Sample records for study twrs privatization

  1. Management assessment of tank waste remediation system contractor readiness to proceed with phase 1B privatization

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Honeyman, J.O.

    1998-01-09

    This Management Assessment of Tank Waste Remediation System (TWRS) Contractor Readiness to Proceed With Phase 1B Privatization documents the processes used to determine readiness to proceed with tank waste treatment technologies from private industry, now known as TWRS privatization. An overall systems approach was applied to develop action plans to support the retrieval and disposal mission of the TWRS Project. The systems and infrastructure required to support the mission are known. Required systems are either in place or plans have been developed to ensure they exist when needed. Since October 1996 a robust system engineering approach to establishing integrated Technicalmore » Baselines, work breakdown structures, tank farms organizational structure and configurations, work scope, and costs has become part of the culture within the TWRS Project. An analysis of the programmatic, management, and technical activities necessary to declare readiness to proceed with execution of the mission demonstrates that the system, personnel, and hardware will be on-line and ready to support the private contractors. The systems approach included defining the retrieval and disposal mission requirements and evaluating the readiness of the Project Hanford Management Contract (PHMC) team to support initiation of waste processing by the private contractors in June 2002 and to receive immobilized waste shortly thereafter. The Phase 1 feed delivery requirements from the private contractor Requests for Proposal were reviewed. Transfer piping routes were mapped, existing systems were evaluated, and upgrade requirements were defined.« less

  2. Management assessment of tank waste remediation system contractor readiness to proceed with phase 1B privatization

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Certa, P.J.

    1998-01-07

    Readiness to Proceed With Phase 1B Privatization documents the processes used to determine readiness to proceed with tank waste treatment technologies from private industry, now known as TWRS privatization. An overall systems approach was applied to develop action plans to support the retrieval and disposal mission of the TWRS Project. The systems and infrastructure required to support the mission are known. Required systems are either in place or plans have been developed to ensure they exist when needed. Since October 1996 a robust system engineering approach to establishing integrated Technical Baselines, work breakdown structures, tank farms organizational structure and configurations,more » work scope, and costs has become part of the culture within the TWRS Project. An analysis of the programmatic, management, and technical activities necessary to declare readiness to proceed with execution of the mission demonstrates that the system, personnel, and hardware will be on line and ready to support the private contractors. The systems approach included defining the retrieval and disposal mission requirements and evaluating the readiness of the Project Hanford Management Contract (PHMC) team to support initiation of waste processing by the private contractors in June 2002 and to receive immobilized waste shortly thereafter. The Phase 1 feed delivery requirements from the private contractor Requests for Proposal were reviewed. Transfer piping routes were mapped, existing systems were evaluated, and upgrade requirements were defined.« less

  3. Data quality objectives for TWRS privatization phase 1: confirm tank T is an appropriate feed source for low-activity waste feed batch X

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NGUYEN, D.M.

    1999-06-01

    The US. Department of Energy, Richland Operations Office (DOE-RL) has initiated Phase 1 of a two-phase privatization strategy for treatment and immobilization of low-activity waste (LAW) currently being managed by the Hanford Tank Waste Remediation System (TWRS) Project. In this strategy, DOE will purchase services from a contractor-owned and operated facility under a fixed price. The Phase 1 TWRS privatization contract requires that the Project Hanford Management Contract (PHMC) contractors, on behalf of DOE, deliver LAW feed in specified quantities and composition to the Privatization Contractor in a timely manner (DOE-RL 1996). Additional requirements are imposed by the interface controlmore » document (ICD-19) for LAW feed (PHMC 1997). In response to these requirements, the Tank Waste Remediation System Operation and Utilization Plan (TWRSO and UP) (Kirkbride et al. 1997) was prepared by the PHMC. The TWRSO and UP, as updated by the Readiness-To-Proceed deliverable (Payne et al. 1998), establishes the baseline operating scenario for the delivery of LAW feed to the Privatization Contractor. The scenario specifies tanks from which LAW will be provided for each feed batch, the operational activities needed to prepare and deliver each batch, and the timing of these activities. The operating scenario was developed based on current knowledge of waste composition and chemistry, waste transfer methods, and operating constraints, such as tank farm logistics and availability of tank space. A project master baseline schedule (PMBS) has been developed to implement the operating scenario. The PMBS also includes activities aimed at reducing programmatic risks. One of the activities, ''Confirm Plans and Requirements,'' was identified to verify the basis used to develop the scenario. Additional data on waste quantity, physical and chemical characteristics, and transfer properties will be needed to support this activity. This document describes the data quality objective (DQO) process undertaken to assme appropriate data will be collected to support the activity, ''Confirm Tank Plans and Requirements.'' The DQO process was implemented in accordance with the TWRS DQO process (Banning 1997) with some modifications to accommodate project or tank-specific requirements and constraints.« less

  4. Data quality objectives for TWRS privatization phase 1: confirm tank T is an appropriate feed source for high-level waste feed batch X

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NGUYEN, D.M.

    1999-06-01

    The U.S. Department of Energy-Richland Operations Office (DOE-RL) has initiated Phase 1 of a two-phase privatization strategy for treatment and immobilization of high-level waste (HLW) that is currently managed by the Hanford Tank Waste Remediation System (TWRS) Project. In this strategy, DOE will purchase services from a contractor-owned and operated facility under a fixed price. The Phase 1 TWRS privatization contract requires that the Project Hanford Management Contract (PHMC) contractors, on behalf of DOE, deliver HLW feed in specified quantities and composition to the Privatization Contractor in a timely manner (DOE-RL 1996). Additional requirements are imposed by the interface controlmore » document (ICD) for HLW feed (PHMC 1997). In response to these requirements, the Tank Waste Remediation System Operation and Utilization Plan (TWRSO and UP) (Kirkbride et al. 1997) was prepared by the PHMC. The TWRSO and UP, as updated by the Readiness-To-Proceed (RTP) deliverable (Payne et al. 1998), establishes the baseline operating scenario for the delivery of HLW feed to the Privatization Contractor. The scenario specifies tanks from which HLW will be provided for each feed batch, the operational activities needed to prepare and deliver each batch, and the timing of these activities. The operating scenario was developed based on current knowledge of waste composition and chemistry, waste transfer methods, and operating constraints such as tank farm logistics and availability of tank space. A project master baseline schedule (PMBS) has been developed to implement the operating scenario. The PMBS also includes activities aimed at reducing programmatic risks. One of the activities, ''Confirm Tank TI is Acceptable for Feed,'' was identified to verify the basis used to develop the scenario Additional data on waste quantity, physical and chemical characteristics, and transfer properties will be needed to support this activity. This document describes the data quality objective (DQO) process undertaken to assure appropriate data will be collected to support the activity, ''Confirm Tank T is Acceptable for HLW Feed.'' The DQO process was implemented in accordance with the TWRS DQO process (Banning 1997) with some modifications to accommodate project or tank-specific requirements and constraints.« less

  5. Tank waste remediation system functions and requirements document

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Carpenter, K.E

    1996-10-03

    This is the Tank Waste Remediation System (TWRS) Functions and Requirements Document derived from the TWRS Technical Baseline. The document consists of several text sections that provide the purpose, scope, background information, and an explanation of how this document assists the application of Systems Engineering to the TWRS. The primary functions identified in the TWRS Functions and Requirements Document are identified in Figure 4.1 (Section 4.0) Currently, this document is part of the overall effort to develop the TWRS Functional Requirements Baseline, and contains the functions and requirements needed to properly define the top three TWRS function levels. TWRS Technicalmore » Baseline information (RDD-100 database) included in the appendices of the attached document contain the TWRS functions, requirements, and architecture necessary to define the TWRS Functional Requirements Baseline. Document organization and user directions are provided in the introductory text. This document will continue to be modified during the TWRS life-cycle.« less

  6. TWRS configuration management requirement source document

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vann, J.M.

    The TWRS Configuration Management (CM) Requirement Source document prescribes CM as a basic product life-cycle function by which work and activities are conducted or accomplished. This document serves as the requirements basis for the TWRS CM program. The objective of the TWRS CM program is to establish consistency among requirements, physical/functional configuration, information, and documentation for TWRS and TWRS products, and to maintain this consistency throughout the life-cycle of TWRS and the product, particularly as changes are being made.

  7. TWRS technical baseline database manager definition document

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Acree, C.D.

    1997-08-13

    This document serves as a guide for using the TWRS Technical Baseline Database Management Systems Engineering (SE) support tool in performing SE activities for the Tank Waste Remediation System (TWRS). This document will provide a consistent interpretation of the relationships between the TWRS Technical Baseline Database Management software and the present TWRS SE practices. The Database Manager currently utilized is the RDD-1000 System manufactured by the Ascent Logic Corporation. In other documents, the term RDD-1000 may be used interchangeably with TWRS Technical Baseline Database Manager.

  8. TWRS Configuration management program plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vann, J.M.

    The TWRS Configuration Management Program Plan (CMPP) integrates technical and administrative controls to establish and maintain consistency among requirements, product configuration, and product information for TWRS products during all life cycle phases. This CMPP will be used by TWRS management and configuration management personnel to establish and manage the technical and integrated baselines and controls and status changes to those baselines.

  9. Tank waste remediation system multi-year work plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    The Tank Waste Remediation System (TWRS) Multi-Year Work Plan (MYWP) documents the detailed total Program baseline and was constructed to guide Program execution. The TWRS MYWP is one of two elements that comprise the TWRS Program Management Plan. The TWRS MYWP fulfills the Hanford Site Management System requirement for a Multi-Year Program Plan and a Fiscal-Year Work Plan. The MYWP addresses program vision, mission, objectives, strategy, functions and requirements, risks, decisions, assumptions, constraints, structure, logic, schedule, resource requirements, and waste generation and disposition. Sections 1 through 6, Section 8, and the appendixes provide program-wide information. Section 7 includes a subsectionmore » for each of the nine program elements that comprise the TWRS Program. The foundation of any program baseline is base planning data (e.g., defendable product definition, logic, schedules, cost estimates, and bases of estimates). The TWRS Program continues to improve base data. As data improve, so will program element planning, integration between program elements, integration outside of the TWRS Program, and the overall quality of the TWRS MYWP. The MYWP establishes the TWRS baseline objectives to store, treat, and immobilize highly radioactive Hanford waste in an environmentally sound, safe, and cost-effective manner. The TWRS Program will complete the baseline mission in 2040 and will incur costs totalling approximately 40 billion dollars. The summary strategy is to meet the above objectives by using a robust systems engineering effort, placing the highest possible priority on safety and environmental protection; encouraging {open_quotes}out sourcing{close_quotes} of the work to the extent practical; and managing significant but limited resources to move toward final disposition of tank wastes, while openly communicating with all interested stakeholders.« less

  10. Tank waste remediation system multi-year work plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1994-09-01

    The Tank Waste Remediation System (TWRS) Multi-Year Work Plan (MYWP) documents the detailed total Program baseline and was constructed to guide Program execution. The TWRS MYWP is one of two elements that comprise the TWRS Program Management Plan. The TWRS MYWP fulfills the Hanford Site Management System requirement for a Multi-Year Program Plan and a Fiscal-Year Work Plan. The MYWP addresses program vision, mission, objectives, strategy, functions and requirements, risks, decisions, assumptions, constraints, structure, logic, schedule, resource requirements, and waste generation and disposition. Sections 1 through 6, Section 8, and the appendixes provide program-wide information. Section 7 includes a subsectionmore » for each of the nine program elements that comprise the TWRS Program. The foundation of any program baseline is base planning data (e.g., defendable product definition, logic, schedules, cost estimates, and bases of estimates). The TWRS Program continues to improve base data. As data improve, so will program element planning, integration between program elements, integration outside of the TWRS Program, and the overall quality of the TWRS MYWP. The MYWP establishes the TWRS baseline objectives to store, treat, and immobilize highly radioactive Hanford waste in an environmentally sound, safe, and cost-effective manner. The TWRS Program will complete the baseline mission in 2040 and will incur costs totalling approximately 40 billion dollars. The summary strategy is to meet the above objectives by using a robust systems engineering effort, placing the highest possible priority on safety and environmental protection; encouraging {open_quotes}out sourcing{close_quotes} of the work to the extent practical; and managing significant but limited resources to move toward final disposition of tank wastes, while openly communicating with all interested stakeholders.« less

  11. Tank waste remediation system configuration management implementation plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vann, J.M.

