Evaluation of the public–private mix: how economics can contribute to tuberculosis control

2010 ◽  
Vol 8 (5) ◽  
pp. 489-491 ◽  
Author(s):  
Bryce S Sutton
Keyword(s):  
Tuberculosis Control ◽  
The Public ◽  
Public Private Mix

Modernization, Globalization, Trends, and Convergence in Health Expenditure in Latin America and the Caribbean

2015 ◽  
Vol 1 (2) ◽  
pp. 321-346 ◽  
Author(s):  
Shiri Noy ◽  
Patricia A. McManus
Keyword(s):  
Health Care ◽  
Latin America ◽  
Health Care Systems ◽  
Health Care Financing ◽  
Health Spending ◽  
Modernization Theory ◽  
The Public ◽  
National Differences ◽  
Care Systems ◽  
Public Private Mix

Are health care systems converging in developing nations? We use the case of health care financing in Latin America between 1995 and 2009 to assess the predictions of modernization theory, competing strands of globalization theory, and accounts of persistent cross-national differences. As predicted by modernization theory, we find convergence in overall health spending. The public share of health spending increased over this time period, with no convergence in the public-private mix. The findings indicate robust heterogeneity of national health care systems and suggest that globalization fosters human investment health policies rather than neoliberal, “race to the bottom” cutbacks in public health expenditures.

scholarly journals Evaluating the impact of the nationwide public–private mix (PPM) program for tuberculosis under National Health Insurance in South Korea: A difference in differences analysis

PLoS Medicine ◽  
2021 ◽  
Vol 18 (7) ◽  
pp. e1003717
Author(s):  
Sarah Yu ◽  
Hojoon Sohn ◽  
Hae-Young Kim ◽  
Hyunwoo Kim ◽  
Kyung-Hyun Oh ◽  
...  
Keyword(s):  
South Korea ◽  
Private Sector ◽  
Treatment Outcomes ◽  
Difference In Differences ◽  
Public And Private ◽  
The Public ◽  
Tb Control ◽  
Tb Treatment ◽  
Private And Public ◽  
Public Private Mix

Background Public–private mix (PPM) programs on tuberculosis (TB) have a critical role in engaging and integrating the private sector into the national TB control efforts in order to meet the End TB Strategy targets. South Korea’s PPM program can provide important insights on the long-term impact and policy gaps in the development and expansion of PPM as a nationwide program. Methods and findings Healthcare is privatized in South Korea, and a majority (80.3% in 2009) of TB patients sought care in the private sector. Since 2009, South Korea has rapidly expanded its PPM program coverage under the National Health Insurance (NHI) scheme as a formal national program with dedicated PPM nurses managing TB patients in both the private and public sectors. Using the difference in differences (DID) analytic framework, we compared relative changes in TB treatment outcomes—treatment success (TS) and loss to follow-up (LTFU)—in the private and public sector between the 2009 and 2014 TB patient cohorts. Propensity score matching (PSM) using the kernel method was done to adjust for imbalances in the covariates between the 2 population cohorts. The 2009 cohort included 6,195 (63.0% male, 37.0% female; mean age: 42.1) and 27,396 (56.1% male, 43.9% female; mean age: 45.7) TB patients in the public and private sectors, respectively. The 2014 cohort included 2,803 (63.2% male, 36.8% female; mean age: 50.1) and 29,988 (56.5% male, 43.5% female; mean age: 54.7) patients. In both the private and public sectors, the proportion of patients with transfer history decreased (public: 23.8% to 21.7% and private: 20.8% to 17.6%), and bacteriological confirmed disease increased (public: 48.9% to 62.3% and private: 48.8% to 58.1%) in 2014 compared to 2009. After expanding nationwide PPM, absolute TS rates improved by 9.10% (87.5% to 93.4%) and by 13.6% (from 70.3% to 83.9%) in the public and private sectors. Relative to the public, the private saw 4.1% (95% confidence interval [CI] 2.9% to 5.3%, p-value < 0.001) and −8.7% (95% CI −9.7% to −7.7%, p-value <0.001) higher rates of improvement in TS and reduction in LTFU. Treatment outcomes did not improve in patients who experienced at least 1 transfer during their TB treatment. Study limitations include non-longitudinal nature of our original dataset, inability to assess the regional disparities, and verify PPM program’s impact on TB mortality. Conclusions We found that the nationwide scale-up of the PPM program was associated with improvements in TB treatment outcomes in the private sector in South Korea. Centralized financial governance and regulatory mechanisms were integral in facilitating the integration of highly diverse South Korean private sector into the national TB control program and scaling up of the PPM intervention nationwide. However, TB care gaps continued to exist for patients who transferred at least once during their treatment. These programmatic gaps may be improved through reducing administrative hurdles and making programmatic amendments that can help facilitate management TB patients between institutions and healthcare sectors, as well as across administrative regions.

Shifting the Public-Private Mix

2012 ◽  
pp. 151-175 ◽  
Author(s):  
Martin Seeleib-Kaiser ◽  
Adam Saunders ◽  
Marek Naczyk
Keyword(s):  
The Public ◽  
Public Private Mix

Sustainable Basic Care and the Public/Private Mix

1993 ◽  
Vol 20 (1) ◽  
pp. 87-100
Author(s):  
Ingvar Theo Olsen ◽  
Sigrun Møgedal
Keyword(s):  
The Public ◽  
Basic Care ◽  
Public Private Mix
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