Private Health Care Institutions Research Articles

Adaptação e reinvenção estratégica: atuação de empresas de saúde privada em tempos de pandemia

Objective: To investigate at which points and to what extent private healthcare institutions adapt and strategically reinvent themselves in the times of a pandemic.Methodology: This was a qualitative, exploratory, and descriptive study based on a case study carried out in a health clinic in northwestern Rio Grande do Sul State. For data collection, bibliographic research and semi-structured interviews were carried out with managers and collaborators of the researched clinic. For data analysis and interpretation, categorical content analysis was used, in addition to the typology model of Hrebiniak and Joyce (1985).Originality/Relevance: Little research on management, strategic adaptation, health, and the pandemic has been carried out in private healthcare institutions. Additionally, few studies have addressed organizational strategic adaptation models as a reinvention strategy and organizational perspectives. In this way, this article opens precedents for further academic-scientific investigations regarding this theme and object of study.Results: The results showed that the changes and strategic adaptation of the analyzed company initially occurred by the influence of the external environment and then by the company’s ability to identify opportunities and implement development and optimization actions in its routines, processes, and dynamics, expanding such opportunities to future perspectives and broader contextsTheoretical/Methodological Contributions: The study contributes to the extent that it allows us to approach the method of organizational strategic adaptation of Hrebiniak and Joyce (1985) under a different approach as a strategic and proactive tool for analysis, reinvention, and organizational perspectives in the face of complex and changing contexts such as of the pandemic. The study also brings practical contributions, especially regarding optimizing strategies and predicting perspectives for private healthcare institutions, a segment that is still little studied in the scientific arena regarding the theme of strategic adaptation in the context of the pandemic.

An investigation of the factors influencing the choice of healthcare facility in South Africa

The objective of the study was to assess the factors that motivate or demotivate households to choose among the three healthcare facilities, public healthcare, private health care and traditional healthcare facilities in South Africa as revealed by Statistics South Africa . The utilisation of healthcare facilities in South Africa is such that more households prefer public healthcare facilities more than other healthcare facilities. The multinomial logit model was used, with traditional/self-medication category as the reference or baseline category. The results indicated that gender, income and access to grants were significant in influencing the probability of a household choosing a public healthcare facility, while age, income, grants, salaries/wages/commission and pensions were significant in influencing the choice of private healthcare institutions. Therefore the study recommends that due to a large portion of households that are using public health facilities compared to private and traditional facilities, the government must invest more in public healthcare facilities in South Africa.

The subcutaneous defibrillator in patients with low BMI - insights from a large European multicenter registry

Abstract Funding Acknowledgements Type of funding sources: None. Background The subcutaneous implantable cardioverter defibrillator (S-ICD) has become an alternative to transvenous ICDs (tv-ICD), especially in young patients without a need for pacing. One of the current limitations of the S-ICD is the relatively large size of the generator compared to tv-ICDs. There is little evidence whether the size of the current S-ICD generator is associated with an elevated risk of device-related complications in patients with a low body mass index (BMI). Purpose To compare the device-related complications and long-term outcomes in a large real world cohort of S-ICD recipients in patients with a BMI <18 kg/m2 compared to patients with a BMI >18 kg/m2. Methods The iSuSI registry is a European, multi-center, open-label, independent, and physician-initiated observational registry. A total of twenty-two Public and Private Healthcare Institutions from 4 different countries in Europe were involved in the registry. All consecutive patients meeting current guideline indications for ICD implantation and undergoing implantation of a S-ICD device (Boston Scientific, Marlborough, Massachusetts, USA) at 21 European institutions enrolled in the registry were used for the current analysis. Patients were classified into two cohorts, depending on the BMI at the time of device implantations: BMI < 18 kg/m2 versus > 18 kg/m2. Results Out of a total of 1497 pts, 58 pts (3.9%) had a BMI < 18 kg/m2. Patients with BMI <18 kg/m2 were younger (44.6±2.4 vs 50.8±0.4; p=0.004) and more frequently female (58.6% vs 22.3%, p<0.001). No differences in any of the other baseline characteristic were observed. Implantation techniques resulted comparable between the groups (Rates of 2-incision technique: 87.8% vs 91.9%; p=0.256; inter-muscular placement: 89.7% vs 83.3%; p=0.198). Of note, the mean PRAETORIAN score at implantation of patients with BMI <18 kg/m2 was significantly lower (33.8±9.1 vs 54.1±47.3; p=0.035), although the vast majority of pts in both cohorts qualify as at low risk of conversion failure (100% vs 91.4%; p=0.436). Over a median follow up time of 22.4 [11.6–36.8] months, both overall device-related complications (5.2% vs 7.4%) and rates of inappropriate shocks (12.0% vs 8.8%) resulted comparable between the two groups (p =0.517 and p=0.385, respectively). Figure1 reports Kaplan-Meier curves reporting the combined incidence of device-related complications and inappropriate shocks in the two groups (log-rank p = 0.576). Conclusion No difference in device-related complications and long-term outcomes after S-ICD implantation were observed in patients with BMI <18 kg/m2 compared to the remaining recipients from a large, multi-centered S-ICD registry. Figure 1: Kaplan-Meier-survival curve for the combined endpoint of inappropriate shocks (IAS) and device-related complications (DRC)

