Structure and Dynamics of Private Health Sector.
Implications for India’s Health Policy.
Authors: Prasanta Mahapatra, P. Sridhar, K.T. Rajshree
Publication Year: 2002
About the book:
Starting with the National Health Policy in 1983 private and voluntary organisations have received increasing mention in official documents. But specific policy towards the private health sector have been slow to emerge. Various factors have contributed to the recent interest in the structure and dynamics of private health sector in India. Fristly, the private health sector has grown in many parts of the country, particularly in the areas experiencing economic development. The economic reforms with its emphasis on privatisation have contributed to policy interest in private health sector. Public financing and private provision of health care is being talked about in this context. Private provision ofhealth services appears attractive when there are budgetary contraints for expansion of public healthservice sin the public sector. There is hope that private provision of health care will help ameliorate the need for increased allocation of public funds for health care and at the same time keep up expansion of services to meet growing demand from people. On the other hand, growth of private forprofit healthcare institutions in an unregulated arket has raised concerns about exploitation of consumers and quality of care. Concerns have also been raised about utilisation of tax concessions by the state and responsiveness private corporate health care institutions to the needs of poor.
Naturally many questions arise. How big is the private health sector? Do private health care institutions provide better quality care? Are they more efficient? Do they serve the poor? What's the role of the private health care providers elsewhere in the world? And many more. This book elucidates these issues, examinse and analyses evidence from within and outside India and seeks to answer at least some questions.
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| Ch | Title | Page | View | MB |
|---|---|---|---|---|
| Front Pages, Table of Contents, List of Tables & Figures. | 👁 | 1.5 | ||
| Private health sector and state of health policy in India. An introduction. | 1 | 👁 | 2.0 | |
| Materials and methods for a study on the structure and dynamics of private health sector in Andhra Pradesh. Sampling of health care institutions for the study. Data collection formats and the quoestionnaires. Secondary data analysis and re👁 of literature. Summary of materials and methods. |
7 | 👁 | 1.9 | |
| Motivations, establishment, and growth of privat health care institutions. Overseas experience with institutional forms in private sector. Forprofit response to demand for services. Proprietary and corporate health care institutions. Nonprofit health care institutions in the US and other industrialised countries. Indian experience with institutional forms in private sector. Motivations, establishment, and growth of private health care institutions in AP. Motivating circumstances and incorporation status of Pvt HCIs. Period establishment and growth of HCIs in Andhra Pradesh. Growth in size of HCIs after establishment. Summary of Evidence about institutional forms in health care. |
7 | 👁 | 2.6 | |
| Accessibility characteristics of private and public sector HCIs. Geographic distribution of health care institutions. Re👁 of literature about geographic distribution of health care institutions. Findings from the present study about the geographic spread of private and public HCIs in AP. Socioeconomic character of patients treated by private and public health care institutions. Re👁 of overseas literature about socioeconomic character of patients treated by private and public health care institutions. Re👁 of Indian literature about socioeconomic character of patients treated by private and public health care institutions. Findings from the present study about Socioeconomic character of patients treated by private and public health care institutions. Findings from the present study about responsiveness of private and public HCIs. Summary of evidence about accessibility characteristics of private and public HCIs. |
35 | 👁 | 3.6 | |
| Health seeking behaviour and patterns of resort to private or public HCIs. Factors affecting pattern of resort to different HCIs. Pattern of resort to private and public HCIs for ambulatory care. Pattern of resort to Private and Public HCIs for hospital care Socio Economic status and Pattern of resort to health care. Summary of evidence about health seeking behaviour. |
49 | 👁 | 1.7 | |
