scholarly journals Effects of increased private health insurance on hospital utilisation in Victoria

2004 ◽  
Vol 28 (3) ◽  
pp. 320 ◽  
Author(s):  
Vijaya Sundararajan ◽  
Kaye Brown ◽  
Toni Henderson ◽  
Don Hindle
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Severe Disease ◽  
Public Hospitals ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public ◽  
Number Of Patients ◽  
Hospital Utilisation ◽  
Two Sectors

The proportion of Victorians and Australians generally with private health insurance (PHI) increased from 31% in 1998 to 45% in 2001. We analysed a dataset containing all hospital separations throughout Victoria to determine whether changes in the level of private health insurance have had any impact on patterns of public and private hospital utilisation in Victoria. Total utilisation of private hospitals grew by 31% from 1998?99 to 2002?03, whereas utilisation of public hospitals increased by 18%. Total bed-days have increased in both private hospitals and public hospitals by 12%. The proportion of all separations at private hospitals has remained relatively stable between these 2 years, with 33% of all separations being private patients in private hospitals in 1998? 99, increasing slightly to 35% by 2002?03. Analysis of a number of specific DRGs shows that patients with more severe disease are more likely to be seen at public hospitals; notably this trend has strengthened between 1998?99 and 2002?03. The number of patients treated in Victorian public hospitals has continued to grow, despite a rapid increase in the utilisation of private hospitals. Given the limited extent of the shift in caseload share between the two sectors, the effectiveness of the Commonwealth?s subsidy of private health insurance as a mechanism to reduce pressure on the public sector needs to be carefully examined.

Do the servicescape of public and private hospitals differ? The Malaysian context

2019 ◽  
Vol 11 (3) ◽  
pp. 357-377 ◽  
Author(s):  
Kim Piew Lai ◽  
Siong Choy Chong
Keyword(s):  
Design Methodology ◽  
Recovery Process ◽  
Public Hospitals ◽  
Ambient Conditions ◽  
Private Hospitals ◽  
Public And Private ◽  
Content Type ◽  
The Public ◽  
Public And Private Hospitals ◽  
Practical Implications

Purpose This study aims to explore if public and private hospitals have differing servicescape attributes. Design/methodology/approach The study uses a two-stage (EFA and CFA) procedure for identifying the servicescape attributes and examining their validity in the context of public and private hospitals. Findings The findings indicate that, in different contexts, patients would expect different aesthetics of servicescape attributes and how they are influenced by the hospital premises. Research limitations/implications It is interesting to note that: not all of the attributes that appear in both contexts are exactly the same; patients do not seem to face difficulties in analysing and interpreting directional cues, even though the spatial orientation in private hospitals is relatively smaller; the way patients of public hospitals draw inference about the ambient conditions is not consistent with private hospitals; and patients perceive that private hospitals pay special attention to developing a built environment that facilitates treatment and recovery process via interior layout, as well as decoration and architecture attributes. Practical implications The study grounds the servicescape attributes and provides insights to effectively promote public and private hospitals. Originality/value This study may be amongst the first to offer servicescape evidence in both the public and private hospitals.

scholarly journals Private health insurance and the Pharmaceutical Benefits Scheme: how effective has recent government policy been?

2004 ◽  
Vol 28 (1) ◽  
pp. 34 ◽  
Author(s):  
Jeff R J Richardson ◽  
Leonie Segal
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Public Hospitals ◽  
Common Element ◽  
Cost Shifting ◽  
The Public ◽  
Pharmaceutical Expenditures ◽  
The Government ◽  
The Cost ◽  
Pharmaceutical Benefits Scheme

The cost to government of the Pharmaceutical Benefits Scheme (PBS) is rising at over 10 percent per annum. The government subsidy to Private Health Insurance (PHI) is about $2.4 billion and rising. Despite this, the queues facing public patients ? which were the primary justification for the assistance to PHI ? do not appear to be shortening. Against this backdrop, we seek to evaluate recent policies. It is shown that the reason commonly given for the support of PHI ? the need to preserve the market share of private hospitals and relieve pressure upon public hospitals ? is based upon a factually incorrect analysis of the hospital sector in the last decade. It is similarly true that the ?problem? of rising pharmaceutical expenditures has been exaggerated. The common element in both sets of policies is that they result in cost shifting from the public to the private purse and have little to do with the quality or quantity of health services.

scholarly journals Assessment of surgical capacity in Chiapas, Mexico: a cross-sectional study of the public and private sector

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e044160
Author(s):  
Lina Roa ◽  
Ellie Moeller ◽  
Zachary Fowler ◽  
Fernando Carrillo ◽  
Sebastian Mohar ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Public Hospitals ◽  
Surgical Volume ◽  
Sectional Study ◽  
Surgical Capacity ◽  
Catastrophic Expenditure ◽  
Cross Sectional ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public

