre las comunidades autónomas (CCAA, particularmente en las dotaciones geriátricas, y más aún en las psiquiátricas. Es notable la desigualdad que conlleva la oferta privada no benéfica en las distintas CCAA. Asimismo, las dotaciones de aparatos de alta tecnología médica (ATM son todavía muy desiguales entre las CCAA, particularmente las más recientes, pero se distribuyen de forma más homogénea que hace 10 años. Las desigualdades territoriales en la oferta de servicios sanitarios, aunque tangibles, son menores que las de los servicios sociosanitarios. Todavía mayor, aunque menos visible, es la desigualdad de utilización y acceso a los servicios sanitarios y sociales que el dispositivo asistencial ofertado. Además, en este ámbito la desigualdad de género se superpone a la de ámbito territorial.This chapter summarizes the main territorial inequalities in health care supply, and the related effects on access and use of health care facilities. Firstly, in the field of primary health care, the most notable inequalities refer to the process of introduction of the reform and to complementary services supply, together with the coverage of and access to some health care programs. Secondly, the distribution of hospital beds across regions is far from being uniform, specially with respect to geriatric and psychiatric beds. In addition, profit oriented private care is unequally distributed across

  19. Rastreamento mamográfico do câncer de mama em serviços de saúde públicos e privados Breast cancer mammographic screening in public and private health care systems

    Directory of Open Access Journals (Sweden)

    Ailton Augustinho Marchi

    2006-04-01

    Full Text Available OBJETIVO: avaliar a utilização da mamografia no rastreamento do câncer de mama em serviços de saúde públicos e privados. MÉTODOS: realizou-se estudo seccional entrevistando-se 643 mulheres submetidas à mamografia na cidade de Taubaté, região Sudeste do Brasil: 472 atendidas em serviços de saúde públicos e 171 em serviços privados. Avaliaram-se, por meio dos testes de chi2, exato de Fisher e Wilcoxon, o perfil sociodemográfico e reprodutivo das entrevistadas e características de utilização da mamografia, tais como, a proporção de entrevistadas previamente rastreadas, a idade de início do rastreamento, o intervalo e a freqüência entre as mamografias realizadas. RESULTADOS: as médias de idade das entrevistadas em ambos os grupos foram similares. As proporções de mulheres previamente rastreadas - respectivamente 54,2 e 79,5% em serviços públicos e privados - assim como a idade de início desse rastreamento - 46,8 anos (DP 10,2 nos serviços públicos e 40,2 anos (DP 7,7 nos privados - diferiram significativamente (pPURPOSE: to evaluate the characteristics of mammography use and the social demographic profile of women accessing public and private health care services. METHODS: a cross-sectional study was carried out in the city of Taubaté, southeast Brazil. Six hundred and forty-three women who underwent mammographic examinations in the available health care services were interviewed, 472 of them in public and 171 in private health services. The social demographic and reproductive profiles of the women interviewed and the characteristics of the mammography use, such as the proportion of the women interviewed who had been previously screened, the age when the screening began, the interval between the screenings and their frequency, were evaluated by means of the Fisher exact, Wilcoxon and chi2 tests. RESULTS: the mean age of the interviewed women was similar in both studied groups. The proportion of women previously

  20. Training Public Health Advisors.

    Science.gov (United States)

    Meyer, Pamela A; Brusuelas, Kristin M; Baden, Daniel J; Duncan, Heather L

    2015-01-01

    Federal public health advisors provide guidance and assistance to health departments to improve public health program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering public health programs. This article describes the evolving training and is based on internal CDC documents and interviews. The first federal public health advisors worked in health departments to assist with controlling syphilis after World War II. Over time, more CDC prevention programs hired them. To meet emerging needs, 3 major changes occurred: the Public Health Prevention Service, a fellowship program, in 1999; the Public Health Associate Program in 2007; and integration of those programs. Key components of the updated training are competency-based training, field experience, supervision, recruitment and retention, and stakeholder support. The enduring strength of the training has been the experience in a public health agency developing practical skills for program implementation and management.

  1. [Public interactions, private censorship: the case of Facebook].

    Science.gov (United States)

    Silveira, Sergio Amadeu da

    2015-12-01

    Facebook is examined as a transnational online social networking platform where public discussions and interactions take place. The study surveys the private control of cultural and political expressions exercised by the platform's managers, which can be defined as private censorship. Cases of removal of content are presented and Facebook's political control policies discussed. The article also shows how Facebook rules display highly discretionary components and an aesthetic that can be portrayed as a kind of biopolitics of the information-age society.

  2. HRM in private and public organizations in Serbia

    Directory of Open Access Journals (Sweden)

    Berber Nemanja

    2016-01-01

    Full Text Available Human resource management (HRM is a management concept which obtains many practices and activities. Although there is a substantial literature on HRM in the private sector, the practice of HRM in the public sector is still scarce. In the private sector, HRM is found as a factor for gaining competitive advantage, especially if HR practices are implemented in the way of high-performing working practice (HPWP. In the public sector, HRM is seen as paternalistic management, with the standardization of employment practices, collective bargaining and working practices that emphasize equal opportunities for employees. The goal of this research is to explore the characteristics and differences between HRM practice in organizations from the private and public sector. The subject of the research is HRM practice (staffing, training and development, compensation and benefits, and industrial relation and communication in the private and public organizations in the Republic of Serbia. The methodology of the paper includes exploration of the available literature on the theme and statistical analysis of the differences between HR practices in organizations from the private and public sector. The research is based on the HR data gathered in the second CRANET research round in Serbia, performed in 2015.

  3. 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.

  4. We do not recognise anything 'private': public interest and private law under the socialist legal tradition and beyond

    NARCIS (Netherlands)

    R. Mańko

    2015-01-01

    In line with Lenin’s famous quote that Bolsheviks "do not recognise anything private" and that private law must be permeated with public interest, the private (civil) law of the USSR and other countries of the Soviet bloc, including Poland underwent reform aimed at furthering the public interest at

  5. Factors Influencing the Private Involvement in Urban Rail Public-Private Partnership Projects in China

    Directory of Open Access Journals (Sweden)

    Yongjian Ke

    2017-03-01

    Full Text Available Private investors have been encouraged to participate in the development and operation of urban rail projects in China through Public-Private Partnerships (PPPs, given the fact that subnational governments are suffering from urgent development demands and severe fiscal pressure. However, there is no formal assessment to determine the private involvement in a PPP project. This problem is particularly critical in the sector of urban rail, in which the huge investment cannot rely on the private sector alone. This study hence aimed to uncover and identify the influencing factors. Multiple research methods, including content analysis, case study and focus group discussion were adopted to achieve the research purpose. Seven types of influencing factors were identified, including project financial model, government fiscal commitment, risk allocation, public accountability, efficiency considerations, policy and regulations, and organisational marketing strategies. The findings add to the current knowledge base by uncovering the drivers behind private involvement in a PPP project. They are also beneficial for industry practitioners as a basis/checklist to determine the private involvement.

  6. Comparison of thromboprophylaxis patterns in arthroplasty in public and private hospitals

    Science.gov (United States)

    Cortada, Aline Pinheiro dos Santos; da Silva, Telma Gomes; da Silva, André Campos; Golmia, Ricardo Prado; Guerra, Renata Leborato; Takemoto, Maíra Libertad Soligo; Monteiro, Roberta Dyonisio Canaveira; Scheinberg, Morton Aaron

    2015-01-01

    Objective To compare therapy for prophylaxis of venous thromboembolism and costs related to hospitalization of patients undergoing total knee and hip replacement within the context of the Brazilian health system. Methods A retrospective study of patients undergoing arthroplasty in 2010 in a public hospital and two private hospitals in the state of São Paulo, conducted by means of medical record review. Costs were estimated based on the use of health care resources during hospitalization. A descriptive analysis was performed using frequency and mean (standard deviation) according to the type of care delivered (by public or private organization). Results A total of 215 patients were evaluated, and 56.3% were submitted to knee surgery and 43.7%, to hip replacement. Approximately 88% and 98% of patients from public and private health services, respectively, received some form of venous thromboembolism prophylaxis, and enoxaparin was the drug most widely used in both systems. The total cost of prophylaxis was R$ 1,873.01 (R$ 26.38 per patient) in the public service and R$ 21,559.73 (R$ 163.33 per patient) in the private service. For the individuals who presented with thromboembolism, the average cost of hospitalization was R$ 6,210.80 and R$ 43,792.59 per patient in public and private health services, respectively. Conclusion Thromboembolism prophylaxis in patients undergoing arthroplasty is most commonly used in the private health services than public organizations, despite its high costs in both services. The cost per patient with thrombosis during hospitalization was higher than the total cost of prophylaxis, suggesting that prevention is associated to better cost-benefit ratio. PMID:26313439

  7. Improving Sustainability Performance for Public-Private-Partnership (PPP Projects

    Directory of Open Access Journals (Sweden)

    Liyin Shen

    2016-03-01

    Full Text Available Improving sustainability performance in developing infrastructure projects is an important strategy for pursuing the mission of sustainable development. In recent years, the business model of public-private-partnership (PPP is promoted as an effective approach in developing infrastructure projects. It is considered that the distribution of the contribution on project investment between private and public sectors is one of the key variables affecting sustainability performance of PPP-type projects. This paper examines the impacts of the contribution distribution between public and private sectors on project sustainability performance. A model named the sustainability performance-based evaluation model (SPbEM is developed for assisting the assessment of the level of sustainability performance of PPP projects. The study examines the possibility of achieving better sustainability through proper arrangement of the investment distribution between the two primary sectors in developing PPP-type infrastructure projects.

  8. Public private co-operation in urban regeneration investment planning

    DEFF Research Database (Denmark)

    Jensen, Jesper Ole; Larsen, Jacob Norvig

    Increasing renovation costs and ever more limited public funding for urban regeneration in combination with a political desire to stimulate the development of a sense of ownership in urban regeneration neighbourhoods has brought about a growing interest in attracting private sector funding......' rationalities, and developers have limited knowledge of urban regeneration programs. Nevertheless, there is ample evidence that developers possess crucial competences in relation to the urban regeneration processes, for instance to establish a shared vision of a neighbourhood amongst different local actors...... involved, to negotiate with private as well as public parts, and - most importantly - to 'sell' the project to the right investors. Hence, there are several reasons for the public planners to increase the engagements with private developers in the urban regeneration. Compared to international research...

  9. Private health insurance and the use of health care services - a review of the theoretical literature with application to voluntary private health insurance in universal health care systems

    OpenAIRE

    Kiil, Astrid

    2012-01-01

    This paper reviews the theoretical literature on the demand for private health insurance and its effect on the use of health care services and applies the theoretical framework to the type of private health insurance that exists alongside a universal health care system. The predominant share of the theoretical literature on private health insurance is developed to model private health insurance in settings where this provides the primary source of coverage and the choice is between purchasing...

  10. Public investment does not crowd out private supply of environmental goods on private land.

    Science.gov (United States)

    Duncan, David H; Kyle, Garreth; Morris, William K; Smith, F Patrick

    2014-04-01

    In landscapes where private land tenure is prevalent, public funds for ecological landscape restoration are sometimes spent subsidising the revegetation of cleared land, and the protection of remnant vegetation from livestock. However, the total area treated may be unclear because such projects are not always recorded, and landholders may undertake similar activities without subsidisation. In the absence of empirical data, in the state of Victoria, Australia, a reporting assumption has been employed that suggests that wholly privately funded sites match publicly subsidised sites on a hectare for hectare basis (a so-called "x2" assumption). Conversely, the "crowding out" theory of investment in public goods such as environmental benefits suggests that public investment may supplant private motivation. Using aerial photography we mapped the extent of revegetation, native vegetation fencing and restoration on 71 representative landholdings in rural south-eastern Australia. We interviewed each landholder and recorded the age and funding model of each site. Contrary to the local "x2" reporting assumption, about 75% of the total area of the 412 sites was from subsidised sites, and that proportion was far higher for the period after 1997. However, rather than displacing unsubsidised activity, our modelling showed that landholders who had recently been subsidised for a project were more likely to have subsequently completed unsubsidised work. This indicates that, at least in terms of medium-term economic impact, the large increase in public subsidies did not diminish privately funded activity, as might be expected according to the theory of crowding out.

  11. Public-Private Partnerships in Chronic Disease Prevention-Part 5

    Centers for Disease Control (CDC) Podcasts

    2009-04-06

    This podcast is the fifth of a seven part series discussing public health partnerships with the private sector. In this segment, CDC's Elizabeth Majestic and University of North Carolina's Gene Matthews talk about how the economic downturn will increase the demands on public heath.  Created: 4/6/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/6/2009.

  12. Public and Private Posture : Zadie Smith

    NARCIS (Netherlands)

    Heynders, Odile

    2016-01-01

    This chapter will focus on Smith’s posture, and in particular on how her public position and literary work negotiate issues such as identification, celebrity, style and authenticity. First, the paradox of the ‘celebrity authority’ will be examined, followed by a Derrida-inspired analysis of Smith’s

  13. The paradoxes of small Public Private Partnerships

    DEFF Research Database (Denmark)

    Koch, Christian; Jensen, Jesper Ole

    that the largest portion of small PPPs are of a size below 5,4 million roughly reflecting the lower limit of obligatory tendering according to EU-law. Among these there are indeed a good portion of “real” PPPs. It appears that local public units endeavour in PPPs because they are attracted by the innovation...

  14. [Public and private in times of the pest].

    Science.gov (United States)

    Caponi, S

    1999-01-01

    The paper explores how Hannah Arendt's oppositions public-private and intimate-social can be used as an analytical tool to better understand a very concrete, extreme situation: the state of emergency triggered when an epidemiological outbreak hits a city, totally altering its inhabitants lives. Studied observation of what specific individuals (be they imagined or real) feel and think during times of epidemic is an underutilized tool that may prove helpful in studying epidemics themselves. Focusing on Camus' "The pest" and events in the city of Oran, the article looks at how victims of the plague felt about their public or private lives and their intimate and social ties.

  15. An Excursion Into The Public-Private Partnership Jungle

    DEFF Research Database (Denmark)

    Stelling, Christiane

    2014-01-01

    While the Private Finance Initiative (PFI) is doubtless the most visible Public-Private Partnership (PPP) in the public debate it is by no means the only one. A number of scholars have outlined the ambiguity of the PPP concept beyond PFIs and pointed to the multiplicity of differing types...... and classifications. Following, the article first of all identifies the emergence of two dimensions that are differently emphasized by the proposed PPP definitions (1) the co-responsibility dimension and (2) the relational governance dimension. Second, the arti-cle finds two differing approaches within each dimension...

  16. Discover: What Is Public Health?

    Science.gov (United States)

    ... Series Undergraduate Network Membership Contact Discover What is Public Health? Public health protects and improves the health of individuals, families, communities, and populations, locally and globally. Public health is personal. Public health professionals focus on preventing ...

  17. The public/private debate in the funding, administration and delivery of healthcare in Canada.

    Science.gov (United States)

    Marchildon, Gregory P

    2004-01-01

    To help clarify the confusing debate concerning the public-private divide in Canada and the respective positions of the Romanow and Kirby reports, a new approach is proposed. The funding, administration and delivery of the healthcare "system" is split into distinct analytical categories and then applied to three major coverage groupings: universal public (Canada Health Act) coverage for medically necessary/required services; mixed coverage for drug care, home and long-term care; and private health goods and services. While there were no fundamental differences between Romanow and Kirby concerning the funding of public healthcare in Canada, there were some important differences on issues of administration. In particular, the Romanow report recommended that home mental healthcare services become universally covered under the Canada Health Act as well as fundamental changes to the regulation and administration of prescription drug care. The reports also differed in terms of framing the private delivery question, with the Romanow report questioning whether the evidence justified private-for-profit delivery replacing current private not-for-profit or public arm's length delivery modes.

  18. Health Management Information System in Private Clinics in Ilorin ...

    African Journals Online (AJOL)

    Health Management Information System in Private Clinics in Ilorin, Nigeria. ... Journal Home > Vol 46, No 5 (2004) > ... private clinics located in Ilorin, Kwara State, Nigeria to determine the awareness and level of involvement ... Article Metrics.

  19. Quality of mental health care at a student-run clinic: care for the uninsured exceeds that of publicly and privately insured populations.

