Private Health Care Providers Research Articles

Management of groin hernia repair in Sweden: A register-based comparative analysis of public and private healthcare providers.

Swedish healthcare is in a period of transition with an expanding private sector. This study compares quality of outcome after groin hernia repair performed in a public or private healthcare setting. A cohort study based on data from the Swedish National Hernia Register combined with Patient-Reported Outcome Measures (PROMs) 1 year after groin hernia repair. Between September 2012 and December 2018, a questionnaire was sent to all patients registered in the hernia register 1 year after surgery. Endpoints were reoperation for recurrence, chronic pain, and patient satisfaction. From a total of 87,650 patients with unilateral groin hernia repair, 61,337 PROM answers (70%) were received from 71 public and 28 private healthcare providers. More females, acute and recurrent cases, and patients with high American Society of Anesthesiology (ASA) scores were operated under the national healthcare system. The private sector had more experience surgeons with higher annual volume per surgeon, shorter time on waiting lists, and shorter operation times. No difference was seen in patient satisfaction. Groin hernia repair performed in a private clinic was associated with less postoperative chronic pain (OR 0.85, 95% CI 0.8-0.91) but a higher recurrence rate (HR 1.41; 95% CI 1.26-1.59) in a multivariable logistic regression analysis. Despite private clinics having a higher proportion of experienced surgeons and fewer complex cases, the recurrence rate was higher, whereas the risk for chronic postoperative pain was higher among patients treated in the public sector.

An Examination of Inter-State Variation in Utilization of Healthcare Services, Associated Financial Burden and Inequality: Evidence from Nationally Representative Survey in India.

This study examines the health care utilization pattern, associated financial catastrophes, and inequality across Indian states to understand the subnational variations and aid the policy makers in this regard. Data from recent National Sample Survey (2017-2018), titled, "Household Social Consumption: Health," covering 113,823 households, was employed in the study. Descriptive statistics, Erreygers concentration index (CI), and recentered influence function decomposition were applied in the study. We found that, in India, 7 percent of households experienced catastrophic health expenditure (CHE) and 1.9 percent of households were pushed below poverty line due to out-of-pocket expenditure on hospitalization. Notably, outpatient care was more burdensome (CHE: 12.1%; impoverishment: 4%). Substantial interstate variations were observed, with high financial burden in poorer states. Utilization of health care services from private health care providers was pro-rich (hospitalization CI 0.31; outpatient CI 0.10), while the occurrence of CHE incidence was pro-poor (hospitalization CI -0.10; outpatient CI -0.14). Education level, economic status, health insurance, and area of residence contributed significantly to inequalities in utilization of health care services from private providers and financial burden. The high financial burden of seeking health care necessitates the need to increase public health spending and strengthen public health infrastructure. Also, concerted efforts directed towards increasing awareness about health insurance and introducing comprehensive health insurance products (covering both inpatient and outpatient services) are imperative to augment financial risk protection in India.

Knowledge and practices of private healthcare providers regarding tuberculosis case notification in Rural Maharashtra

India carries the highest share of active and missing tuberculosis (TB) cases globally. The Government of India is prioritizing private sector engagement (PSE) in TB elimination activities, as most healthcare-seeking in the country happens in this sector. This study aimed to understand the knowledge and practices of private healthcare providers (PHP) on various aspects of TB case notification through the National TB Elimination Programme (NTEP). This cross-sectional study was carried out between Oct 2020 to April 2021 amongst PHPs in the Junnar Tuberculosis Unit (TU), Pune District, Maharashtra. Junnar Block has 299 PHPs who assess, diagnose, and/or treat TB cases. A total of 97 participants were enrolled in the study. About 89 (91.8%) PHPs are aware that TB case notifications are mandatory by law. However, 80.4% are unaware of the Ni-kshay portal (web-based case surveillance system) by NTEP. Similarly, 74 (76.3%) must be aware of incentives for PHPs to collaborate with the government healthcare delivery system. 82.8% of total Ayurveda, Unani, Naturopathy, Siddha, and Homeopathy (AYUSH) practitioners and 46.2% of Allopathic practitioners have poor knowledge about TB case notification, with a Chi-square value of 14.36 (p<0.01). Our study shows that the active engagement of private providers (PPs), especially AYUSH practitioners in rural areas, is a need of the hour in achieving TB elimination.

