Private Health Companies Research Articles

Digital Public Health and Digital Health: twins or Neighbors? A data protection perspective

Abstract Enhancing digital public health (DiPH) terminology may foster a better understanding of the legal framework that grounds the use of personal health data within and outside public health policy and public health systems. Terminology accuracy is, therefore, relevant to understanding the data protection regulations that apply to DiPH interventions. The broader or narrower possibilities for using personal health data in digital health interventions depend on the legal basis that justifies (or not) the access to personal health data, whether inside public health policy or outside (e.g., in private health companies). In the context of digital health policy for DiPH, using personal health data is based on public law, analyzing proportionality, necessity, and the legitimacy of the interest. In contrast, for digital health interventions outside public health policy or in an individual clinical approach (like in digital health), the use of personal health data is based on informed consent. Brazilian data protection law (LGPD) and European GDPR provide the legal basis for public health systems’ use of health data in health policy. As a result, the DiPH approach highlights the relevance of using digital technologies and health data to strengthen public health systems within the platform economy and the context of surveillance capitalism. This presentation will shed light on the expansion of digital technologies and health data in health policy in the face of data science, highlighting the need to delve into the terminology of DiPH, understanding its boundaries and legal differences from its neighbors (not twins) outside health policy. Clarifying the DiPH approach, potentially leading to standards in terminology and embedding a data protection perspective, may maximize the accuracy of the legal justification for personal health data use in health policies. DiPH, therefore, may foster data protection, public health systems, and policies strengthening with health data.

Editorial

Editorial

Managing Internal Marketing Mix to Build Competitive Advantages In Companies - Study on a Sample of Algerian Private Health Institutions

The aim of this study to test the relationship of internal marketing mix management with build competitive advantages in the Algerian private health organizations companies. This study was conducted based on a psychometrically validated questionnaire, designed and distributed to a random sample of 176 managers of Algerian private medical and medical surgical companies. The response rate was 76% as 134 managers filled the questionnaire. The questionnaire included (44) questions. Statistical methods have been used to analyse the three hypotheses developed.
 In particularly, we found that: (a) there is statistically significant on the existence of internal marketing mix management in Algerian private health companies. (b) Internal marketing mix management is positively associated with build competitive advantages in Algerian private health companies. (C)There is a statistically significant relationship difference amongst Algerian private health companies toward “build competitive advantages by Internal marketing Mix Management” due to experience of company

Quality in private health companies in Peru: The relation of QMS & ISO 9000 principles on TQM factor

ABSTRACT This paper examines whether there is a significant difference between Peruvian private health companies that have a Quality Management System (QMS), in comparison to those that do not have one, based on the nine key success factors for Total Quality Management (TQM) implementation and the relation with the ISO 9000:2015 principles on each factor. The methodology used to measure TQM is based on an instrument of four (4) blocks (top management, supplier, process and customer) with nine (9) success factors and thirty-five (35) variables. We analyzed the responses of the surveys sent to 120 private health companies and found that certified companies have significant differences and a better average in eight of the nine success factors in all the TQM blocks.

La reputación corporativa como gestión de la comunicación en las instituciones sanitarias privadas