IntroductionSurgical, anaesthesia and obstetric (SAO) care are essential, life-saving components of universal healthcare. In Chiapas, Mexico’s southernmost state, the capacity of SAO care is unknown. This study aims to assess the surgical capacity in Chiapas, Mexico, as it relates to access, infrastructure, service delivery, surgical volume, quality, workforce and financial risk protection.MethodsA cross-sectional study of Ministry of Health public hospitals and private hospitals in Chiapas was performed. The translated Surgical Assessment Tool (SAT) was implemented in sampled hospitals. Surgical volume was collected retrospectively from hospital logbooks. Fisher’s exact test and Mann-Whitney U test were used to compare public and private hospitals. Catastrophic expenditure from surgical care was calculated.ResultsData were collected from 17 public hospitals and 20 private hospitals in Chiapas. Private hospitals were smaller than public hospitals and public hospitals performed more surgeries per operating room. Not all hospitals reported consistent electricity, running water or oxygen, but private hospitals were more likely to have these basic infrastructure components compared with public hospitals (84% vs 95%; 60% vs 100%; 94.1% vs 100%, respectively). Bellwether surgical procedures performed in private hospitals cost significantly more, and posed a higher risk of catastrophic expenditure, than those performed in public hospitals.ConclusionCapacity limitations are greater in public hospitals compared with private hospitals. However, the cost of care in the private sector is significantly higher than the public sector and may result in catastrophic expenditures. Targeted interventions to improve the infrastructure, workforce availability and data collection are needed.

scholarly journals Availability, prices, and affordability of selected essential cancer medicines in a middle-income country – the case of Mexico

2019 ◽  
Author(s):  
Daniela Moye-Holz ◽  
Margaret Ewen ◽  
Anahi Dreser ◽  
Sergio Bautista-Arredondo ◽  
Rene Soria-Saucedo ◽  
...  
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Public Hospitals ◽  
World Health ◽  
Public And Private ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Public And Private Sector

Abstract Background: More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. Objective: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO’s Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People’s Health Insurance” were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization’s 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.

scholarly journals Impact on public hospitals if private health insurance rates in Victoria declined

2004 ◽  
Vol 28 (3) ◽  
pp. 330 ◽  
Author(s):  
Brian W T Hanning
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Health Insurance ◽  
Operating Cost ◽  
Public Hospitals ◽  
Income Loss ◽  
The Public ◽  
Capital Costs ◽  
Recurrent Cost ◽  
Insurance Rates

The additional cost of treating acute care type Victorian private patients as public patients in Victorian public hospitals based on the current public sector payment model and rates was calculated, as was the loss of health fund income to public hospitals. If all private cases became public the net recurrent cost would be $1.05 billion assuming all patients were still treated. If private health insurance (PHI) uptake had declined to 23.3% as was projected without Lifetime Health Cover and the 30% rebate, the additional operating cost and income loss would be $385 million. This compares to the Victorian cost of the 30% rebate for acute hospital cases of $383 million. This takes no account of capital costs and possible public sector access problems. The analysis suggests that 31 extra operating theatres would be needed in the public sector (had the transfer of surgical patients from the public sector to the private sector not occurred). This analysis suggests that without the PHI rebate the current stresses on Victorian public hospitals would be increased, not decreased.

Quality of Immediate Postoperative Nursing Care for Patients in Public and Private Hospitals in Erbil City, Iraq- Comparative Study

2020 ◽  
Vol 3 (2) ◽  
pp. 126-135
Author(s):  
Sideeq Ali ◽  
Keyword(s):  
Comparative Study ◽  
Nursing Care ◽  
Public Hospitals ◽  
Care Practice ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public ◽  
Post Operation ◽  
Public And Private Hospitals

Background and objective: The 1 to 2 hours for the first 24 hours after surgical operation is a crucial time to perform patient care. The study aimed to assess and compare quality of immediate post operation nursing care for patients undergoing surgeries in the public and private hospitals in Erbil City. Methods: A comparative study design was conducted on non-probability and purposive sample of 106 nurses (53 nurses of public hospitals and 53 nurses from private hospitals) in the surgical unit in all public and some private hospitals in Erbil city. The data was col-lected between February and July, 2019 by direct observation and using an observational questionnaire. Results: The majority of the nurses were young adults who had graduated from a nursing institute who were of middle income and lived in an urban area. The duration of experi-ence as a nurse was between 1 to 10 years. The majority of the nurses (98.1%) in the pub-lic hospitals they practiced poor nursing care practice, while most of the nurses (69.8) in the private hospitals practiced good nursing care practices. Very high significant differ-ence found between immediate post operation nursing care in public and private hospi-tals (P <0.000). Conclusion: The study concluded that; postoperative nursing care is very important to improve health services, but the quality of the nursing care in the public hospitals as a generally was very poor when compared with the private hospitals. We recommended improving their skills by implementation job description, opening training course and monitoring of the nurses as well as awareness and follow-up.

scholarly journals Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation

2018 ◽  
Vol 33 (8) ◽  
pp. 1400-1410 ◽  
Author(s):  
Charlene A. Wong ◽  
Sajal Kulhari ◽  
Ellen J. McGeoch ◽  
Arthur T. Jones ◽  
Janet Weiner ◽  
...  
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Decision Aids ◽  
Consumer Decision ◽  
Public And Private ◽  
The Public

scholarly journals The utilisation of public and private hospitals in Victoria: An issue of access?

