Explore the vast range of titles available.

Objective: With the participation of private hospitals in the health system, improving hospital efficiency becomes more important. This study aimed to evaluate the technical efficiency of public and private hospitals in Beijing, China, and analyze the influencing factors of hospitals’ technical efficiency, and thus provide policy implications to improve the efficiency of public and private hospitals. Method: This study used a data set of 154–232 hospitals from “Beijing’s Health and Family Planning Statistical Yearbooks” in 2012–2017. The data envelopment analysis (DEA) model was employed to measure technical efficiency. The propensity score matching (PSM) method was used for matching “post-randomization” to directly compare the efficiency of public and private hospitals, and the Tobit regression was conducted to analyze the influencing factors of technical efficiency in public and private hospitals. Results: The technical efficiency, pure technical efficiency and scale efficiency of public hospitals were higher than those of private hospitals during 2012–2017. After matching propensity scores, although the scale efficiency of public hospitals remained higher than that of their private counterparts, the pure technical efficiency of public hospitals was lower than that of private hospitals. Panel Tobit regression indicated that many hospital characteristics such as service type, level, and governance body affected public hospitals’ efficiency, while only the geographical location had an impact on private hospitals’ efficiency. For public hospitals in Beijing, those with lower average outpatient and inpatient costs per capita had better performance in technical efficiency, and bed occupancy rate, annual visits per doctor, and the ratio of doctors to nurses also showed a positive sign with technical efficiency. For private hospitals, the average length of stay was negatively associated with technical efficiency, but the bed occupancy rate, annual visits per doctor, and average outpatient cost were positively associated with technical efficiency. Conclusions: To improve technical efficiency, public hospitals should focus on improving the management standards, including the rational structure of doctors and nurses as well as appropriate reduction of hospitalization expenses. Private hospitals should expand their scale with proper restructuring, mergers, and acquisitions, and pay special attention to shortening the average length of stay and increasing the bed occupancy rate.

Background Palliative care is a modality of treatment that addresses physical, psychological and spiritual symptoms. Dignity therapy, a form of psychotherapy, was developed by Professor Harvey Chochinov, MD in 2005.The aim of the study was to assess the effect of one session of dignity therapy on quality of life in advanced cancer patients. Methods This was a randomized control trial of 144 patients (72 in each arm) randomized into group 1 (intervention arm) and group 2 (control arm). Baseline ESAS scores were determined in both arms following which group 1 received Dignity therapy while Group 2 received usual care only. Data collected was presented as printed (Legacy) documents to group 1 participants. These documents were a summary of previous discussions held. Post intervention ESAS scores were obtained in both groups after 6 weeks. Analysis was based on the intention to treat principle and descriptive statistics computed. The main outcome was symptom distress scores on the ESAS (summated out of 100 and symptom specific scores out of 10). The student T-test was used to test for difference in ESAS scores at follow up and graphs were computed for common cancers and comorbidities. Results Of the 144 (72 patients in each arm) patients randomized, 70%were female while 30% were male with a mean age of 50 years. At 6 weeks, 11 patients were lost to follow up, seven died and 126 completed the study. The commonly encountered cancers were gastrointestinal cancers (43%, p  = 0.29), breast cancer (27.27% p  = 0.71) and gynaecologic cancers (23% p  = 0.35). Majority of the patients i.e. 64.3% had no comorbidities. The primary analysis results showed higher scores for the DT group (change in mean = 1.57) compared to the UC group (change in mean = − 0.74) yielding a non-statistically significant difference in change scores of 1.44 ( p  = 0.670; 95% CI − 5.20 to 8.06). After adjusting for baseline scores, the mean (summated) symptom distress score was not significant (GLM p  = 0.78). Dignity therapy group showed a trend towards statistical improvement in anxiety ( p  = 0.059). The largest effects seen were in improvement of appetite, lower anxiety and improved wellbeing (Cohen effect size 0.3, 0.5 and 0.31 respectively). Conclusion Dignity therapy showed no statistical improvement in overall quality of life. Symptom improvement was seen in anxiety and this was a trend towards statistical significance ( p  = 0.059). Trial registration Trial registration number PACTR201604001447244 retrospectively registered with Pan African Clinical trials on 28th January 2016.