    Science.gov (United States)

    Liberman, Kate M; Meah, Yasmin S; Chow, Andrew; Tornheim, Jeffrey; Rolon, Omayra; Thomas, David C

    2011-10-01

    Diagnosing and treating depression in a primary care practice is an important, yet difficult task, especially for safety-net practices serving the uninsured. In the United States healthcare system, there is a mismatch between the need for mental health care and access to services. This disparity is most striking among the uninsured. Mental health disorders are more prevalent among the uninsured, and even when diagnosed with mental illness, they are less likely to obtain necessary treatment than insured patients. Given the increasing burden of depression on society, growing numbers of uninsured and negative repercussions of untreated mental illness, improvements in screening and management protocols are becoming more important in primary care practices serving this population. The quality of depression treatment at commercial and public insurance plans in New York City (NYC) and New York State (NYS) were compared to that of the East Harlem Health Outreach Partnership (EHHOP), the student-run clinic of the Mount Sinai School of Medicine. Based on the comparison, the study made recommendations for an integrated, on-site mental health service program at the community health clinic. A cohort of 49 depressed patients were evaluated and treated at the EHHOP clinic. The quality of the mental health care was evaluated according to variables from the Healthcare Effectiveness Data and Information Set (HEDIS). Indicators of quality included demographics, method of diagnosis, type of pharmacological treatment, referral to specialty care, patient adherence to follow-up care and adherence to pharmacologic treatment. When compared to insured patients in NYS, more EHHOP patients had the appropriate number of physician contacts after being diagnosed with depression than patients with commercial health plans (P = 0.008) and Medicaid (P = 0.09). Similarly, a greater number of EHHOP patients had better acute phase (P = 0.001; P = 0.096) and continuous phase (P = 0.049; P

  20. Addressing conflicts of interest in Public Private Partnerships

    Science.gov (United States)

    2010-01-01

    Background Many articles have been written on conflicts of interests (COIs) in fields such as medicine, business, politics, public service and education. With the growing abundance of Public Private Partnerships (PPPs), often involving complex relationships among the partners, it is important to understand how COIs can be mitigated and managed in PPPs. Discussion We wanted to study PPPs, particularly in the areas of global health and agriculture, but discovered no single source of information available to identify and compare various approaches for avoiding and managing COIs in PPPs. This is a significant gap, especially for those wishing to study, compare and strengthen existing COI policies related to PPPs. In order to bridge this gap, we reviewed how PPPs currently address COIs and highlight what might be considered good practice in developing COI policies. We reviewed the online COI policies of 10 PPPs in global health and agriculture, and interviewed two global health PPP chief executives. Summary Based on our review of policies and interviews, we conclude that there exists a range of good practices including attention to accountability and governance, acknowledgement and disclosure, abstention and withdrawal, reporting and transparency, and independent monitoring. There appears to be a need for PPPs to interact closely and learn from each other on these parameters and to also place more emphasis on independent external monitoring of COIs as a means of strengthening their major social objectives on which their activities are largely predicated. We also recommend the establishment of a web based database, which would serve as a forum to discuss COI issues and how they can be resolved. PMID:20615242

  1. Addressing conflicts of interest in Public Private Partnerships.

    Science.gov (United States)

    Omobowale, Emmanuel B; Kuziw, Michael; Naylor, Melinda Treurnicht; Daar, Abdallah S; Singer, Peter A

    2010-07-08

    Many articles have been written on conflicts of interests (COIs) in fields such as medicine, business, politics, public service and education. With the growing abundance of Public Private Partnerships (PPPs), often involving complex relationships among the partners, it is important to understand how COIs can be mitigated and managed in PPPs. We wanted to study PPPs, particularly in the areas of global health and agriculture, but discovered no single source of information available to identify and compare various approaches for avoiding and managing COIs in PPPs. This is a significant gap, especially for those wishing to study, compare and strengthen existing COI policies related to PPPs. In order to bridge this gap, we reviewed how PPPs currently address COIs and highlight what might be considered good practice in developing COI policies. We reviewed the online COI policies of 10 PPPs in global health and agriculture, and interviewed two global health PPP chief executives. Based on our review of policies and interviews, we conclude that there exists a range of good practices including attention to accountability and governance, acknowledgement and disclosure, abstention and withdrawal, reporting and transparency, and independent monitoring. There appears to be a need for PPPs to interact closely and learn from each other on these parameters and to also place more emphasis on independent external monitoring of COIs as a means of strengthening their major social objectives on which their activities are largely predicated. We also recommend the establishment of a web based database, which would serve as a forum to discuss COI issues and how they can be resolved.

  2. Addressing conflicts of interest in Public Private Partnerships

    Directory of Open Access Journals (Sweden)

    Daar Abdallah S

    2010-07-01

    Full Text Available Abstract Background Many articles have been written on conflicts of interests (COIs in fields such as medicine, business, politics, public service and education. With the growing abundance of Public Private Partnerships (PPPs, often involving complex relationships among the partners, it is important to understand how COIs can be mitigated and managed in PPPs. Discussion We wanted to study PPPs, particularly in the areas of global health and agriculture, but discovered no single source of information available to identify and compare various approaches for avoiding and managing COIs in PPPs. This is a significant gap, especially for those wishing to study, compare and strengthen existing COI policies related to PPPs. In order to bridge this gap, we reviewed how PPPs currently address COIs and highlight what might be considered good practice in developing COI policies. We reviewed the online COI policies of 10 PPPs in global health and agriculture, and interviewed two global health PPP chief executives. Summary Based on our review of policies and interviews, we conclude that there exists a range of good practices including attention to accountability and governance, acknowledgement and disclosure, abstention and withdrawal, reporting and transparency, and independent monitoring. There appears to be a need for PPPs to interact closely and learn from each other on these parameters and to also place more emphasis on independent external monitoring of COIs as a means of strengthening their major social objectives on which their activities are largely predicated. We also recommend the establishment of a web based database, which would serve as a forum to discuss COI issues and how they can be resolved.

  3. PUBLIC PRIVATE PARTNERSHIP AS A MECHANISM TO REDUCE SOCIAL RISKS

    Directory of Open Access Journals (Sweden)

    А. Oleynik

    2015-04-01

    Full Text Available The role of public-private partnership in the overall development of the country and its regions is determined in the article. The opinions of foreign and domestic scientists on the interpretation of the concept of PPP are analyzed, the main causes and social factors in favor of the introduction of PPP in Ukraine are determined. Singled out the main components of the PPP in the social sphere, including: public-regulation, public policy, transparency and accountability of PPP, financing and benefits of the project, the division of responsibilities between the public and private partners, taking into account the interests of consumers. Author determined the main provisions of the law of Ukraine “On Public Private Partnership”. The essence of social risk factors that cause them, their main features are determined. Differentiated concept of social risk and social insurance risk, the role of insurance in PPP agreements and key factors for cooperation between the state and the insurance segment are determined. Risk sharing agreement between the parties to the PPP when the state is a partner insurance company or other private partner is demonstrated.

  4. Alternative solutions for public and private catastrophe funding in Austria

    Directory of Open Access Journals (Sweden)

    M. Gruber

    2008-07-01

    Full Text Available The impacts of natural hazards as well as their frequency of occurrence during the last decades have increased decisively. Therefore, the public as well as the private sector are expected to react to this development by providing sufficient funds, in particular for the improvement of protection measures and an enhanced funding of damage compensation for affected private individuals, corporate and public entities.

    From the public stance, the establishment of an appropriate regulatory environment seems to be indispensable. Structural and legal changes should, on the one hand, renew and improve the current distribution system of public catastrophe funds as well as the profitable investment of these financial resources, and on the other hand, facilitate the application of alternative mechanisms provided by the capital and insurance markets.

    In particular, capital markets have developed alternative risk transfer and financing mechanisms, such as captive insurance companies, risk pooling, contingent capital solutions, multi-trigger products and insurance securitisation for hard insurance market phases. These instruments have already been applied to catastrophic (re-insurance in other countries (mainly the US and off-shore domiciles, and may contribute positively to the insurability of extreme weather events in Austria by enhancing financial capacities. Not only private individuals and corporate entities may use alternative mechanisms in order to retain, thus, to finance certain risks, but also public institutions.

    This contribution aims at analysing potential solutions for an improved risk management of natural hazards in the private and the public sector by considering alternative mechanisms of the capital and insurance markets. Also the establishment of public-private-partnerships, which may contribute to a more efficient cat funding system in Austria, is considered.

  5. Alternative solutions for public and private catastrophe funding in Austria

    Science.gov (United States)

    Gruber, M.

    2008-07-01

    The impacts of natural hazards as well as their frequency of occurrence during the last decades have increased decisively. Therefore, the public as well as the private sector are expected to react to this development by providing sufficient funds, in particular for the improvement of protection measures and an enhanced funding of damage compensation for affected private individuals, corporate and public entities. From the public stance, the establishment of an appropriate regulatory environment seems to be indispensable. Structural and legal changes should, on the one hand, renew and improve the current distribution system of public catastrophe funds as well as the profitable investment of these financial resources, and on the other hand, facilitate the application of alternative mechanisms provided by the capital and insurance markets. In particular, capital markets have developed alternative risk transfer and financing mechanisms, such as captive insurance companies, risk pooling, contingent capital solutions, multi-trigger products and insurance securitisation for hard insurance market phases. These instruments have already been applied to catastrophic (re-)insurance in other countries (mainly the US and off-shore domiciles), and may contribute positively to the insurability of extreme weather events in Austria by enhancing financial capacities. Not only private individuals and corporate entities may use alternative mechanisms in order to retain, thus, to finance certain risks, but also public institutions. This contribution aims at analysing potential solutions for an improved risk management of natural hazards in the private and the public sector by considering alternative mechanisms of the capital and insurance markets. Also the establishment of public-private-partnerships, which may contribute to a more efficient cat funding system in Austria, is considered.

  6. Hospitalization flow in the public and private systems in the state of Sao Paulo, Brazil.

    Science.gov (United States)

    Rocha, Juan Stuardo Yazlle; Monteiro, Rosane Aparecida; Moreira, Marizélia Leão

    2015-01-01

    OBJECTIVE To describe the migration flows of demand for public and private hospital care among the health regions of the state of Sao Paulo, Brazil.METHODS Study based on a database of hospitalizations in the public and private systems of the state of Sao Paulo, Southeastern Brazil, in 2006. We analyzed data from 17 health regions of the state, considering people hospitalized in their own health region and those who migrated outwards (emigration) or came from other regions (immigration). The index of migration effectiveness of patients from both systems was estimated. The coverage (hospitalization coefficient) was analyzed in relation to the number of inpatient beds per population and the indexes of migration effectiveness.RESULTS The index of migration effectiveness applied to the hospital care demand flow allowed characterizing health regions with flow balance, with high emigration of public and private patients, and with high attraction of public and private patients.CONCLUSIONS There are differences in hospital care access and opportunities among health regions in the state of Sao Paulo, Brazil.

  7. O mix público-privado no Sistema de Saúde Brasileiro: financiamento, oferta e utilização de serviços de saúde The public-private mix in the Brazilian Health System: financing, delivery and utilization of health services

    Directory of Open Access Journals (Sweden)

    Isabela Soares Santos

    2008-10-01

    Full Text Available O artigo analisa o mix público-privado do sistema de saúde brasileiro a partir da oferta, utilização e financiamento dos serviços de saúde. Contempla os subsídios públicos para o setor privado. Trata-se de um estudo quantitativo, baseado em dados secundários provenientes de bases de dados oficiais. Mostra que existem desigualdades na oferta e na utilização de serviços em prol da população com plano de saúde, em decorrência da peculiar inserção do setor suplementar, que oferece cobertura suplementar e duplicada ao sistema público (SUS, sem desconsiderar que outros fatores podem determinar o uso de serviços de saúde e aumentar as desigualdades. A análise é feita com base na tipologia de mix público-privado desenvolvida pela OECD em 2004, que auxilia a compreensão das desigualdades que ocorrem em cada tipo de mix, e mostra que as que ocorrem no sistema de saúde brasileiro se dão pelo fato de a cobertura de serviços ofertados pelo segmento de seguro privado ser duplicada à cobertura de serviços do SUS. Ainda, as desigualdades verificadas no sistema de saúde brasileiro ocorrem num sistema de saúde em que o financiamento público ao SUS é minoritário e existem grandes subsídios públicos para o setor privado.This paper analyzes the public-private mix in the Brazilian Health System from the perspective of health care delivery, utilization and financing. Moreover, this quantitative study based on secondary data from official databases contemplates the subsidies granted by the government to the private sector. It shows the existence of some inequalities favoring the population having private health plans, a result of the peculiar participation of the private sector in the Brazilian Health System not only offering supplementary care but duplicating the coverage offered by the public system (called SUS. The analysis is made on the basis of the classification of public-private mix in Health Systems developed by the OECD in

  8. Inovações na intermediação entre os setores público e privado na assistência à saúde Innovations in the intermediation between public and private sectors in health care

    Directory of Open Access Journals (Sweden)

    Rosimary Gonçalves de Souza

    2002-01-01

    Full Text Available Este artigo busca uma aproximação de algumas das mudanças em curso no sistema de saúde, focalizando especificamente o setor privado prestador de serviços de saúde, que, ao longo das últimas décadas, vem mantendo peso decisivo na condução da política de saúde. Nesse sentido, importa mapear as diferentes modalidades sob as quais se insere a iniciativa privada na prestação de serviços de saúde, mostrando as mudanças mais significativas na relação entre o setor público e o privado, tendo como contraponto o contexto das décadas de 1970 e 1980. Algumas dessas modalidades se constituem, na verdade, de uma intensificação ou consolidação de padrões e tendências presentes desde os anos 70, como o setor que integra as seguradoras de saúde e as empresas de medicina de grupo. Outras, como a atuação das cooperativas médicas junto ao setor público, mostram-se como tendências em expansão numa conjuntura de crise fiscal do estado e regressividade dos investimentos no campo social.This article intends an approach with some of the changes in course in the health system, specifically the private supplier of health services, that comes maintaining along the last decades decisive weight in the conduction of the health policy. In that sense, it imports to show the different modalities under which this sector interferes the private initiative in the installment of health services, showing the more important changes in the relationship between the public and the private sectors, tending as counterpoint the context of the decades of 70 and 80. Some of those modalities are constituted, actually, an consolidation of patterns and present tendencies since the seventies, as the section that integrates the insurance companies of health and the group medicine companies. Other, as the performance of the medical cooperatives close to the public section, they are shown as tendencies in expansion in a conjuncture of fiscal crisis of the state and

  9. The political economy of the public-private mix in heath expenditure: an empirical review of thirteen OECD countries.

    Science.gov (United States)

    Mou, Haizhen

    2013-12-01

    This study investigates the factors that may have influenced the public-private mix of health expenditure in 13 OECD countries from 1981 to 2007. The degree to which health services are socialized is regarded as the product of a trade-off between the desire to redistribute income through the fiscal system and the losses some citizens will incur when the public health care system expands. The estimation results show that, greater income inequality and population aging are associated with a smaller share of public health expenditure in total health expenditure. The more ideologically left-leaning the electorate is, the larger the share of public health expenditure. Private health insurance tends to erode the political support for the public health care systems in countries with private duplicate health insurance, but not in countries with private primary health insurance. The findings suggest that the role of private sources of funding for health care is likely to grow in developed countries. The expansion of public coverage to include pharmaceuticals and long-term care in some countries may (theoretically) encounter less opposition if the current insurance holders have no duplicate coverage, if the voters as a whole share more left-leaning political ideology, and if low-income voters are more politically mobilized. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Buying best value health care: Evolution of purchasing among Australian private health insurers.

    Science.gov (United States)

    Willcox, Sharon

    2005-03-31

    Since 1995 Australian health insurers have been able to purchase health services pro-actively through negotiating contracts with hospitals, but little is known about their experience of purchasing. This paper examines the current status of purchasing through interviews with senior managers representing all Australian private health insurers. Many of the traditional tools used to generate competition and enhance efficiency (such as selective contracting and co-payments) have had limited use due to public and political opposition. Adoption of bundled case payment models using diagnosis related groups (DRGs) has been slow. Insurers cite multiple reasons including poor understanding of private hospital costs, unfamiliarity with DRGs, resistance from the medical profession and concerns about premature discharge. Innovation in payment models has been limited, although some insurers are considering introduction of volume-outcome purchasing and pay for performance incentives. Private health insurers also face a complex web of regulation, some of which appears to impede moves towards more efficient purchasing.