Interoperability of Botswana’s healthcare systems using semantic prescription ontologies

<p>The developing country of Botswana’s health information system faces interoperability challenges mainly due to the lack of shared patient medical data and histories between private and public healthcare providers, which leads to increased medical errors, increased healthcare costs, and potentially fatal outcomes. This research proposes an intelligent electronic prescription ontology (IEPO) framework to share Botswana’s patient electronic health records (EHRs) between private and public healthcare systems for a standardized and semantically rich data exchange. IEPO was evaluated for interoperability using the recall metric for completeness to capture the degree of all relevant information for exchange and the precision metric for accuracy performance to gauge the degree of error minimization during interoperability. The harmonic means of precision and recall called the F1- score, offered the overall interoperability performance. IEPO outperformed related works by 75% in recall, 54% in precision, and 76% in F1-score, demonstrating improved interoperability performance. Furthermore, IEPO was evaluated for correctness and expressiveness through competency questions via queries, results confirming correct and expressive responses.</p>

Examining the nexus of relationship marketing and patient loyalty: The mediation and moderation analysis

Studies on association amongst relationship marketing and loyalty of patients are still trying to establish its presence in the healthcare management. Also, the variables impacting this association are still in exploratory phases. The research is being carried out for determining the nature of that relationship and also examining mediating and moderating effect of different variables. Data collected through various Scopus and other online databases have been used for this study. Literature review has been carried out by dividing it into three parts, relationship marketing, patient loyalty and variables like patient satisfaction, age, gender, family size, health insurance, etc. Primary data was collected from 938 patients of private healthcare providers by administering questionnaire online as well as in person. PLS-SEM was applied to analyze the data, which was used after testing the instrument for reliability and validity. After Covid-19 pandemic everyone felt need of a good health insurance but in actual many people were not having a simple health insurance cover also. Hospitals will have a major role in promoting health insurance and in turn providing quality service, but their role is currently limited to processing of health insurance and nothing more. Model from the study will help understand organizations the strength and direction of relationship between patient loyalty and efforts taken for marketing along with impact of moderating and mediating variable on the same. Future research can look into the other variables that will moderate or mediate the relationship in turn will help not only healthcare organizations but insurance companies also to develop product or service according to requirement of relationship. Research focuses on impact of moderating effect of health insurance on association amongst marketing efforts taken for relationship marketing and loyalty of patients through patient satisfactions’ mediation which was not studied before this. The study aims to test the conceptual model of moderating impact of health insurance on association between relationship marketing, patient loyalty and patient satisfaction using SEM.

Structural reforms in action - Singapore's population health journey and the structural changes at the national and local level

Summary: This workshop explores the challenges and opportunities for health systems in transition using Singapore as a case study to explore:
 
 a) How the health system is shifting towards a population approach
 b) Change management and implementation approaches required at the macro, meso and micro level
 
 Background: Confronted with the challenges of an ageing population, rising prevalence of chronic diseases, and increasing healthcare costs – Singapore’s Ministry of Health has embarked on “Healthier SG”, an ambitious health transformation strategy which aims to shift the system to a population health approach and place a stronger focus on preventive health. Healthier SG is a multi-year healthcare transformation journey which will be launched in the second half of 2023, with the commencement of a national enrolment programme for residents, to a primary care physician of their choice.  Key enablers such as financing shift towards capitation will also be implemented gradually, along the with building of a strong digital data background and relevant supporting IT architecture. 
 Objectives:
 1.Introduce Singapore’s “Healthier SG” strategy, a primary care and community-centric movement to bring key stakeholders across public and private healthcare providers, and community care partners, to better enable Singaporeans to take charge of their health.  
 2.Share on a range of Singapore’s population health strategies, including child and maternal health, promoting a healthy lifestyle, enhancing personal mental health, and supporting well-being and care planning for our elderly population. 
 3.Through the sharing, understand the process and journey for countries and health systems undergoing similar transformation journeys, and be able to describe and discuss the structural changes that are happening at the national and local levels.
 4.Discuss and explore the enablers, challenges and opportunities for structural reforms in this case study, using the selected Pillars of Integrated Care as a reference
  