    1998-03-31

    The Tank Waste Remediation System (TWRS) Configuration Management Implementation Plan describes the actions that will be taken by Project Hanford Management Contract Team to implement the TWRS Configuration Management program defined in HNF 1900, TWRS Configuration Management Plan. Over the next 25 years, the TWRS Project will transition from a safe storage mission to an aggressive retrieval, storage, and disposal mission in which substantial Engineering, Construction, and Operations activities must be performed. This mission, as defined, will require a consolidated configuration management approach to engineering, design, construction, as-building, and operating in accordance with the technical baselines that emerge from themore » life cycles. This Configuration Management Implementation Plan addresses the actions that will be taken to strengthen the TWRS Configuration Management program.« less

  12. Technology development in support of the TWRS process flowsheet. Revision 1

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Washenfelder, D.J.

    1995-10-11

    The Tank Waste Remediation System is to treat and dispose of Hanford`s Single-Shell and Double-Shell Tank Waste. The TWRS Process Flowsheet, (WHC-SD-WM-TI-613 Rev. 1) described a flowsheet based on a large number of assumptions and engineering judgements that require verification or further definition through process and technology development activities. This document takes off from the TWRS Process Flowsheet to identify and prioritize tasks that should be completed to strengthen the technical foundation for the flowsheet.

  13. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Stickney, R.G.

    This report presents the results of a systematic evaluation conducted to identify miscellaneous TWRS facilities, tanks and components with potential needed authorization basis upgrades. It provides the Authorization Basis upgrade plan for those miscellaneous TWRS facilities, tanks and components identified.

  14. TWRS authorization basis configuration control summary

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mendoza, D.P.

    This document was developed to define the Authorization Basis management functional requirements for configuration control, to evaluate the management control systems currently in place, and identify any additional controls that may be required until the TWRS [Tank Waste Remediation System] Configuration Management system is fully in place.

  15. Tank waste remediation system tank waste retrieval risk management plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Klimper, S.C.

    1997-11-07

    This Risk Management Plan defines the approach to be taken to manage programmatic risks in the TWRS Tank Waste Retrieval program. It provides specific instructions applicable to TWR, and is used to supplement the guidance given by the TWRS Risk Management procedure.

  16. Tank 241-AZ-102 Privatization Push Mode Core Sampling and Analysis Plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    RASMUSSEN, J.H.

    1999-08-02

    This sampling and analysis plan (SAP) identifies characterization objectives pertaining to sample collection, laboratory analytical evaluation, and reporting requirements for samples obtained from tank 241-AZ-102. The purpose of this sampling event is to obtain information about the characteristics of the contents of 241-AZ-102 required to satisfy the Data Quality Objectives For TWRS Privatization Phase I: Confirm Tank TIS An Appropriate Feed Source For High-Level Waste Feed Batch X(HLW DQO) (Nguyen 1999a), Data Quality Objectives For TWRS Privatization Phase 1: Confirm Tank TIS An Appropriate Feed Source For Low-Activity Waste Feed Batch X (LAW DQO) (Nguyen 1999b), Low Activity Waste andmore » High Level Waste Feed Data Quality Objectives (L&H DQO) (Patello et al. 1999) and Characterization Data Needs for Development, Design, and Operation of Retrieval Equipment Developed through the Data Quality Objective Process (Equipment DQO) (Bloom 1996). The Tank Characterization Technical Sampling Basis document (Brown et al. 1998) indicates that these issues, except the Equipment DQO apply to tank 241-AZ-102 for this sampling event. The Equipment DQO is applied for shear strength measurements of the solids segments only. Poppiti (1999) requires additional americium-241 analyses of the sludge segments. Brown et al. (1998) also identify safety screening, regulatory issues and provision of samples to the Privatization Contractor(s) as applicable issues for this tank. However, these issues will not be addressed via this sampling event. Reynolds et al. (1999) concluded that information from previous sampling events was sufficient to satisfy the safety screening requirements for tank 241 -AZ-102. Push mode core samples will be obtained from risers 15C and 24A to provide sufficient material for the chemical analyses and tests required to satisfy these data quality objectives. The 222-S Laboratory will extrude core samples, composite the liquids and solids, perform chemical analyses, and provide subsamples to the Process Chemistry Laboratory. The Process Chemistry Laboratory will prepare test plans and perform process tests to evaluate the behavior of the 241-AZ-102 waste undergoing the retrieval and treatment scenarios defined in the applicable DQOs. Requirements for analyses of samples originating in the process tests will be documented in the corresponding test plan.« less

  17. Tank waste remediation system configuration management plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vann, J.M.

    The configuration management program for the Tank Waste Remediation System (TWRS) Project Mission supports management of the project baseline by providing the mechanisms to identify, document, and control the functional and physical characteristics of the products. This document is one of the tools used to develop and control the mission and work. It is an integrated approach for control of technical, cost, schedule, and administrative information necessary to manage the configurations for the TWRS Project Mission. Configuration management focuses on five principal activities: configuration management system management, configuration identification, configuration status accounting, change control, and configuration management assessments. TWRS Projectmore » personnel must execute work in a controlled fashion. Work must be performed by verbatim use of authorized and released technical information and documentation. Application of configuration management will be consistently applied across all TWRS Project activities and assessed accordingly. The Project Hanford Management Contract (PHMC) configuration management requirements are prescribed in HNF-MP-013, Configuration Management Plan (FDH 1997a). This TWRS Configuration Management Plan (CMP) implements those requirements and supersedes the Tank Waste Remediation System Configuration Management Program Plan described in Vann, 1996. HNF-SD-WM-CM-014, Tank Waste Remediation System Configuration Management Implementation Plan (Vann, 1997) will be revised to implement the requirements of this plan. This plan provides the responsibilities, actions and tools necessary to implement the requirements as defined in the above referenced documents.« less

  18. Temporal and Spatial Variations in the Twinning Rate in Norway.

    PubMed

    Fellman, Johan

    2016-08-01

    Strong geographical variations have been noted in the twinning rate (TWR). In general, the rate is high among people of African origin, intermediate among Europeans, and low among most Asiatic populations. In Europe, there tends to be a south-north cline, with a progressive increase in the TWR from south to north and a minimum around the Basque provinces. The highest TWRs in Europe have been found among the Nordic populations. Furthermore, within larger populations, small isolated subpopulations have been identified to have extreme, mainly high, TWRs. In the study of the temporal variation of the TWR in Norway, we consider the period from 1900 to 2014. The regional variation of the TWR in Norway is analyzed for the different counties for two periods, 1916-1926 and 1960-1988. Heterogeneity between the regional TWRs in Norway during 1916-1926 was found, but the goodness of fit for the alternative spatial models was only slight. The optimal regression model for the TWR in Norway has the longitude and its square as regressors. According to this model, the spatial variation is distributed in a west-east direction. For 1960-1988, no significant regional variation was observed. One may expect that the environmental and genetic differences between the counties in Norway have disappeared and that the regional TWRs have converged towards a common low level.

  19. Compatibility Grab Sampling and Analysis Plan for FY 2000

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    SASAKI, L.M.

    1999-12-29

    This sampling and analysis plan (SAP) identifies characterization objectives pertaining to sample collection, laboratory analytical evaluation, and reporting requirements for grab samples obtained to address waste compatibility. It is written in accordance with requirements identified in Data Quality Objectives for Tank Farms Waste Compatibility Program (Mulkey et al. 1999) and Tank Farm Waste Transfer Compatibility Program (Fowler 1999). In addition to analyses to support Compatibility, the Waste Feed Delivery program has requested that tank samples obtained for Compatibility also be analyzed to confirm the high-level waste and/or low-activity waste envelope(s) for the tank waste (Baldwin 1999). The analytical requirements tomore » confirm waste envelopes are identified in Data Quality Objectives for TWRS Privatization Phase I: Confirm Tank T is an Appropriate Feed Source for Low-Activity Waste Feed Batch X (Nguyen 1999a) and Data Quality Objectives for RPP Privatization Phase I: Confirm Tank T is an Appropriate Feed Source for High-Level Waste Feed Batch X (Nguyen 1999b).« less

  20. Authorization basis requirements comparison report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brantley, W.M.

    The TWRS Authorization Basis (AB) consists of a set of documents identified by TWRS management with the concurrence of DOE-RL. Upon implementation of the TWRS Basis for Interim Operation (BIO) and Technical Safety Requirements (TSRs), the AB list will be revised to include the BIO and TSRs. Some documents that currently form part of the AB will be removed from the list. This SD identifies each - requirement from those documents, and recommends a disposition for each to ensure that necessary requirements are retained when the AB is revised to incorporate the BIO and TSRs. This SD also identifies documentsmore » that will remain part of the AB after the BIO and TSRs are implemented. This document does not change the AB, but provides guidance for the preparation of change documentation.« less

  1. Tank waste remediation system nuclear criticality safety program management review

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    BRADY RAAP, M.C.

    1999-06-24

    This document provides the results of an internal management review of the Tank Waste Remediation System (TWRS) criticality safety program, performed in advance of the DOE/RL assessment for closure of the TWRS Nuclear Criticality Safety Issue, March 1994. Resolution of the safety issue was identified as Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Milestone M-40-12, due September 1999.

  2. K Basins sludge removal temporary sludge storage tank system

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mclean, M.A.

    1997-06-12

    Shipment of sludge from the K Basins to a disposal site is now targeted for August 2000. The current path forward for sludge disposal is shipment to Tank AW-105 in the Tank Waste Remediation System (TWRS). Significant issues of the feasibility of this path exist primarily due to criticality concerns and the presence of polychlorinated biphenyls (PCBS) in the sludge at levels that trigger regulation under the Toxic Substance Control Act. Introduction of PCBs into the TWRS processes could potentially involve significant design and operational impacts to both the Spent Nuclear Fuel and TWRS projects if technical and regulatory issuesmore » related to PCB treatment cannot be satisfactorily resolved. Concerns of meeting the TWRS acceptance criteria have evolved such that new storage tanks for the K Basins sludge may be the best option for storage prior to vitrification of the sludge. A reconunendation for the final disposition of the sludge is scheduled for June 30, 1997. To support this decision process, this project was developed. This project provides a preconceptual design package including preconceptual designs and cost estimates for the temporary sludge storage tanks. Development of cost estimates for the design and construction of sludge storage systems is required to help evaluate a recommendation for the final disposition of the K Basin sludge.« less

  3. FY 95 engineering work plan for the design reconstitution implementation action plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bigbee, J.D.

    Design reconstitution work is to be performed as part of an overall effort to upgrade Configuration Management (CM) at TWRS. WHC policy is to implement a program that is compliant with DOE-STD-1073-93, Guide for Operational Configuration Management Program. DOE-STD-1073 requires an adjunct program for reconstituting design information. WHC-SD-WM-CM-009, Design Reconstitution Program Plan for Waste Tank Farms and 242-A Evaporator of Tank Waste Remediation System, is the TWRS plan for meeting DOE-STD-1073 design reconstitution requirements. The design reconstitution plan is complex requiring significant time and effort for implementation. In order to control costs, and integrate the work into other TWRS activities,more » a Design Reconstitution Implementation Action Plan (DR IAP) will be developed, and approved by those organizations having ownership or functional interest in this activity.« less

  4. Mission analysis for cross-site transfer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Riesenweber, S.D.; Fritz, R.L.; Shipley, L.E.

    1995-11-01

    The Mission Analysis Report describes the requirements and constraints associated with the Transfer Waste Function as necessary to support the Manage Tank Waste, Retrieve Waste, and Process Tank Waste Functions described in WHC-SD-WM-FRD-020, Tank Waste Remediation System (TWRS) Functions and Requirements Document and DOE/RL-92-60, Revision 1, TWRS Functions and Requirements Document, March 1994. It further assesses the ability of the ``initial state`` (or current cross-site transfer system) to meet the requirements and constraints.

  5. Functions and requirements document for interim store solidified high-level and transuranic waste

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Smith-Fewell, M.A., Westinghouse Hanford

    1996-05-17

    The functions, requirements, interfaces, and architectures contained within the Functions and Requirements (F{ampersand}R) Document are based on the information currently contained within the TWRS Functions and Requirements database. The database also documents the set of technically defensible functions and requirements associated with the solidified waste interim storage mission.The F{ampersand}R Document provides a snapshot in time of the technical baseline for the project. The F{ampersand}R document is the product of functional analysis, requirements allocation and architectural structure definition. The technical baseline described in this document is traceable to the TWRS function 4.2.4.1, Interim Store Solidified Waste, and its related requirements, architecture,more » and interfaces.« less

  6. Significant volume reduction of tank waste by selective crystallization: 1994 Annual report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Herting, D.L.; Lunsford, T.R.