  11. Public-private partnerships in urban regeneration areas in Denmark

    DEFF Research Database (Denmark)

    Sørensen, Michael Tophøj; Aunsborg, Christian

    2006-01-01

    The paper focuses formal as well as informal public-private partnerships (PPP) in Danish urban regeneration areas. The concept ‘urban regeneration areas’ was introduced in the 2003 Planning Act as old, remaining industrial areas within the city boundaries by now were recognized as an ressource...

  12. Optimal Provision of Infrastructure Using Public-Private Partnership Contracts

    NARCIS (Netherlands)

    van der Laan, G.; Ruys, P.H.M.; Talman, A.J.J.

    2000-01-01

    This paper deals with the optimal provision of infrastructure by means of public-private partnership contracts.In the economic literature infrastructure is characterized as a large, indivisible and non-rival capital good that produces services for its users.Users can be both consumers and producers.

  13. Public-Private Partnerships : Risk Allocation and Value for Money

    NARCIS (Netherlands)

    Miranda Sarmento, J.; Renneboog, L.D.R.

    2014-01-01

    This paper reviews the literature on the allocation and valuation of public-private partnerships (PPPs). First, the paper discusses why governments pursue PPPs and how value for money (VfM) is achieved. Second, the paper reviews the principles of risk allocation and valuation from an academic and pu

  14. Quantum Key Distribution Protocol with Private-Public Key

    OpenAIRE

    Serna, Eduin H.

    2009-01-01

    A quantum cryptographic protocol based in public key cryptography combinations and private key cryptography is presented. Unlike the BB84 protocol [1] and its many variants [2,3] two quantum channels are used. The present research does not make reconciliation mechanisms of information to derive the key. A three related system of key distribution are described.

  15. Public-private partnerships as facilitators of environmental improvement

    DEFF Research Database (Denmark)

    Jeppesen, Søren; Lehmann, Martin

    2004-01-01

    Public-private partnerships in the environmental field have emerged as one option in the pursuit of sustainable development in different contexts. So-called ?Green Networks?, ?Cleaner Production Centres?, ?Waste Minimisation Clubs? are among others highlighted as alternatives to (governmental...

  16. How do governments support the development of Public Private Partnerships?

    DEFF Research Database (Denmark)

    Verhoest, Koen; Petersen, Ole Helby; Scherrer, Walter

    2015-01-01

    Taking an institutional perspective, in this article we develop an index of the governmental support for public private partnership (PPP) — a ‘PPP Governmental Support Index’ (GSI) — which aims to measure the extent to which national governments provide an institutional framework that is either...

  17. Public-Private Partnerships : Risk Allocation and Value for Money

    NARCIS (Netherlands)

    Miranda Sarmento, J.; Renneboog, L.D.R.

    This paper reviews the literature on the allocation and valuation of public-private partnerships (PPPs). First, the paper discusses why governments pursue PPPs and how value for money (VfM) is achieved. Second, the paper reviews the principles of risk allocation and valuation from an academic and

  18. Public-Private Partnerships : Risk Allocation and Value for Money

    NARCIS (Netherlands)

    Miranda Sarmento, J.; Renneboog, L.D.R.

    2014-01-01

    This paper reviews the literature on the allocation and valuation of public-private partnerships (PPPs). First, the paper discusses why governments pursue PPPs and how value for money (VfM) is achieved. Second, the paper reviews the principles of risk allocation and valuation from an academic and

  19. Optimal Provision of Infrastructure Using Public-Private Partnership Contracts

    NARCIS (Netherlands)

    van der Laan, G.; Ruys, P.H.M.; Talman, A.J.J.

    2000-01-01

    This paper deals with the optimal provision of infrastructure by means of public-private partnership contracts.In the economic literature infrastructure is characterized as a large, indivisible and non-rival capital good that produces services for its users.Users can be both consumers and producers.

  20. Public-Private Partnerships for Clean Energy Manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-09-01

    As part of its mission, CEMI builds partnerships around strategic priorities to increase U.S. clean energy manufacturing competitiveness. This requires an “all-hands-on-deck” approach that involves the nation’s private and public sectors, universities, think tanks, and labor leaders working together.

  1. Public-Private Partnership as Incentive Institution of Entrepreneurship

    Directory of Open Access Journals (Sweden)

    Elena S. Averkieva

    2017-03-01

    Full Text Available The interaction system of national public and private sectors institutions is becoming increasingly important in the conditions that characterize the current stage of economic development (such as globalization and post-industrialization trends, geopolitical threats, transformation of production and financial processes. Instability and the dependence of national economies from external environment factors, exposure to systemic crises increase the vulnerability of national business and require the state institutions’ activation in order to support and promote national business initiatives. In these circumstances, one of the most adequate to modern realities forms of entrepreneurial activity stimulation is the public-private partnership model, which proved to be highly effective, both in foreign countries and in Russia. The author reveals potential of public-private partnership as an institution to stimulate entrepreneurial activity by analyzing features of its organizational and management mechanism in the Russian Federation. The practical aspects of the introduction of the public-private partnership model are studied on the example of the Rostov region. The author shows that the implemented programs to encourage entrepreneurship through PPP projects have a positive effect, but at the same time remain a number of problems in the development of the business sector in Russia. The improving ways of the interaction mechanism between government and business at the regional level are identified based on the assessing results of the PPP level in Russia as a whole and in separate regions, implemented by the Association "Center for PPP development".

  2. Waste water treatment through public-private partnerships

    DEFF Research Database (Denmark)

    Carpintero, Samuel; Petersen, Ole Helby

    2014-01-01

    This paper analyses the experience of the regional government of Aragon (Spain) that has extensively used public-private partnerships for the construction and operation of waste water treatment plants. The paper argues that although overall the implementation of this PPP program might be considered...

  3. Ecological responsibility of business as public-private partnership element

    Directory of Open Access Journals (Sweden)

    I.M. Potravniy

    2011-10-01

    Full Text Available In the article the questions of social and ecological responsibility of business are considered within the public-private partnership mechanism framework. Methods of the ecological significant project economic regulation are shown in wildlife management and environment protection sphere.

  4. PUBLIC-PRIVATE PARTNERSHIPS IN IMPLEMENTATION OF GERBANGMASTRA PROGRAM

    Directory of Open Access Journals (Sweden)

    La Ode Mustafa Muchtar

    2014-03-01

    Full Text Available This research attempts to describe and analyze the effect of public-private partnerships and community participation on successful of the implementation of Gerbangmastra program in Kolaka regency of South East Sulawesi Province. This study is conducted using a combination of qualitative and quantitative methods. This paper finds that public-private partnerships affect the community participation and successful of the implementation of Gerbangmastra program. It also uncovers that community participation affects the successful of the implementation of Gerbangmastra program. Furthermore, it reveals that the implementation of public-private partnership that are supported by community participation have an impact on the successful of the implementation of Gerbangmastra program.Keywords: Public-private partnerships, community participation, Gerbangmastra programJEL classifications: H80, O21.AbstrakPenelitian ini bertujuan untuk mendeskripsikan dan menganalisis pengaruh kemitraan pemerintah-swasta dan partisipasi dari masyarakat terhadap keberhasilan pelaksanaan program Gerbangmastra di Kabupaten Kolaka Propinsi Sulawesi Tenggara. Penelitian ini dilakukan dengan menggunakan kombinasi metode kuantitatif yaitu metode regresi analisis jalur dan kualitatif berupa metode deskriptif analitik. Hasil penelitian menunjukkan bahwa kemitraan antara pemerintah-swasta memiliki pengaruh terhadap partisipasi masyarakat dan keberhasilan pelaksanaan program Gerbangmastra. Sementara itu partisipasi dari masyarakat berpengaruh terhadap keberhasilan pelaksanaan program Gerbangmastra. Pelaksanaan kemitraan pemerintah-swasta yang didukung oleh partisipasi masyarakat berpengaruh terhadap keberhasilan pelaksanaan program Gerbangmastra di daerah tersebut.Kata kunci: Kemitraan pemerintah-swasta, partisipasi masyarakat, program GerbangmastraJEL classifications: H80, O21.

  5. Public-Private Partnership and Infrastructural Development in Nigerian Universities

    Science.gov (United States)

    Oduwaiye, R. O.; Sofoluwe, A. O.; Bello, T. O.; Durosaro, I. A.

    2014-01-01

    This study investigated the degree to which Public-Private Partnership (PPP) services are related to infrastructural development in Nigerian Universities. The research design used was descriptive survey method. The population for the study encompassed all the 20 universities in South-west Nigeria. Stratified random sampling was used to select 12…

  6. Lost in diffusion? Democratic accountability in public-private partnerships

    OpenAIRE

    Willems, Tom

    2016-01-01

    Abstract: In academic literature and in the popular press complex forms of governance such as public-private partnerships (PPPs) are very often associated with democratic deficits due to a shortfall in accountability. Although this negative outlook on democratic accountability in PPPs is almost a self-evident truth, it remains insufficiently supported by empirical research.

  7. Public-Private Partnerships and Sustainable Agricultural Development

    Directory of Open Access Journals (Sweden)

    Paul Castle

    2011-07-01

    Full Text Available Agriculture in Africa is not sustainable because average yields have been stagnating for decades due to underinvestment, especially in the development of agricultural markets, crop improvement and the sustainable management of agricultural systems. Low public sector funding for agricultural research and lack of incentives for the private sector to operate in areas where there is no market largely explain the yield gap in many food-importing developing countries. Yet, there are effective ways in which the public and the private sector could work together and jointly improve agricultural sustainability in poor countries. The public sector provides a favorable institutional environment for the development of agricultural markets and investment in rural infrastructure, facilitates local business development and funds research with local relevance. The private sector, in return, brings its considerable expertise in product development and deployment. This article illustrates how new forms of public-private partnerships (PPPs for agricultural development can work in challenging environments. It discusses three promising examples of PPPs in which the Syngenta Foundation for Sustainable Agriculture (SFSA is actively involved, and shows that an experimental approach can sometimes be more effective than social planning in efforts to achieve sustainable agriculture.

  8. The Perfect Storm and the Privatization of Public Higher Education

    Science.gov (United States)

    Ehrenberg, Ronald G.

    2006-01-01

    During the last quarter of a century, public higher education institutions have found themselves buffeted by a perfect storm. This storm has led to discussions about the privatization of those institutions, which has implications for their ability to improve, or at least maintain, their quality and their accessibility to students from all…

  9. Public-Private Partnerships : Risk Allocation and Value for Money

    NARCIS (Netherlands)

    Miranda Sarmento, J.; Renneboog, L.D.R.

    2014-01-01

    This paper reviews the literature on the allocation and valuation of public-private partnerships (PPPs). First, the paper discusses why governments pursue PPPs and how value for money (VfM) is achieved. Second, the paper reviews the principles of risk allocation and valuation from an academic and pu

  10. Public private co-operation in urban regeneration investment planning

    DEFF Research Database (Denmark)

    Jensen, Jesper Ole; Larsen, Jacob Norvig

    Increasing renovation costs and ever more limited public funding for urban regeneration in combination with a political desire to stimulate the development of a sense of ownership in urban regeneration neighbourhoods has brought about a growing interest in attracting private sector funding. Previ...

  11. Public and Private Self-Consciousness: Assessment and Theory

    Science.gov (United States)

    Fenigstein, Allen; And Others

    1975-01-01

    A scale was constructed to assess individual differences in self-consciousness. Norms and test-retest reliability are presented. Factor analysis of the scale revealed that self-consciousness has three components: public, private, and social anxiety. The relationships among these three factors are examined. (Author)

  12. Public-Private Partnerships in Chronic Disease Prevention-Part 2

    Centers for Disease Control (CDC) Podcasts

    2009-04-06

    This podcast is the second of a seven part series discussing public health partnerships with the private sector. In this segment, CDC's Elizabeth Majestic and University of North Carolina's Gene Matthews talk about sharing resources and forming relationships that address chronic diseases, as well as urgent health threats, such as terrorism.  Created: 4/6/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/6/2009.

  13. American Public Health Association

    Science.gov (United States)

    ... Published Books Fact Sheets Reports and Issue Briefs Advertising Public Health Buyers Guide Publications Contacts Professional Development ... Steps Challenge doubles its goal Apr 11 2017 Facebook Is your organization an APHA member? As an ...

  14. Lighting and public health.

    NARCIS (Netherlands)

    Ierland, J. van & Schreuder, D.A.

    1969-01-01

    The following topics; are discussed with respect to public health: - the effect of visible and ultraviolet radiation upon man. - vision with respect to lighting. interior lighting. - artificial lighting of work environments. - day light and windows. - recommendations for lighting. public lighting. -

  15. Evolutionary Game Analysis of the Supervision Behavior for Public-Private Partnership Projects with Public Participation

    Directory of Open Access Journals (Sweden)

    Congdong Li

    2016-01-01

    Full Text Available The public can directly or indirectly participate in the PPP (public-private partnership projects and then has an impact on the project profit and public or private behavior. To explore the influence of the public participation of the PPP projects supervision behavior, this paper analyzes the mutual evolutionary regularity of the private sector and government supervision department and the influence of public participation level on public and private behavior based on evolutionary game theory. The results show that the supervision strategy is not chosen when the supervision cost of government supervision department is greater than the supervision benefit; it can make private sector consciously provide the high-quality public products/services with the improvement of public participation level. Therefore, the government should reduce the cost of public participation and improve the public participation level and influence through the application of the Internet, big data, and other advanced technologies, in order to restrain the behavior of the private sector and improve the supervision efficiency.

  16. Climate change: the public health response.

    Science.gov (United States)

    Frumkin, Howard; Hess, Jeremy; Luber, George; Malilay, Josephine; McGeehin, Michael

    2008-03-01

    There is scientific consensus that the global climate is changing, with rising surface temperatures, melting ice and snow, rising sea levels, and increasing climate variability. These changes are expected to have substantial impacts on human health. There are known, effective public health responses for many of these impacts, but the scope, timeline, and complexity of climate change are unprecedented. We propose a public health approach to climate change, based on the essential public health services, that extends to both clinical and population health services and emphasizes the coordination of government agencies (federal, state, and local), academia, the private sector, and nongovernmental organizations.

  17. The future of public hospitals in a globalized world: corporate governance, corporatization or privatization?

    Science.gov (United States)

    Mordelet, Patrick

    2008-01-01

    This paper contributes to research in health systems and hospitals governance by examining the reasons and expected outcomes of the generalization of corporate governance rules in both public and private non-profit hospitals, all over the world, in order to achieve its clinical, quality and financial objectives.

  18. Private Giving Crowding Government Funding in Public Higher Education

    Directory of Open Access Journals (Sweden)

    G. Thomas Sav

    2010-01-01

    Full Text Available Problem statement: Private giving and government funding are critical revenue sources for public colleges and universities. If increased private giving reduces government funding, then that type and extent of crowding out carries important managerial and public policy implications. Approach: The study used a government funding reaction function and an instrumental variable approach to empirically estimate the potential for crowding out. Results: The study examined the extent to which private giving reduces or crowds out state government funding of public colleges and universities. Government free riding was at question and investigated to determine how active it is in terms of private donations partially or wholly displacing state government funding. The findings suggested that the rate of crowding out was 43% on the dollar. That compares to the 45% political substitution of the 1960’s but is much diminished from the 1980’s dollar for dollar crowding out. Those are aggregate comparisons for all public institutions. A disaggregated approach in this study additionally revealed that doctoral universities were victims of the same 43% crowd out but that at two other levels, master degree granting and associate degree granting colleges, there was the opposite effect of crowding in. Those colleges received state funding augmentations of 32-92% on their dollar of privately provided donations. Conclusion/Recommendations: The study’s finding of the existence of both crowding out and crowding in can carry important policy implications for college and university funding. Future managerial and public policy decision making should take that into account. However, political sustainability and economy wide and localized effects over time of crowding out and in could prove fruitful avenues of inquiry for future research.