 Target Audience: Policy makers, health sector decision makers, health managers, health authorities, health and social care professionals, researchers, academia, health experts, and the staff working on implementation, digitalization and/or evaluation of integrated care.
 Session Format:
 Time
 10 minsIntroduce Singapore’s “Healthier SG” population health strategy and plans
 15 minsHighlight the opportunities, challenges and structural changes happening at (a) national, (b) local, and (c) primary care levels
 40 minsModerated group discussion, using the selected Pillars of Integrated Care as reference, for 4 groups
 10 minsRead back on group discussion and insightsPlenary style read-back by groups, facilitated by group leads
 15 minsDiscussion and Round Up, facilitated by workshop lead
 Group discussions will be guided and facilitated by the workshop speakers, and attendees will be encouraged to contribute and participate actively in the group discussions. Flipcharts and post-its will be used to facilitate the group discussions.
 Key Learnings / Takeaways
 1.Gain knowledge about how other countries are progressing with their integrated care, people-centred care and population health journeys
 2.Understand and appreciate the importance of the local context and cultural considerations for countries and health systems undergoing transformation and structural changes
  
  

Antecedents of patient health engagement in the radiotherapy service (evidence from Indonesia).

Private radiotherapy (RT) facilities in emerging countries are growing with cancer incidence. Private healthcare providers must provide better care based on patient perspectives to reach more patients. This study investigated the relationship between antecedents of patient health engagement (PHE) with revisit intention (RVI) and intent to recommend (ITR) in private RT facilities. The survey was conducted in a private hospital with a RT service in Central Java province, Indonesia. A quantitative, cross-sectional design with a purposive sampling method was used. Patient questionnaire survey modified from validated self-administered radiotherapy experience (RTEQ) and PHE questionnaire were used to collect data. Partial least squares-structural equation modelling was used to analyse the data. In this study, 173 respondents consented to participate, which demonstrated that seven of the eight experience antecedents of PHE measured by reliable and valid RTEQ and were significantly related to PHE (p-value <0.05). At the same time, the degree of PHE has a significant relationship with RVI and ITR (p-value <0.05). Patient informational needs elements from the patient experience, followed by situational repose, were shown to have a prominent relation to PHE. The management of private RT facilities needs to focus more on these elements to encourage PHE to establish hospital performance. The findings denote that six elements of RTEQ relate to PHE and further hospital outcomes. Hospital management could utilise this approach to improve the quality of care in RT facilities, specifically in private hospitals in emerging countries.

Implementation and evaluation of an oncological case management system among public and private healthcare providers in Chile

Implementation and evaluation of an oncological case management system among public and private healthcare providers in Chile

‘COVID-19 is just another way to die…’: a qualitative longitudinal study of frontline COVID-19 response governance across Syria

IntroductionGovernance of COVID-19 responses has been challenging for all countries. Syria has been particularly challenged due to protracted multiparty conflict and debilitated health systems fragmented across different areas of control....

Determining Marketing and Communication Dimensions of Healthcare Providers in Hungary

Abstract While the actors of the developed world are deeply concerned with the complex interpretation of health, studying the path leading to that is a less investigated area, although, among the global Sustainable Development Goals (SDGs), a prominent role is given to the complex experience of health and its quality improvement. Regarding the V4 countries, many indicators of health need to be improved, while the quality of online marketing and communication, as well as the social media activities of private healthcare providers, largely determines the intensity and efficiency of using the service they provide. The focus of the online survey, with the involvement of almost 2,000 respondents, was to assess whether the marketing activities of healthcare services and their activities on social media platforms meet the expectations of Hungarian female consumers. Due to the results, social media platforms proved to be extremely critical, although older respondents trust advertisements about marketing services less. In the selection of service providers, patients base their decisions to a decisive extent on the expressions of the community of acquaintances, which assumes the management of a multi-level marketing, and communication tool park, and the emphatic and controlled education of brand ambassadors.