\"This book analyses Bangladeshi government efforts to strengthen local governance and identifies the challenges posed by a collaboration with NGOs. Presenting a dominantly qualitative study, the analysis explores whether engagement between the Sharique strengthening local governance project and the Union Parishads has translated into success. In so doing, it argues that evidence points to a positive impact on institutionalising good governance and fiscal autonomy through widening participation in planning and decision-making, reinforcing accountability of functionaries and enhancing tax collection. Furthermore, this book demonstrates that the collaboration has aided the process of development of social capital between officials of councils and NGOs, and among the community members, encouraging future partnership governance. However, with phasing out of the project as a propelling force, it also shows that the results fall short of being sustainable and as such statuary support, unequivocal political commitment and incentivising engagements are required to stabilise outcomes. Bridging a gap in the Development Studies literature, this book presents new findings on the collaboration of NGOs at the local level. It will be of interest to academics working in the field of South Asian Studies, Development Studies and Asian Politics\"-- Provided by publisher.

There has been a huge expansion in the private health-care sector over the past two decades, particularly in South Asia, resulting in over 80 % of patients seeking care from private health providers. Despite concerns about the quality and equity of private sector service provision, most government public health bodies recognize that the private sector reaches individuals that public institutions cannot cater to, thereby being important in moving closer to universal health coverage. Numerous initiatives have been launched and are being planned to involve private practitioners in effectively diagnosing, reporting and managing infectious diseases such as tuberculosis. However, there is a notable dearth of papers discussing which elements of private sector engagement strategies are more or less successful and the ethical issues that arise when engagement strategies are operationalized. This article brings together the authors’experiences of working on projects to engage private allopathic health providers in Pakistan, Bangladesh and India for improved tuberculosis control. Motivations of and strategies required to engage private allopathic heath providers, specifically doctors, diagnostic laboratories and pharmacies, and some of the ethical issues that arise when designing programmes for engagement are discussed. 过去 20 年，特别是南亚地区，私人医疗服务领域有巨大的发 展，有超过 80% 的病人到私立医疗服务提供者那里就医。尽 管对私人领域提供服务的质量和公平性有所质疑，大多数政 府公共医疗机构认可私立领域能够比公共领域更好地接触到 个人，因此在实现全民医疗服务覆盖方面是非常重要的。有 很多已经实施或者正在实施的项目都在将私人执业者包括进 来以更有效地诊断、报告和控制感染性疾病，如结核病。然 而，还缺少文献探讨私人领域参与的策略中哪些元素是或多 或少成功的，以及参与策略的操作中引发的道德问题。本文 结合了笔者在巴基斯坦、孟加拉和印度参与的为了加强结核 病控制引入私人对抗疗法服务提供者的项目经验。文章中讨 论了引入的私人对抗疗法服务提供者的动机和策略，具体地 说，讨论了在设计参与项目时的医生、诊断实验室、药店以 及一些道德问题。 Ha habido una gran expansión en el sector privado del cuidado de la salud en las últimas dos décadas, particularmente en el Asia del Sur, lo cual ha resultado en que más del 80% de los pacientes busquen atención de proveedores de salud privados. A pesar de las preocupaciones relacionadas con la calidad y la equidad en la prestación de servicios del sector privado, la mayor parte de los organismos de salud pública gubernamentales reconocen que el sector privado llega a personas que las instituciones públicas no pueden atender, siendo por ello importante en el objetivo de la cobertura universal de la salud. Se han puesto en marcha numerosas iniciativas y se está planeando involucrar a los practicantes privados de la salud en diagnosticar, reportar y manejar efectivamente las enfermedades infecciosas, como la tuberculosis. Sin embargo, hay una notable escasez de informes que discutan qué elementos de las estrategias de participación del sector privado son más o menos exitosas y los problemas éticos que surgen cuando las estrategias de participación se ponen en funcionamiento. Este artículo reúne experiencias de los autores de trabajos en proyectos para vincular proveedores privados de salud alopática en Pakistán, Bangladesh y la India para mejorar el control de la tuberculosis. Se discuten las motivaciones y las estrategias necesarias para involucrar a los proveedores privados de salud alopática, específicamente médicos, laboratorios de diagnóstico y farmacias, y algunos de los problemas éticos que surgen en el diseño de programas de participación.