  19. 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

  20. Public-private partnerships in translational medicine: concepts and practical examples.

    Science.gov (United States)

    Luijten, Peter R; van Dongen, Guus A M S; Moonen, Chrit T; Storm, Gert; Crommelin, Daan J A

    2012-07-20

    The way forward in multidisciplinary research according to former NIH's director Elias Zerhouni is to engage in predictive, personalized, preemptive and participatory medicine. For the creation of the optimal innovation climate that would allow for such a strategy, public-private partnerships have been widely proposed as an important instrument. Public-private partnerships have become an important instrument to expedite translational research in medicine. The Netherlands have initiated three large public-private partnerships in the life sciences and health area to facilitate the translation of valuable basic scientific concepts to new products and services in medicine. The focus of these partnerships has been on drug development, improved diagnosis and regenerative medicine. The Dutch model of public-private partnership forms the blueprint of a much larger European initiative called EATRIS. This paper will provide practical examples of public-private partnerships initiated to expedite the translation of new technology for drug development towards the clinic. Three specific technologies are in focus: companion diagnostics using nuclear medicine, the use of ultra high field MRI to generate sensitive surrogate endpoints based on endogenous contrast, and MRI guidance for High Intensity Focused Ultrasound mediated drug delivery.

  1. A systematic framework for infrastructure development through public private partnerships

    Directory of Open Access Journals (Sweden)

    Xueqing Zhang

    2013-03-01

    Full Text Available Public–private partnerships (PPPs play an important role in bringing private sector competition to public monopolies in infrastructure development and service provision and in merging the resources of both public and private sectors to better serve the public needs. However, in worldwide practices, there are mixed results, substantial controversy, criticism and conflict over PPPs. This paper proposes a systematic framework for the delivery of public works and services through PPPs in general. Justified by public procurement principles, aimed at a public–private win–win solution, and based on worldwide best industrial practices and lessons from unsuccessful projects, this framework integrates the four broadly divided stages that repeat over time: (1 design of a workable concession, (2 competitive concessionaire selection, (3 financial regulation, and (4 periodic reconcession and rebidding. The four-stage framework takes into account the requirements of public services, realignment of responsibility and reward among multiple participants in PPPs, the monopolistic rights of the concessionaire, and the wide range of risks and uncertainties in the long concession period. Varying competition elements are incorporated in each of the four stages for continuous performance improvement in the delivery of public works and services. The design of the right concession forms the base on which other stages are implemented in addition to planning the project and allocating risks for enhanced efficiency. The financial regulation allows the government to address changing conditions and to regulate the concession for efficient operation with due discretion, whereas the competitive concessionaire selection and periodic reconcession and rebidding play critical roles in achieving innovation, efficiency and cost effectiveness through direct competition rather than government discretionary intervention.

  2. The Privatization of Public Enterprises in the United Kingdom, 1979–1987

    NARCIS (Netherlands)

    Auger, J.F.

    2010-01-01

    How do states have privatized public enterprises? In the book The Official History of Privatization, David Parker, a notorious economist of regulation and privatization, shed light on a country at the forefront of economic reforms, the United Kingdom.

  3. Establishment of national laboratory standards in public and private hospital laboratories.

    Science.gov (United States)

    Anjarani, Soghra; Safadel, Nooshafarin; Dahim, Parisa; Amini, Rana; Mahdavi, Saeed; Mirab Samiee, Siamak

    2013-01-01

    In September 2007 national standard manual was finalized and officially announced as the minimal quality requirements for all medical laboratories in the country. Apart from auditing laboratories, Reference Health Laboratory has performed benchmarking auditing of medical laboratory network (surveys) in provinces. 12(th) benchmarks performed in Tehran and Alborz provinces, Iran in 2010 in three stages. We tried to compare different processes, their quality and accordance with national standard measures between public and private hospital laboratories. The assessment tool was a standardized checklist consists of 164 questions. Analyzing process show although in most cases implementing the standard requirements are more prominent in private laboratories, there is still a long way to complete fulfillment of requirements, and it takes a lot of effort. Differences between laboratories in public and private sectors especially in laboratory personnel and management process are significant. Probably lack of motivation, plays a key role in obtaining less desirable results in laboratories in public sectors.

  4. Variation in exemptions to school immunization requirements among New York State private and public schools.

    Science.gov (United States)

    Lai, Yun-Kuang; Nadeau, Jessica; McNutt, Louise-Anne; Shaw, Jana

    2014-12-12

    School immunization requirements have ensured high vaccination rates and have helped to control vaccine-preventable diseases. However, vaccine exemptions have increased in the last decade. This study compared New York State private versus public schools with respect to medical and religious exemption rates. This retrospective study utilizes New York State Department of Health Immunization Survey data from the 2003 through 2012 academic years. Schools were categorized as private or public, the former further categorized by religious affiliation. Rates of medical and religious vaccine exemptions were compared by school category. From 2003 to 2012, religious exemptions increased in private and public schools from 0.63% to 1.35% and 0.17% to 0.29% (Spearman's R: 0.89 and 0.81), respectively. Among private schools, increases in religious exemption rates during the study period were observed in Catholic/Eastern Orthodox, Protestant/Other Christian, Jewish, and secular schools (Spearman's R=0.66, 0.99, 0.89, and 0.93), respectively. Exemption rate ratios in private schools compared to public schools were 1.39 (95% CI 1.15-1.68) for medical and 3.94 (95% CI: 3.20-4.86) for religious exemptions. Among private school students, all school types except for Catholic/Eastern Orthodox and Episcopal affiliates were more likely to report religious exemptions compared to children in public schools. Medical and religious exemption rates increased over time and higher rates were observed among New York State private schools compared to public schools. Low exemption rates are critical to minimize disease outbreaks in the schools and their community. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries.

    Science.gov (United States)

    Mackintosh, Maureen; Channon, Amos; Karan, Anup; Selvaraj, Sakthivel; Cavagnero, Eleonora; Zhao, Hongwen

    2016-08-06

    Private health care in low-income and middle-income countries is very extensive and very heterogeneous, ranging from itinerant medicine sellers, through millions of independent practitioners-both unlicensed and licensed-to corporate hospital chains and large private insurers. Policies for universal health coverage (UHC) must address this complex private sector. However, no agreed measures exist to assess the scale and scope of the private health sector in these countries, and policy makers tasked with managing and regulating mixed health systems struggle to identify the key features of their private sectors. In this report, we propose a set of metrics, drawn from existing data that can form a starting point for policy makers to identify the structure and dynamics of private provision in their particular mixed health systems; that is, to identify the consequences of specific structures, the drivers of change, and levers available to improve efficiency and outcomes. The central message is that private sectors cannot be understood except within their context of mixed health systems since private and public sectors interact. We develop an illustrative and partial country typology, using the metrics and other country information, to illustrate how the scale and operation of the public sector can shape the private sector's structure and behaviour, and vice versa.

  6. Coverage of abortion controversial in both public and private plans.

    Science.gov (United States)

    Sollom, T

    1996-09-01

    During 1995-96, 17 of 50 US states used their own resources, either voluntarily or under state court order, to pay for all or most abortions for low-income women. Alaska, Maryland, New York, and Washington are the only states to voluntarily pay for these abortions. Anti-choice legislators in California, Illinois, New York, and West Virginia tried unsuccessfully to cut funding for these abortions. Arkansas is the only state to circumvent direct payment for abortions for low-income women. Alabama, Mississippi, and South Dakota still are not complying with the court order but remain in the Medicaid program. Massachusetts has passed legislation to allow health insurance to cover abortions for state and city employees, thereby undoing a 17-year ban on the use of public funds for abortions for employees or their spouses. On the other hand, Virginia's governor has unilaterally, via an executive order, eliminated health insurance coverage for most abortions for state employees and their dependents. Anti-choice legislators have shepherded legislation that prohibit private insurance coverage for abortion unless women pay an extra premium in Idaho, Kentucky, Missouri, and North Dakota. Legislators in Illinois and Minnesota have passed state subsidized health care reform programs that exclude abortion from coverage except when the mother's life is endangered. There appears to be a loophole in the MinnesotaCare program that allows women to obtain state-financed abortions for other reasons, so antifunding lawmakers will introduce a bill in 1997 to close the loophole. The loophole is a result of a conflict between state and federal laws as a result of a 1995 federal waiver granted to Minnesota. The waiver allows pregnant women who earn up to 275% of the federal poverty level to be eligible for either MinnesotaCare or Medicaid. Abortion-rights legislators find MinnesotaCare's exclusion of abortion coverage to be a violation of the court order. They plan to submit a bill in 1997 to

  7. Potential follow-up increases private contributions to public goods.

    Science.gov (United States)

    Rogers, Todd; Ternovski, John; Yoeli, Erez

    2016-05-10

    People contribute more to public goods when their contributions are made more observable to others. We report an intervention that subtly increases the observability of public goods contributions when people are solicited privately and impersonally (e.g., mail, email, social media). This intervention is tested in a large-scale field experiment (n = 770,946) in which people are encouraged to vote through get-out-the-vote letters. We vary whether the letters include the message, "We may call you after the election to ask about your voting experience." Increasing the perceived observability of whether people vote by including that message increased the impact of the get-out-the-vote letters by more than the entire effect of a typical get-out-the-vote letter. This technique for increasing perceived observability can be replicated whenever public goods solicitations are made in private.

  8. The productivity of public and private sector in Poland

    Directory of Open Access Journals (Sweden)

    Robert Pater

    2014-07-01

    Full Text Available In the article a concept of comparing public and private sector effectiveness is presented. It is based on an analysis of the productivity of capital and labour in both sectors. For this purpose, the authors build growth model in the general and intensive form, taking into account public and private sectors and their relationships in terms of gross value of fixed assets, and employment. Empirical analysis is carried out using a panel model for Polish provinces in the years 2002-2009. The analysis show that the size of the public sector in terms of labour and capital is negatively correlated with Gross Domestic Product and gross value added per employee. Research has shown that the productivity in the two sectors is different. The private sector has a higher productivity of both labour and capital in comparison to the public sector. The authors are of the opinion that the analysis in terms of labour and capital in both sectors substantially complements the more common approach aimed at measuring the effectiveness of public sector from the point of view of expenditures. Proposed analysis has the advantage that it expresses two sectors, which use different accounting categories, in the same economic terms – productivity.

  9. PUBLIC-PRIVATE PARTNERSHIPS IN FUNCTION OF RAPID ECONOMIC DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Ljubiša Vladušić

    2012-01-01

    Full Text Available This paper contains a review of themost important characteristics of public-privatepartnerships, explaining mutual adjustment ofpublic and private sectors goals during theimplementation of a particular public project. Inaddition, this paper outlines the benefits of publicprivatepartnership through redefining governmentrole in economy ensuring the necessary efficiencyand productivity in the management of publicgoods. The author specially noted that forsuccessful development of public-privatepartnership it is necessary for all stakeholders to beadequately involved in the process and to clearlyrecognize the possibility of better and higherquality in realization of their own interests bydefining the contractual assumptions of riskdiversification. The author also points out that inexplaining the concept of public-privatepartnership it is necessary to distinguish betweenthis kind of contractual relationship and thetraditional ways of providing public services,privatization and concessions. The circumstancessuggest that the experience in strategic merger ofpublic and private sectors in developed countries ispositive and that these processes in countries intransition are delayed both in view of legal aspectand application in practice. The author believesthat not only the legal solutions but also newprocedures and regulations as well as mechanismsfor effective implementation of models of publicprivatepartnership will be of great importance forfurther economic development of the countries intransition.

  10. Constraints, Challenges and Prospects of Public-Private Partnership ...

    African Journals Online (AJOL)

    hanumantp

    millennium development goals (MDGs) if it continues ... In theory this ... administered to 466 respondents (251 health workers and 215 community members), selected ... PPP refers to the establishment of on-going relationship ... to that the new PATHS-2 program has sensitized the Enugu State ..... More jobs in the private.

  11. Successful public-private partnerships: The NYPD shield model.

    Science.gov (United States)

    Amadeo, Vincent; Iannone, Stephen

    2017-12-01

    This article will identify the challenges that post 9/11 law enforcement faces regarding privatepublic partnerships and describe in detail the NYPD Shield programme, created to combat those challenges. Recommendations made by the 911 Commission included the incorporation of the private sector into future homeland security strategies. One such strategy is NYPD Shield. This programme is a nationally recognized award-winning public-private partnership dedicated to providing counterterrorism training and information sharing with government agencies, non-government organizations, private businesses, and the community. Information is shared through several platforms that include a dedicated website, instruction of counterterrorism training curricula, e-mail alerts, intelligence assessments and the hosting of quarterly conferences. This article also details how the NYPD Shield is providing its successful template to other law enforcement agencies enabling them to initiate similar programmes in their respective jurisdictions, and in doing so joining a National Shield Network.

  12. Systems-Level Smoking Cessation Activities by Private Health Plans

    Directory of Open Access Journals (Sweden)

    Sharon Reif, PhD

    2011-01-01

    Full Text Available IntroductionThe US Public Health Service urges providers to screen patients for smoking and advise smokers to quit. Yet, these practices are not widely implemented in clinical practice. This study provides national estimates of systems-level strategies used by private health insurance plans to influence provider delivery of smoking cessation activities.MethodsData are from a nationally representative survey of health plans for benefit year 2003, across product types offered by insurers, including health maintenance organizations (HMOs, preferred provider organizations, and point-of-service products, regarding alcohol, tobacco, drug, and mental health services. Executive directors of 368 health plans responded to the administrative module (83% response rate. Medical directors of 347 of those health plans, representing 771 products, completed the clinical module in which health plan respondents were asked about screening for smoking, guideline distribution, and incentives for guideline adherence.ResultsOnly 9% of products require, and 12% verify, that primary care providers (PCPs screen for smoking. HMOs are more likely than other product types to require screening. Only 17% of products distribute smoking cessation guidelines to PCPs, and HMOs are more likely to do this. Feedback to PCPs was most frequently used to encourage guideline adherence; financial incentives were rarely used. Furthermore, health plans that did require screening often conducted other cessation activities.ConclusionFew private health plans have adopted techniques to encourage the use of smoking cessation activities by their providers. Increasing health plan involvement is necessary to reduce tobacco use and concomitant disease in the United States.

  13. Ethics in Public Health Research

    Science.gov (United States)

    Curtis, Valerie A.; Garbrah-Aidoo, Nana; Scott, Beth

    2007-01-01

    Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public–Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships. PMID:17329646

  14. Democracy, Redistributive Taxation and the Private Provision of Public Goods

    DEFF Research Database (Denmark)

    Markussen, Thomas

    The paper studies in a simple, Downsian model of political competition how the private provision of public goods is affected when it is embedded in a system of democracy and redistributive taxation. Results show that the positive effect of inequality on public goods production, which Olson (1965......) pointed to, is weakened and might even be reversed in this context. Also, the median voter may choose a negative tax rate, even if he is poorer than the mean, in order to stimulate public goods production. The relevance of the model is illustrated with an application to the finance of higher education....

  15. Mechanisms in the privatization process of public education

    Directory of Open Access Journals (Sweden)

    Cristina Díez Pampliega

    2010-08-01

    Full Text Available The situation in the district of Puente de Vallecas (Madrid, Spani can be taken as an example of the progressive development of private schools held by public funds at the expense of the public schools network. This situation is the result of different mechanisms: first, the lost perception of education as a common good; second, the neglect of the right to free compulsory education in all schools supported by public funds; and third, the unfair distribution of students from economic and cultural disadvantaged backgrounds.

  16. Public-private partnerships in urban regeneration areas in Denmark

    DEFF Research Database (Denmark)

    Sørensen, Michael Tophøj; Aunsborg, Christian

    2006-01-01

    into housing while neighbouring noisy industries go on. Beyond this, from a municipal point of view there are several public interests to manage when old, remaining industrial areas face re-development. The motive of the municipal council can either be regulative (safeguarding certain financial or other public......The paper focuses formal as well as informal public-private partnerships (PPP) in Danish urban regeneration areas. The concept ‘urban regeneration areas’ was introduced in the 2003 Planning Act as old, remaining industrial areas within the city boundaries by now were recognized as an ressource...

  17. Public health workforce taxonomy.

    Science.gov (United States)

    Boulton, Matthew L; Beck, Angela J; Coronado, Fátima; Merrill, Jacqueline A; Friedman, Charles P; Stamas, George D; Tyus, Nadra; Sellers, Katie; Moore, Jean; Tilson, Hugh H; Leep, Carolyn J

    2014-11-01

    Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a public health workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all public health workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of public health workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, public health specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection.