    1994-09-27

    The objective of this technology task plan is to develop and demonstrate a scaleable process of reclaim sodium nitrate (NaNO{sub 3}) from Hanford waste tanks as a clean nonradioactive salt. The purpose of the so-called Clean Salt Process is to reduce the volume of low level waste glass by as much as 70%. During the reporting period of October 1, 1993, through May 31, 1994, progress was made on four fronts -- laboratory studies, surrogate waste compositions, contracting for university research, and flowsheet development and modeling. In the laboratory, experiments with simulated waste were done to explore the effects ofmore » crystallization parameters on the size and crystal habit of product NaNO{sub 3} crystals. Data were obtained to allows prediction of decontamination factor as a function of solid/liquid separation parameters. Experiments with actual waste from tank 101-SY were done to determine the extent of contaminant occlusions in NaNO{sub 3} crystals. In preparation for defining surrogate waste compositions, single shell tanks were categorized according to the weight percent NaNO{sub 3} in each tank. A detailed process flowsheet and computer model were created using the ASPENPlus steady state process simulator. This is the same program being used by the Tank Waste Remediation System (TWRS) program for their waste pretreatment and disposal projections. Therefore, evaluations can be made of the effect of the Clean Salt Process on the low level waste volume and composition resulting from the TWRS baseline flowsheet. Calculations, using the same assumptions as used for the TWRS baseline where applicable indicate that the number of low level glass vaults would be reduced from 44 to 16 if the Clean Salt Process were incorporated into the baseline flowsheet.« less

  7. Tank 241-AY-101 Privatization Push Mode Core Sampling and Analysis Plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    TEMPLETON, A.M.

    2000-01-12

    This sampling and analysis plan (SAP) identifies characterization objectives pertaining to sample collection, laboratory analytical evaluation, and reporting requirements for samples obtained from tank 241-AY-101. The purpose of this sampling event is to obtain information about the characteristics of the contents of 241-AY-101 required to satisfy Data Quality Objectives For RPP Privatization Phase I: Confirm Tank T Is An Appropriate Feed Source For High-Level Waste Feed Batch X(HLW DQO) (Nguyen 1999a), Data Quality Objectives For TWRS Privatization Phase I : Confirm Tank T Is An Appropriate Feed Source For Low-Activity Waste Feed Batch X (LAW DQO) (Nguyen 1999b), Low Activitymore » Waste and High-Level Waste Feed Data Quality Objectives (L and H DQO) (Patello et al. 1999), and Characterization Data Needs for Development, Design, and Operation of Retrieval Equipment Developed through the Data Quality Objective Process (Equipment DQO) (Bloom 1996). Special instructions regarding support to the LAW and HLW DQOs are provided by Baldwin (1999). Push mode core samples will be obtained from risers 15G and 150 to provide sufficient material for the chemical analyses and tests required to satisfy these data quality objectives. The 222-S Laboratory will extrude core samples; composite the liquids and solids; perform chemical analyses on composite and segment samples; archive half-segment samples; and provide subsamples to the Process Chemistry Laboratory. The Process Chemistry Laboratory will prepare test plans and perform process tests to evaluate the behavior of the 241-AY-101 waste undergoing the retrieval and treatment scenarios defined in the applicable DQOs. Requirements for analyses of samples originating in the process tests will be documented in the corresponding test plans and are not within the scope of this SAP.« less

  8. Tank 241-AY-101 Privatization Push Mode Core Sampling and Analysis Plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    TEMPLETON, A.M.

    2000-05-19

    This sampling and analysis plan (SAP) identifies characterization objectives pertaining to sample collection, laboratory analytical evaluation, and reporting requirements for samples obtained from tank 241-AY-101. The purpose of this sampling event is to obtain information about the characteristics of the contents of 241-AY-101 required to satisfy ''Data Quality Objectives For RPP Privatization Phase I: Confirm Tank T Is An Appropriate Feed Source For High-Level Waste Feed Batch X(HLW DQO)' (Nguyen 1999a), ''Data Quality Objectives For TWRS Privatization Phase I: Confirm Tank T Is An Appropriate Feed Source For Low-Activity Waste Feed Butch X (LAW DQO) (Nguyen 1999b)'', ''Low Activity Wastemore » and High-Level Waste Feed Data Quality Objectives (L&H DQO)'' (Patello et al. 1999), and ''Characterization Data Needs for Development, Design, and Operation of Retrieval Equipment Developed through the Data Quality Objective Process (Equipment DQO)'' (Bloom 1996). Special instructions regarding support to the LAW and HLW DQOs are provided by Baldwin (1999). Push mode core samples will be obtained from risers 15G and 150 to provide sufficient material for the chemical analyses and tests required to satisfy these data quality objectives. The 222-S Laboratory will extrude core samples; composite the liquids and solids; perform chemical analyses on composite and segment samples; archive half-segment samples; and provide sub-samples to the Process Chemistry Laboratory. The Process Chemistry Laboratory will prepare test plans and perform process tests to evaluate the behavior of the 241-AY-101 waste undergoing the retrieval and treatment scenarios defined in the applicable DQOs. Requirements for analyses of samples originating in the process tests will be documented in the corresponding test plans and are not within the scope of this SAP.« less

  9. Tank waste remediation system systems engineering management plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Peck, L.G.

    1998-01-08

    This Systems Engineering Management Plan (SEMP) describes the Tank Waste Remediation System (TWRS) implementation of the US Department of Energy (DOE) systems engineering policy provided in 97-IMSD-193. The SEMP defines the products, process, organization, and procedures used by the TWRS Project to implement the policy. The SEMP will be used as the basis for tailoring the systems engineering applications to the development of the physical systems and processes necessary to achieve the desired end states of the program. It is a living document that will be revised as necessary to reflect changes in systems engineering guidance as the program evolves.more » The US Department of Energy-Headquarters has issued program management guidance, DOE Order 430. 1, Life Cycle Asset Management, and associated Good Practice Guides that include substantial systems engineering guidance.« less

  10. Progress and future direction for the interim safe storage and disposal of Hanford high-level waste

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kinzer, J.E.; Wodrich, D.D.; Bacon, R.F.

    This paper describes the progress made at the largest environmental cleanup program in the United States. Substantial advances in methods to start interim safe storage of Hanford Site high-level wastes, waste characterization to support both safety- and disposal-related information needs, and proceeding with cost-effective disposal by the U.S. Department of Energy (DOE) and its Hanford Site contractors, have been realized. Challenges facing the Tank Waste Remediation System (TWRS) Program, which is charged with the dual and parallel missions of interim safe storage and disposal of the high-level tank waste stored at the Hanford Site, are described. In these times ofmore » budget austerity, implementing an ongoing program that combines technical excellence and cost effectiveness is the near-term challenge. The technical initiatives and progress described in this paper are made more cost effective by DOE`s focus on work force productivity improvement, reduction of overhead costs, and reduction, integration and simplification of DOE regulations and operations requirements to more closely model those used in the private sector.« less

  11. Feasibility study of tank leakage mitigation using subsurface barriers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Treat, R.L.; Peters, B.B.; Cameron, R.J.

    1994-09-21

    The US Department of Energy (DOE) has established the Tank Waste Remediation System (TWRS) to satisfy manage and dispose of the waste currently stored in the underground storage tanks. The retrieval element of TWRS includes a work scope to develop subsurface impermeable barriers beneath SSTs. The barriers could serve as a means to contain leakage that may result from waste retrieval operations and could also support site closure activities by facilitating cleanup. Three types of subsurface barrier systems have emerged for further consideration: (1) chemical grout, (2) freeze walls, and (3) desiccant, represented in this feasibility study as a circulatingmore » air barrier. This report contains analyses of the costs and relative risks associated with combinations retrieval technologies and barrier technologies that from 14 alternatives. Eight of the alternatives include the use of subsurface barriers; the remaining six nonbarrier alternative are included in order to compare the costs, relative risks and other values of retrieval with subsurface barriers. Each alternative includes various combinations of technologies that can impact the risks associated with future contamination of the groundwater beneath the Hanford Site to varying degrees. Other potential risks associated with these alternatives, such as those related to accidents and airborne contamination resulting from retrieval and barrier emplacement operations, are not quantitatively evaluated in this report.« less

  12. Implementation plan for HANDI 2000 TWRS master equipment list

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    BENNION, S.I.

    This document presents the implementation plan for an additional deliverable of the HANDI 2000 Project. The PassPort Equipment Data module processes include those portions of the COTS PassPort system required to support tracking and management of the Master Equipment List for Lockheed Martin Hanford Company (LMHC) and custom software created to work with the COTS products.

  13. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Guo Baonian; Gossmann, Hans-Joachim; Toh, Terry

    Angle control has been widely accepted as the key requirement for ion implantation in semiconductor device processing. From an ion implanter point of view, the incident ion direction should be measured and corrected by suitable techniques, such as XP-VPS for the VIISta implanter platform, to ensure precision ion placement in device structures. So called V-curves have been adopted to generate the wafer-based calibration using channeling effects as the Si lattice steer ions into a channeling direction. Thermal Wave (TW) or sheet resistance (Rs) can be used to determine the minimum of the angle response curve. Normally it is expected thatmore » the TW and Rs have their respective minima at identical angles. However, the TW and Rs response to the angle variations does depend on factors such as implant species, dose, and wafer temperature. Implant damage accumulation effects have to be considered for data interpretation especially for some 'abnormal' V-curve data. In this paper we will discuss some observed 'abnormal' angle responses, such as a) TW/Rs reverse trend for Arsenic beam, 2) 'W' shape of Rs Boron, and 3) apparent TW/Rs minimum difference for high tilt characterization, along with experimental data and TCAD simulations.« less

  14. Portable exhausters POR-004 SKID B, POR-005 SKID C, POR-006 SKID D storage plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nelson, O.D.

    1997-09-04

    This document provides a storage plan for portable exhausters POR-004 SKID B, POR-005 SKID C, AND POR-006 SKID D. The exhausters will be stored until they are needed by the TWRS (Tank Waste Remediation Systems) Saltwell Pumping Program. The storage plan provides criteria for portable exhauster storage, periodic inspections during storage, and retrieval from storage.

  15. Office of River Protection Integrated Safety Management System Description

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    CLARK, D.L.

    Revision O was never issued. Finding safe and environmentally sound methods of storage and disposal of 54 million gallons of highly radioactive waste contained in 177 underground tanks is the largest challenge of Hanford cleanup. TWRS was established in 1991 and continues to integrate all aspects of the treatment and management of the high-level radioactive waste tanks. In fiscal Year 1997, program objectives were advanced in a number of areas. RL TWRS refocused the program toward retrieving, treating, and immobilizing the tank wastes, while maintaining safety as first priority. Moving from a mode of storing the wastes to getting themore » waste out of the tanks will provide the greatest cleanup return on the investment and eliminate costly mortgage continuance. There were a number of safety-related achievements in FY1997. The first high priority safety issue was resolved with the removal of 16 tanks from the ''Wyden Watch List''. The list, brought forward by Senator Ron Wyden of Oregon, identified various Hanford safety issues needing attention. One of these issues was ferrocyanide, a chemical present in 24 tanks. Although ferrocyanide can ignite at high temperature, analysis found that the chemical has decomposed into harmless compounds and is no longer a concern.« less

  16. TWRS Retrieval and Storage Mission and Immobilized Low Activity Waste (ILAW) Disposal Plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    BURBANK, D.A.

    This project plan has a twofold purpose. First, it provides a waste stream project plan specific to the River Protection Project (RPP) (formerly the Tank Waste Remediation System [TWRS] Project) Immobilized Low-Activity Waste (LAW) Disposal Subproject for the Washington State Department of Ecology (Ecology) that meets the requirements of Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Milestone M-90-01 (Ecology et al. 1994) and is consistent with the project plan content guidelines found in Section 11.5 of the Tri-Party Agreement action plan (Ecology et al. 1998). Second, it provides an upper tier document that can be used as themore » basis for future subproject line-item construction management plans. The planning elements for the construction management plans are derived from applicable U.S. Department of Energy (DOE) planning guidance documents (DOE Orders 4700.1 [DOE 1992] and 430.1 [DOE 1995a]). The format and content of this project plan are designed to accommodate the requirements mentioned by the Tri-Party Agreement and the DOE orders. A cross-check matrix is provided in Appendix A to explain where in the plan project planning elements required by Section 11.5 of the Tri-Party Agreement are addressed.« less

  17. Safety equipment list for the 241-SY-101 RAPID mitigation project

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    MORRIS, K.L.

    1999-06-29

    This document provides the safety classification for the safety (safety class and safety RAPID Mitigation Project. This document is being issued as the project SEL until the supporting authorization basis documentation, this document will be superseded by the TWRS SEL (LMHC 1999), documentation istlralized. Upon implementation of the authorization basis significant) structures, systems, and components (SSCS) associated with the 241-SY-1O1 which will be updated to include the information contained herein.