\"Rethinking Private Authority examines the role of non-state actors in global environmental politics, arguing that a fuller understanding of their role requires a new way of conceptualizing private authority. Jessica Green identifies two distinct forms of private authority--one in which states delegate authority to private actors, and another in which entrepreneurial actors generate their own rules, persuading others to adopt them.Drawing on a wealth of empirical evidence spanning a century of environmental rule making, Green shows how the delegation of authority to private actors has played a small but consistent role in multilateral environmental agreements over the past fifty years, largely in the area of treaty implementation. This contrasts with entrepreneurial authority, where most private environmental rules have been created in the past two decades. Green traces how this dynamic and fast-growing form of private authority is becoming increasingly common in areas ranging from organic food to green building practices to sustainable tourism. She persuasively argues that the configuration of state preferences and the existing institutional landscape are paramount to explaining why private authority emerges and assumes the form that it does. In-depth cases on climate change provide evidence for her arguments.Groundbreaking in scope, Rethinking Private Authority demonstrates that authority in world politics is diffused across multiple levels and diverse actors, and it offers a more complete picture of how private actors are helping to shape our response to today's most pressing environmental problems\"-- Provided by publisher.

Purpose – The purpose of this paper is to identify the motives that enforce consumers to find out the major determinants that frame healthscape in private healthcare service that leads to their satisfaction in a developing country like India. Design/methodology/approach – The generic motive dimensions are identified using an exploratory factor analysis. Next the reliability and validity of the factors are established followed by regression analysis using SPSS 20.0 s/w. Findings – This paper identifies six healthscape motives in the private healthcare sector named as service personnel conduct and cleanliness, service delivery and facilities, ambience, location and look, appealing decoration, and upgraded safety service, out of which only service delivery, ambience, location, and decorations contribute the most to build customer satisfaction as per their significance value. Research limitations/implications – The various dimensions of healthcare motives should be viewed as the levers of improving hospitals’ service quality in the minds of its present and future customers. This finding can offer valuable insight to the forthcoming as well as existing developer who are planning to have their healthcare service presence in India. Practical implications – This study suggests some important strategic guidelines for service positioning and market segmentation of healthcare services as per customer requirements. In the recent past, availing services from hospitals were purely utilitarian in nature. Customers were more inclined to get proper and timely services and cared more about the service quality of the healthcare service provider. Originality/value – This paper is among the few works done on understanding private healthcare service delivery process in India and customer satisfaction level from those Hospitals. This study addresses the gap by identifying a set of dimensions that are relevant to customers for a unique healthcare experience.

Ownership of healthcare providers has been considered as one factor that might influence their health and healthcare related performance. The aim of this article was to provide an overview of what is known about the effects on economic, administrative and health related outcomes of different types of ownership of healthcare providers--namely public, private non-for-profit (PNFP) and private for-profit (PFP)--based on the findings of systematic reviews (SR). An overview of systematic reviews was performed. Different databases were searched in order to select SRs according to an explicit comprehensive criterion. Included SRs were assessed to determine their methodological quality. Of the 5918 references reviewed, fifteen SR were included, but six of them were rated as having major limitations, so they weren't incorporated in the analyses. According to the nine analyzed SR, ownership does seem to have an effect on health and healthcare related outcomes. In the comparison of PFP and PNFP providers, significant differences in terms of mortality of patients and payments to facilities have been found, both being higher in PFP facilities. In terms of quality and economic indicators such as efficiency, there are no concluding results. When comparing PNFP and public providers, as well as for PFP and public providers, no clear differences were found. PFP providers seem to have worst results than their PNFP counterparts, but there are still important evidence gaps in the literature that needs to be covered, including the comparison between public and both PFP and PNFP providers. More research is needed in low and middle income countries to understand the impact on and development of healthcare delivery systems.