  18. Privatization and the Public Good: Public Universities in the Balance

    Science.gov (United States)

    Lambert, Matthew T.

    2014-01-01

    "Public education is in crisis--and it has been for some time. The problem is, no one can agree on the problem, and when there is no agreement on the problem, developing solutions is nearly impossible." Thus writes Matthew T. Lambert in this study of present-day public higher education, which is currently plagued by momentous challenges.…

  19. Public private partnership as a last resort for traditional public procurement

    Directory of Open Access Journals (Sweden)

    Bojović Viktorija

    2006-01-01

    Full Text Available This paper discusses recent changes in the way public services are delivered A marked increase in the cooperation between the public and private sector in the realization of complex projects, mostly concerning development of infrastructure, is the main characteristic of present-day developing economies. The creation of new, innovative agreements is driven by the limitation of public funds and an ever-growing demand for an increase in the quality of public services. Looking upon the western economies experience alternatives to the traditional public sector procurement are identified in the public/private partnership. The public/private partnership can be seen as one component in the rearrangement of the public sector with a management culture that focuses on the citizen or customer. Also included in this are accountability for results, investigation of a wide variety of alternative service delivery mechanisms, and competition between public and private bodies for contracts to deliver services consistent with cost recovery and the achievement of value for money. The partnership can be realized through an array of models and in this paper priority is given to the DBFO (design-build-finance-operate model, due to its importance in implementation. The DBFO model is considered to be a synonym for the public/private partnership, as it is the most suitable for complex projects and gains the most benefits.

  20. Privatization Financing Alternatives: Blending Private Capital and Public Resources for a Successful Project

    Energy Technology Data Exchange (ETDEWEB)

    BT Oakley; JH Holbrook; L Scully; MR Weimar; PK Kearns; R DiPrinzio

    1998-10-19

    The U.S. Department of Energy (DOE) launched the Contract Reform Initiative in 1994 in order to improve the effectiveness and effkiency of managing major projects and programs. The intent of this initiative is to help DOE harness both technical and market forces to reduce the overall cost of accomplishing DOE's program goals. The new approach transfers greater risk to private contractors in order to develop incentives that align contractor performance with DOE's objectives. In some cases, this goal can be achieved through public-private partnerships wherein the govermhent and the contractor share risks associated with a project in a way that optimizes its economics. Generally, this requires that project risks are allocated to the party best equipped to manage and/or underwrite them. While the merits of privatization are well documented, the question of how privatized services should be financed is often debated. Given the cost of private sector equity and debt, it is difficult to ignore the lure of the government's "risk free" cost of capital. However, the source of financing for a project is an integral part of its overall risk allocation, and therefore, participation by the government as a financing source could alter the allocation of risks in the project, diminishing the incentive structure. Since the government's participation in the project's financing often can be a requirement for financial feasibility, the dilemma of structuring a role for the government without undermining the success of the project is a common and difficult challenge faced by policymakers around the world. However, before reverting to a traditional procurement approach where the government enters into a cost-plus risk profile, the government should exhaust all options that keep the private entity at risk for important aspects of the project. Government participation in a project can include a broad range of options and can be applied with precision to bridge a

  1. Social economy partnerships and the public/private cleavages

    Directory of Open Access Journals (Sweden)

    Joxerramon Bengoetxea

    2012-06-01

    Full Text Available Public/Private Partnerships can be seen as one particular topos where the divide between the public domain, all levels of the Public Administration and the private initiative and private property is turned into a joint venture rather than a confrontation or a cleavage. Some of the possible combinations of public and private and where public/private partnerships might fit are displayed analytically. The importance of political theory or ideology in conceiving the relationships between ‘public’ and ‘private’, and the conceptions of a market economy as opposed to a social market economy cannot be exaggerated enough, but equally important are the legal or regulatory framework and the underlying dominant legal culture and legal principles, and of course the economic and financial situation. Public/private partnerships thrive in some conditions, but seem to wane in others, and the current predicament is not favourable, taking into account that only the regulatory framework is supportive of these ventures. Los partenariados público-privados se pueden entender como un espacio particular, en el que el sector público, todos los niveles de la administración pública, y la iniciativa privada y la propiedad privada, abordan una empresa conjunta, en lugar mantener posturas contrapuestas. Se muestran algunas de las posibles combinaciones del sector público y privado, en las que tendrían cabida los partenariados público/privados. Es patente la importancia de la teoría o la ideología política para entender las relaciones entre lo público y lo privado, y las concepciones de una economía de mercado frente a una economía social, pero tampoco se puede negar la importancia del marco legal o reglamentario y la cultura jurídica dominante subyacente, y los principios jurídicos, sin olvidar la situación económica y financiera. Los partenariados público-privados prosperan en algunas condiciones, pero no lo hacen siempre, y la situación econ

  2. 45 CFR 400.61 - Services to public/private RCA recipients.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Services to public/private RCA recipients. 400.61... Refugee Cash Assistance § 400.61 Services to public/private RCA recipients. (a) Services provided to recipients of refugee cash assistance in the public/private RCA program may be provided by the...

  3. Public perceptions of drinking water: a postal survey of residents with private water supplies

    Directory of Open Access Journals (Sweden)

    McEwen Scott A

    2006-04-01

    Full Text Available Abstract Background In Canada, the legal responsibility for the condition of private water supplies, including private wells and cisterns, rests with their owners. However, there are reports that Canadians test these water supplies intermittently and that treatment of such water is uncommon. An estimated 45% of all waterborne outbreaks in Canada involve non-municipal systems. An understanding of the perceptions and needs of Canadians served by private water supplies is essential, as it would enable public health professionals to better target public education and drinking water policy. The purpose of this study was to investigate the public perceptions of private water supplies in the City of Hamilton, Ontario (Canada, with the intent of informing public education and outreach strategies within the population. Methods A cross-sectional postal survey of 246 residences with private water supplies was conducted in May 2004. Questions pertained to the perceptions of water quality and alternative water sources, water testing behaviours and the self-identified need for further information. Results Private wells, cisterns or both, were the source of household water for 71%, 16% and 13% of respondents, respectively. Although respondents rated their water quality highly, 80% also had concerns with its safety. The most common concerns pertained to bacterial and chemical contamination of their water supply and its potential negative effect on health. Approximately 56% and 61% of respondents used in-home treatment devices and bottled water within their homes, respectively, mainly due to perceived improvements in the safety and aesthetic qualities compared to regular tap water. Testing of private water supplies was performed infrequently: 8% of respondents tested at a frequency that meets current provincial guidelines. Two-thirds of respondents wanted more information on various topics related to private water supplies. Flyers and newspapers were the two

  4. PUBLIC AND PRIVATE IN THE ANTHROPOLOGY OF HANNAH ARENDT

    Directory of Open Access Journals (Sweden)

    MIHAELA MORARIU

    2011-11-01

    Full Text Available This article focuses on the ancient and modern meanings of the “public” and the “private” spaces – carefully analyzed by Hannah Arendt in The Human Condition –, and on the way in which these meanings appeared, also on how they reflect themselves in establishing the relation public-private. The perspectives of the relation between “public” and “private” shade away the tendency of “being together”, alienating the public space from that spectacular attribute of the commonly shared deliberations, bringing the decisions towards an absolute sovereignty. Whereas in the ancient Greece the question of the conflict between the “public” and the “private” has appeared, through the shading of the private sphere and through the over-bidding of the public one, in the Western exegesis the inability to make a distinction between the public and the private did not have the same explanations, but it is rather based on an interpretation and transfer gap. The author acknowledges the decline of the “public” to its extinction in the totalitarianisms of the 20th century, as being due to the modern loss of the meaning and practice of the political action.

  5. Nursing organizational climates in public and private hospitals.

    Science.gov (United States)

    García, I García; Castillo, R F; Santa-Bárbara, E S

    2014-06-01

    Researchers study climate to gain an understanding of the psychological environment of organizations, especially in healthcare institutions. Climate is considered to be the set of recurring patterns of individual and group behaviour in an organization. There is evidence confirming a relationship between ethical climate within organizations and job satisfaction. The aim of this study is to describe organizational climate for nursing personnel in public and private hospitals and to confirm the relationships among the climate variables of such hospitals. A correlational study was carried out to measure the organizational climate of one public hospital and two private hospitals in Granada. The Work Environment Scale was used for data collection. The Work Environment Scale includes 10 scales, ranging from 0 to 9, which were used to evaluate social, demographic and organizational climate variables. In this study, 386 subjects were surveyed in three hospitals. A total of 87% of the participants were female and 16% were male. Most participants were nurses (65.6%), followed by nursing aides (20%), and technicians (14.4%). The results obtained reflected different patterns of organizational climate formation, based on hospital type (i.e. public or private) within the Spanish context. Most of the dimensions were below the midpoint of the scale. In conclusion, in public hospitals, there is a greater specialization and the organizational climate is more salient than in the private hospitals. In addition, in the public hospitals, the characteristics of the human resources and their management can have a significant impact on the perception of the climate, which gives greater importance to the organizational climate as decisive of the ethical climate. © The Author(s) 2013.

  6. Public Policy Exceptions in European Private Law : A New Research Project

    NARCIS (Netherlands)

    Colombi Ciacchi, Aurelia

    2014-01-01

    Public policy exceptions arguably exist in all fields of private and commerciallaw, not only in private international law but also in substantive law. In substantive private law, the term 'public policy exception' could be used to indicate general illegality rules that make an act of private

  7. A comparison between antenatal care quality in public and private sector in rural Hebei, China

    Science.gov (United States)

    Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H.M.M.T.; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W.

    2013-01-01

    Aim To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. Methods We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Results Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. Conclusion The quality of ANC in Hebei was poorer than required by China’s national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities. PMID:23630142

  8. Pigs in Public Health

    DEFF Research Database (Denmark)

    Svendsen, Mette N.

    2017-01-01

    Animals are rare topics in public health science texts and speech despite the fact that animal bodies and lives are woven into the health of human populations, and vice versa. Years of ethnographic and documentary research – following pigs and their humans in and out of biomedical research – made...... me mindful and watchful of the porous passages between animal and human bodies and environments that do not confine themselves to ‘national health programs’ directed towards a specific (human) population. These unrecognized species encounters and relationships, which exceed the conventional framework...... of public health, made me re-evaluate both what ‘public’ and what ‘health’ means in public health. In this commentary I provide a short personal account of that intellectual journey. I argue that entanglements between species make it urgent that public health scholars investigate the moral, socio...

  9. Public or private water management: Experience from different European Countries

    Science.gov (United States)

    Wackerbauer, Johann

    2008-11-01

    Faced with liberalisation proposals and an increasing internationalisation of water resource management, the question arises as to how a change of the regulatory framework would affect the market structure and the supply conditions in this area. While the term "privatisation" relates to the ownership structure of the providers, the term "liberalisation" implies extensive free market ideas. Privatisation involves the outsourcing of public services from the public authorities to a privately organised organisation. Through this, however, nothing needs to change in terms of the market or the intensity of competition for the commodity in question. Within the framework of privatisation it can also occur that the public monopoly is only transferred to a private monopoly. The term "liberalisation" in addition refers to the basic regulatory constraints: liberalisation signifies the cessation of limitations to competition and supply monopolies, and open competition between several suppliers for the consumers. In the EU-15, the only country where the provision of operational services in the water supply has been totally passed to the private sector is the UK, but this is only true for UK and Wales. Another singular case is France, where there is a mix of mainly private operating companies and municipalities which have divided the regional supply areas among themselves. In six other EU-15 countries where some privatisation took place, either the municipalities or (majority) publicly owned companies are controlling water supply. In the remaining seven countries, the water supply is organised by municipality companies only. In an international comparison, there are three basic models for the regulation of natural monopolies in the public water supply: the Anglo-Saxon, the French and the German model. The delimitation between supervisory bodies and operations in the water supply is strongest in the first model and weakest in the last. This has led to three basic types of

  10. Africa's health: could the private sector accelerate the progress towards health MDGs?

    Science.gov (United States)

    2011-01-01

    Background Out of 1.484 billion disability-adjusted life years lost globally in 2008, 369.1 million (25%) were lost in the WHO African Region. Despite the heavy disease burden, the majority of countries in the Region are not on track to achieve Millennium Development Goals (MDG) 4 (reducing child mortality), 5 (improving maternal health), and 6 (combating HIV/AIDS, malaria and other diseases). This article provides an overview of the state of public health, summarizes 2010-2015 WHO priorities, and explores the role that private sector could play to accelerate efforts towards health MDGs in the African Region. Discussion Of the 752 total resolutions adopted by the WHO Regional Committee for Africa (RC) between years 1951 and 2010, 45 mention the role of the private sector. We argue that despite the rather limited role implied in RC resolutions, the private sector has a pivotal role in supporting the achievement of health MDGs, and articulating efforts with 2010-2015 priorities for WHO in the African Region: provision of normative and policy guidance as well as strengthening partnerships and harmonization; supporting the strengthening of health systems based on the Primary Health Care approach; putting the health of mothers and children first; accelerating actions on HIV/AIDS, malaria and tuberculosis; intensifying the prevention and control of communicable and noncommunicable diseases; and accelerating response to the determinants of health. Conclusion The very high maternal and children mortality, very high burden of communicable and non-communicable diseases, health systems challenges, and inter-sectoral issues related to key determinants of health are too heavy for the public sector to address alone. Therefore, there is clear need for the private sector, given its breadth, scope and size, to play a more significant role in supporting governments, communities and partners to develop and implement national health policies and strategic plans; strengthen health

  11. Research contributions on childhood obesity from a public-private partnership

    OpenAIRE

    2015-01-01

    Background Childhood obesity remains a significant global problem with immediate and long-term individual health and societal consequences. Targets for change should include the most potent and predictive factors for obesity at all levels of the personal, social and physical environments. The Michael & Susan Dell Center for Healthy Living (‘the Center’) is a public-private partnership that was developed to address child health issues through research, service, and education. This overview pap...

  12. Public-Private Partnerships in Chronic Disease Prevention-Part 4

    Centers for Disease Control (CDC) Podcasts

    2009-04-06

    This podcast is the fourth of a seven part series discussing public health partnerships with the private sector. In this segment, CDC's Elizabeth Majestic and University of North Carolina's Gene Matthews talk about strategies that should serve as the cornerstone for partnership development.  Created: 4/6/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/6/2009.

  13. Public-Private Partnerships in Chronic Disease Prevention-Part 7

    Centers for Disease Control (CDC) Podcasts

    2009-04-06

    This podcast is the last installment of a seven part series discussing public health partnerships with the private sector. In this segment, CDC's Elizabeth Majestic and Georgia State University's Michael Eriksen discuss how some lessons learned in the tobacco control experience might be relevant for the obesity epidemic.  Created: 4/6/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/6/2009.

  14. Public-Private Partnerships in Chronic Disease Prevention-Part 3

    Centers for Disease Control (CDC) Podcasts

    2009-04-06

    This podcast is the third of a seven part series discussing public health partnerships with the private sector. In this segment, CDC's Elizabeth Majestic and University of North Carolina's Gene Matthews talk about how building credibility on preparedness issues can help develop support for initiatives around chronic disease prevention.  Created: 4/6/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/6/2009.

  15. Public/private information sharing in healthcare fraud investigations.

    Science.gov (United States)

    Sheehan, J G

    1999-01-01

    Private insurers have good reason, both in their private interest and in the public interest, for pursuing and rooting out fraud in the healthcare system; moreover, they often have sophisticated data systems, substantial investigative information, and management expertise that can be useful to prosecutors. It makes sense, as a public policy matter, to undertake steps to encourage insurers to be aggressive in pursuing legitimate fraud cases, and to provide a framework for effective cooperation and information sharing with law enforcement. At the same time, prosecutors are responsible for enforcing equal justice under the law; thus, any such relationship must be handled in an appropriate manner, with safeguards to protect privacy and the reputation of investigative subjects. While the courts have not yet explored many of the relevant legal and factual issues in this area, the author surveys existing guidance under governing laws and policies applicable to state and federal prosecutors, and suggests techniques to prevent inappropriate communication or use of such information.