Universal and Equitable Access to High-Cost Drugs in Uruguay. Results of 15 Years of Treatment of Non-Hodgkin Difusse Large B Cell Lymphoma (DLBCL) with Ritiximab in First Line Treatment in Uruguay

Introduction The Integrated National Health System (INHS) allows the worker or retiree and their families to have universal health coverage through a contribution proportional to their income, with the option of a public or private healthcare provider. This determines universal and equitable care coverage for the entire population. In 2004, with the arrival of the first high-cost drugs, rituximab and imatinib, healthcare providers had difficulties financially covering them. The National Resource Fund is a non-state public Entity created in 1980 to provide coverage for highly specialized medical techniques. It currently provides universal financial coverage to all residents linked to the INHS and encompasses almost all the coverage of patients nationwide. On January 1, 2005, financial coverage for high-cost drugs began with rituximab and imatinib under regulations that required strict diagnosis, treatment, and follow-up criteria. Non Hodgkin Lymphoma incidence in Uruguay is 11,53 cases per 100,000 men/year, and 7,9 cases per 100.000 women/year. Uruguay's population is estimated in 3,400,000. This study shows the results obtained with rituximab in DLBCL. Methods Analytical retrospective study of a historical cohort of consecutive patients with DLBCL who started first line treatment with chemo-immunotherapy with rituximab between January 1, 2005 and December 31, 2019. Follow-up was conducted until March 8, 2021. All patients signed informed consent. Results In the period considered, 1699 requests for rituximab treatment for patients with DLBCL were received, 1597 (94%) treatments were authorized. The results of the 1413 (89%) patients with onset of the disease are analyzed, 51,1% were from the capital city, Montevideo and 48,9% from other cities, 21% from public hospitals and 79% from private health system. Median age was 61 years (9-90), 4 patients &amp;lt; 18 years. Male patients 751 (53.2%) Regarding the characteristics of the disease, Ann Arbor stage was I in 223 (16.01%), II in 370 (26.56%), III in 326 (23.40%) and IV in 474 (34.03%) of the patients. IPI Score from 0 to 5 were 168 (12.03%), 390 (27.94%), 306 (21.92%), 412 (29.51%), 104 (7.45%), 16 (1.15%) respectively. The most frequent components of the IPI score were age &amp;gt;=60 (54.92%), elevated LDH (46.35%), and Ann Arbor stage III-IV (55.87%). B symptoms were present in 38.19% of the patients and Bulky disease in 479 patients (36%). HIV diagnosis was recorded in 2.05% of patients (n=29). CHOP with Rituximab was the treatment in 83.79% of the patients. With a median follow-up of 84.8 months, the median overall survival (OS) for the study population was 126.9 months (95% CI 102.6 - 138.3). The OS rate at 2 years was 72.75% (95%CI 70.37 - 75.01), at 3 years 69.14% (95%CI 66.69 - 71.50) and at 5 years 64.76% (95%CI 62.22 - 67.20) In the IPI univariate analysis, age &amp;gt; 60, Ann Arbor Stage III-IV, elevated LDH, and PS&amp;gt;=2 were associated with shorter survival time, but extra-nodal involvement greater than or equal to 2 was not. These prognostic associations were maintained when performing a multivariate analysis. Median OS according to the IPI for low-, low-intermediate, high-intermediate, and high-risk patients was 190.8, 138.2, 45.5, and 27.9 months, respectively. (p=0.00001). The 2 years OS for patients &amp;lt; 60 years was 77.86% (95% CI 74.48 - 80.92) while in those &amp;gt; 60 years was 68.56% (95% CI 65.21 - 71.73) (P&amp;lt;0.00001). Median OS was 114 months and 129 months for patients from public and private health system respectively (p=0.7) Discussion The results of OS and its relationship with the factors that make up the IPI are those expected according to the studies that determined that the use of rituximab associated with CHOP was the standard in DLBCL. Access to the medication was universal for the entire population of Uruguay, we found a lower-than-expected number of patients from the public health system. Conclusions The regulations provided the possibility of universal use of rituximab in DLBCL; the diagnosis, treatment and follow-up of these patients was standardized throughout the country. This is reflected in results comparable with international standards in the public and private health system. The survival results found in this study are those expected according to the reference works used in the design of the rituximab coverage regulations. Said regulation was the beginning of financial coverage by the National Resources Fund for other high-cost medicines.