OPPORTUNITIES FOR COMPETITIVE ADVANTAGE IN THE VALUE, CREATED BY PRIMARY HEALTH CARE INSTITUTIONS IN LITHUANIA: DOES COMPETITIVENESS POSSIBLY DEPENDENT ON THE FORM OF OWNERSHIP?

Background. In the face of competition between primary health care institutions (PHCIs), attempts are made to gain a competitive advantage in the market by creating greater value for patients. Little research has been conducted on whether the form of a PHCI’s ownership is a factor of its competitive advantage. The aim of the study. To determine opportunities for competitive advantage in the management of value creation in public and private primary health care institutions by using the method of focus group discussion with managers. Methods. Focus group discussions were held in 10 Lithuanian counties, and 10 focus group sessions were carried out overall. A total of 48 primary health care managers were interviewed. Results. The competitive advantage of a PHCI depends on its form of ownership, which makes for unfair competitive conditions. A competitive advantage is created by factors such as: the variety of services available; the health care policy in action; the function of the manager; the professionalism of the staff; and the location of the institution. Medical staff have the same opportunities to express and develop their professional skills in public and private PHCIs, but private institutions attract the most skilled staff because they have the resources to increase their motivation. Conclusions. The managers of PHCIs indicated that the competitive advantage depends on the form of ownership. In management science this study and the results can be a basis for the health care reform development and the foundation for new theories.

MEDİKAL TURİZM KAPSAMINDAKİ SAĞLIK ÇALIŞANLARININ MEMNUNİYET VE ÖRGÜTSEL BAĞLILIK DÜZEYLERİ: KAYSERİ ÖRNEĞİ

The aim of this study is to evaluate the satisfaction and organizational commitment levels of healthcare professionals in private healthcare institutions serving within the scope of medical tourism. In addition, it is to reveal the relationship between satisfaction and organizational commitment levels of healthcare workers and that two factors do not differ according to demographic characteristics. The research population consists of healthcare professionals working in private health institutions that have the Ministry of Health tourism authorization certificate in Kayseri. Accordingly, a questionnaire was applied to 346 healthcare workers working in private health institutions. In the study, "Personal Information Form", "Employee Satisfaction Scale" and "Organizational Commitment Scale" were used as data collection tools. Percentage and frequency distributions, independent sample t-test, one-way ANOVA test and Pearson correlation analysis were used in the analyzes performed with the SPSS 22 (Statistical Package of Social Sciences) package program used in the analysis of the obtained data. According to the results of the research, it is seen that there is a positive significant relationship between the satisfaction and organizational commitment levels of healthcare workers (r =, 620; p =, 000

HEALTHCARE SERVICE QUALITY- A REVIEW OF LITERATURE

Healthcare is a service sector with unique characteristics. Across the world public and private healthcare institutions have been the matter of priority. There are so many studies done on the various factors of hospital like assessing competition in hospital care market,performance relationship, and environment uncertainty in hospital,patient loyalty in India and outside India.Healthcare Service quality is a broad concept.This paper examines the review of literature on Healthcare Service Quality. Review of healthcare service quality was done by analysing 25 articles. The study investigates the factor of quality affecting the value care and patient satisfaction. Patient satisfaction is an important parameter to measure healthcare service quality level. This study is based on secondary data literature review and it explores the important factors on Healthcare Service Quality.