1996 ◽  
Vol 19 (3) ◽  
pp. 40 ◽  
Author(s):  
Denise O'Hara ◽  
Chris Brook
Keyword(s):  
Elective Surgery ◽  
Care Delivery ◽  
Public Hospitals ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public ◽  
Urgent Surgery ◽  
Surgical Emergencies ◽  
Public And Private Hospitals ◽  
Occupancy Rates

Consumers regard access to hospital services as one of the key components of qualityin health care delivery. A mixed public/private system operates in Victoria, but amorbidity collection from private hospitals was commenced only relatively recently.In 1993?94 the collection covered 82- per cent of private hospital separations, andit was considered timely to examine the utilisation patterns in the private system andcompare them with those in the public system. Medical and surgical emergencies andother complex conditions and procedures are serviced largely in the public sector,whereas private hospitals are utilised for elective and less complex surgery and non-urgentconditions. Occupancy rates are around 79- per cent in public hospitals and67- per cent in private hospitals. Elective surgery waiting list data suggest that whileurgent cases are treated within a month, significant proportions wait six months ormore for non-urgent surgery. Private health insurance is the main factor indetermining access to and the utilisation private hospitals. The current MedicareAgreement and the move to separate the role of purchaser and provider may allowthe maximal utilisation of private hospitals and diminish the burden of chronicillness.

scholarly journals Private health insurance: the problem child faces adulthood

2002 ◽  
Vol 25 (2) ◽  
pp. 38 ◽  
Author(s):  
Mark Cormack
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Medical Profession ◽  
Public Hospitals ◽  
Reform Process ◽  
Private Hospitals ◽  
Policy Initiatives ◽  
Problem Child ◽  
Insurance Funds ◽  
Health Insurance Funds

Since its election to office in 1996, reform of Private Health Insurance (PHI) has been the most obvious health policy focus of the Howard Government. The reform process has focussed on price, product, promotion, legislation and regulation. It has resulted in one of thelargest new Commonwealth health outlays in recent memory. Health insurance funds have emerged as activepurchasers of care, not just passive reimbursers of costs. PHI fund reserves have moved from precarious liquidity tohealthy surplus. Private hospitals are busier than ever before, but margins are slim. Anecdotally, public hospitals report little benefit to date. Waiting lists have not been reduced, and their budgets are unchanged as a result of the $2 Bn allocated under the 30% Rebate scheme. The paper begins by describing the origins of the PHI reform. Its objectives, policy initiatives, results to date and criticisms are analysed. Criticisms include the actual and opportunity costs. Specific concerns remain as to its effectiveness to date in reducing pressure on public hospitals, and perceived lack of equity for certain client groups. Themost significant result is that much of the reform package is here to stay including the expensive and much criticised 30% rebate. Like Medicare before it, the PHI reforms have achieved bipartisan support. The paper concludes by describing future implications for Government, industry, consumers and the medical profession.

scholarly journals Determinants of patient satisfaction with outpatient health services at public and private hospitals in Addis Ababa, Ethiopia

2012 ◽  
Vol 4 (1) ◽  
Author(s):  
Tayue Tateke ◽  
Mirkuzie Woldie ◽  
Shimeles Ololo
Keyword(s):  
Patient Satisfaction ◽  
Health Services ◽  
Addis Ababa ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public ◽  
Outpatient Health Services ◽  
Public And Private Hospitals

Background: Patients have explicit desires or requests for services when they visit hospitals. However, inadequate discovery of their needs may result in patient dissatisfaction. This study aimed to determine the levels and determinants of patient satisfaction with outpatient health services provided at public and private hospitals in Addis Ababa, Central Ethiopia.Methods: A comparative cross-sectional study was conducted from 27 March to 30 April 2010. The study included 5 private and 5 public hospitals. Participants were selected using systematic random sampling. A pre-tested and contextually prepared structured questionnaire was used to conduct interviews. Descriptive statistics, analysis of variance, factor analysis and multiple linear regressions were performed using computer software (SPSS 16.0).Results: About 18.0% of the patients at the public hospitals were very satisfied whilst 47.9% were just satisfied with the corresponding proportions a bit higher at private hospitals. Selfjudged health status, expectation about the services, perceived adequacy of consultation duration, perceived providers’ technical competency, perceived welcoming approach and perceived body signalling were determinants of satisfaction at both public and private hospitals.Conclusions: Although patients at the private hospitals were more satisfied than those at the public hospitals with the health care they received, five of the predictors of patient satisfaction in this study were common to both settings. Thus, hospitals in both categories should work to improve the competencies of their employees, particularly health professionals, to win the interests of the clients and have a physical structure that better fits the expectations of the patients.

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