| Efficiency of health care institutions (HCIs) in private sector. Studies comparing efficiency of health care institutions in private forprofit, nonprofit and public sector. Findings from the present study about capacity utilisation by private and public HCIs in AP. Summary of evidence about efficiency of private forprofit, nonprofit and public HCIs. |
49 | 👁 | 1.0 | |
| Quality of care characteristics of private and public health care institutions. A framework for assessment of healthcare quality. Premises and floor space. Re👁 of overseas literature on healthcare quality and ownership of HCIs. Healthcare quality in private and public HCIs in India. Structure and process quality characteristics of private health care institutions in AP. Premises and floor space. Practice guidelines and medical records. Patient satisfaction in private and public health care institutions. Owner managers’ opinion about interventions for improvement of quality of care in private sector: Summary of evidence about quality of services. |
69 | 👁 | 4.3 | |
| Range of services in private and public health care institutions. Nature of services provided by the private sector and medical interventions where private institutions have an advantage. Findings from the present study about range of clinical services provided by private and public HCIs in Andhra Pradesh. Range of public health related services, participation in national disease control and family welfare programs by private and public HCIs. The healthcare diagnostic services market in AP. Intramural diagnostic services. Extramural diagnostic services. Availability of auxiliary services in private and public HCIs. Summary of evidence about range of services in private and public HCIs. |
97 | 👁 | 2.8 | |
| Human resources and job satisfaction in private and public health care institutions. Staffing and human resource utilisation by private health care institutions in AP. Job satisfaction of health care professionals in private and public sector. Job satisfaction and related concepts. Conceptual basis of the health care professional (HCP) questionnaire. Job satisfaction in private and public HCIs in AP. Summary of findings about human resource utilisation and job satisfaction in private and public health care institutions. |
115 | 👁 | 1.8 | |
| Financial aspects of private HCIs. Revenue sources for private HCIs. Sources of capital for private health care institutions. Rates and charges. Transparency in rates and charges. Fair financing practices. Summary of findings about financial aspects of private HCIs. |
131 | 👁 | 2.3 | |
| Patient referral, regulatory environment and infrastructure problems faced by private HCIs. Patient referrals. Regulatory environment. Public utility and infrastructure related problems perceived by owner managers of private HCIs. Summary of findings about patient referral, regulatory environment and infrastructure problems faced by private HCIs. |
149 | 👁 | 0.6 | |
| Alternative Private Practitioners in Andhra Pradesh. Summary. |
155 | 👁 | 1.1 | |
| Experiences from policy interventions in the United States (US) directed or otherwise affecting the private health sector. Licensing and accreditation. Blue cross insurance plans. Tax waivers for health insurance. Capital Subsidy by US Federal Government for Hospital Construction from 1946-74 under the Hill-Burton Programme. Health Services Planning and Certificate-of-Need (CON) Regulation in the US. Health Maintenance Organizations (HMOs). Peer re👁 and practice guidelines. Summary of the US experience of health policy interventions affecting the private health sector. |
163 | 👁 | 1.0 | |
| Policy Recommendations. | 171 | 👁 | 1.0 | |
| Executive Summary. Materials and methods. Motivation, and establishment of private health care institutions. Accessibility character of private and public HCIs. Patterns of resort to private or public HCIs. Efficiency of health care institutions in the private sector. Quality healtcare in private and public institutions. Human resources utilisation and job satisfaction in health care institutions. Financial aspects of private health care institutions. Patient referral, regulatory environemnt and infrastructure problems faced by private HCIs. Alternative Private Practitioners. Experiences from the United States (US). Policy Recommendations. |
179 | 👁 | 1.2 | |
| Acknowledgements. | 195 | 👁 | 0.1 | |
| References. | 197 | 👁 | 1.2 | |
| Appendix: 1.1 Health Care Institution - Basic Information. 1.2 Additional questionnaire for owner - managers of private health facilities (Hospitals / Nursing Homes). 1.3 Health Care Diagnostic Facility Questionnaire. 1.4 Health Care Professional - Personal Questionnaire. 1.5 Questionnaire for Alternate Priate Practitioner. 1.6E Patient Exit Inter👁 - English version. 1.6T Patient Exit Inter👁 - Telugu version. |
207 | 👁 | 3.9 | |
| Back Cover. | 197 | 👁 | 0.3 | |
| Notes: | ||||