Supervisor support, career satisfaction, and career adaptability of healthcare sector employees

Purpose The purpose of this study is to examine the mediating role of career adaptability (CA) in the relationship between supervisor support (SS) and career satisfaction (CS). Design/methodology/approach Data were collected from 193 full-time employees working in private health-care institutions in Ankara, Turkey. The participants were asked to respond to a self-reported survey. Structural equation modeling was used to examine the hypothesized relationships between the research variables. Findings The results indicated that SS has a significant and positive effect on CS. It further reveals that CA mediates the effect of SS on CS. Research limitations/implications As this study had a cross-sectional research design, causality could not be established between study variables. Practical implications CA ought to be considered by the managers and it ought to be advanced as it provides the employees fundamental instruments to deal with their career advancement efficiently. Originality/value The present study adds to the existing literature by providing additional evidence for the relationship among SS, CA and CS by examining a sample of health-care professionals.

Demographic Characteristics and Job Satisfaction: The Mediation Role of Organisational Justice Perceptions in Public and Private Sector Health Organisations in Nigeria

The health sector is of critical importance to the wellbeing of the labour force, dependent demographic structure and life expectancy for economic development. Effective and efficient health care delivery is of a prime focus among stakeholders in the health sector in Nigeria. The current status of the health sector is fraught with industrial unrest and picketing following the failure of the government to meet the expectation of workers. Employee work-related attitude of job satisfaction, distributive, procedural and interactional justice perceptions of health workers in part play a key role to attaining quality health care. However, a large number of factors are responsible for job satisfaction of health professionals. In this paper, the nexus between demographics and job satisfaction is examined as well as the mediating role of organisational justice perceptions of workers in public and private healthcare institutions in Nigeria. Demographics of age, gender, education, job experience were considered with respect to overall job satisfaction and organisational justice. The study is grounded in the equity theoretical foundation of Adams in 1965. An analytical descriptive survey design was adopted in this study. A sample of 300 employees from private (150 workers) and public (150 workers) health care institutions were selected for the study through the use of a stratified random sampling procedure. The data were collected from self-report of workers via the administration of a structured questionnaire to employees. The numeric scores were determined from the summated scales of job satisfaction and organisational justice. The data were analysed with multivariate regression and structural equation modelling. From the analysed data, the study found that gender and job tenure were significant predictors of distributive justice, procedural justice and extrinsic job satisfaction while organisational justice had a significant effect on job satisfaction. In terms of the indirect effects, organisational justice mediated the relationships between gender, job tenure and overall job satisfaction. Consistent with the findings of the study, all health professionals should be treated on the basis of fairness without discrimination irrespective of status and professional dichotomy. Accordingly, the study recommended that the health care workforce who play managerial roles should ensure fairness and consider job tenure and gender in the formulation of policy frameworks for the overall job satisfaction of employees.

Percipirani kvalitet usluga u privatnim zdravstvenim ustanovama

One of the regular activities in the developed countries of the world is an evaluation of the degree of healthcare sector services qualities, as perceived by the patients. This evaluation has been carried out in regular time spans and many methods are being used to measure the degree of certain services' quality increase, as well as to spot certain downsides that need to be improved in a timely manner. Unfortunately, measuring the healthcare sector services quality, regarding both the state and the private one, is not sufficiently present. The concept of marketing in the healthcare institutions business is not particularly developed, especially regarding public healthcare institutions. Unlike state healthcare institutions, private healthcare institutions have become aware of the great necessity of implementing both internal and external marketing modes in business, with the ultimate goal being reflected in a better customer experience and in the creation of long-term loyalty. The work is based upon research among the citizens on the perceived quality of the provided healthcare services. By means of a comprehensive perception of the healthcare sector's state, the aim was to contrast the quality of the provided services in the private healthcare institutions to the same services provided by the state ones. Apart from the quality of services, another aim of the research was getting an insight into the level of the marketing conception utilization within the private healthcare institutions business, based upon the customer perception of the services' quality and its determinants, and the market orientation of the healthcare institutions, as well.