La valoración de los públicos sobre las compañías de sanidad privadas es un elemento clave hoy en día en la gestión de la comunicación de las instituciones. Así pues, las organizaciones empiezan a gestionar su comunicación para transmitir valores relacionados con la identidad la organización, basándose en una buena estrategia de trabajo y de una gestión integral de la comunicación.Las empresas de sanidad avanzan hacia una comunicación más interactiva, restructurando su comunicación acorde con la actualidad social y tecnológica.Los públicos, tienen más herramientas de información con el que poder establecer relaciones con las instituciones, interactuar con ellas, dar aportaciones y opiniones. Esto implica una comunicación ágil en cuanto a información inmediata que es lo que los públicos demandan cada día más a las organizaciones.La adaptación al desarrollo de las aplicaciones informáticas y de la tecnología móvil, hacen que los públicos sean más exigentes. Es importante gestionar la imagen corporativa y reputacional a través de una comunicación completa con el que interactuar con sus públicos y que se sientan parte de la organización.La reputación corporativa es una parte importante de las estrategias de comunicación del sector salud, es imprescindible resaltar los mensajes, reportes y acciones referidas a la sanidad y que los públicos se sientan seguros con los servicios y el trato recibido por parte de los profesionales. Por ello es importante la opinión de cada usuario y lo que piensa de la institución con el fin de poder gestionar la comunicación para poder brindar un servicio acorde con las necesidades de los públicos.Para el siguiente artículo se ha extraído la información de las redes sociales y contenidos de medios digitales sobre datos de las valoraciones por parte de los profesionales y de los usuarios siendo las compañías mejor valoradas Sanitas, Segur Caixa Adeslas y Asisa.______________The assessment of the public on private health companies is a key element for the communication management of the institutions. Thus, organizations begin to manage their communication to transmit values related to the identity of the organization, based on good work planning and a comprehensive management of communication aimed at meeting the expectations of its stakeholders, generating important intangible values as theorganizational reputation. The reputational approach in institutional communication acquires special relevance in the health sector, especially sensitive from the perspective of information management, where it is betting on a more interactive communication, in accordance with the interests of society and tending to effectively satisfy the needs of society. needs (not only sanitary) demanded by their key audiences. In this sense, through a qualitative methodological design based on the combined use of secondary data sources and in-depth interviews with privileged observers (Corbetta, 2010), the objective of this paper is to analyze what factors determine the reputation of the health sector organizations.

Practice Cervical Cancer Screening and Treatment in FGAE Clinics

Background and context: In 2010, it was estimated that 20.9 million women were at risk for developing cervical cancer in Ethiopia and the estimated annual number of cervical cancer cases and deaths was 4648 and 3235, respectively. The Family Guidance Association of Ethiopia (FGAE), established in 1966 has been working with solid commitment to contribute to the national effort to improve the reproductive health of women, men and young people through providing quality and integrated sexual and reproductive health (SRH) services. Cervical cancer screening services using Papanicolaou test, FGAE began in 1990 and in 1994 the service was expanded to eight higher clinics. Aim: To integrate single visit approach with visual inspection with acetic acid (VIA) screening and cryotherapy to the existing SRH services. Strategy/Tactics: FGAE has provided an integrated quality SRH services through 42 service delivery points, 222 outreaches and 324 franchised clinics. Based on this, this strategy is developed to ensure that VIA and cryotherapy can be successfully integrated to the current SRH service package, such as demand generation, improve access to integrated quality SRH services, capacity building, strengthening partnership and quality assurance system and scaling up SRH/CCP service to private and public facilities. Program/Policy process: FGAE continued Papanicolaou test services, and promoted single visit approach, which combines visual inspection with acetic acid (VIA) screening and cryotherapy. In 2013, this approach was introduced to 5 higher FGAE clinics following the pilot study. Since 2015, all eight higher FGAE clinics and its GYN/OB specialty clinics have successfully integrated single visit approach to the exiting SRH services. Facility readiness was assessed and gaps were filled. Partnership with FMoH and other government institutions public and private health facilities and companies were established to scale up services and set up referral pathways. Data on service utilization were recorded using manual and electronic tools and national algorism for screening and treatment was applied. Regular mentoring and supervision was carried out to ensure quality and performance. Outcomes: Data for a period of 2010-2017 on cancer screening and treatment by FGAE were analyzed and shows that a total of 79,286 women were screened. The overwhelming majority of the screened women (96.2%) were age 25 and above. For women who chose VIA, 10.3% of them received positive result. 6164 were treated with cryotherapy while 12 women was referred as a suspected case of invasive cancer. The number of women screened has increased from 805 in 2010 to 79,286 in 2017. What was learned: The proportion of women tested positive for precancerous cervical lesion in FGAE clinics is high and comparable with national estimates of 12.3%. Integrating single visit approach into SRH services is feasible and effective in identifying and treating precancerous cervical lesions.