Trajectories of primary health care utilization: a 10-year follow-up after the Swedish Patient Choice Reform of primary health care

BackgroundIn January 2010, the choice reform was instituted in Swedish primary health care establishing free entry for private primary health care providers and enabling patients to choose freely among primary health care centers. The motivation behind the reform was to improve access to primary care and responsiveness to patient expectations. Reform effects on health care utilization have previously been investigated by using subgroup analyses assuming a pattern of homogeneous subgroups of the population. By using a different methodological approach, the aim of this study was to, from an equity perspective, investigate long term trends of primary health care utilization following the choice reform.MethodA closed cohort was created based on register data from Region Skåne, the third most populated region in Sweden, describing individuals’ health care utilization between 2007–2017. Using a novel approach, utilization data, measured as primary health care visits, was matched with socioeconomic and geographic determinants, and analyzed using logistic regression models.ResultsA total of 659,298 individuals were included in the cohort. Sex differences in utilization were recorded to decrease in the older age group and to increase in the younger age group. Multivariable logistic regression showed increasing utilization in older men to be associated with higher socioeconomic position, while in women it was associated with lower socioeconomic position. Furthermore, groups of becoming high utilizers were all associated with lower socioeconomic position and with residence in urban areas.ConclusionThe impact of demographic, socioeconomic and geographic determinants on primary health care utilization varies in magnitude and direction between groups of the population. As a result, the increase in utilization as observed in the general population following the choice reform is unevenly distributed between different population groups.

‘Accident and emergency’? Exploring the reasons for increased privatisation in England's NHS

England's NHS is experiencing rising privatisation as services are increasingly being delivered by private healthcare providers. This has led to concerns about the supposed benefit of this process on healthcare quality but the reasons for the increase – and whether processes prioritise quality – are not well understood. In-depth semi-structured interviews with 20 people involved in the commissioning process, sampled from 3 commissioning sites (regional health boards) are thematically analysed. Four key themes of reasons for outsourcing were identified: unmet need; the “choice agenda”; appetite for change amongst key individuals working at the commissioning body; and the impact of financial pressures. The study concludes that the experience of commissioners navigating the provision of healthcare with worsening social determinants of health and financial austerity means that decisions to use private providers based on anticipated quality are sometimes but not always possible - sometimes they constitute ‘accidents’, sometimes ‘emergencies’.

Is There a VA Advantage? Evidence from Dually Eligible Veterans

We study public versus private provision of health care for veterans aged 65 and older who may receive care provided by the US Department of Veterans Affairs (VA) and in private hospitals financed by Medicare. Utilizing the ambulance design of Doyle et al. (2015), we find that the VA reduces 28-day mortality by 46 percent (4.5 per centage points) and that these survival gains are persistent. The VA also reduces 28-day spending by 21 percent and delivers strikingly different reported services relative to private hospitals. We find suggestive evidence of complementarities between continuity of care, health IT, and integrated care. (JEL H51, I11, I12, I18, J14)

Assessing a digital technology-supported community child health programme in India using the Social Return on Investment framework.