  18. Chemical composition of Hanford Tank SY-102

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Birnbaum, E.; Agnew, S.; Jarvinen, G.

    1993-12-01

    The US Department of Energy established the Tank Waste Remediation System (TWRS) to safely manage and dispose of the radioactive waste, both current and future, stored in double-shell and single-shell tanks at the Hanford sites. One major program element in TWRS is pretreatment which was established to process the waste prior to disposal using the Hanford Waste Vitrification Plant. In support of this program, Los Alamos National Laboratory has developed a conceptual process flow sheet which will remediate the entire contents of a selected double-shelled underground waste tank, including supernatant and sludge, into forms that allow storage and final disposalmore » in a safe, cost-effective and environmentally sound manner. The specific tank selected for remediation is 241-SY-102 located in the 200 West Area. As part of the flow sheet development effort, the composition of the tank was defined and documented. This database was built by examining the history of liquid waste transfers to the tank and by performing careful analysis of all of the analytical data that have been gathered during the tank`s lifetime. In order to more completely understand the variances in analytical results, material and charge balances were done to help define the chemistry of the various components in the tank. This methodology of defining the tank composition and the final results are documented in this report.« less

  19. Clean option: An alternative strategy for Hanford Tank Waste Remediation. Volume 2, Detailed description of first example flowsheet

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Swanson, J.L.

    1993-09-01

    Disposal of high-level tank wastes at the Hanford Site is currently envisioned to divide the waste between two principal waste forms: glass for the high-level waste (HLW) and grout for the low-level waste (LLW). The draft flow diagram shown in Figure 1.1 was developed as part of the current planning process for the Tank Waste Remediation System (TWRS), which is evaluating options for tank cleanup. The TWRS has been established by the US Department of Energy (DOE) to safely manage the Hanford tank wastes. It includes tank safety and waste disposal issues, as well as the waste pretreatment and wastemore » minimization issues that are involved in the ``clean option`` discussed in this report. This report describes the results of a study led by Pacific Northwest Laboratory to determine if a more aggressive separations scheme could be devised which could mitigate concerns over the quantity of the HLW and the toxicity of the LLW produced by the reference system. This aggressive scheme, which would meet NRC Class A restrictions (10 CFR 61), would fit within the overall concept depicted in Figure 1.1; it would perform additional and/or modified operations in the areas identified as interim storage, pretreatment, and LLW concentration. Additional benefits of this scheme might result from using HLW and LLW disposal forms other than glass and grout, but such departures from the reference case are not included at this time. The evaluation of this aggressive separations scheme addressed institutional issues such as: radioactivity remaining in the Hanford Site LLW grout, volume of HLW glass that must be shipped offsite, and disposition of appropriate waste constituents to nonwaste forms.« less

  20. Integration and baseline management training and transition plan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jech, J.B.

    The purpose of the Integration and Baseline Management Training and Transition Plan is to provide a training outline for the Integration and Baseline Management (I and BM) organization and a transition strategy for the Master Equipment List (MEL) Phase 1 application. The training outline includes the following courses: MEL Phase 1 Application Course 1 Master Equipment List General Overview. Course 2 Master Equipment List Editing. Tank Waste Remediation System (TWRS) Labeling Related Course 3 TWRS Equipment Labeling Program (Course Number 350545). As part of courses 1, 2, and 3, it is recommended that a lesson plan be developed and integratedmore » into each of the three courses on the subject of Configuration Management (CM) to include: CM concepts, terminology, definitions, fundamentals and its application with respect to the course. The strategy for the MEL Phase 1 application is to train internal organizations (I and BM) on the MEL-General Overview for read only users and train MEL-Editing for edit users (only on an as needed basis). For external organizations, the strategy is to train selected personnel on the MEL-General Overview and transition them from read only privileges to editing privileges when the appropriate administrative procedures that outline the external organization`s responsibilities (to support MEL) are established. The purpose of this training is to ensure support of the I and BM organization objectives within the TV,IRS Division. These training courses will be added to the existing required training for I and BM personnel only. Other organizations implementing the training will be directed by their management on which training is required.« less

  1. Waste Management Project fiscal year 1998 multi-year work plan, WBS 1.2

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jacobsen, P.H.

    The Waste Management Project manages and integrates (non-TWRS) waste management activities at the site. Activities include management of Hanford wastes as well as waste transferred to Hanford from other DOE, Department of Defense, or other facilities. This work includes handling, treatment, storage, and disposal of radioactive, nonradioactive, hazardous, and mixed solid and liquid wastes. Major Waste Management Projects are the Solid Waste Project, Liquid Effluents Project, and Analytical Services. Existing facilities (e.g., grout vaults and canyons) shall be evaluated for reuse for these purposes to the maximum extent possible.

  2. Technical information report: Plasma melter operation, reliability, and maintenance analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hendrickson, D.W.

    1995-03-14

    This document provides a technical report of operability, reliability, and maintenance of a plasma melter for low-level waste vitrification, in support of the Hanford Tank Waste Remediation System (TWRS) Low-Level Waste (LLW) Vitrification Program. A process description is provided that minimizes maintenance and downtime and includes material and energy balances, equipment sizes and arrangement, startup/operation/maintence/shutdown cycle descriptions, and basis for scale-up to a 200 metric ton/day production facility. Operational requirements are provided including utilities, feeds, labor, and maintenance. Equipment reliability estimates and maintenance requirements are provided which includes a list of failure modes, responses, and consequences.

  3. Functions and requirements for tank farm restoration and safe operations, Project W-314. Revision 3

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Garrison, R.C.

    1995-02-01

    This Functions and Requirements document (FRD) establishes the basic performance criteria for Project W-314, in accordance with the guidance outlined in the letter from R.W. Brown, RL, to President, WHC, ``Tank Waste Remediation System (TWRS) Project Documentation Methodology,`` 94-PRJ-018, dated 3/18/94. The FRD replaces the Functional Design Criteria (FDC) as the project technical baseline documentation. Project W-314 will improve the reliability of safety related systems, minimize onsite health and safety hazards, and support waste retrieval and disposal activities by restoring and/or upgrading existing Tank Farm facilities and systems. The scope of Project W-314 encompasses the necessary restoration upgrades of themore » Tank Farms` instrumentation, ventilation, electrical distribution, and waste transfer systems.« less

  4. Preliminary survey of separations technology applicable to the pretreatment of Hanford tank waste (1992--1993)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lawrence, W.E.; Kurath, D.E.

    1994-04-01

    The US Department of Energy has established the Tank Waste Remediation System (TWRS) to manage and dispose of radioactive wastes stored at the Hanford Site. Within this program are evaluations of pretreatment system alternatives through literature reviews. The information in this report was collected as part of this project at Pacific Northwest Laboratory. A preliminary survey of literature on separations recently entered into the Hanford electronic databases (1992--1993) that have the potential for pretreatment of Hanford tank waste was conducted. Separation processes that can assist in the removal of actinides (uranium, plutonium, americium), lanthanides, barium, {sup 137}Cs, {sup 90}Sr,{sup 129more » }I, {sup 63}Ni, and {sup 99}Tc were evaluated. Separation processes of interest were identified through literature searches, journal reviews, and participation in separation technology conferences. This report contains brief descriptions of the potential separation processes, the extent and/or selectivity of the separation, the experimental conditions, and observations. Information was collected on both national and international separation studies to provide a global perspective on recent research efforts.« less

  5. Hanford analytical sample projections FY 1998--FY 2002

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Joyce, S.M.

    1998-02-12

    Analytical Services projections are compiled for the Hanford site based on inputs from the major programs for the years 1998 through 2002. Projections are categorized by radiation level, protocol, sample matrix and program. Analyses requirements are also presented. This document summarizes the Hanford sample projections for fiscal years 1998 to 2002. Sample projections are based on inputs submitted to Analytical Services covering Environmental Restoration, Tank Waste Remediation Systems (TWRS), Solid Waste, Liquid Effluents, Spent Nuclear Fuels, Transition Projects, Site Monitoring, Industrial Hygiene, Analytical Services and miscellaneous Hanford support activities. In addition, details on laboratory scale technology (development) work, Sample Management,more » and Data Management activities are included. This information will be used by Hanford Analytical Services (HAS) and the Sample Management Working Group (SMWG) to assure that laboratories and resources are available and effectively utilized to meet these documented needs.« less

  6. Load drop evaluation for TWRS FSAR

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Julyk, L.J.; Ralston, G.L.

    1996-09-30

    Operational or remediation activities associated with existing underground high-level waste storage tank structures at the Hanford Site often require the installation/removal of various equipment items. To gain tank access for installation or removal of this equipment, large concrete cover blocks must be removed and reinstalled in existing concrete pits above the tanks. An accidental drop of the equipment or cover blocks while being moved over the tanks that results in the release of contaminants to the air poses a potential risk to onsite workers or to the offsite public. To minimize this potential risk, the use of critical lift hoistingmore » and rigging procedures and restrictions on lift height are being considered during development of the new tank farm Basis for Interim Operation and Final Safety Analysis Report. The analysis contained herein provides information for selecting the appropriate lift height restrictions for these activities.« less

  7. TWRS vadose zone contamination issue expert panel report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shafer, D.S.

    1997-05-01

    When members were first canvassed for participation in the Vadose Zone Expert Panel the stated purpose for convening the Panel was to review a controversial draft report, the SX Tank Farm Report. This report was produced by a DOE Grand Junction Project Office (GJPO) contractor, RUST Geotech, now MACTEC-ERS, for the DOE Richland Office (DOERL). Three meetings were planned for June, July and August, 1995 to review the draft report and to complete a Panel report by mid-September. The Expert Panel has found its efforts confounded by various non-technical issues. The Expert Panel has chosen to address some of themore » non-technical issues in this Preface rather than to dilute the technical discussion that follows in the body of this independent expert panel status report (Panel Report). Rather than performing a straightforward manuscript review, the Panel was asked to resolve conflicting interpretations of gamma-ray logging measurements performed in vadose zone boreholes (drywells) surrounding the high-level radioactive wastes of the SX tank farm. There are numerous and complex technical issues that must be evaluated before the vertical and radial extent of contaminant migration at the SX tank farm can be accurately assessed. When the Panel first met in early June, 1996, it quickly became apparent that the scientific and technical issues were obscured by policy and institutional affairs which have polarized discussion among various segments of the Hanford organization. This situation reflects the kinds of institutional problems described separately in reports by the National Research Council of the National Academy of Sciences (NAS/NRC), The Hanford Tanks Environmental Impacts and Policy Choices and BmTiers to Science: Technical Management of the Department of Energy Environmental Remediation Program. The Vadose Zone Characterization Program, appears to be caught between conflicting pressures and organizational mandates, some imposed from outside DOE-RL and some self-imposed. The institutional problems they encountered include having both Tank Waste Remediation System (TWRS), the parent organization of the Vadose Zone Characterization Program and Environmental Restoration (ER), each under different regulatory controls and different organizational units, seeking to defend the status quo and discount many of the Panel`s conclusions and recommendations. The results presented in the SX Tank Farm Report, especially the visualizations, have created concern in the public sector, both on a local, personal level and on a national political level.« less

  8. Tank characterization report for single-shell tank 241-C-109

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Simpson, B.C.

    1997-05-23

    One of the major functions of the Tank Waste Remediation System (TWRS) is to characterize wastes in support of waste management and disposal activities at the Hanford Site. Analytical data from sampling and analysis, along with other available information about a tank, are compiled and maintained in a tank characterization report (TCR). This report and its appendices serve as the TCR for single-shell tank 241-C-109. The objectives of this report are: (1) to use characterization data in response to technical issues associated with tank 241 C-109 waste; and (2) to provide a standard characterization of this waste in terms ofmore » a best-basis inventory estimate. The response to technical issues is summarized in Section 2.0, and the best-basis inventory estimate is presented in Section 3.0. Recommendations regarding safety status and additional sampling needs are provided in Section 4.0. Supporting data and information are contained in the appendices.« less

  9. Type C investigation of electrical fabrication projects in ICF Kaiser shops

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Huckfeldt, R.A.