  16. Public-Private Partnerships: The Evolving Role of Industry Funding in Nutrition Research12

    Science.gov (United States)

    Zachwieja, Jeffrey; Hentges, Eric; Hill, James O.; Black, Richard; Vassileva, Maria

    2013-01-01

    The global burdens of morbidity and mortality associated with obesity-related chronic diseases are crippling public health and are predicted to exponentially increase over the next 3 decades. Meanwhile, the resources necessary to conduct research that may offer solutions to the obesity epidemic continue to decline and funding has become increasingly difficult to secure. Alternative models for funding nutrition and health research are necessary to make considerable and timely progress to improve public health. Key stakeholders include, but are not limited to, government agencies, foundations, private industry, and nongovernmental organizations. PMID:24038261

  17. Jurisdictional Competition Between Private and Public Sector Auditors

    DEFF Research Database (Denmark)

    Klarskov Jeppesen, Kim

    2012-01-01

    . In Denmark, the competitive relation has led to a jurisdictional dispute between public and private sector auditors in which the former have developed a special qualification for public sector auditors. The paper analyses the development of this qualification using Abbott's (1988) theory of the system...... of professions, thus focusing on how the involved groups have attempted to build networks of support for their competing jurisdictional claims of expertise. The case contributes to knowledge about the potential for development of a distinct public sector auditor identity. The case suggests that to develop...... such an identity and gain professional recognition, public sector auditors need to convince parliaments, standard-setting bodies and universities that a public sector auditing qualification serves as a solution to some of their problems, too....

  18. COLLECTIVE BARGAINING DYNAMICS IN THE NIGERIAN PUBLIC AND PRIVATE SECTORS

    Directory of Open Access Journals (Sweden)

    Mariam A. Gbajumo-Sheriff (Mrs.

    2011-09-01

    Full Text Available The objective of this paper is to examine the dynamics of collective bargaining machinery in both the public and private sectors in Nigeria; with a view to bringing to the fore the peculiarities associated with both sectors with regard to the practice of bargaining. To achieve this objective, the paper adopts a theoretical approach. The author observes that the practice of industrial relations as a discipline and that of collective bargaining in particular emanated from the private sector the world over. Thus, much of the practices of public sector collective bargaining are modelled after the private sector collective bargaining. However, in Nigeria, the obverse is the case as collective bargaining gained its root in the public sector owing to the near absence of private sector at the turn of the century. However, in Nigeria, the public sector pays lip-service to the collective bargaining machinery. Governments at all levels (Federal, State and Local have continued to set aside collective bargaining and to give wage awards to score political points in spite of its commitment to the ILO Convention 98 to freely bargain with workers. The State or the government in the course of regulating wages and employment terms and conditions revert to the use of wage commissions. Thus, wage determination is by fiat. This preference for wage commissions can at best be regarded as a unilateral system as collective bargaining is relegated to the background.Wage tribunals or commissions offer little opportunity for workers’ contribution in the determination of terms and conditions of employment and can hardly be viewed as bilateral or tripartite. Thus, the State preference for wage commissions is anti-collective bargaining. In spite of Nigeria’s commitment to Conventions of the ILO with particular reference to such Conventions as 87 of 1948 and 98 of 1949 which provide for freedom of association and the right of workers to organize and bargain collectively

  19. Renegotiation of transportation public-private partnerships: The US experience

    OpenAIRE

    Gifford, Jonathan; Bolaños, Lisardo; Daito, Nobuhiko

    2014-01-01

    Public-private partnerships (P3s) typically rely on long-term contracts between participants. When conditions arise that fall outside the expectations embodied in the contract, one party may seek to renegotiate the contract terms. Globally, the frequency of P3 contract renegotiations has been sufficient to raise questions regarding why these events occur and what their consequences are for the projects and society. The literature highlights four relevant causes behind renegotiation occurrence...

  20. Analyzing public health policy: three approaches.

    Science.gov (United States)

    Coveney, John

    2010-07-01

    Policy is an important feature of public and private organizations. Within the field of health as a policy arena, public health has emerged in which policy is vital to decision making and the deployment of resources. Public health practitioners and students need to be able to analyze public health policy, yet many feel daunted by the subject's complexity. This article discusses three approaches that simplify policy analysis: Bacchi's "What's the problem?" approach examines the way that policy represents problems. Colebatch's governmentality approach provides a way of analyzing the implementation of policy. Bridgman and Davis's policy cycle allows for an appraisal of public policy development. Each approach provides an analytical framework from which to rigorously study policy. Practitioners and students of public health gain much in engaging with the politicized nature of policy, and a simple approach to policy analysis can greatly assist one's understanding and involvement in policy work.

  1. Public health and business: a partnership that makes cents.

    Science.gov (United States)

    Simon, Paul A; Fielding, Jonathan E

    2006-01-01

    Historically, public health agencies have had relatively few formal partnerships with private business. However, both groups share an interest in ensuring a healthy population. Businesses have a financial interest in supporting organized public health efforts; in turn, business partnerships can increase the reach and effectiveness of public health. This paper makes the case for the business sector's participation in the broad public health system and its support of governmental public health agencies. Examples of past and current partnerships exemplify how public health efforts benefit business and suggest opportunities for future collaboration to improve the public's health.

  2. Managing the relational character of public-private partnership contracts

    Directory of Open Access Journals (Sweden)

    Cvetković Predrag

    2015-01-01

    Full Text Available A public-private partnership contract has the character of a relational contract. Relational contracts are incomplete agreements governing transactions where the contracting parties have mutually agreed that it is impossible or economically inefficient to contractually define ex ante possible difficulties and contingencies in the contract implementation, nor the difficulties and contingencies underlying the ex post control of contract performance by a third entity (court or arbitration. Considering the methodology of managing relational contracts, it is essential that the theory of relational contracts does not advocate for the establishment of relational contracts as a separate category of contracts, with specifically designated contractual instruments. This theory defines the relational contract as a category which legitimizes 'the relational mode' of a particular contract. The methodology of relational contracts is important for contracts on public-private partnership as it ensures that the contractual relationship is aligned with the changes in the immediate environment where the PPP contract operates. The aforementioned alignment has two aspects. The first one is the ex ante aspect of the alignment which is primarily aimed at preventing the detrimental effect of such alignment to the public partner's interests. Therefore, the intent to prevent such an effect shall be taken into account when defining the criteria for the selection of the most favorable private partner and the best offer. At the same time, it is essential to establish verifiable standards for measuring the private partner performance in the phase of contract implementation. For this goal to be achieved, it is crucial to specify the subject matter of the private partner's obligations, to establish the priority rank of PPP project objectives, to elaborate on the specific requirements governing the eligibility of private partners to participate in the bidding process, to specify

  3. The role of Public Private Partnership: the Brazilian experience of modernizing hospitals in the São Paulo Prefecture Health Secretariat.

    Science.gov (United States)

    Vicente, Roser; Castillejo, Joan

    2012-01-01

    Within the health sector, the aim of the PPP model is to improve management efficiency and innovation in health care services while it also helps to accelerate the modernization of national health systems. Gesaworld's experience in Brazil, including the modernization of the hospital network of the São Paulo Prefecture, has contributed to improvements in the health of the population by offering better health care facilities. The scope of the project, which is based on the legal model of an administrative concession contract, includes sustainability criteria as part of the project.

  4. Public-Private Partnerships and Sustainable Regional Innovation Systems

    DEFF Research Database (Denmark)

    Lehmann, Martin; Christensen, Per; Johnson, Bjørn

    in this connection, and their roles (if any) are still somewhat unclear. So, the question is: What is or could be the role of universities in P3s? A third mission of universities, often referred to as ‘outreach’, is increasingly coming into focus. One aspect of the third mission is the role universities is or may...... be playing in public-private partnerships for sustainable development, and the links and benefits this may provide towards universities fulfilling their first (science) and second (education) missions. In this paper, the first part is dedicated to the discussion and clarification of the concept of public...

  5. The Public Market Equivalent and Private Equity Performance

    DEFF Research Database (Denmark)

    Sørensen, Morten; Jagannathan, Ravi

    2015-01-01

    betas due to changes in financial leverage, operating leverage, or the nature of the business are automatically taken into account; (2) the public market index used in evaluations should be the one that best approximates the wealth portfolio of the investor considering the PE investment opportunity.......The authors show that the public market equivalent approach is equivalent to assessing the performance of private equity (PE) investments using Rubinstein’s dynamic version of the CAPM. They developed two insights: (1) one need not compute betas of PE investments, and any changes in PE cash flow...

  6. Public versus private treatment of chronic diseases in seniors: Argentina, Brazil, Chile and Uruguay.

    Science.gov (United States)

    Cataife, Guido

    2012-01-01

    This article measures differences in the likelihood of treatment of chronic diseases in elders across types of coverage (private, public and social security) in four major Latin American cities: Buenos Aires (Argentina), Sao Paulo (Brazil), Santiago (Chile) and Montevideo (Uruguay). We used a logistic regression to estimate the odds ratio for treatment of chronic diseases carried by individuals with public, private and social security coverage. The data were from the Survey on health, well-being and aging in Latin America and the Caribbean (SABE) conducted in 1999 and 2000. We find a strong association between possession of public coverage only and treatment failure of chronic diseases in elders in Argentina. We find no significant association for Brazil, Chile and Uruguay. In Buenos Aires, access to private or social security coverage is a necessity for elders because the public sector fails to provide proper treatment. In the remaining cities, private or social security coverage provides similar coverage for chronic diseases in elders compared with the public sector. For this group of countries, the main difference between the former and the latter seems to be in terms of 'luxurious' characteristics, such as the quality of the facilities and waiting times.

  7. The Development of Public-private Partnerships in the Region in Terms of Global Economic Slowdown

    Directory of Open Access Journals (Sweden)

    Pakulin Serhij

    2017-01-01

    Full Text Available The aim of the study is to develop scientifically grounded methodological tools of public-private partnerships in the region in terms of slowing economic globalization. According to this goal, organizes interaction of the government and businesses in the implementation of public-private partnerships; the mechanism for implementation of public-private partnerships in the Kharkiv region; the model of economic management in the region using a public-private partnership.

  8. Recruitment for Competencies in Public and Private Sectors

    Directory of Open Access Journals (Sweden)

    Codruța OSOIAN

    2014-02-01

    Full Text Available The capacity to attract highly skilled human resources is dependent on the employee recruitment process implemented by organizations, which plays an important role for their competitiveness on the market. As the concern for the success of the recruitment process in public sectors is becoming more salient, the present study compares the use of recruitment practices in public and private sectors through a survey applied to 97 organizations. It also explores the outcomes in terms of quantity and quality of applications received when using various recruitment methods. Common points and differences were identified. Internal recruitment methods and e-recruitment based on job posting on the website of the organization are favored regardless of the type of organization (private or public. The differences weight mostly against public sector as public institutions use less often the recommendations received from acquaintances and networks, post fewer job adds on specialized online job boards, get fewer direct applications from candidates, and participate less often in job fairs. The largest number of applications is received through the use of online job boards, job posting on the website of the hiring organization and job advertising in written press. On the other hand, internal recruitment is perceived to result in attracting the highest quality applications.  

  9. Public-Private Partnerships as Hybrid Organizational Drivers of Innovation in the Public Sector

    DEFF Research Database (Denmark)

    Dam, Sofie

    framework, which can be used to investigate the potential for innovation in different PPP types across sectors. The last decades have seen sequential waves of public sector reforms, which have resulted in an increased hybridity in the public sector, where ideas, goals and tools from hierarchy, market...... in the organizational form of PPPs provide different mixes of coordination mechanisms for public-private innovation. The paper investigates three PPP types, Long-term Infrastructure Partnerships (LTICs), Public-Private Service Partnerships (PPSPs) and Public-Private Innovation Partnerships (PPIPs), and shows how...... collaboration, and LTICs are mostly coordinated through competition, though each PPP type displays a specific mix of both competition and collaboration. The article provides a conceptually based explanation for the various degree of innovation in different PPP types displayed in current empirical investigations...

  10. Productivity Analysis of Public and Private Airports: A Causal Investigation

    Science.gov (United States)

    Vasigh, Bijan; Gorjidooz, Javad

    2007-01-01

    Around the world, airports are being viewed as enterprises, rather than public services, which are expected to be managed efficiently and provide passengers with courteous customer services. Governments are, increasingly, turning to the private sectors for their efficiency in managing the operation, financing, and development, as well as providing security for airports. Operational and financial performance evaluation has become increasingly important to airport operators due to recent trends in airport privatization. Assessing performance allows the airport operators to plan for human resources and capital investment as efficiently as possible. Productivity measurements may be used as comparisons and guidelines in strategic planning, in the internal analysis of operational efficiency and effectiveness, and in assessing the competitive position of an airport in transportation industry. The primary purpose of this paper is to investigate the operational and financial efficiencies of 22 major airports in the United States and Europe. These airports are divided into three groups based on private ownership (7 British Airport Authority airports), public ownership (8 major United States airports), and a mix of private and public ownership (7 major European Union airports. The detail ownership structures of these airports are presented in Appendix A. Total factor productivity (TFP) model was utilized to measure airport performance in terms of financial and operational efficiencies and to develop a benchmarking tool to identify the areas of strength and weakness. A regression model was then employed to measure the relationship between TFP and ownership structure. Finally a Granger causality test was performed to determine whether ownership structure is a Granger cause of TFP. The results of the analysis presented in this paper demonstrate that there is not a significant relationship between airport TFP and ownership structure. Airport productivity and efficiency is

  11. 77 FR 42801 - Public Private Partnerships Public Meeting

    Science.gov (United States)

    2012-07-20

    ...The FAA is conducting a public meeting on August 7 regarding program design and implementation of an equipage incentives program for commercial aircraft and general aviation to equip their aircraft with Next Generation Air Transportation (NextGen) capabilities, pursuant to the FAA's authority in the FAA Modernization and Reform Act of 2012 (sec. 221). The purpose of this meeting is to serve as an information sharing session.

  12. Illegal private clinics: ideal health services choices among rural-urban migrants in China?

    Science.gov (United States)

    Li, Yan

    2014-01-01

    The main purpose of this article is to explore the important issues and the role of illegal private clinics in health services access among rural-urban migrants in China. The function that illegal private clinics substantially play on the health among rural-urban migrants in China is rarely discussed in studies. A study on a migrant community in Beijing shows the disadvantaged status of health services choices and the constraints for access to health services among migrants. It argues that the existence of illegal private clinics provides a channel to migrants for medical services in the city and reflects the difficulties and high cost of providing medical services to migrants in urban public hospitals. Occasionally the illegal private clinics can cause danger to the health of migrants.

  13. How to Keep Your Health Information Private and Secure

    Science.gov (United States)

    ... health information technology and keeping your health information private and secure, visit our website at http: / / www. healthit. gov. For information and resources on HIPAA privacy and security issues, visit the Office for Civil Rights website ...

  14. Children's Health Publications

    Science.gov (United States)

    Each title has a brief description and link for downloading the full text. Includes the publications catalog, the Child Health Champion resource guide, student curriculum materials, reports, fact sheets, and booklets/brochures of advice and tools.

  15. Roundtable discussion: what is the future role of the private sector in health?

    Science.gov (United States)

    2014-01-01

    Background The role for the private sector in health remains subject to much debate, especially within the context of achieving universal health coverage. This roundtable discussion offers diverse perspectives from a range of stakeholders – a health funder, a representative from an implementing organization, a national-level policy-maker, and an expert working in a large multi-national company – on what the future may hold for the private sector in health. Discussion The first perspective comes from a health funder, who argues that the discussion about the future role of the private sector has been bogged down in language. He argues for a ‘both/and’ approach rather than an ‘either/or’ when it comes to talking about health service provision in low- and middle-income countries. The second perspective is offered by an implementer of health insurance in sub-Saharan Africa. The piece examines the comparative roles of public sector actors, private sector actors and funding agencies, suggesting that they must work together to mobilize domestic resources to fund and deliver health services in the longer term. Thirdly, a special advisor working in the federal government of Nigeria considers the situation in that country. He notes that the private sector plays a significant role in funding and delivering health services there, and that the government must engage the private sector or forever be left behind. Finally, a representative from a multi-national pharmaceutical corporation gives an overview of global shifts that are creating opportunities for the private sector in health markets. Summary Overall, the roundtable discussants agree that the private sector will play an important role in future health systems. But we must agree a common language, work together, and identify key issues and gaps that might be more effectively filled by the private sector. PMID:24961806

  16. GIS and Public Health

    Directory of Open Access Journals (Sweden)

    Stefania Bertazzon

    2014-06-01

    Full Text Available This Special Issue on GIS and public health is the result of a highly selective process, which saw the participation of some 20 expert peer-reviewers and led to the acceptance of one half of the high-quality submissions received over the past year. Many threads link these papers to each other and, indeed, to our original call for papers, but the element that most clearly emerges from these works is the inextricable connection between public health and the environment. Indeed, GIS analysis of public health simply cannot disregard the geospatial dimension of environmental resources and risks. What consistently emerges from these analyses is that current geospatial research can only scratch the surface of the complex interactions of spatial resources, risks, and public health. In today’s world, or at least in the developed world, researchers and practitioners can count on virtually endless data, on inexpensive computational power, and on seamless connectivity. In this research environment, these papers point to the need for improved analytical tools, covering concepts, representation, modeling and reliability. These works are important contributions that help us to identify what advances in geospatial analysis can better address the complex interactions of public health with our physical and cultural environment, and bridge research and practice, so that geospatial analyses can inform public health policy making. [...