Optimización de la predicción de problemas financieros en empresas sanitarias privadas españolas aplicando algoritmos genéticos

ObjectiveThis paper presents a methodology to optimize, using Altman's Z-Score for private companies, the prediction of private companies of the Spanish health sector entering a situation of bankruptcy. MethodThe proposed method consists of the application of genetic algorithms (GA) to find the coefficients of the formula of the chain of ratios proposed by Altman in the version of the score for private companies which optimize the prediction for Spanish private health companies, maximizing sensitivity and specificity, and thereby reducing type I and type II errors. For this purpose, a sample of 5,903 companies from the Spanish private health sector obtained from the database of the Iberian Balance Analysis System (SABI) between 2007 and 2015 was used. ResultsThe results show that the predictive model obtained with the AG presents greater accuracy, sensitivity and specificity than that proposed by Altman for private companies with both test data and all sample data. ConclusionsThe most important finding of this study was to establish a methodology that can identify the optimized coefficients for the Altman Z-Score, which allows a more accurate prediction of bankruptcy in Spanish private healthcare companies.

Management towards financial sustainability for private health companies

Purpose The purpose of this study was to identify a set of management practices towards financial sustainability for Brazilian private health insurance and plans companies. Design/methodology/approach The present paper uses a bimodal two-step approach. The first step was quantitative, with the data envelopment analysis (DEA) technique in 521 Brazilian private health companies (PHCs). At this stage, the objective was to obtain scores to rank the PHCs regarding their financial performance and services in 2013. From the quantitative analysis, two PHCs displaying contrasting performances were selected and interviewed to identify differentiating management practices. Findings The Group Medicine PHCs displayed a higher performance in the financial approach. Following the qualitative comparative analysis, the financially sustainable PHC presented the following differentials: a high level of financial management professionalization, a deliberate policy for the control and prevention of claims and a larger share of revenues from health plans over service revenues. Research limitations/implications However, a limitation of the study lies in the fact that by not using any cash flow or financial result variables, the financial efficiency model used in the study does not evaluate the generation capacity of long-term results. It is noteworthy that, because it is a multiple case study, the results found cannot be generalized and should be understood only as characteristics of the studied PHCs in here. Practical implications The present paper can contribute to managers of Brazilian PCHs towards the implementation of management tools aimed at the sustainability of those organizations. Originality/value Despite the importance of the Supplemental Health Insurance System for public health in Brazil, PHCs have received a high volume of complaints and struggled with constant financial problems.

A saúde suplementar em perspectiva bioética

ObjectiveTo describe and analyze, from the perspective of Intervention Bioethics, the legal, institutional and ethical contexts, the conflicts and regulations of supplemental health care in Brazil, since the approval of the regulatory law in 1998 until 2010. MethodsQualitative research, using Intervention Bioethics as the theoretical reference. Bibliographical and documental study of the legislation, regulations and assistential framework, as well as interviews with members of the Supplemental Health Board. ResultsThere was improvement in the records and rules of action in private health companies, as well as flow of information, contractual and financial guarantees provided to consumers. Conflicts persist regarding access to services and procedures, price increases, policies on autonomy and medical fees. There is a dispute with the public sector regarding the network of health services, with rising costs and no improvement in quality of care. DiscussionPrivate participation in health demands comparative assessments and improvement of public-private care regulation, as well as promoting greater balance in the funding and reevaluation of the health care model. ConclusionIt is necessary to review the regulatory framework considering the supplementary, complementary or duplicate characteristic of assistance, the social actors involved, bioethical and political issues regarding associations between Supplemental Health Care and the National Health System (SUS).

Ambulatory Laparoscopic Cholecystectomy. A Cohort Study of 1600 Consecutive Cases

ObjectiveA descriptive analysis of day-case laparoscopic cholecystectomy (ALC) in a cohort of 1600 consecutive patients performed in Instituto de Cirugía y Aparato Digestivo (ICAD), Clínica Quirón de Valencia in the period 1997–2010. Patients and methodsProspective observational study of 1601 consecutive patients undergoing elective laparoscopic cholecystectomy (LC) provided by the regional health service and private health companies. Main measuresConversion rate, non-planned admissions, readmissions, surgery duration and demographics. ResultsALC was successfully performed in 80.8% of cases. LC with over-night (ON) stay accounted for 13.4% of patients. Admission was necessary in 4.6%. Mortality was 0.13%, 0.08 in ALC and 0.5% in ON LC. Readmissions occurred in 2.1%, 1.6% in ALC group, 5.4% in ON stay and 4.2% in admission group. ConclusionsALC is a reliable and safe procedure. Minimization of admission rates is the key for cost-effective optimization in the management of cholelithiasis. ALC should be considered as the reference standard in gallbladder stone disease treatment.

