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| IHS
Mission & Goals: |
Groom
Skills,
Gather Evidence and
Generate Knowledge for people's health.
To Improve the
Efficacy,
Quality & Equity
of Health Systems. |
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Structure
and Dynamics of Private Health Sector
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Implications
for India's Health Policy
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Contents
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Chapters |
Page |
| 1. |
Private health
sector and state health policy in India. An introduction |
1 |
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| 2. |
Materials and methods
for a study on the structure and
dynamics of private health sector in Andhra Pradesh.
Sampling
of health care institutions for the study. Data collection formats and
the questionnaires.
Secondary data analysis and review of literature. Summary of materials
and methods |
7 |
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| 3. |
Motivations,
establishment, and growth of private health care institutions.
Overseas
experience with institutional forms in private sector. Forprofit
response to demand for services. Proprietary and corporate health care
institutions. Nonprofit health care institutions in the US and other
industrialised countries. Indianexperience with institutional
forms in private sector. Private and voluntary health care
institutions in India. Nonprofit HCls in India. Motivations,
establishment, and growth of private health care institutions in AP.
Motivating circumstances and incorporation status of Pvt HCls. Period
establishment and growth of HCls in Andhra Pradesh. Growth in size of
HCls after establishment. Summary of Evidence about institutional
forms in health. |
17
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| 4. |
Accessibility
characteristics of private and public sector HCls.
Geographic
distribution of health care institutions. Review of literature about
geographic distribution of health care institutions. Findings from the
present study about the geographic spread of private and public HCls
in AP. Socioeconomic character of patients treated by private and
public health care institutions. Review of overseas literature about
socioeconomic character of patients treated by private and public
health care institutions. Review of Indian literature about
socioeconomic character of patients treated by private and public
health care institutions. Findings from the present study about
Socioeconomic character of patients treated by private and public
health care institutions. Findings from the present study about
accessibility of private and public HCls. Summary of evidence about
accessibility characteristics of private and public HCls. |
35
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| 5. |
Health seeking behaviour and patterns
of resort to private or public HCls.
Factors
affecting pattern of resort to different HCls. Pattern ofresort to
private and public HCls for ambulatory care. Pattern of resort to
Private and Public HCls for hospital care. Socio Economic status and
Pattern of resort to health care. Summary . of evidence about health
seeking behaviour. |
49
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| 6. |
Efficiency of health care institutions
(HCls) in private sector
Studies comparing efficiency of health
care institutions in private forprofit, nonprofit and public
sector.Findings from the present study about capacity utilisation by
private and public HCls in AP. Summary of evidence about efficiency of
private forprofit, nonprofit and public HCls. |
61
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| 7. |
Quality of care characteristics of
private and public health care institutions
A framework
for assessment of healthcare quality. Review of overseas literature on
healthcare quality and ownership of HCls. Healthcare quality in
private and public HCls in India. Structure and process quality
characteristics of private health care institutions in AP. Premises
and floor space. Practice guidelines, and medical records. Patient
satisfaction in private and public health care institutions. Owner
managers' opinion about interventions for improvement of quality of
care in private sector. Summary of evidence about quality of services. |
69
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| 8. |
Range of
services in private and public health care institutions
Nature of services provided by the private sector and medical
interventions where private institutions have an advantage. Find- ings
from the present study about range of clinical services pro- vided by
private and public HCls in Andhra Pradesh. Range of public health
related services, participation in national disease control and family
welfare programs by private and public HCls in AP. The healthcare
diagnostic services market in AP. Intra- mural diagnostic services.
Extramural diagnostic services. Avail- ability of auxiliary services
in private and public HCls. Sum- mary of evidence about range of
services in private and public HCls. |
97
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| 9. |
Human resources and job satisfaction
in private and public health care institutions
Staffing and human
resource utilisation by private health care institutions in AP. Job
satisfaction of health care professionals in private and public
sector. Job s.atisfaction and related concepts. Conceptual basis of
the health care professional (HCP) questionnaire. Job satisfaction in
private and public HCls in AP. Summary of findings about human
resource utilisation and job satisfaction in private and public health
care institutions. |
115
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| 10 |
Financial aspects of private HCls.
Revenue
sources for private HCls. Sources of capital for private health care
institutions. Rates and charges. Transparency in rates and charges.
Fair financing practices. Summary of findings about financial aspects
of private HCls. |
131
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| 11. |
Patient referral, regulatory
environment and infrastructure problems faC.ed by private HCls
Patient
referrals. Regulatory environment. Public utility and infrastructure
related problems perceived by owner managers of private HCls. Summary
of findings about patient referral, regulatory environment and
infrastructure problems faced by private HCls.
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149
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| 12. |
Alternate Private Practitioners
in Andhra Pradesh
Summary
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155
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| 13. |
Experiences from policy interventions
in the United States (US) directed or otherwise affecting the private
health sector
Licensing and accreditation. Blue cross insurance
plans. Tax waivers for health insurance. Capital Subsidy by US Federal
Government for Hospital Construction from 1946-74 under the
Hill-Burton Programme. Health Services Planning and
Certificate-of-Need (CON) Regulation in the US. Health Maintenance
Organizations (HMOs). Peer review and practice guidelines. Summary of
the US experience of health policy interventions affecting the
pri-vate health sector
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163 |
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| 14. |
Policy Recommendations
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171
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| 15. |
Execute Summary
Materials and
methods. Motivation, and establishment of private health care
institutions. Accessibility character of private and public HCls.
Patterns of resort to private or public H91s. Efficiency of health
care institutions in private sector. Quality healthcare in private and
public institutions. Range of services in private and public health
care institutions. Human resources utilisation and job satisfaction in
health care institutions. Financial aspects of private health care
institutions. Patient referral, regulatory environment and
infrastructure problems faced by private HCls. Alternate Private
Practitioners. Experiences from the United States (US). Policy
Recommendations.
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179
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| 16. |
Acknowlegdements
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195
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| 17. |
References
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197
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| 18. |
Appendix
Appendix-1.1
Health Care Institution - Basic Information. Appendix-1.2 Additional
questionnaire for owner - managers of private
health facilities (Hospitals / Nursing Homes). Appendix-1.3 Health
Care Diagnostic Facility Questionnaire. Appendix-1.4 Health Care
Professional - Personal Question- naire. Appendix-1.5 Questionnaire
for Alternate Private Practitioner. Appendix-1.6E Patient Exit
Interview-English version. Appendix-1.6T Patient Exit Interview-
Telugu version
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207
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