    1995-06-01

    A Type C Investigation Board was convened to investigate an electrical miswiring problem found during the operation of the electrical distribution trailer for the TWRS Rotary Mode Core Sampling Truck {number_sign}2. The trailer was designed by WHC and fabricated ICF KH on site for use in the Characterization Program. This problem resulted in a serious safety hazard since the support truck frame/chassis became electrically energized. This final report provides results of the ``Type C Investigation, Electrical Fabrication Projects in ICF KH Shops, June, 1995.`` It contains the investigation scope, executive summary, relevant facts, analysis, conclusions and corrective actions. DOE Ordermore » 5484.1, ``Environmental Protection, Safety and Health Protection Information Reporting Requirements,`` was followed in preparation of this report. Because the incident was electrical in nature and involved both Westinghouse Hanford Company and ICF Kaiser Hanford organizations, the board included members from both contractors and members with considerable electrical expertise.« less

  10. A systematic review and meta-analysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals

    PubMed Central

    Devereaux, P.J.; Choi, Peter T.L.; Lacchetti, Christina; Weaver, Bruce; Schünemann, Holger J.; Haines, Ted; Lavis, John N.; Grant, Brydon J.B.; Haslam, David R.S.; Bhandari, Mohit; Sullivan, Terrence; Cook, Deborah J.; Walter, Stephen D.; Meade, Maureen; Khan, Humaira; Bhatnagar, Neera; Guyatt, Gordon H.

    2002-01-01

    Background Canadians are engaged in an intense debate about the relative merits of private for-profit versus private not-for-profit health care delivery. To inform this debate, we undertook a systematic review and meta-analysis of studies comparing the mortality rates of private for-profit hospitals and those of private not-for-profit hospitals. Methods We identified studies through an electronic search of 11 bibliographical databases, our own files, consultation with experts, reference lists, PubMed and SciSearch. We masked the study results before determining study eligibility. Our eligibility criteria included observational studies or randomized controlled trials that compared private for-profit and private not-for-profit hospitals. We excluded studies that evaluated mortality rates in hospitals with a particular profit status that subsequently converted to the other profit status. For each study, we calculated a relative risk of mortality for private for-profit hospitals relative to private not-for-profit hospitals and pooled the studies of adult populations that included adjustment for potential confounders (e.g., teaching status, severity of illness) using a random effects model. Results Fifteen observational studies, involving more than 26 000 hospitals and 38 million patients, fulfilled the eligibility criteria. In the studies of adult populations, with adjustment for potential confounders, private for-profit hospitals were associated with an increased risk of death (relative risk [RR] 1.020, 95% confidence interval [CI] 1.003–1.038; p = 0.02). The one perinatal study with adjustment for potential confounders also showed an increased risk of death in private for-profit hospitals (RR 1.095, 95% CI 1.050–1.141; p < 0.0001). Interpretation Our meta-analysis suggests that private for-profit ownership of hospitals, in comparison with private not-for-profit ownership, results in a higher risk of death for patients. PMID:12054406

  11. Payments for care at private for-profit and private not-for-profit hospitals: a systematic review and meta-analysis

    PubMed Central

    Devereaux, P.J.; Heels-Ansdell, Diane; Lacchetti, Christina; Haines, Ted; Burns, Karen E.A.; Cook, Deborah J.; Ravindran, Nikila; Walter, S.D.; McDonald, Heather; Stone, Samuel B.; Patel, Rakesh; Bhandari, Mohit; Schünemann, Holger J.; Choi, Peter T.-L.; Bayoumi, Ahmed M.; Lavis, John N.; Sullivan, Terrence; Stoddart, Greg; Guyatt, Gordon H.

    2004-01-01

    Background It has been shown that patients cared for at private for-profit hospitals have higher risk-adjusted mortality rates than those cared for at private not-for-profit hospitals. Uncertainty remains, however, about the economic implications of these forms of health care delivery. Since some policy-makers might still consider for-profit health care if expenditure savings were sufficiently large, we undertook a systematic review and meta-analysis to compare payments for care at private for-profit and private not-for-profit hospitals. Methods We used 6 search strategies to identify published and unpublished observational studies that directly compared the payments for care at private for-profit and private not-for-profit hospitals. We masked the study results before teams of 2 reviewers independently evaluated the eligibility of all studies. We confirmed data or obtained additional data from all but 1 author. For each study, we calculated the payments for care at private for-profit hospitals relative to private not-for-profit hospitals and pooled the results using a random effects model. Results Eight observational studies, involving more than 350 000 patients altogether and a median of 324 hospitals each, fulfilled our eligibility criteria. In 5 of 6 studies showing higher payments for care at private for-profit hospitals, the difference was statistically significant; in 1 of 2 studies showing higher payments for care at private not-for-profit hospitals, the difference was statistically significant. The pooled estimate demonstrated that private for-profit hospitals were associated with higher payments for care (relative payments for care 1.19, 95% confidence interval 1.07–1.33, p = 0.001). Interpretation Private for-profit hospitals result in higher payments for care than private not-for-profit hospitals. Evidence strongly supports a policy of not-for-profit health care delivery at the hospital level. PMID:15184339

  12. Private Scholarships Count: Access to Higher Education and the Critical Role of the Private Sector

    ERIC Educational Resources Information Center

    McSwain, Courtney; Cunningham, Alisa; Keselman, Yuliya; Merisotis, Jamie

    2005-01-01

    The first comprehensive study of private scholarship aid, this report provides an understanding of this type of aid, and examines its importance to students and to private aid providers. Key findings from the study indicate that over 3 billion dollars in private scholarship aid was awarded in 2003-04, that approximately one hundred million dollars…

  13. Universities and Fields of Study in Argentina: A Public-Private Comparison from the Supply and Demand Side. PROPHE Working Paper Series. WP No. 15

    ERIC Educational Resources Information Center

    Rabossi, Marcelo

    2010-01-01

    Private higher education literature recognizes large public-private differentiation in terms of field of study. Relative to public counterparts, private universities tend to offer their services in fields that require low initial investments and present at least relatively attractive internal private rates of return. Thus, the main objective of…

  14. Tank characterization report for single-shell tank 241-S-111

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Conner, J.M.

    1997-04-28

    One of the major functions of the Tank Waste Remediation System (TWRS) is to characterize wastes in support of waste management and disposal activities at the Hanford Site. Analytical data from sampling and analysis, along with other available information about a tank, are compiled and maintained in a tank characterization report (TCR). This report and its appendices serve as the TCR for single-shell tank 241-S-111. The objectives of this report are: (1) to use characterization data to address technical issues associated with tank 241-S-111 waste; and (2) to provide a standard characterization of this waste in terms of a best-basismore » inventory estimate. The response to technical issues is summarized in Section 2.0, and the best-basis inventory estimate is presented in Section 3.0. Recommendations regarding safety status and additional sampling needs are provided in Section 4.0. Supporting data and information are contained in the appendices. This report also supports the requirements of Hanford Federal Facility Agreement and Consent Order (Ecology et al. 1996) milestone M-44-10.« less

  15. Performance of fully private and concessionary water and sewerage companies: a metafrontier approach.

    PubMed

    Molinos-Senante, María; Sala-Garrido, Ramon

    2016-06-01

    As many countries have privatized their water industries, there is increasing interest in comparing the efficiency of public and private water and sewerage companies (WaSCs). However, previous studies have not considered that privatization can be carried out following two main approaches: fully private WaSCs, which involve the sale of utilities to the private sector, and concessionary WaSCs, in which only the operation of the services is privatized. This paper investigates, for the first time, the impact of both privatization approaches on the efficiency of WaSCs. In doing so, data envelopment analysis (DEA) was applied. However, unlike traditional models, the metafrontier concept was used in this research as it cannot be assumed that fully private and concessionary WaSCs share the same production frontier. The empirical application focused on the Chilean water industry as it was privatized from 1998 to 2004 following the two approaches described. The results suggest that the performance of fully private WaSCs is better than that of concessionary WaSCs. The conclusions of this study will be of great interest to water authorities worldwide facing the challenge of water industry privatization.

  16. Implementation of RNTCP in a private medical college: five years' experience.

    PubMed

    Arora, Vijay; Jaiswal, Ashish K; Gupta, Sonisha; Gupta, Mohan B; Jain, Vidhushi; Ghanchi, Firoz

    2012-07-01

    Revised National Tuberculosis Control Programme (RNTCP) recognizes the need for involvement of all sectors, public and private, to create an epidemiological impact on Tuberculosis control. The private health sector in the country is an important source of care, even with the availability of public health services and Directly Observed Treatment Strategy (DOTS). The data regarding Private-Private mix in our country is lacking. To evaluate the contribution of {private health sector (Private Medical Colleges and Private practioners (PP)} in TB case-detection, diagnosis and treatment outcomes in Delhi NCR, Ghaziabad, India. We analyzed the TB registers from May 2006-Dec 2010 from our institution and recruited the patients in our study, irrespective of the source. We strengthened the referral by promoting educational intra and inter departmental activities and awareness programme with more stress on retrieval action by contact tracing and counselling. We made a list of PP in our drainage area and regularly met them and tried to understand the barriers in referring cases to DOTS centre. During the study, we tried to maintain the flow of information working as a single window information system. We regularly passed on the information of follow up of patients to private practioners referred to us by them to generate confidence in them. During the study, no incentive was offered to any patient. Various indicators and data were collected annually and analyzed statistically. Retrospective, Descriptive Analysis. There was a substantial increase of 116.3% in the total patients referred from all sources to Santosh Hospital. The proportion of extra-pulmonary cases was 29.1% to 34.4% of all total cases from the year 2006 to 2010. During subsequent years, we found a significant increase in referral from Private Practioners that was the result of our activities performed in private set up. It was 12.5%, 21.2%, 30.8%, 27.3%, and 29% during 2006, 2007, 2008, 2009 and 2010 respectively. The outcome in our study was in accordance with the outcome at national level under RNTCP. Because of extensive educational activities, single window information system and referring the patients back to private sector after completion of treatment increased the confidence amongst the private physicians. These results strengthen the Private-Private Collaboration and show that a stronger link can be developed between medical college and private setup, leading to implementation of successful Private-Private Strategy.

  17. Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana

    PubMed Central

    Awoke, Mamaru Ayenew; Negin, Joel; Moller, Jette; Farell, Penny; Yawson, Alfred E.; Biritwum, Richard Berko; Kowal, Paul

    2017-01-01

    ABSTRACT Background: Previous studies investigating factors associated with healthcare utilization by older Ghanaians lack distinction between public and private health services. The present study examined factors associated with public and private healthcare service use, and the resulting perceived health system responsiveness. Objectives: To identify factors associated with public and private healthcare utilization among older adults aged 50 and older in Ghana; and to compare perceived differences in health system responsiveness between the private and public sectors. Methods: Cross-sectional data was analyzed from the World Health Organization Study on global AGEing and adult health (SAGE) Wave 1 in Ghana. Using Andersen’s conceptual framework, public and private outpatient care utilization was examined using multinomial logistic regression to estimate and identify predictor variables associated with the type of outpatient healthcare facility accessed. Health system responsiveness was compared using chi-square tests. Results: Of 2517 respondents who used outpatient care in the 12 months preceding interview, 51.7% of respondents used a public facility, 17.8% a private facility, and 30.5% used other facilities. Older age group, higher education and higher wealth were associated with the use of private outpatient healthcare services. Using public outpatient care facilities was associated with having health insurance. Respondents with two or more chronic conditions were more likely to use public and private outpatient care than other facilities. Perceived health system responsiveness was better in private for-profit than in public and private not-for-profit healthcare facilities. Conclusions: This study suggested that higher wealth and multimorbidity were significant predictors of public and private outpatient healthcare utilization; however, health insurance was a predictor only for the use of public facilities. Future mixed-method studies could further elucidate factors influencing the choice of public and private outpatient healthcare use. PMID:28578615

  18. Access to Higher Education in Chile: A Public vs. Private Analysis

    ERIC Educational Resources Information Center

    Espinoza, Oscar; González, Luis Eduardo

    2013-01-01

    This study analyzes how access to public and private institutions of higher education in Chile has changed as the post-secondary system has become increasingly privatized. It analyses access by young people to higher education from four perspectives: funding type (public/private), gender, family income level, and ethnicity. The study uses…

  19. Differences between Public and Private Universities' Fields of Study in Argentina

    ERIC Educational Resources Information Center

    Rabossi, Marcelo Alberto

    2011-01-01

    The literature on private higher education has identified striking differences between the public and private sectors in terms of fields of study. For example, unlike their public counterparts, private universities have traditionally specialised in the social sciences and humanities. This paper explores the university market in Argentina to see if…

  20. Comparing the services and quality of private and public clinics in rural China.

    PubMed

    Meng, Q; Liu, X; Shi, J

    2000-12-01

    After 15 years eradication of the private health sector in Socialist China, private practice was restored in 1980 along with the market oriented economic reform. In recent years, however, debates on its pros and cons are increasing. Arguments against private practice have led to a ban on private practice in some rural counties. The arguments against private practice state that the service quality of private clinics tends to be lower than that of public ones; private clinics are less likely to provide preventive care; and private clinics are more likely to provide over-treatment. This paper presents the major findings from a study conducted in China, aiming at comparing private and public village health clinics in terms of quality of services, willingness to provide preventive care and over-prescription of drugs. While it was found that the quality of services was poor and a large proportion of patient expenditure was due to over-treatment for all village clinics, there was no difference between public and private clinics. Both private and public clinics were willing to provide preventive services if they were subsidized for the provision. This study finds no evidence that care provided by private clinics is inferior to that of public clinics.