Supplemental care from a bioethical perspective

ObjectiveTo describe and analyze, from the perspective of Intervention Bioethics, the legal, institutional and ethical contexts, the conflicts and regulations of supplemental health care in Brazil, since the approval of the regulatory law in 1998 until 2010. MethodsQualitative research, using Intervention Bioethics as the theoretical reference. Bibliographical and documental study of the legislation, regulations and assistential framework, as well as interviews with members of the Supplemental Health Board. ResultsThere was improvement in the records and rules of action in private health companies, as well as flow of information, contractual and financial guarantees provided to consumers. Conflicts persist regarding access to services and procedures, price increases, policies on autonomy and medical fees. There is a dispute with the public sector regarding the network of health services, with rising costs and no improvement in quality of care. DiscussionPrivate participation in health demands comparative assessments and improvement of public-private care regulation, as well as promoting greater balance in the funding and reevaluation of the health care model. ConclusionIt is necessary to review the regulatory framework considering the supplementary, complementary or duplicate characteristic of assistance, the social actors involved, bioethical and political issues regarding associations between Supplemental Health Care and the National Health System (SUS).

Colecistectomía laparoscópica ambulatoria. Estudio de cohortes de 1.600 casos consecutivos

ObjectiveA descriptive analysis of day-case laparoscopic cholecystectomy (ALC) in a cohort of 1,600 consecutive patients performed in Instituto de Cirugía y Aparato Digestivo (ICAD), Clínica Quirón de Valencia in the period 1997-2010. Patients and methodsProspective observational study of 1,601 consecutive patients undergoing elective laparoscopic cholecystectomy (LC) provided by the regional health service and private health companies. Main measuresConversion rate, non-planned admissions, readmissions, surgery duration and demographics. ResultsALC was successfully performed in 80.8% of cases. LC with over-night (ON) stay accounted for 13.4% of patients. Admission was necessary in 4.6%. Mortality was 0.13%, 0.08 in ALC and 0.5% in ON LC. Readmissions occurred in 2.1%, 1.6% in ALC group, 5.4% in ON stay and 4.2% in admission group. ConclusionsALC is a reliable and safe procedure. Minimization of admission rates is the key for cost-effective optimization in the management of cholelithiasis. ALC should be considered as the reference standard in gallbladder stone disease treatment.

The Public Funding of Abortion Services: Comparative Developments in the United States and Australia

Attempts by anti-abortionists to eliminate public funding for abortion services were recently made in Australia and in the US; these attempts were successful in the US and unsuccessful in Australia. The attempts to restrict funding for abortion were described and 3 possible explanations of why the outcomes differed in these countries were offered. In the US legislation passed in 1965 created Medicaid a joint federal and state health program to provide health care for the poor. In 1973 the Supreme Court ruling in the Roe v. Wade case decriminalized abortion and declared that women had a right to abortion. It was generally interpreted that Medicaid should pay for medically indicated abortions. Most states complied with this interpretation till the mid 1970s. Between 1976-1981 a series of amendments referred to as Hyde Amendments were passed by Congress. These amendments gradually restricted the use of public funds for abortion services to cases where the life of the mother was endangered or to cases involving rape or incest. In 1980 the Supreme Court ruled that states participating in Medicaid programs were not required to pay for medically required abortions. These restrictions place great hardships on poor women who seek abortions in the US. In Australia the federal government administers a national health insurance scheme and also subsidizes private health companies. Abortions are included in the medical benefits schedule. In 1979 an effort was made in Parliament to restrict funding for pregnancy termination. The effort was defeated by a 65 to 47 vote. These differences in outcome may reflect 1) a rebound effect in the US due to the abrupt way in which abortion was legalized in 1972 compared to the gradual liberalization of abortion law in Australia or 2) the fact that the restriction of abortion funds in the US affected only the lower socioeconomic class while in Australia a restriction on funding would have affected a broad spectrum of the society. On the other hand these differences in outcome may simply be a product of differing legislative procedures and further efforts in Australia to restrict funding may be forthcoming and successful.