Organizaciona posvećenost zdravstvenih radnika u privatnom sektoru

Introduction: Organizational commitment is defined as 'psychological relationship of an individual with an organization'. The aims of this study were to analyze organizational affective and normative commitment of young healthcare providers, factors that determine their perception of organizational support, as well as to identify possibilities to promote employee dedication to the healthcare organization they worked for. Method: The research was conducted as a cross-sectional study in a private healthcare institution 'Fizio Vracar' in Belgrade. Meyer-Allen questionnaire (with 24 questions) was distributed during the third week of May 2018, and 30 physical therapists of both sexes and with median age 29.9 completed it, voluntarily and anonymously. Results: The organizational normative commitment declined with the increase of organizational support (r=-0.526; p<0.001), while organizational affective commitment increased with the increase of organizational support (r=0.756; p<0.001). On the scale from 1 to 5, all the employees had the average score above 3 for affective and normative commitment (3.72±0.56 and 3.19±0.75), while the score for organizational support was above 4 (4.11±0.54). The model of multiple linear regression showed that affective and normative commitment were factors that determined the perception of organizational support (B=0.66; 95% CI: 0.41-0.91; and B=-0.20; 95% CI: -0.38; -0.02). Conclusion: Even though organizational support had better score than affective and normative commitment, there is certainly room for their improvement. Managers and employees should consider the employee requests together, care more about employee general satisfaction, empower team spirit, while the organization should implement mechanisms to retain work force.

(Dis)Trust in Doctors and Public and Private Healthcare Institutions in the Western Balkans

(Dis)Trust in Doctors and Public and Private Healthcare Institutions in the Western Balkans

СHARACTERISTICS OF APPEALS OF THE POPULATION FOR OUTPATIENT MEDICAL CARE RELATED TO DEPRESSIVE DISORDERS

Goal of research: to study the appeal of the population of Transcarpathian region for specialized outpatient medical care related to depressive disorders.Materials and methods. Research materials: statistical reports according tothe form №10 (annual) "Report on the provision of psychiatric care to the population" for the period 2018-2020 of communal and private health care institutions of theTranscarpathian region. Methods of research: bibliosemantic, of structural-and-logical analysis.Results. The tendency to the decrease of the number of the population seeking outpatient and polyclinic care for depressive disorders is registered. Most of these patients are men living in rural areas. The proportion of patients whose treatment resulted in recovery or persistent remission is lower than in Ukraine as a whole.Conclusions. The results of the study indicate the need to optimize the system of outpatient medical care for depressive disorders.

Maintained activity in ankylosing spondylitis patients treated with TNFi and/or NSAID for at least 12 weeks: a cross-sectional study in Brazil