An estimated 5.0 million children aged under 5 years died in 2020, with 82% of these deaths occurring in sub-Saharan Africa and southern Asia. Over one-third of Mumbai's population has limited access to healthcare, and child health outcomes are particularly grave among the urban poor. We describe the implementation of a digital technology-based child health programme in Mumbai and evaluate its holistic impact. Using an artificial intelligence (AI)-powered mobile health platform, we developed a programme for community-based management of child health. Leveraging an existing workforce, community health workers (CHW), the programme was designed to strengthen triage and referral, improve access to healthcare in the community, and reduce dependence on hospitals. A Social Return on Investment (SROI) framework is used to evaluate holistic impact. The programme increased the proportion of illness episodes treated in the community from 4% to 76%, subsequently reducing hospitalisations and out-of-pocket expenditure on private healthcare providers. For the total investment of Indian Rupee (INR) 2,632,271, the social return was INR 34,435,827, delivering an SROI ratio of 13. The annual cost of the programme per child was INR 625. Upskilling an existing workforce such as CHWs, with the help of AI-driven decision- support tools, has the potential to extend capacity for critical health services into community settings. This study provides a blueprint for evaluating the holistic impact of health technologies using evidence-based tools like SROI. These findings have applicability across income settings, offering clear rationale for the promotion of technology-supported interventions that strengthen healthcare delivery.

Is health insurance really benefitting Indian population? Evidence from a nationally representative sample survey.

Universal health coverage (UHC) is the centrepiece of the sustainable development goals and aims to ensure access to essential and quality healthcare services to all without facing financial hardships. Several health insurance programmes have been launched in India to progress towards UHC. This study aims to assess the impact of health insurance (overall health insurance, government sponsored health insurance (GSHI), and private voluntary health insurance) on accessibility and utilization of inpatient care, out-of-pocket health expenditure (OOPE), catastrophic health expenditure (CHE), and impoverishment in India. The 75th round of National Sample Survey Office was used in the study, which covered 555,115 individuals, 113,823 households, and 91,445 hospitalization incidence all over India. Descriptive statistics, multivariable logistic regression, and propensity score matching (PSM) methods were employed. Enrolment under health insurance has impacted the accessibility and utilization pattern of hospitalization to some extent for the insured. PSM showed that enrolment under GSHI schemes reduced OOPE by INR 3314 (USD 49) and CHE incidence by 1%-4% at various thresholds. Among poor persons, there was a marginal but statistically significant reduction of OOPE among those enrolled under GSHI schemes (p<0.05). However, GSHI schemes did not statistically significantly reduce the CHE burden for poor persons enrolled (p>0.05). Furthermore, enrolment under private voluntary health insurance reduced OOPE by INR 13,511 (USD 198) and CHE by 13.47% at 10% threshold, 4.61% at 25% threshold, and 2.65% at 40% threshold. However, its uptake was primarily confined to richer economic quintiles and urban areas that exacerbates equity concerns. All the results were confirmed through robustness measures employed. There is a necessity to increase awareness and uptake of health insurance, along with introducing comprehensive insurance packages covering both inpatient and outpatient care. Also, increasing public health spending, strengthening public healthcare facilities, and improving regulatory implementation of private healthcare providers are imperative to augment financial protection.

Factors influencing public and private healthcare utilisation in Uganda.

In Uganda, health care utilisation remains very low despite a number of government reforms that have been implemented in the health sector since the 1990's such as decentralization and removal of user fees in public health facilities among others. To examine the factors influencing public and private health care utilisation in Uganda. The study used cross sectional data from the Uganda National Household Survey collected between July 2016 and June 2017. Anderson's conceptual framework was used to identify explanatory variables associated with choice of health care providers and a multinomial logistic regression model was estimated. Out of the 17,912 individuals who sought care, 36% used a government facility, 60% used private facility while 4% had self- care/treatment. The results show that out of pocket health expenditure, age, level of education, marital status, residence, and type of illness significantly influenced choice of public healthcare providers. Similarly, utilisation of private healthcare providers was associated with household welfare, level of education, residence, marital status, illness days, and type of illness. The findings highlight the need for a national health insurance scheme to reduce out of pocket payments for health care and enable the poor and vulnerable patients visit the modern health facilities.