  1. Strategies for engaging the private sector in sexual and reproductive health: how effective are they?

    PubMed

    Peters, David H; Mirchandani, Gita G; Hansen, Peter M

    2004-10-01

    The private health sector provides a significant portion of sexual and reproductive health (SRH) services in developing countries. Yet little is known about which strategies for intervening with private providers can improve quality or coverage of services. We conducted a systematic review of the literature through PubMed from 1980 to 2003 to assess the effectiveness of private sector strategies for SRH services in developing countries. The strategies examined were regulating, contracting, financing, franchising, social marketing, training and collaborating. Over 700 studies were examined, though most were descriptive papers, with only 71 meeting our inclusion criteria of having a private sector strategy for one or more SRH services and the measurement of an outcome in the provider or the beneficiary. Nearly all studies (96%) had at least one positive association between SRH and the private sector strategy. About three-quarters of the studies involved training private providers, though combinations of strategies tended to give better results. Maternity services were most commonly addressed (55% of studies), followed by prevention and treatment of sexually transmitted diseases (32%). Using study design to rate the strength of evidence, we found that the evidence about effectiveness of private sector strategies on SRH services is weak. Most studies did not use comparison groups, or they relied on cross-sectional designs. Nearly all studies examined short-term effects, largely measuring changes in providers rather than changes in health status or other effects on beneficiaries. Five studies with more robust designs (randomized controlled trials) demonstrated that contraceptive use could be increased through supporting private providers, and showed cases where the knowledge and practices of private providers could be improved through training, regulation and incentives. Although tools to work with the private sector offer considerable promise, without stronger research designs, key questions regarding their feasibility and impact remain unanswered. Copyright 2004 Oxford University Press

  2. Private prayer associations with depression, anxiety and other health conditions: an analytical review of clinical studies.

    PubMed

    Anderson, James W; Nunnelley, Paige A

    2016-09-01

    To critically analyze appropriate clinical studies to assess the relationship between health conditions and the frequency of private prayer. Private prayer is defined as individuals praying for themselves. Using PubMed and other search engines, we identified over 300 articles reporting relationships between prayer and health conditions. We identified 41 observational clinical studies that evaluated the relationship between private prayer and health conditions. Prayer scores of 5 to 1 were assigned to studies, with 5 being private prayer for health and 1 being prayer in combination with meditation or Bible study. Frequency scores ranged from 3 to 1 with 3 being twice daily or more and 0 when frequency was not assessed. Studies were ranked from 8 to 1 based on the sum of Prayer and Frequency Scores. Twenty-one studies had Prayer-Frequency scores of 5 to 8, indicating that they evaluated private prayer (praying for one's own health) of suitable frequency in association with health conditions. Nine of 11 studies indicated that private prayer was associated with a significantly lower prevalence of depression (P value, <0.01). Optimism as well as coping were significantly improved by prayer in four studies (P value, P < 0.01). In 10 studies of mental health conditions-including anxiety and confusion-there was a significant benefit associated with prayer (P < 0.01), In the reviewed studies, prayer did not have a significant effect on physical health or blood pressure. The reported observational studies suggest that frequent private prayer is associated with a significant benefit for depression, optimism, coping, and other mental health conditions such as anxiety. Controlled clinical trials are required to critically assess the associations of private prayer and health conditions.

  3. Engineering study of 50 miscellaneous inactive underground radioactive waste tanks located at the Hanford Site, Washington

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Freeman-Pollard, J.R.

    1994-03-02

    This engineering study addresses 50 inactive underground radioactive waste tanks. The tanks were formerly used for the following functions associated with plutonium and uranium separations and waste management activities in the 200 East and 200 West Areas of the Hanford Site: settling solids prior to disposal of supernatant in cribs and a reverse well; neutralizing acidic process wastes prior to crib disposal; receipt and processing of single-shell tank (SST) waste for uranium recovery operations; catch tanks to collect water that intruded into diversion boxes and transfer pipeline encasements and any leakage that occurred during waste transfer operations; and waste handlingmore » and process experimentation. Most of these tanks have not been in use for many years. Several projects have, been planned and implemented since the 1970`s and through 1985 to remove waste and interim isolate or interim stabilize many of the tanks. Some tanks have been filled with grout within the past several years. Responsibility for final closure and/or remediation of these tanks is currently assigned to several programs including Tank Waste Remediation Systems (TWRS), Environmental Restoration and Remedial Action (ERRA), and Decommissioning and Resource Conservation and Recovery Act (RCRA) Closure (D&RCP). Some are under facility landlord responsibility for maintenance and surveillance (i.e. Plutonium Uranium Extraction [PUREX]). However, most of the tanks are not currently included in any active monitoring or surveillance program.« less

  4. Private Higher Education in India: A Study of Two Private Universities

    ERIC Educational Resources Information Center

    Angom, Sangeeta

    2015-01-01

    The Private higher education sector is growing fast in many settings, including India, and there are variations at the national level. Privatization of higher education in India has been the result of changes in the economic policy towards liberalization and privatization by the Government of India. Till 1980, higher education sector was…

  5. The "Decline" of Private Higher Education

    ERIC Educational Resources Information Center

    Levy, Daniel C.

    2013-01-01

    No topic in private higher education study has attracted as great attention globally as has growth. This is appropriate as private growth has soared to nearly a third of the world's total higher education enrolment. But while private growth continues to be the dominant trend, important declines in private shares have emerged. These must be…

  6. [Private health insurance in Brazil: approaches to public/private patterns in healthcare].

    PubMed

    Sestelo, José Antonio de Freitas; Souza, Luis Eugenio Portela Fernandes de; Bahia, Lígia

    2013-05-01

    This article draws on a previous review of 270 articles on private health plans published from 2000 to 2010 and selects 17 that specifically address the issue of the relationship between the public and private healthcare sectors. Content analysis considered the studies' concepts and terms, related theoretical elements, and predominant lines of argument. A reading of the argumentative strategies detected the existence of a critical view of the modus operandi in the public/private relationship based on Social Medicine and the theoretical tenets of the Brazilian Health Reform Movement. The study also identified contributions based on neoliberal business approaches that focus strictly on economic issues to discuss private health insurance. Understanding the public/private link in healthcare obviously requires the development of a solid empirical base, analyzed with adequate theoretical assumptions due to the inherent degree of complexity in the public/private healthcare interface.

  7. Systematic literature review of integrated community case management and the private sector in Africa: Relevant experiences and potential next steps.

    PubMed

    Awor, Phyllis; Miller, Jane; Peterson, Stefan

    2014-12-01

    Despite substantial investments made over the past 40 years in low income countries, governments cannot be viewed as the principal health care provider in many countries. Evidence on the role of the private sector in the delivery of health services is becoming increasingly available. In this study, we set out to determine the extent to which the private sector has been utilized in providing integrated care for sick children under 5 years of age with community-acquired malaria, pneumonia or diarrhoea. We reviewed the published literature for integrated community case management (iCCM) related experiences within both the public and private sector. We searched PubMed and Google/Google Scholar for all relevant literature until July 2014. The search terms used were "malaria", "pneumonia", "diarrhoea", "private sector" and "community case management". A total of 383 articles referred to malaria, pneumonia or diarrhoea in the private sector. The large majority of these studies (290) were only malaria related. Most of the iCCM-related studies evaluated introduction of only malaria drugs and/or diagnostics into the private sector. Only one study evaluated the introduction of drugs and diagnostics for malaria, pneumonia and diarrhoea in the private sector. In contrast, most iCCM-related studies in the public sector directly reported on community case management of 2 or more of the illnesses. While the private sector is an important source of care for children in low income countries, little has been done to harness the potential of this sector in improving access to care for non-malaria-associated fever in children within the community. It would be logical for iCCM programs to expand their activities to include the private sector to achieve higher population coverage. An implementation research agenda for private sector integrated care of febrile childhood illness needs to be developed and implemented in conjunction with private sector intervention programs.

  8. Systematic literature review of integrated community case management and the private sector in Africa: Relevant experiences and potential next steps

    PubMed Central

    Awor, Phyllis; Miller, Jane; Peterson, Stefan

    2014-01-01

    Background Despite substantial investments made over the past 40 years in low income countries, governments cannot be viewed as the principal health care provider in many countries. Evidence on the role of the private sector in the delivery of health services is becoming increasingly available. In this study, we set out to determine the extent to which the private sector has been utilized in providing integrated care for sick children under 5 years of age with community–acquired malaria, pneumonia or diarrhoea. Methods We reviewed the published literature for integrated community case management (iCCM) related experiences within both the public and private sector. We searched PubMed and Google/Google Scholar for all relevant literature until July 2014. The search terms used were “malaria”, “pneumonia”, “diarrhoea”, “private sector” and “community case management”. Results A total of 383 articles referred to malaria, pneumonia or diarrhoea in the private sector. The large majority of these studies (290) were only malaria related. Most of the iCCM–related studies evaluated introduction of only malaria drugs and/or diagnostics into the private sector. Only one study evaluated the introduction of drugs and diagnostics for malaria, pneumonia and diarrhoea in the private sector. In contrast, most iCCM–related studies in the public sector directly reported on community case management of 2 or more of the illnesses. Conclusions While the private sector is an important source of care for children in low income countries, little has been done to harness the potential of this sector in improving access to care for non–malaria–associated fever in children within the community. It would be logical for iCCM programs to expand their activities to include the private sector to achieve higher population coverage. An implementation research agenda for private sector integrated care of febrile childhood illness needs to be developed and implemented in conjunction with private sector intervention programs. PMID:25520804

  9. The "Failure" of Private Universities in Uruguay: A Tale of Three Institutions. ASHE Annual Meeting Paper.

    ERIC Educational Resources Information Center

    Roane, Warren

    In Latin America private universities are a recent phenomenon; Uruguay began its experiment with privatization only 15 years ago. This study explores several factors which have impeded formation of private universities by analyzing the "failures" of three institutions. The theoretical framework of the study is based on work by D.C. Levy…

  10. Training and Jobs Programs in Action: Case Studies in Private-Sector Initiatives for the Hard-to-Employ.

    ERIC Educational Resources Information Center

    Robison, David

    This book contains fifty-three case studies covering a wide variety of private-sector activities and public-private partnerships designed to increase training and employment opportunities for the hard-to-employ and speed the transition of the unemployed from government support and subsidized jobs to permanent private employment. Compiled from a…

  11. An Analysis of Private School Closings

    ERIC Educational Resources Information Center

    Pandey, Lakshmi; Sjoquist, David L.; Walker, Mary Beth

    2009-01-01

    We add to the small literature on private school supply by exploring exits of K-12 private schools. We find that the closure of private schools is not an infrequent event and use national survey data from the National Center for Education Statistics to study closures of private schools. We assume that the probability of an exit is a function of…

  12. Contractor Past Performance Information (PPI) in Source Selection: A Comparison Study of Public and Private Sector

    DTIC Science & Technology

    2005-05-01

    efficiencies similar to those in the private sector . However, along the way, Government and private sector industry have begun to disagree about how PPI is...double that of the private sector due to an evaluation process that is cumbersome, time-consuming, and lacking the efficiencies enjoyed by private

  13. IVHS Institutional Issues And Case Studies: Westchester Commuter Central Case Study

    DOT National Transportation Integrated Search

    1997-01-01

    Shared resource projects are public-private arrangements that involve sharing public property such as rights-of-way and private resources such as telecommunications capacity and expertise. Typically, private telecommunications providers are granted a...

  14. A Comparative Study of Students' Access to and Utilization of Learning Resources in Selected Public and Private Universities in Southwest, Nigeria

    ERIC Educational Resources Information Center

    Lawal, B. O.; Viatonu, Olumuyiwa

    2017-01-01

    The study investigated students' access to and utilization of some learning resources in selected public and private universities in southwest Nigeria. Stratified random sampling technique was used to select 585 (295 public and 290 private) students from 12 (six public and six private) universities in southwest Nigeria. Two instruments--Cost and…

  15. The "Decline" of Private Higher Education. PROPHE Working Paper Series. WP No. 16

    ERIC Educational Resources Information Center

    Levy, Daniel C.