BackgroundThe aim of this study was to evaluate disease activity among patients with axial spondyloarthritis (AS) treated with tumor necrosis factor inhibitors (TNFi) and/or nonsteroidal anti-inflammatory drugs (NSAIDs) for at least 12 weeks in private outpatient settings in Brazil.MethodsThis was a cross-sectional, real-world study conducted in 17 Brazilian private health care institutes. Patients were selected if diagnosed with AS or axial radiographic spondyloarthritis (AxSpA) and treated with NSAIDs or TNFi for at least 12 weeks within the last 26 weeks prior to enrollment. The data were collected from interviewed-based and self-administered questionnaires from patients and physicians. Disease activity was defined as active (≥ 4), low /suboptimal (≥ 2 and < 4) and inactive (< 4) by Bath AS Disease Activity Index (BASDAI) and/or very high (≥ 3.5), high (≥ 2.1 to < 3.5), low (≥ 1.3 to < 2.1), and inactive (< 1.3) by AS Disease Activity Score (ASDAS-CRP). Both patients and physicians’ perceptions of disease control were assessed using a numeric rating scale (NRS; 0—inactive to 10—very active disease).ResultsThe cohort included 378 patients with a mean age of 46 years, and the median time since diagnosis until enrollment was 5.4 years (interquartile range 2.7–10.5). Most patients were treated with TNFi alone (74%), followed by TNFi in combination with NSAID (15%), and NSAID alone (11%). About half AS patients showed active disease and 24% of patients showed low activity/suboptimal disease control despite having been treated for at least 12 weeks. Although TNFi showed better disease control than NSAID, inactive disease was experienced by few patients. The NRS (mean [standard deviation]) score for disease perception was 4.24 (3.3) and 2.85 (2.6) for patients and physicians, respectively.ConclusionThis real-world study showed that most AS patients on TNFi and/or NSAID had not achieved an adequate disease control, as almost 75% of them exhibited active disease or low activity/suboptimal disease control. There remains a need for improved disease management among patients with AS.

State Policy for the Private Healthcare Sector Development of Ukraine

The need to ensure quality and comprehensive healthcare at the world standard level determines the establishment and importance of private medicine in the healthcare system. It forms the task to reform, develop, and implement targets for private medicine. This article aims to investigate the measures by state policy in promoting private medical services. The methodological basis of this study is the dialectical method of scientific knowledge, system approach, and methods of logistic analysis. The empirical research involved retrospective, structural and comparative analyses. To achieve the study goal, the following tasks were solved: 1) determination of the theoretical basis of the state policy in private healthcare based on scientific background; 2) the analysis of the state policy in Ukrainian healthcare; 3) identification of the role of private medicine in the health care system; 4) the comprehensive analysis of the medical institution activities on the example of a private clinic «L-MED Clinic»; 5) determination of the connection between the effectiveness of activities and the marketing activities in promoting medical services. is study determined the importance of private medicine in the healthcare system of Ukraine. Private treatment and prevention facilities relieve the burden on public hospitals and clinics. The main competitive advantages of private healthcare institutions include availability, sufficient admission time, responsibility and organized attitude to the treatment process, quality diagnosis, full-range medical services, courtesy and attentive staff, comfortable and pleasant interior, etc. Based on the findings, the authors provided practical recommendations for improving the state policy, state regulation of private medical activity, and implementing the best world practices of branching out of the health care sector. The obtained results could be useful to the Ministry of Health of Ukraine, the Ministry of Social Policy of Ukraine, the Cabinet of Ministers of Ukraine, and the Verkhovna Rada of Ukraine in state regulation of healthcare reformation in Ukraine.

Factors Affecting the Choice of Public Vs Private Healthcare Institutions for Delivery and Postnatal Care-A Study in a Rural District of Pakistan

Maternal health is one of the most critical public health challenges in many developing countries availability of comprehensive maternal healthcare services by skilled health professionals can improve the quality of maternal health outcomes. In Pakistan, the rate of institutional delivery is lower than many other developing countries and a significant proportion of mothers seek maternal healthcare in the private health sector. There are many factors associated with utilization of maternal healthcare services including both supply side and demand side factors. The objective of this paper is to identify significant socio-economic factors affecting utilization of delivery and postnatal services in public and private healthcare facilities in district Rajanpur, Pakistan. Using multi-stage random sampling technique, 368 mothers who delivered within 6 months prior to data collection in selected basic health unit (BHU) areas were selected. Multivariate binary logistic regression was applied on primary data collected from Rajanpur district during 1st November, 2020 – 31st January, 2021. The results indicated that the household’s preference for private healthcare sector for delivery and postnatal care increases with increase in households’ education and incomes. It also showed that accessibility to healthcare facilities is significant in utilization of maternal healthcare services. Distance to healthcare facilities, cost of transport and out-of-pocket expenditure are significantly affecting the choice of healthcare institutions.