Financial burden of seeking diabetes mellitus care in India: Evidence from a Nationally Representative Sample Survey

AbstractBackgroundDiabetes mellitus (DM) is a major public health concern in India, and entails a severe burden in terms of disability, death, and economic cost. This study examined the out‐of‐pocket health expenditure (OOPE) and financial burden associated with DM care in India.MethodsThe study used data from the latest round of the National Sample Survey on health, which covered 555,115 individuals from 113,823 households in India. In the present study, data of 1216 individuals who sought inpatient treatment and 6527 individuals who sought outpatient care for DM were analysed.ResultsIn India, 10.04 per 1000 persons reported having DM during the last 15 days before the survey date, varying from 6.94/1000 in rural areas to 17.45/1000 in urban areas. Nearly 38% of Indian households with diabetic members experienced catastrophic health expenditure (at the 10% threshold) and approximately 10% of DM‐affected households were pushed below the poverty line because of OOPE, irrespective of the type of care sought. 48.5% of households used distressed sources to finance the inpatient costs of DM. Medicines constituted one of the largest proportion of total health expenditure, regardless of the type of care sought or type of healthcare facility visited. The average monthly OOPE was over 4.5‐fold and 2.5‐fold higher for households who sought inpatient and outpatient care, respectively, from private health facilities, compared with those treated at public facilities. Notably, the financial burden was more severe for households residing in rural areas, those in lower economic quintiles, those belonging to marginalised social groups, and those using private health facilities.ConclusionThe burden of DM and its associated financial ramifications necessitate policy measures, such as prioritising health promotion and disease prevention strategies, strengthening public healthcare facilities, improved regulation of private healthcare providers, and bringing outpatient services under the purview of health insurance, to manage the diabetes epidemic and mitigate its financial impact.

The COVID-19 Pandemic and the Private Health Sector: Profiting without Socially Contributing.

The COVID-19 pandemic necessitated the mobilization of all available health care resources, including private, for-profit ones. The aim of this multiple methods study (combination of document and secondary data analysis) was to assess government regulations facilitating the private health sector's participation in the COVID-19 response in Greece. During the pandemic, the government made three successive increases in private providers' reimbursement fees, provided additional financial incentives to private providers, and allocated €280 million of emergency funding for the private sector's involvement in the national COVID-19 response. In response, private hospitals made available on average 2.2% of their total bed capacity per epidemic wave for the treatment of COVID-19 patients and 1.7% of their total bed capacity for the treatment of non-COVID-19 patients transferred from National Health System (NHS) hospitals. In 2020 the five largest health care corporate groups maintained their revenues, while in 2021 they increased them by 18.7%-a striking comparison with the 9% recession experienced by the Greek economy in 2020 and its 8.4% recovery in 2021. In a time of an acute public health crisis, private health care providers responded to society's pressing health care needs by insulating their facilities from COVID-19 patients and NHS patient transfers, minimizing their social contribution and safeguarding their revenues and profits.

İnfantil Dermatolojik Hastalık ve Tedavilerin Sıklığı: Özel Hastane ve Özel Klinik Analizi

The aim of this study was to determine the prevalence and distribution of dermatologic diseases and treatments in pediatric patients between the ages of 0-2 and the relation between skin diseases and age, gender and application year in private healthcare providers. The study was retrospectively analysed and conducted at dermatology department in a private hospital and private dermatology clinics. A total of 482 patients aged 0-2 years of outpatient admissions from January 1, 2015, to December 1, 2022 were included the study. The most common diseases group were eczemas (53.6%), nevus and benign skin tumors (8.3%), viral diseases (6%), pigmentation disorders (5.7%), and parasitic infections (4%). The dermatitis group was statistically significantly higher in 0-1 age group than 1-2 age. Atopic dermatitis was the most common diagnosis. The viral infections, parasitic infections, nail diseases, and dermatoses due to physical factors were higher in 1-2 age group (p&amp;lt;0.05). Benign skin tumors were commonly observed in girls and 0-1 age group (p&amp;lt;0.05). The topical treatment were usually prescribed to the patients. Systemic treatment was commonly prescribed in 1-2 age (p=0.007) and follow-up decision was usually given to girls than boys (p=0.001). Viral and bacterial infections were observed in higher rates after coronavirus disease 2019 pandemic (p&amp;lt;0.05). New studies in specific pediatric age groups will help to better understand the frequency of dermatological diseases and treatments and also studies conducted at different levels of health care may contribute better to develop health care policies, designing preventive health services and education programmes.