    2011-01-01

    No topic in private higher education study has attracted as great attention globally as has growth. This is appropriate as private growth has soared to nearly a third of the world's total higher education enrollment. But while private growth continues to be the dominant trend, important declines in private shares have emerged. These must be…

  16. Private Prometheus: Private Higher Education and Development in the 21st Century. Contributions to the Study of Education, Number 77.

    ERIC Educational Resources Information Center

    Altbach, Philip G., Ed.

    This document addresses changes and trends in private higher education, with particular emphasis on Latin America. It focuses on specific issues facing private higher education, which has developed significantly worldwide. A variety of factors have brought private higher education to the forefront. There has been a shift in several countries from…

  17. Prisons, jobs and privatization: The impact of prisons on employment growth in rural US counties, 1997-2004.

    PubMed

    Genter, Shaun; Hooks, Gregory; Mosher, Clayton

    2013-05-01

    In this study of prison privatization we draw on the insights of a recent body of literature that challenges a widespread belief that prisons help to spur employment growth in local communities. We look to these studies to provide an empirically and theoretically grounded approach to addressing our research question: what are the benefits, if any, to employment growth in states that have privatized some of their prisons, compared to states with only public prisons? Our research makes use of a large, national, and comprehensive dataset. By examining the employment contributions of prisons, as recent research has done, we were able to corroborate the general findings of this research. To study prison privatization we distinguish between states in which privatization has grown rapidly and those states in which privatization has grown slowly (or not at all). Our findings lend support to recent research that finds prisons do not improve job prospects for those communities that host them. We contribute to this literature by demonstrating that new prisons in states in which privatization is surging impede employment growth in the host community. To explain this we highlight the significant reduction in prison staffing - in both private and public prisons - where privatization is growing quickly. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Utilization of skilled birth attendants in public and private sectors in Vietnam.

    PubMed

    Do, Mai

    2009-05-01

    The private sector in health care in Vietnam has been increasingly competing with the government in primary health care services. However, little is known about the use of skilled birth attendance or about choice of public and private sectors among those who opt for skilled attendants. Using data from the Vietnam 2002 Demographic and Health Survey, this study examines factors related to women's decision-making of whether to have a skilled birth attendant at a recent childbirth, and if they did, whether it was a public or private sector provider. The study indicates that the use of the private sector for delivery services was significant. Women's household wealth, education, antenatal care and community's wealth were positively related to skilled birth attendance, while ethnicity and order of childbirth were negatively related. Order of childbirth was positively associated with skilled birth attendance in the private sector. Among service environment factors, increased access to public sector health centres was associated with an increased likelihood of skilled birth attendance in general, but a lowered chance of that in the private sector. Further studies are needed to assess the current situation in the private sector, the demand for delivery services in the private sector, and its readiness to provide quality services.

  19. Insurance premiums and insurance coverage of near-poor children.

    PubMed

    Hadley, Jack; Reschovsky, James D; Cunningham, Peter; Kenney, Genevieve; Dubay, Lisa

    States increasingly are using premiums for near-poor children in their public insurance programs (Medicaid/SCHIP) to limit private insurance crowd-out and constrain program costs. Using national data from four rounds of the Community Tracking Study Household Surveys spanning the seven years from 1996 to 2003, this study estimates a multinomial logistic regression model examining how public and private insurance premiums affect insurance coverage outcomes (Medicaid/SCHIP coverage, private coverage, and no coverage). Higher public premiums are significantly associated with a lower probability of public coverage and higher probabilities of private coverage and uninsurance; higher private premiums are significantly related to a lower probability of private coverage and higher probabilities of public coverage and uninsurance. The results imply that uninsurance rates will rise if both public and private premiums increase, and suggest that states that impose or increase public insurance premiums for near-poor children will succeed in discouraging crowd-out of private insurance, but at the expense of higher rates of uninsurance. Sustained increases in private insurance premiums will continue to create enrollment pressures on state insurance programs for children.

  20. Privatization and the globalization of energy markets

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    1996-10-01

    This report reviews recent global efforts to privatize energy resources and outlines the opportunities and challenges privatization has presented to U.S. and foreign multinational energy companies. The group of energy companies studied in this report includes the major U.S. petroleum companies and many foreign companies. The foreign companies reviewed include state-run energy enterprises, recently privatized energy enterprises, and foreign multinationals that have been privately held. The privatization of non-petroleum energy industries, such as electricity generation and transmission, natural gas transmission, and coal mining, are also discussed. Overseas investments made by electric companies, natural gas companies, and coal companies are included.more » The report is organized into six chapters: (1) economics of privatization; (2) petroleum privatization efforts among non-U.S. Organization for Economic Cooperation and Development nations; (3) petroleum privatization efforts in Latin America; (4) privatization in socialist and former socialist regimes; (5) privatization efforts in global electric power generation, transmission, and distribution industries; and (6) privatization and globalization of world coal.« less

  1. A Motivational Explanation of Private Self-Consciousness.

    ERIC Educational Resources Information Center

    Franzoi, Stephen L.; And Others

    Private self-consciousness (PSC) refers to the dispositional tendency to be attentive to the private, covert aspects of oneself. Studies were conducted to investigate whether there are motivational underpinnings for individual differences in level of PSC. Four separate studies were conducted at three different institutions. Study 1 (N=59) results…

  2. Seeking Major Gifts: How 57 Institutions Do It.

    ERIC Educational Resources Information Center

    Altizer, Anne W.

    A study was done of how educational institutions seek major gifts in their fund raising strategies. The study surveyed 57 institutions in 4 major categories: private colleges (24), private universities (6), public universities (12), and private elementary/secondary schools (15). The study sought to discover whether significant changes had taken…

  3. Exploring the Public Health Impacts of Private Security Guards on People Who Use Drugs: a Qualitative Study.

    PubMed

    Markwick, Nicole; McNeil, Ryan; Small, Will; Kerr, Thomas

    2015-12-01

    Private security guards occupy an increasingly prominent role in the policing of private and public spaces. There are growing concerns regarding security guards' potential to shape violence, discrimination, and adverse health outcomes among vulnerable populations, including people who use drugs (PWUD). This is relevant in Vancouver, Canada, where private security guards have increasingly been employed by private organizations to manage public and private spaces, including those within urban drug scenes. This qualitative study sought to understand interactions between PWUD and private security guards and explore their impacts on health care access, risks, and harms among PWUD. Semi-structured interviews were conducted with 30 PWUD recruited from two ongoing prospective cohort studies. Interviews were transcribed and analyzed using a coding framework comprised of a priori and emergent categories. Study data indicate that participants experience pervasive, discriminatory profiling and surveillance by security guards, which exacerbates existing social marginalization and structural vulnerability, particularly among PWUD of Aboriginal ancestry. Participants reported that security guards restrict PWUD's access to public and private spaces, including pharmacies and hospitals. PWUD also reported that their interactions with security guards often involved interpersonal violence and aggression, experiences that served to increase their vulnerability to subsequent risks and harms. Our findings highlight that private security forces contribute significantly to the everyday violence experienced by PWUD within drug scenes and elsewhere and do so in a manner very similar to that of traditional police forces. These findings point to the urgent need for greater oversight and training of private security guards in order to protect the health and safety of PWUD.

  4. Role of the private sector in the provision of immunization services in low- and middle-income countries.

    PubMed

    Levin, Ann; Kaddar, Miloud

    2011-07-01

    The authors conducted a literature review on the role of the private sector in low- and middle-income countries. The review indicated that relatively few studies have researched the role of the private sector in immunization service delivery in these countries. The studies suggest that the private sector is playing different roles and functions according to economic development levels, the governance structure and the general presence of the private sector in the health sector. In some countries, generally low-income countries, the private for-profit sector is contributing to immunization service delivery and helping to improve access to traditional EPI vaccines. In other countries, particularly middle-income countries, the private for-profit sector often acts to facilitate early adoption of new vaccines and technologies before introduction and generalization by the public sector. The not-for-profit sector plays an important role in extending access to traditional EPI vaccines, particularly in low-income countries. Not-for-profit facilities are situated in rural as well as urban areas and are more likely to be coordinated with public services than the private for-profit sector. Although numerous studies on non-governmental organizations (NGOs) suggest that the extent of NGO provision of immunization services in low- and middle-income countries is substantial, the contribution of this sector is poorly documented, leading to a lack of recognition of its role at national and global levels. Studies on quality of immunization service provision at private health facilities suggest that it is sometimes inadequate and needs to be monitored. Although some articles on public-private collaboration exist, little was found on the extent to which governments are effectively interacting with and regulating the private sector. The review revealed many geographical and thematic gaps in the literature on the role and regulation of the private sector in the delivery of immunization services in low- and middle-income countries.

  5. How well can physicians manage tuberculosis? A public-private sector comparison from Karachi, Pakistan.

    PubMed

    Naseer, Maliha; Khawaja, Ali; Pethani, Amin S; Aleem, Salik

    2013-10-25

    Tuberculosis (TB) is endemic in Pakistan which ranks fifth amongst the twenty two countries designated to be highly burdened by TB according to the World Health Organization. However, there is paucity of data regarding the knowledge of diagnosis of TB and its management amongst public and private practitioners. In this study, we endeavor to identify this gap in knowledge regarding the diagnosis and management of TB between public and private doctors and the factors affecting these knowledge scores in urban Pakistan. This cross sectional survey was conducted between June and December 2011. Doctors from public hospitals, private hospitals and private clinics scattered in all eighteen towns of Karachi were included in the study. Qualified MBBS doctors working in any specialty were eligible to participate whereas doctors working in both the public and private sectors were excluded from the study. Vignette based clinical scenarios were given to assess the knowledge score regarding the diagnosis and management of TB. A total of 196 doctors participated in the study. There was a significant difference between private and public physicians in terms of age and years of practice (p-value <0.05). Significant differences in the proportion of knowledge scores were observed between the public and private doctors and National TB Control Program trained and untrained doctors in Karachi. Factors associated with inadequate knowledge scores were being female gender [OR: 2.76 (95% CI: 1.418-5.384)], private employment status [OR: 1.50 (95% CI: 1.258-2.439)], and not trained by NTP [OR: 2.98 (95% CI: 1.286-3.225)] on multivariate logistic regression analysis. It is concluded that a knowledge gap exists between the public and private doctors in Karachi. Strengthening of currently implemented public private mix model along with improvement in the trainings of public and private practitioners is highly recommended to control TB in Pakistan.

  6. Effects of alcohol retail privatization on excessive alcohol consumption and related harms: a community guide systematic review.

    PubMed

    Hahn, Robert A; Middleton, Jennifer Cook; Elder, Randy; Brewer, Robert; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci L; Chattopadhyay, Sajal; Lawrence, Briana; Campbell, Carla Alexia

    2012-04-01

    Excessive alcohol consumption is the third-leading cause of preventable death in the U.S. This systematic review is one in a series exploring effectiveness of interventions to reduce alcohol-related harms. The focus of this review was on studies evaluating the effects of the privatization of alcohol retail sales on excessive alcohol consumption and related harms. Using Community Guide methods for conducting systematic reviews, a systematic search was conducted in multiple databases up to December 2010. Reference lists of acquired articles and review papers were also scanned for additional studies. A total of 17 studies assessed the impact of privatizing retail alcohol sales on the per capita alcohol consumption, a well-established proxy for excessive alcohol consumption; 9 of these studies also examined the effects of privatization on the per capita consumption of alcoholic beverages that were not privatized. One cohort study in Finland assessed the impact of privatizing the sales of medium-strength beer (MSB) on self-reported alcohol consumption. One study in Sweden assessed the impact of re-monopolizing the sale of MSB on alcohol-related harms. Across the 17 studies, there was a 44.4% median increase in the per capita sales of privatized beverages in locations that privatized retail alcohol sales (interquartile interval: 4.5% to 122.5%). During the same time period, sales of nonprivatized alcoholic beverages decreased by a median of 2.2% (interquartile interval: -6.6% to -0.1%). Privatizing the sale of MSB in Finland was associated with a mean increase in alcohol consumption of 1.7 liters of pure alcohol per person per year. Re-monopolization of the sale of MSB in Sweden was associated with a general reduction in alcohol-related harms. According to Community Guide rules of evidence, there is strong evidence that privatization of retail alcohol sales leads to increases in excessive alcohol consumption. Published by Elsevier Inc.