Http://www.samj.org.za/index.php/samj/article/view/13517

Background. Patients with severe COVID-19 may require endotracheal intubation. Unique adjustments to endotracheal intubation and extubation practices are necessary to decrease the risk of SARS-CoV-2 transmission to healthcare workers (HCWs) while avoiding complications of airway management. Objectives. To investigate the practice of endotracheal intubation and extubation, resources available and complications encountered by clinicians performing endotracheal intubation and extubation of COVID-19 and suspected COVID-19 patients in South Africa (SA). Method. A cross-sectional observational study was conducted during the initial surge of COVID-19 cases in SA. Data were collected by means of a self-administered questionnaire completed by clinicians in the private and public healthcare sectors after performing an endotracheal intubation and/or extubation of a patient with confirmed or suspected COVID-19. Results. Data from 135 endotracheal intubations and 45 extubations were collected. Anaesthetists accounted for 87.0% (n=120) of the study participants, specialist clinicians in their respective fields for 59.4% (n=82), and public HCWs for 71.0% (n=98). Cases from Gauteng Province made up 76.8% (n=106) of the database. Haemoglobin desaturation was the most frequent complication encountered during endotracheal intubation (40.0%; n=54). Endotracheal intubations performed at private healthcare institutions were associated with a significantly lower complication rate of 17.5% (n=7) compared with 52.6% (n=50) in the public healthcare sector (p&lt;0.001). Endotracheal intubations performed in theatre had the lowest complication rate of 10.4% (n=5; p&lt;0.001). Propofol was used in 90 endotracheal intubations (66.7%), and its use was associated with fewer complications relative to other induction agents. Minimising the number of intubation attempts (p=0.009) and the use of checklists (p=0.013) significantly reduced the frequency of complications encountered during endotracheal intubation. Intravenous induction technique, neuromuscular blocking agent used, intubating device used and time at which intubation was performed did not affect the incidence of complications. The majority of endotracheal extubations were uncomplicated (88.9%). Conclusions. The study provides valuable insight into the resources used by clinicians and complications encountered when endotracheal intubations and/or extubations were performed. Data from this study may be used to guide future clinical practice and research, especially in resource-limited settings.

The prevalence of medical violation claims and associated predictors at the Eastern Province in Saudi Arabia: A logistic regression analysis

Despite efforts to improve healthcare delivery and ensure patient safety, medicolegal claims in Saudi Arabia remain a concerning issue. This study investigated medical violation claims referred to the medical violation committee in the Eastern Province in Saudi Arabia. A retrospective study was conducted on medical violation claims from 2016 to 2019. Binary logistic regression was performed to examine the association between issued verdicts and a set of defendant, plaintiff and healthcare institution variables. During the study's period, the medical violation committee reached final verdicts against 1242 healthcare professionals in which 69% of them were found guilty. The majority of the defendants worked in private healthcare institutions (66%), were physicians (30%), male (53%), and non-Saudi (64%). Working at pharmacies, other healthcare settings, and the private sector were significantly associated with receiving a guilty verdict. Male healthcare professionals as well as pharmacists were found to have a higher likelihood to receive a guilty verdict than their respective counterparts. Medical violation claims filled by the Ministry of Health were more likely to receive guilty verdicts than those filled by patients or healthcare professionals. Findings of the study extend the literature on medicolegal claims and introduces implications for healthcare professionals and policymakers at institutional and national levels.

Measuring the antecedents of turnover intentions: Perspectives of private healthcare employees in a less-developed economy