  17. Private vs. public self-consciousness and self-discrepancies

    Directory of Open Access Journals (Sweden)

    Adam Falewicz

    2015-11-01

    Full Text Available Background We studied the relationships of self-discrepancies with private and public self-consciousness. It was postulated that private self-consciousness is more strongly related to actual–ideal discrepancy than to actual–ought discrepancy, and that the latter is more strongly related to public self-consciousness. Participants and procedure The sample consisted of 71 students aged 19-25, who completed the Self-Consciousness Scale and the DRP procedure for measuring self-discrepancies. Results The results did not confirm the hypotheses, but revealed a correlation between actual–ideal discrepancy and social anxiety. It also turned out that private self-consciousness negatively correlates with the time of rating ideal-self attributes and positively with the time of rating ought-self attributes. Conclusions Self-consciousness may be related not so much to the size of self-discrepancies as to the accessibility of the content of each self-standard. The results are also consistent with the sequence of studies that challenge the central thesis of Higgins’s theory concerning the specific relationship between actual-ought discrepancy and anxiety.

  18. Management of behavioral health provider networks in private health plans.

    Science.gov (United States)

    Garnick, Deborah W; Horgan, Constance M; Reif, Sharon; Merrick, Elizabeth L; Hodgkin, Dominic

    2008-01-01

    We explored the techniques used by private health plans or by their contracted managed behavioral healthcare organizations (MBHOs) to maintain networks of behavioral health providers. In particular, we focused on differences by health plans' product types (health maintenance organization, point-of-service plan, or preferred provider organization) and contracting arrangements (MBHO contracts, comprehensive contracts, or no contracts). More than 94% of products selected providers using credentialing standards, particular specialists, or geographic coverage. To retain providers viewed as high quality, 54% offer reduced administrative burden and 44% higher fees. Only 16% reported steerage to a core group of highest-quality providers and few reported an annual bonus or guaranteed volume of referrals. Some standard activities are common, but some health plans are adopting other approaches to retain higher-quality providers.

  19. The current situation in the public and private hospitals in Greece

    OpenAIRE

    E Iakovidou; Maria Maniou

    2009-01-01

    The fundamental concept of the policy of the health-care sector, is the creation of a modern System of Health, in which the protection of health and not only the management of illness will come first and it will be ensured that all the citizens will have the same access in the health serviced of high quality.Aim: The purpose of the present study was to evaluate the public and private hospitals in Greece.Conclusively: There is necessity and it is important to evaluate proposals and solutions f...

  20. Equitable Financial Evaluation Method for Public-Private Partnership Projects

    Institute of Scientific and Technical Information of China (English)

    KE Yongjian; LIU Xinping; WANG Shouqing

    2008-01-01

    The feasibility study of a public-private partnership (PPP) project is regarded as one of the critical factors for successful implementation,but unfortunately the common financial evaluation methods currently used only represent the benefits of the private sector.There is,therefore,an urgent need to develop an equitable financial evaluation method for PPP projects.This paper presents a comprehensive literature review that examines international practices.An equitable financial evaluation method was then developed taking into account the inherent characteristics of PPP projects using six separate indicators and Monte Carlo simulations.The result for a bridge project in Romania shows that the method combines the viewpoints of all the relevant stakeholders to achieve an equitable financial evaluation of PPP projects.

  1. A comparative study on the availability of modern contraceptives in public and private health facilities in a peri-urban community in Ghana

    OpenAIRE

    Adjei, Kwame K.; Laar, Amos K.; Narh, Clement T.; Abdulai, Martha A.; Newton, Sam; Owusu-Agyei, Seth; Adjei, Sam

    2015-01-01

    Background Sub-Saharan Africa reports low use of family planning methods and high unmet need. Availability of these methods is one of the major barriers to contraceptive use in the region. This study determined the availability of modern contraceptives and perceived factors affecting this in health facilities in the Ga East municipality of Ghana. Methods This was a cross-sectional study involving quantitative and qualitative techniques. Data was obtained from 51 randomly selected health facil...

  2. Hospital information system institutionalization processes in indonesian public, government-owned and privately owned hospitals.

    Science.gov (United States)

    Handayani, P W; Hidayanto, A N; Ayuningtyas, Dumilah; Budi, Indra

    2016-11-01

    The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals' management is more motivated to implement HIS to comply with the regulations, while private hospitals' management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors-self-efficacy, social influence, and management support-have a significant influence on the individual acceptance of HIS.

  3. Blurring personal health and public priorities: an analysis of celebrity health narratives in the public sphere.

    Science.gov (United States)

    Beck, Christina S; Aubuchon, Stellina M; McKenna, Timothy P; Ruhl, Stephanie; Simmons, Nathaniel

    2014-01-01

    This article explores the functions of personal celebrity health narratives in the public sphere. This study examines data about 157 celebrities, including athletes, actors, musicians, and politicians, who have shared private information regarding a personal health situation (or that of a loved one) with others in the public domain. Part of a larger project on celebrity health narratives, this article highlights three key functions that celebrity health narratives perform--education, inspiration, and activism--and discusses the implications for celebrities and for public conversations about health-related issues.

  4. A Public-Private Partnership Improves Clinical Performance In A Hospital Network In Lesotho.

    Science.gov (United States)

    McIntosh, Nathalie; Grabowski, Aria; Jack, Brian; Nkabane-Nkholongo, Elizabeth Limakatso; Vian, Taryn

    2015-06-01

    Health care public-private partnerships (PPPs) between a government and the private sector are based on a business model that aims to leverage private-sector expertise to improve clinical performance in hospitals and other health facilities. Although the financial implications of such partnerships have been analyzed, few studies have examined the partnerships' impact on clinical performance outcomes. Using quantitative measures that reflected capacity, utilization, clinical quality, and patient outcomes, we compared a government-managed hospital network in Lesotho, Africa, and the new PPP-managed hospital network that replaced it. In addition, we used key informant interviews to help explain differences in performance. We found that the PPP-managed network delivered more and higher-quality services and achieved significant gains in clinical outcomes, compared to the government-managed network. We conclude that health care public-private partnerships may improve hospital performance in developing countries and that changes in management and leadership practices might account for differences in clinical outcomes.

  5. Public Service Motivation and Attraction to Public Versus Private Sector Employment

    DEFF Research Database (Denmark)

    Pedersen, Mogens Jin

    2013-01-01

    of economics, political science, and law, this article tests (1) the relationship between PSM and attraction to public versus private sector employment, and (2) the moderating effect on this relationship of students’ academic field of study (i.e., their profession once graduated). Overall, results underscore...... the multidimensionality of the PSM construct, as the PSM dimension of “public interest” is positively associated with attraction to public sector employment and negatively associated with attraction to private sector employment, while the PSM dimension of “compassion” is unrelated to both. Importantly, however...

  6. Good legal governance in authoritative public-private partnerships. Conceptualising legitimate partnerships with public authority

    NARCIS (Netherlands)

    Heldeweg, M.A.; Sanders, M.P.T.

    2013-01-01

    The discourse on Public Private Partnerships (PPP) is focused most on Procurement or on what we name ‘Market-PPP’. Placing PPP in the shift from government to governance calls for attention especially to those PPP, which are geared to exercise public legal powers. These ‘Authoritative PPP’ are most

  7. Good legal governance in authoritative public-private partnerships. Conceptualising legitimate partnerships with public authority

    NARCIS (Netherlands)

    Heldeweg, Michiel A.; Sanders, Maurits

    2013-01-01

    The discourse on Public Private Partnerships (PPP) is focused most on Procurement or on what we name ‘Market-PPP’. Placing PPP in the shift from government to governance calls for attention especially to those PPP, which are geared to exercise public legal powers. These ‘Authoritative PPP’ are most

  8. A Level Field for Private and Public Hospitals

    Institute of Scientific and Technical Information of China (English)

    LAN XINZHEN

    2010-01-01

    @@ The State Council on December 3 announced new policies to encourage private and foreign capital in China's medical sector to meet the country's diversifying demands on health care. The new policies, dubbed the "guideline to encourage and lead social capital to sponsor health-care institutes," stipulated that social capital should enjoy preferential treatment as China adjusts its medical resources, and social capital will be encouraged to participate in restructuring the hospital system. As an added bonus, overseas investments are being welcomed to sponsor hospitals and the process of involving more foreign investors will be further simplified in the coming years.

  9. 'Waiting for' and 'waiting in' public and private hospitals: a qualitative study of patient trust in South Australia.

    Science.gov (United States)

    Ward, Paul R; Rokkas, Philippa; Cenko, Clinton; Pulvirenti, Mariastella; Dean, Nicola; Carney, A Simon; Meyer, Samantha

    2017-05-05

    Waiting times for hospital appointments, treatment and/or surgery have become a major political and health service problem, leading to national maximum waiting times and policies to reduce waiting times. Quantitative studies have documented waiting times for various types of surgery and longer waiting times in public vs private hospitals. However, very little qualitative research has explored patient experiences of waiting, how this compares between public and private hospitals, and the implications for trust in hospitals and healthcare professionals. The aim of this paper is to provide a deep understanding of the impact of waiting times on patient trust in public and private hospitals. A qualitative study in South Australia, including 36 in-depth interviews (18 from public and 18 from private hospitals). Data collection occurred in 2012-13, and data were analysed using pre-coding, followed by conceptual and theoretical categorisation. Participants differentiated between experiences of 'waiting for' (e.g. for specialist appointments and surgery) and 'waiting in' (e.g. in emergency departments and outpatient clinics) public and private hospitals. Whilst 'waiting for' public hospitals was longer than private hospitals, this was often justified and accepted by public patients (e.g. due to reduced government funding), therefore it did not lead to distrust of public hospitals. Private patients had shorter 'waiting for' hospital services, increasing their trust in private hospitals and distrust of public hospitals. Public patients also recounted many experiences of longer 'waiting in' public hospitals, leading to frustration and anxiety, although they rarely blamed or distrusted the doctors or nurses, instead blaming an underfunded system and over-worked staff. Doctors and nurses were seen to be doing their best, and therefore trustworthy. Although public patients experienced longer 'waiting for' and 'waiting in' public hospitals, it did not lead to widespread distrust

  10. 45 CFR 400.59 - Eligibility for the public/private RCA program.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Eligibility for the public/private RCA program. 400.59 Section 400.59 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE... RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.59 Eligibility for the public/private RCA program....

  11. Stabilization Operations Beyond Government: Joint Venture Public-Private Partnerships in Iraq and Afghanistan

    Science.gov (United States)

    2010-09-01

    Defense Intelligence Agency. This article won the inaugural young Professionals in Foreign Policy Essay competition. Joint Venture Public-Private...Beyond Government: Joint Venture Public-Private Partnerships in Iraq and Afghanistan 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER... joint venture public-private partnerships hold the best possibility to achieve the goals of A Unique Private Sector Methodology Eurasia Group brings

  12. Public-private partnerships for long-term success. Implementation of public construction projects in public-private partnerships; Mit PPP zu nachhaltigem Erfolg. Partnerschaftliche Realisierung oeffentlicher Bauaufgaben

    Energy Technology Data Exchange (ETDEWEB)

    Simsch, Gerd; Glock, Christian; Herzog, Kati [Bilfinger Berger Hochbau GmbH, Frankfurt (Germany); Prein, Sascha [bauperformance GmbH, Frankfurt am Main (Germany)

    2009-07-01

    Public private partnerships necessitate a comprehensive life cycle assessment, which makes them increasingly important as models of sustainability for public building owners. This is proved by the advantages in terms of efficiency and by the fact that two PPP projects received an award (''Guetesiegel nachhaltiges Bauen''). (orig.)

  13. Public-private partnership: between legal requirements and the real needs

    Directory of Open Access Journals (Sweden)

    Sergiu CORNEA

    2012-12-01

    Full Text Available The overview image of the public-private partnership is represented by cooperation between the public and private actors to carry out the activities of public interest, cooperation based on the capacities of each partner to allocate properly the resources, risks and benefits. The main elements of the institutional framework are established by the national legislation. The traditional domains for the development of the partnerships are necessary at the national level and for infrastructure. The increasing tendency toward decentralization of the provision of services introduces a lot of public-private opportunities like health, education and other social services in the non-traditional areas, as well. The study analysis presents the idea of partnership as a means of solving the problem of more and more limited resources which are at the disposal of public administration. The quality of legal framework and government policies for the development of partnerships gives to this way of cooperation, either the quality of strategy in the public policies, which purpose is to obtain greater benefits by combining the resources of those two sectors, or the limited solution to the re-launch of the economy and to meet the general interest.

  14. CARACAS: PRIVATIZATION AND RE- SIGNIFICATION OF PUBLIC SPACES

    Directory of Open Access Journals (Sweden)

    GÓMEZ HERRERA CARMEN HELENA

    2010-05-01

    Full Text Available Caracas. The Theme of this Paper is the privatization of space and re-signification of the public domain in a space-time urban analysis of the development of the actual urban fabric. The analysis is based on concepts as the metamorphosis of the inhabited space and the different space categories for understanding a social context of social exclusion. This social- space- time construction leads to identifying a particular urban environment, based on privatization of public space, disaffiliated modes of public life and great social disparities. The periodization which gives an understandable overview of the transformations in the socio-political and economical spheres, and clarifies the structure of relationships among the actors involved in the processes, resulting mainly in social inequalities, increased market forces, withdrawal of governments and previous authoritarian regimes. The analysis focus also on three selected main state built urban typologies: the Avenue Parisian, social housing blocks and urban highways. These examples which denote the social processes of adaptation, distortion and integration of imported models and structures to the local context and indicate changes of function through time.

  15. Belle II public and private cloud management in VMDIRAC system.

    Science.gov (United States)

    Grzymkowski, Rafa; Hara, Takanori; Belle computing Group, II

    2015-12-01

    The role of cloud computing technology in the distributed computing for HEP experiments grows rapidly. Some experiments (Atlas, BES-III, LHCb) already exploit private and public cloud resources for the data processing. Future experiments such as Belle II or upgraded LHC experiments will largely rely on the availability of cloud resources and therefore their computing models have to be adjusted to the specific features of cloud environment, in particular to the on-demand computing paradigm. Belle II experiment at SuperKEKB will start physics run in 2017. Belle II computing requirements are challenging. The data size at the level of hundred PB is expected after several years of operation, around 2020. The baseline solution selected for distributed processing is the DIRAC system. DIRAC can handle variety of computing resources including Grids, Clouds and independent clusters. Cloud resources can be connected by VMDIRAC module through public interfaces. In particular the mechanism of dynamic activation of new virtual machines with reserved job slots for new tasks in case of an increasing demand for computing resources is introduced. This work is focused on VMDIRAC interaction with public (Amazon EC2) and private (CC1) cloud. The solution applied by Belle II experiment and the experience from Monte Carlo production campaigns will be presented. Updated computation costs for different use cases will be shown.

  16. Value for Money and Policy Review of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals - Final Report

    OpenAIRE

    Department of Health

    2010-01-01

    This Value for Money and Policy Review (VFM&PR) of the Economic Cost and Charges Associated with Private and Semi-Private Treatment Services in Public Hospitals was initiated by the Department of Health and Children in June 2009 and was conducted under the auspices of the Governmentâ?Ts Value for Money & Policy Review Initiative 2009-2011. The Review was overseen by an independently chaired National Steering Group comprised of senior representatives from the Department of Health and Children...

