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Public Providers (public + provider)
Selected AbstractsThe role of private providers in treating child diarrhoea in Latin AmericaHEALTH ECONOMICS, Issue 1 2008Hugh R. Waters Abstract Diarrhoeal disease, a leading cause of child mortality, disproportionately affects children in low-income countries , where private and non-governmental providers are often an important source of health care. We use 10 Living Standards Measurement Surveys from Latin America to model the choice of care for child diarrhoea in the private sector compared to the public sector. A total of 36.8% of children in the combined data set saw a private provider rather than a public one when taken for treatment. Each additional quintile of household economic status is associated with an increase of 6.5 percentage points in the probability that a child with diarrhoea is taken to a private provider (p<0.001). However, treatments provided in the private sector are manifestly of worse quality than in the public sector. A total of 33.0% of children visiting a public provider received Oral Rehydration Solution, compared to 13.7% of those visiting a private provider. Conversely, children treated by a private provider are more likely to receive drugs, most commonly unnecessary antibiotics. Ironically, when it comes to treatment for child diarrhoea, wealthier and better educated households in Latin America are paying for treatment in the private sector that is ineffective in comparison with treatments that are commonly and inexpensively available. Copyright © 2007 John Wiley & Sons, Ltd. [source] Health insurance and treatment seeking behaviour: evidence from a low-income countryHEALTH ECONOMICS, Issue 9 2004Matthew Jowett Abstract This paper analyses the effect of being insured under the voluntary component of Vietnamese Health Insurance, on patterns of treatment seeking behaviour. A multinomial logit model is estimated using household survey data from three provinces in Vietnam. Decisions regarding both the type of provider sought and type of care received are analysed. Insurance status is treated as both exogenous and endogenous to account for potential selection bias. The results indicate that, overall, insured patients are more likely to use outpatient facilities, and public providers, an effect that is particularly strong at lower income levels. Copyright © 2004 John Wiley & Sons, Ltd. [source] Prescription practices of public and private health care providers in Attock District of PakistanINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 1 2002S. Siddiqi Abstract The irrational use of drugs is a major problem of present day medical practice and its consequences include the development of resistance to antibiotics, ineffective treatment, adverse effects and an economic burden on the patient and society. A study from Attock District of Pakistan assessed this problem in the formal allopathic health sector and compared prescribing practices of health care providers in the public and private sector. WHO recommended drug use indicators were used to study prescription practices. Prescriptions were collected from 60 public and 48 private health facilities. The mean (±,SE) number of drugs per prescription was 4.1,±,0.06 for private and 2.7,±,0.04 for public providers (,p,<,0.0001). General practitioners (GPs) who represent the private sector prescribed at least one antibiotic in 62% of prescriptions compared with 54% for public sector providers. Over 48% of GP prescriptions had at least one injectable drug compared with 22.0% by public providers (,p,<,0.0001). Thirteen percent of GP prescriptions had two or more injections. More than 11% of GP prescriptions had an intravenous infusion compared with 1% for public providers (,p,<,0.001). GPs prescribed three or more oral drugs in 70% of prescriptions compared with 44% for public providers (,p,<,0.0001). Prescription practices were analysed for four health problems, acute respiratory infection (ARI), childhood diarrhoea (CD), fever in children and fever in adults. For these disorders, both groups prescribed antibiotics generously, however, GPs prescribed them more frequently in ARI, CD and fever in children (,p,<,0.01). GPs prescribed steroids more frequently, however, it was significantly higher in ARI cases (,p,<,0.001). For all the four health problems studied, GPs prescribed injections more frequently than public providers (,p,<,0.001). In CD cases GPs prescribed oral rehydration salt (ORS) less frequently (33.3%) than public providers (57.7%). GPs prescribed intravenous infusion in 12.3% cases of fever in adults compared with none by public providers (,p,<,0.001). A combination of non-regulatory and regulatory interventions, directed at providers as well as consumers, would need to be implemented to improve prescription practices of health care providers. Regulation alone would be ineffective unless it is supported by a well-established institutional mechanism which ensures effective implementation. The Federal Ministry of Health and the Provincial Departments of Health have to play a critical role in this respect, while the role of the Pakistan Medical Association in self-regulation of prescription practices can not be overemphasized. Improper prescription practices will not improve without consumer targeted interventions that educate and empower communities regarding the hazards of inappropriate drug use. Copyright © 2002 John Wiley & Sons, Ltd. [source] Health Differences Among Lumbee Indians Using Public and Private Sources of CareTHE JOURNAL OF RURAL HEALTH, Issue 3 2004Alfred Bryant Jr. PhD ABSTRACT: Context: Of 2.4 million American Indians, approximately 60% are eligible to receive Indian Health Service (IHS) benefits, leaving many to seek care elsewhere. It is unknown if their quality of care, health behaviors, and health status vary by source of care, as demonstrated for other populations. Purpose: The purpose of this study was to determine whether preventive services, health behaviors, and number of health conditions vary as a function of having non-IHS public versus private physicians as sources of usual care. Methods: 1,177 Lumbee Indians, who are ineligible to receive IHS services, completed a telephone interview that included information on receipt of preventive measures, tobacco use, physical activity, breast self-examination, and medical conditions. Frequencies, chi-squares, t tests, odds ratios, and confidence intervals were used to compare variables by source of care. Findings: 939 respondents (80%) had a private and 210 (18%) a public health clinic physician as their usual source of care; 28 (2%) reported having neither. Logistic regression analyses, restricted to the 1,149 participants who reported either a private or public source of care, revealed no differences in receipt of preventive services or health status by usual source of care. Smokeless tobacco use was less common among persons using private than public providers. Conclusions: Lumbees whose usual source of care was a public clinic physician did not differ in receipt of preventive services or in health status compared to their counterparts who received care from a private physician. More targeted research into health similarities and differences arising from access to public and private sources of care is warranted. [source] | ||||||||||