This study sets out to investigate the antecedents of turnover intentions, using the private healthcare employees in an emerging economy (Ghana) as a benchmark. Even though myriad studies have been conducted on the aforementioned topic, yet, there are scant investigations on how employees of private healthcare institutions relate towards turnover intentions, specifically in a developing economy context. Therefore, this study draws on extant literature and subsequently proposes a hypothetical argument on the effect of training satisfaction, benefits and incentives on employee turnover intentions as well as resistance to change while establishing the nexus between turnover intentions and resistance to change. Both paper and web-based (online) questionnaires were gauged from employees of private healthcare organizations in Ghana. Data were analyzed by partial least square structural equation modeling (PLS-SEM) on a sample of 544 employees of private healthcare institutions. The findings indicate that training satisfaction, benefits and incentives have a positive impact on an employee’s turnover intentions. Moreover, employee’s resistance to change is influenced by both training satisfaction and benefits and incentives. Further, the investigation established that employee’s resistance to change influences employee turnover intentions. The thoughtful mechanisms of how the running of private healthcare institutions in Ghana can be enhanced are expanded by the empirical results obtained through how employees can be satisfied by training and the application of rewards to reduce turnover. Moreover, administrators of private healthcare organizations are forewarned of the implications of employees’ resistance to change and its effect on employee turnover intentions. Acknowledgment This study was supported by Tomas Bata University in Zlín, through IGA/FaME/2020/003 “Training and development programs and the consequence on employee’s commitment, satisfaction and organizational performance: analysis from Czech public service sector”.

Impact of COVID- 19 on continuity of essential health services in various health care institutions in district Amritsar, Punjab, India

From a point in time where the human race declared itself the master of the universe to this point in time where it is facing an existential threat from the contagion- Covid 19 pandemic has exposed the vulnerability of the human race to a wipeout. The disruption of physical, mental, social, emotional and financial health and health systems is unprecedented. Study the impact of Covid 19 on continuity of essential health services in various health care institutions in district Amritsar, Punjab.: Online survey was conducted through google forms using questionnaire adapted from the World Health Organization-Pulse Survey on Continuity of Essential Health Services during Covid 19 pandemic. Respondents were personnel working at public and Ayushman Bharat empaneled private health care institutions. Response rate was 60% (55 out of 92 health care institutions personnel responded) A highly significant difference was observed between the public and the private health care sector in provision of antenatal care (Mann Whitney U statistic= 78.00, p=.004) and imaging and radio diagnosing services (Mann Whitney U statistic= 48.00, p=.000) while a significant difference was observed in provision of service of institutional delivery (Mann Whitney U statistic= 112.00, p=.046). All the other essential health services were similarly affected in the public and private health sector institutes. Financial difficulties faced during the lockdown was the single most common reason stated for disruption of essential health services. There was a significant difference in level of satisfaction experienced by health care personnel from public and private sector (Mann Whitney U statistic= 94.00, p=.02). Thematic analysis of the data on improving preparedness to minimize disruption in essential health services yielded the themes pertaining to creating a robust public health care infrastructure including use of e-health technology in the district and recruitment of adequate health care man power according to set norms.

Investigating Perceptions of Patients on Healthcare Pricing Within The Private Healthcare Sector In Sri Lanka

Demand for private sector healthcare services in Sri Lanka is on the rise. This is very evident from the increase in the number of registered private healthcare institutions from 1990 to 2017. [1,2] With the increasing utilization of private sector healthcare services, various qualitative factors, and service-related issues associated with the healthcare delivery system have become common debates. A major concern, patients have expressed, is about the fees charged by doctors and hospitals. Principle aim of this study was to investigate the perceptions of patients on healthcare pricing within the private healthcare sector in Sri Lanka. The target population of the study was defined as Sri Lankans who have been inpatients in private hospitals within the past year. The focus districts were Colombo, Kandy, and Galle. These 3 districts represented nearly 60% of the total private sector bed capacity. From each district, three main private hospitals were selected. Over 700 patients were invited to participate, 246 surveys were completed, and 215 were retained as 31 had excessive missing and/or unclear data. In all 3 districts the majority of patients were either dissatisfied with or remained neutral (69%) on the hospital fees,(66%) on doctor’s fees,(74%) on the overall price they ended up paying,(76%) on whether they think the healthcare services they received are value for money. This study did not investigate the reasons or the factors that may affect the satisfaction or dissatisfaction of patients towards the fees they paid Multiple factors can affect patient’s perception on the fees they paid. With negative perception on the above it can be concluded that there is sufficient evidence to challenge private sector healthcare satisfaction level vs price/fees equilibrium in Sri Lanka.