  17. Landmark Law Provides Equal Safeguards to Public,Private Property

    Institute of Scientific and Technical Information of China (English)

    LI XIN

    2007-01-01

    @@ After more than a quarter-century of market-oriented economic policies and unprecedented economic growths,China on March 15, 2007enacted its first law that provides equal legal safeguards to both public and private properties. The 247-article People's Republic of China Property Law, which is due to come into effect as of October 1, 2007, stipulates that "the property of the State, the collecfive, the individual and other obligees shall be protected by law, and no units or individuals may infringe upon it".

  18. Public-Private Investment Partnerships: Efficiency Estimation Methods

    Directory of Open Access Journals (Sweden)

    Aleksandr Valeryevich Trynov

    2016-06-01

    Full Text Available The article focuses on assessing the effectiveness of investment projects implemented on the principles of public-private partnership (PPP. This article puts forward the hypothesis that the inclusion of multiplicative economic effects will increase the attractiveness of public-private partnership projects, which in turn will contribute to the more efficient use of budgetary resources. The author proposed a methodological approach and methods of evaluating the economic efficiency of PPP projects. The author’s technique is based upon the synthesis of approaches to evaluation of the project implemented in the private and public sector and in contrast to the existing methods allows taking into account the indirect (multiplicative effect arising during the implementation of project. In the article, to estimate the multiplier effect, the model of regional economy — social accounting matrix (SAM was developed. The matrix is based on the data of the Sverdlovsk region for 2013. In the article, the genesis of the balance models of economic systems is presented. The evolution of balance models in the Russian (Soviet and foreign sources from their emergence up to now are observed. It is shown that SAM is widely used in the world for a wide range of applications, primarily to assess the impact on the regional economy of various exogenous factors. In order to clarify the estimates of multiplicative effects, the disaggregation of the account of the “industry” of the matrix of social accounts was carried out in accordance with the All-Russian Classifier of Types of Economic Activities (OKVED. This step allows to consider the particular characteristics of the industry of the estimated investment project. The method was tested on the example of evaluating the effectiveness of the construction of a toll road in the Sverdlovsk region. It is proved that due to the multiplier effect, the more capital-intensive version of the project may be more beneficial in

  19. Waste water treatment through public-private partnerships

    DEFF Research Database (Denmark)

    Carpintero, Samuel; Petersen, Ole Helby

    2014-01-01

    This paper analyses the experience of the regional government of Aragon (Spain) that has extensively used public-private partnerships for the construction and operation of waste water treatment plants. The paper argues that although overall the implementation of this PPP program might be considered...... allocation of some tasks. The paper also illustrates two features of this PPP program that arguably have strongly influenced its successful implementation: The mitigation of demand risk and the rigorous estimations of demand carried out by the regional government...

  20. Institutional regime of public-private participation in Uruguay

    Directory of Open Access Journals (Sweden)

    Pablo Schiavi

    2017-01-01

    Full Text Available Recently enacted legislation on Public Private Partnerships in Uruguay provides a new institutional framework for the designing, structuring and subscription of contracts in ppp projects. Among its provisions, the new statute allocates competences to different administrative bodies for the execution, regulation and control of PPP s. Later administrative regulations were also adopted to facilitate the implementation and execution of this type of contracts. The present article studies these reforms, in order to provide a better understanding of the role played by the Technical Commission of the PPP Unit.

  1. Managing the financial challenges of public-private collaboration.

    Science.gov (United States)

    Kirk, R

    1995-01-01

    With the growing emphasis on Medicaid managed care waivers as a method for states to constrain healthcare cost overruns (see also State Policy Review on page 63), new and creative pricing techniques for carve-out and carve-in programs will be a key to their success. The author builds on his experience in developing a Medicaid behavioral healthcare carve-out in Massachusetts to illustrate some basic principles in the pricing and management of such public-private collaborations. These collaborative systems should be based on specific actuarial models, plans for enhanced access to services and the need to change incrementally in the context of the political process.

  2. No Policy for Public Private Partnership? PPP, Collaboration and Institutions

    DEFF Research Database (Denmark)

    Tolstrup Christensen, Lene; Greve, Carsten

    infrastructure projects and public service provision contracts in the transport sector within roads and busses, bridges and tunnels, rail, airports and aviation and harbors. The projects will be categorized in relation to organizational and financial models and it leads to a. discussion of types of policy...... choices across the sector and the reasons behind whether or not PPP was chosen. The final part of the paper presents an institutional historical account of the Danish case, and focuses on the more general question of how PPP policy planning evolves. There is no direct step from privatization...

  3. Inequities in maternal postnatal visits among public and private patients: 2004 Pelotas cohort study

    OpenAIRE

    2009-01-01

    Abstract Background The postnatal period is the ideal time to deliver interventions to improve the health of both the newborn and the mother. However, postnatal care shows low-level coverage in a large number of countries. The objectives of this study were to: 1) investigate inequities in maternal postnatal visits, 2) examine differences in postnatal care coverage between public and private providers and 3) explore the relationship between the absence of maternal postnatal visits and exclusiv...

  4. What Drives Private and Public Merger Waves in Europe?

    DEFF Research Database (Denmark)

    Bartholdy, Jan; Blunck, Benjamin

    What drives merger waves? Harford 2005 argues that mergers are an efficient response to economic shocks to an industry, whereas Rhodes-Kropf, Robinson & Viswanathan 2005 argues that merger waves are driven by overvaluation of the acquiring firm, and to a lesser extent, the target firm. Both paper...... significant differences between driving forces for listed firms and for private firms. Public or listed firm mergers and acquisitions are primarily driven by overvaluation or behavioural factors, whereas private transactions are driven by economic factors.......What drives merger waves? Harford 2005 argues that mergers are an efficient response to economic shocks to an industry, whereas Rhodes-Kropf, Robinson & Viswanathan 2005 argues that merger waves are driven by overvaluation of the acquiring firm, and to a lesser extent, the target firm. Both papers...... are based on empirical analyses of listed US firms. This paper presents additional evidence of merger waves in the European Union (EU). The use of European data allows a more detailed analysis, since firm level data is available for both listed as well as private transactions. This analysis reveals...

  5. Private investment purchase and nursing home financial health.

    Science.gov (United States)

    Orfaly Cadigan, Rebecca; Stevenson, David G; Caudry, Daryl J; Grabowski, David C

    2015-02-01

    To explore the impact of nursing home acquisition by private investment firms on nursing home costs, revenue, and overall financial health. Merged data from the Medicare Cost Reports and the Online Survey, Certification, and Reporting system for the period 1998-2010. Regression specification incorporating facility and time fixed effects. We found little impact on the financial health of nursing homes following purchase by private investment companies. However, our findings did suggest that private investment firms acquired nursing home chains in good financial health, possibly to derive profit from the company's real estate holdings. Private investment acquired facilities are an important feature of today's nursing home sector. Although we did not observe a negative impact on the financial health of nursing homes, this development raises important issues about ownership oversight and transparency for the entire nursing home sector. © Health Research and Educational Trust.

  6. The economics of infrastructure finance: Public-private partnerships versus public provision

    OpenAIRE

    Engel, Eduardo M. R. A.; Fischer, Ronald D.; Galetovic, Alexander

    2010-01-01

    We examine the economics of infrastructure finance, focusing on public provision and Public-Private Partnerships (PPPs). We show that project finance is appropriate for PPP projects, because there are few economies of scope and because assets are project specific. Furthermore, we suggest that the higher cost of finance of PPPs is not an argument in favour of public provision, since it appears to reflect the combination of deficient contract design and the cost-cutting incentives embedded in P...

  7. The economics of infrastructure finance: Public-private partnerships versus public provision

    OpenAIRE

    Eduardo M.R.A. Engel; Ronald D. Fischer; Galetovic, Alexander

    2010-01-01

    We examine the economics of infrastructure finance, focusing on public provision and Public-Private Partnerships (PPPs). We show that project finance is appropriate for PPP projects, because there are few economies of scope and because assets are project specific. Furthermore, we suggest that the higher cost of finance of PPPs is not an argument in favour of public provision, since it appears to reflect the combination of deficient contract design and the cost-cutting incentives embedded in P...

  8. Law, liability, and public health emergencies.

    Science.gov (United States)

    Hoffman, Sharona; Goodman, Richard A; Stier, Daniel D

    2009-06-01

    According to many experts, a public health emergency arising from an influenza pandemic, bioterrorism attack, or natural disaster is likely to develop in the next few years. Meeting the public health and medical response needs created by such an emergency will likely involve volunteers, health care professionals, public and private hospitals and clinics, vaccine manufacturers, governmental authorities, and many others. Conducting response activities in emergency circumstances may give rise to numerous issues of liability, and medical professionals and other potential responders have expressed concern about liability exposure. Providers may face inadequate resources, an insufficient number of qualified personnel, overwhelming demand for services, and other barriers to providing optimal treatment, which could lead to injury or even death in some cases. This article describes the different theories of liability that may be used by plaintiffs and the sources of immunity that are available to public health emergency responders in the public sector, private sector, and as volunteers. It synthesizes the existing immunity landscape and analyzes its gaps. Finally, the authors suggest consideration of the option of a comprehensive immunity provision that addresses liability protection for all health care providers during public health emergencies and that, consequently, assists in improving community emergency response efforts.

  9. Solid Waste Management System: Public-Private Partnership, the Best System for Developing Countries

    Directory of Open Access Journals (Sweden)

    Dr. Nabukeera Madinah

    2016-04-01

    Full Text Available Solid waste management (SWM is a major public health and environmental concern in urban areas of many developing countries. Nairobi’s solid waste situation, which could be taken to generally represent the status which is largely characterized by low coverage of solid waste collection, pollution from uncontrolled dumping of waste, inefficient public services, unregulated and uncoordinated private sector and lack of key solid waste management infrastructure. This paper recapitulates on the public-private partnership as the best system for developing countries; challenges, approaches, practices or systems of SWM, and outcomes or advantages to the approach; the literature review focuses on surveying information pertaining to existing waste management methodologies, policies, and research relevant to the SWM. Information was sourced from peer-reviewed academic literature, grey literature, publicly available waste management plans, and through consultation with waste management professionals. Literature pertaining to SWM and municipal solid waste minimization, auditing and management were searched for through online journal databases, particularly Web of Science, and Science Direct. Legislation pertaining to waste management was also researched using the different databases. Additional information was obtained from grey literature and textbooks pertaining to waste management topics. After conducting preliminary research, prevalent references of select sources were identified and scanned for additional relevant articles. Research was also expanded to include literature pertaining to recycling, composting, education, and case studies; the manuscript summarizes with future recommendationsin terms collaborations of public/ private patternships, sensitization of people, privatization is important in improving processes and modernizing urban waste management, contract private sector, integrated waste management should be encouraged, provisional government

  10. Management of Uncomplicated Malaria in Underfives in Private and Public Health Facilities in South-Eastern Nigeria: A Clinical Audit of Current Practices

    Directory of Open Access Journals (Sweden)

    Ekong Udoh

    2013-01-01

    Full Text Available Malaria remains a leading cause of underfive morbidity and mortality in sub-Saharan Africa. Effective case management is a strategy recommended by the World Health Organization for its control. A clinical audit of case management of uncomplicated malaria in underfives in health facilities in Cross River State, Nigeria, was conducted from January to March 2012. Data was extracted from patients’ case records by trained medical personnel using pretested data extraction forms. Of the 463 case records reviewed, age, gender, and weight were reported in 98.1%, 97.3%, and 49.7% of the children, respectively. A history of fever was obtained in 89.6% and a record of temperature in 74.1% of the children. General examination was performed in 203 (43.8% children. Malaria parasite test was requested in 132 (28.5% while Packed cell volume or haemoglobin was requested in 107 (23.1% children. Appropriate dose of Artemisinin Combination Therapy (ACT was instituted in 300 (64.8%, wrong dose in 109 (23.5%, and inappropriate treatment in 41 (8.9%. The utilization of ACTs for treating uncomplicated malaria in the State has improved but clinical assessment of patients and laboratory confirmation of diagnosis are suboptimum.

  11. A Winning Framework for Public-Private Partnerships : Lessons from 60-plus IFC Projects

    OpenAIRE

    Florizone, Richard; Carter, Laurence

    2013-01-01

    Despite global financial uncertainty and increased public mistrust of business, partnerships between the public and private sectors have continued to grow- driven by governments' need to access external financing and expertise, by the private sector's search for new opportunities, and by governments' desire to grow the private sector. This report addresses the critical question: how can th...

  12. ALGORITHM FOR PUBLIC-PRIVATE PARTNERSHIPS AS A FORM OF BUSINESS IN THE ENVIRONMENT NATIONAL PARKS

    Directory of Open Access Journals (Sweden)

    Gleb A. Sobolev

    2014-01-01

    Full Text Available The article analyzes the current state ofthe public-private partnership in Russia;the algorithm of partnership betweenthe government and the private sectorto develop the business environment ofnational parks. Identified as particularactivities of protected areas, taking into account national and international practices;Consider their relationship and cooperation with public or private entities.

  13. A Winning Framework for Public-Private Partnerships : Lessons from 60-plus IFC Projects

    OpenAIRE

    Florizone, Richard; Carter, Laurence

    2013-01-01

    Despite global financial uncertainty and increased public mistrust of business, partnerships between the public and private sectors have continued to grow- driven by governments' need to access external financing and expertise, by the private sector's search for new opportunities, and by governments' desire to grow the private sector. This report addresses the critical question: how can th...

  14. The operations and effectiveness of public and private provision of solid waste collection services in Kampala

    NARCIS (Netherlands)

    Katusiimeh, M.W.; Mol, A.P.J.; Burger, C.P.J.

    2012-01-01

    This paper compares the operations and discusses the effectiveness of public and private sector provision of solid waste collection in Kampala, Uganda. Household data suggest that the private sector is more effective than the public sector. Private sector companies provide services like container pr

  15. Differences between Public and Private Universities' Fields of Study in Argentina

    Science.gov (United States)

    Rabossi, Marcelo Alberto

    2011-01-01

    The literature on private higher education has identified striking differences between the public and private sectors in terms of fields of study. For example, unlike their public counterparts, private universities have traditionally specialised in the social sciences and humanities. This paper explores the university market in Argentina to see if…

  16. 34 CFR 300.325 - Private school placements by public agencies.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Private school placements by public agencies. 300.325... Programs, and Educational Placements Development of Iep § 300.325 Private school placements by public... child to, a private school or facility, the agency must initiate and conduct a meeting to develop an IEP...

  17. Differences between Public and Private Universities' Fields of Study in Argentina

    Science.gov (United States)

    Rabossi, Marcelo Alberto

    2011-01-01

    The literature on private higher education has identified striking differences between the public and private sectors in terms of fields of study. For example, unlike their public counterparts, private universities have traditionally specialised in the social sciences and humanities. This paper explores the university market in Argentina to see if…

  18. 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.

  19. 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

    and prevention practices for malaria among pregnant women. The main study outcome was the proportion of private health facilities who prescribe treatment of fever among pregnant women as recommended in the guidelines. RESULTS: A total of 241 private health facilities were surveyed; 70.5 % were registered drug...... clinics and pharmacies for prevention of malaria in pregnancy. Few facilities had malaria treatment guidelines; (44.1 % of private clinics, 17.9 % of drug shops, and 41.7 % at pharmacies. Knowledge of people at risk of malaria, P = 0.02 and availability of malaria treatment guidelines, P = 0.03 were......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...

  20. Private and Public Investment in Malaysia: A Panel Time-series Analysis

    Directory of Open Access Journals (Sweden)

    Sallahuddin Hassan

    2011-01-01

    Full Text Available Public capital hypothesis explains that a positive relationship exists between private and public investment. This paper examines the validity of the hypothesis by using a panel time series analysis on four sectors of the Malaysian economy (agriculture, industry and trade, transportation and communication, and construction. Panel co-integration analysis is used to prove the relationship between private domestic investment and public investment by using panel data for the period of 1976–2006. Two interaction variables, public investment and gross domestic product and investment and privatization policy were included as independent variables to take into account the influence of gross domestic product and privatization policy on the effect of public investment on private investment. Results of the study indicate that public investment has positive effect on private investment in all the three sectors except agricultural sector, suggesting that government expenditure encourage more private investment if focus is given towards productive expenditure.