  7. Public versus Private University Presidents Pay Levels and Structure

    ERIC Educational Resources Information Center

    Monks, James

    2007-01-01

    Existing studies examine the determinants of private university presidents' compensation, but ignore recent earnings differentials between public and private university presidents. This paper estimates that public university presidents earn approximately 50 percent less than comparable private university presidents. This salary discount is robust…

  8. Private hospital emergency departments in Australia: challenges and opportunities.

    PubMed

    FitzGerald, Gerry; Toloo, Ghasem; He, Jun; Doig, Gavin; Rosengren, David; Rothwell, Sean; Sultana, Ron; Costello, Steve; Hou, Xiang-Yu

    2013-06-01

    Public hospital EDs in Australia have become increasingly congested because of increasing demand and access block. Six per cent of ED patients attend private hospital EDs whereas 45% of the population hold private health insurance. This study describes the patients attending a small selection of four private hospital EDs in Queensland and Victoria, and tests the feasibility of a private ED database. De-identified routinely collected patient data were provided by the four participating private hospital and amalgamated into a single data set. The mean age of private ED patients was 52 years. Males outnumbered females in all age groups except > 80 years. Attendance was higher on weekends and Mondays, and between 08.00 and 20.00 h. There were 6.6% of the patients triaged as categories 1 and 2, and 60% were categories 4 or 5. There were 36.4% that required hospital admission. Also, 96% of the patients had some kind of insurance. Furthermore, 72% were self-referred and 12% were referred by private medical practitioners. Approximately 25% arrived by ambulance. There were 69% that completed their ED treatment within 4 h. This study is the first public description of patients attending private EDs in Australia. Private EDs have a significant role to play in acute medical care and in providing access to private hospitals which could alleviate pressure on public EDs. This study demonstrates the need for consolidated data based on a consistent data set and data dictionary to enable system-wide analysis, benchmarking and evaluation. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  9. Marketing Strategies and Students' Enrolment in Private Secondary Schools in Calabar Municipality, Cross River State, Nigeria

    ERIC Educational Resources Information Center

    Uchendu, Chika C.; Nwafor, Innocent A.; Nwaneri, Mary G.

    2015-01-01

    The study investigated marketing strategies and students' enrolment in private secondary schools in Calabar Municipality, Cross River State. One research question was raised and two null hypotheses formulated to guide the study. Thirty two (32) school administrators in 32 private secondary schools in the study area constitute the study population…

  10. Research on private cloud computing based on analysis on typical opensource platform: a case study with Eucalyptus and Wavemaker

    NASA Astrophysics Data System (ADS)

    Yu, Xiaoyuan; Yuan, Jian; Chen, Shi

    2013-03-01

    Cloud computing is one of the most popular topics in the IT industry and is recently being adopted by many companies. It has four development models, as: public cloud, community cloud, hybrid cloud and private cloud. Except others, private cloud can be implemented in a private network, and delivers some benefits of cloud computing without pitfalls. This paper makes a comparison of typical open source platforms through which we can implement a private cloud. After this comparison, we choose Eucalyptus and Wavemaker to do a case study on the private cloud. We also do some performance estimation of cloud platform services and development of prototype software as cloud services.

  11. Privatization of Higher Education in Malaysia

    ERIC Educational Resources Information Center

    Sivalingam, G.

    2007-01-01

    The study will trace the external factors influencing the liberalization, deregulation and privatization of higher education in Malaysia from 1970 to the present and to analyze the effects of liberalization, deregulation and privatization on the modes of privatization and the internal restructuring of institutions of higher learning to increase…

  12. Health care privatization in Latin America: comparing divergent privatization approaches in Chile, Colombia, and Mexico.

    PubMed

    Bustamante, Arturo Vargas; Méndez, Claudio A

    2014-08-01

    The public-private mix in Chile, Colombia, and Mexico was very similar until the early 1980s when Chile undertook health care privatization as part of comprehensive health care reform. Since then, health care privatization policies have diverged in these countries. In this study we characterize health care privatization in Latin America and identify the main factors that promoted and hindered privatization by comparing the experiences of these countries. We argue that policy elites took advantage of specific policy environments and the diffusion of privatization policies to promote health care privatization while political mobilization against privatization, competing policy priorities, weak market and government institutions, and efforts to reach universal health insurance hindered privatization. The privatization approaches of Chile and Colombia were classified as "big-bang," since these countries implemented health care privatization more rapidly and with a wider scope compared with the case of Mexico, which was classified as gradualist, since the privatization path followed by this country adopted a slower pace and became more limited and focalized over time. We conclude that the emphasis on policy-driven privatization diminished in the 1990s and 2000s because of increased public health care financing and a shift in health care reform priorities. Health care privatization in the region, however, continued as a consequence of demand-driven privatization. Copyright © 2014 by Duke University Press.

  13. Developing Strategic Leadership for Administrators: Private Vocational College Study

    ERIC Educational Resources Information Center

    Jumnongya, Areeya; Sirisuthi, Chaiyuth; Chansirisira, Pacharawit

    2015-01-01

    The purpose of this study is to study and define a number of factors measuring quality and efficiency in administrators of private vocational college, and to test and evaluate the efficiency of the strategic leadership program. Twelve factors and 83 indicators were identified as vital for strategic leadership for private vocational college…

  14. Comparing Administrative Satisfaction in Public and Private Higher Education.

    ERIC Educational Resources Information Center

    Volkwein, James Fredericks; Parmley, Kelli

    This study examined job satisfaction among administrators in public and private higher education. Data on nearly 1,200 administrators, ranging from directors to presidents, was obtained through surveys of 120 public and private universities. It was found that both public and private higher education administrators were most satisfied with the…

  15. Mathematic Achievement of Canadian Private School Students

    ERIC Educational Resources Information Center

    Cadigan, Francoise Jane; Wei, Yichun; Clifton, Rodney A.

    2013-01-01

    Very little Canadian research has examined the academic achievement of private school students. Data from The Programme for International Student Assessment (PISA) 2003 were used to examine the achievement of private school students. The study found that private school students outperformed their public school peers. In addition, the students'…

  16. Struggle against privatization: a case history in the use of comparative performance evaluation of public hospitals.

    PubMed

    Oh, Juhwan; Lee, Jin-Seok; Choi, Yong-Jun; Park, Hyeung-Keun; Do, Young Kyung; Eun, Sang-Jun

    2011-01-01

    After the 1997 economic crisis, the South Korean government implemented neoliberal policies in many sectors. In health care, the government attempted to privatize nine public hospitals, framing the initiative as "better management." In this discourse, public hospital workers were stereotyped as lazy and incompetent, while public hospitals were portrayed as poorly managed and of low quality. However, the government did not present any relevant evidence of improvement in already privatized hospitals, even though three hospitals had been semi-privatized at that time. In this study, the authors evaluated the effects of the semi-privatization, comparing the performance of the semi-privatized hospitals with that of the nine other hospitals targeted for privatization. The study found adverse effects on performance, unlike the claims made by the government. Semi-privatization intensified the workloads of hospital workers and the instability of employment, froze or decreased real wages, and drastically increased hospital revenue per patient stay. The changes may have resulted from redefining profit as the goal of the hospitals, as opposed to the previous focus on decision-making on public health. These research findings played a decisive role in the struggle to keep the targeted public hospitals free of privatization, especially in two of the nine hospitals targeted for privatization in 2001.

  17. A study on moral hazard in dentistry: costs of care in the private and the public sector.

    PubMed

    Tuominen, Risto; Eriksson, Anna-Leena

    2011-10-01

    The aim of this study was to evaluate the costs of subsidized care for an adult population provided by private and public sector dentists. A sample of 210 patients was drawn systematically from the waiting list for nonemergency dental treatment in the city of Turku. Questionnaire data covering sociodemographic background, dental care utilization and marginal time cost estimates were combined with data from patient registers on treatment given. Information was available on 104 patients (52 from each of the public and the private sectors). The overall time taken to provide treatment was 181 days in the public sector and 80 days in the private sector (P<0.002). On average, public sector patients had significantly (P < 0.01) more dental visits (5.33) than private sector patients (3.47), which caused higher visiting fees. In addition, patients in the public sector also had higher other out-of-pocket costs than in the private sector. Those who needed emergency dental treatment during the waiting time for comprehensive care had significantly more costly treatment and higher total costs than the other patients. Overall time required for dental visits significantly increased total costs. The total cost of dental care in the public sector was slightly higher (P<0.05) than in the private sector. There is no direct evidence of moral hazard on the provider side from this study. The observed cost differences between the two sectors may indicate that private practitioners could manage their publicly funded patients more quickly than their private paying patients. On the other hand, private dentists providing more treatment per visit could be explained by private dentists providing more than is needed by increasing the content per visit. © 2011 John Wiley & Sons A/S.

  18. Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya.

    PubMed

    Keesara, Sirina R; Juma, Pamela A; Harper, Cynthia C

    2015-08-20

    Nearly 40% of women in developing countries seek contraceptives services from the private sector. However, the reasons that contraceptive clients choose private or public providers are not well studied. We conducted six focus groups discussions and 51 in-depth interviews with postpartum women (n = 61) to explore decision-making about contraceptive use after delivery, including facility choice. When seeking contraceptive services, women in this study preferred private over public facilities due to convenience and timeliness of services. Women avoided public facilities due to long waits and disrespectful providers. Study participants reported, however, that they felt more confident about the technical medical quality in public facilities than in private, and believed that private providers prioritized profit over safe medical practice. Women reported that public facilities offered comprehensive counseling and chose these facilities when they needed contraceptive decision-support. Provision of comprehensive counseling and screening, including side effects counseling and management, determined perception of quality. Women believed private providers offered the advantages of convenience, efficiency and privacy, though they did not consistently offer high-quality care. Quality-improvement of contraceptive care at private facilities could include technical standardization and accreditation. Development of support and training for side effect management may be an important intervention to improve perceived quality of care.

  19. Multiple Choice: How Public School Leaders in New Orleans' Saturated Market View Private School Competitors

    ERIC Educational Resources Information Center

    Jabbar, Huriya; Li, Dongmei M.

    2016-01-01

    School choice policies, such as charter schools and vouchers, are in part designed to induce competition between schools. While several studies have examined the impact of private school competition on public schools, few studies have explored school leaders' perceptions of private school competitors. This study examines the extent to which public…

  20. Private sector contribution to childhood immunization: Sri Lankan experience.

    PubMed

    Agampodi, S B; Amarasinghe, D A C L

    2007-04-01

    The main service provider for childhood immunization in Sri Lanka is the government sector. However, utilization of private sector for childhood immunization is increasing rapidly. Existing national immunization data does not routinely include statistics on private sector immunization delivery adequately. To estimate the proportion of children immunized in the private sector; describe socio-demographic characteristics of private sector users and compare these with government sector users. A community-based crosssectional descriptive study was conducted using a pre-tested interviewer-administered structured questionnaire. This was done in the Colombo municipal council area using the WHO 30 cluster methodology. The total number of households in the sample was 553. Out of the 5,028 total immunizations reported in the present study, around one-third (2,544) was obtained through the private sector. Nineteen percent (104) of children were exclusively immunized from the private sector. The distribution of usual immunization provider was - government sector 72.3% (400) and private sector 27.7% (153). Significant differences were observed (P < 0.001) between private and government sector users with regard to family income, social class, ethnicity, religion and educational level of the mother. The age-appropriate immunization among the 12- to 23-month age group was 92.3% (144) in the government sector, whereas it was 95% (38) in the private sector. Among the 24- to 35-month age group, it was 91.7% (121) and 92.7% (76) respectively. The age-adjusted immunization coverage rates were almost same among the government and private sector users except for the measles vaccine, where the private sector users had significantly (P = 0.016) higher coverage. Utilization of private sector immunization services is high in the Colombo municipal council area.

  1. Private equity ownership and nursing home financial performance.

    PubMed

    Pradhan, Rohit; Weech-Maldonado, Robert; Harman, Jeffrey S; Laberge, Alex; Hyer, Kathryn

    2013-01-01

    Private equity has acquired multiple large nursing home chains within the last few years; by 2009, it owned nearly 1,900 nursing homes. Private equity is said to improve the financial performance of acquired facilities. However, no study has yet examined the financial performance of private equity nursing homes, ergo this study. The primary purpose of this study is to understand the financial performance of private equity nursing homes and how it compares with other investor-owned facilities. It also seeks to understand the approach favored by private equity to improve financial performance-for instance, whether they prefer to cut costs or maximize revenues or follow a mixed approach. Secondary data from Medicare cost reports, the Online Survey, Certification and Reporting, Area Resource File, and Brown University's Long-term Care Focus data set are combined to construct a longitudinal data set for the study period 2000-2007. The final sample is 2,822 observations after eliminating all not-for-profit, independent, and hospital-based facilities. Dependent financial variables consist of operating revenues and costs, operating and total margins, payer mix (census Medicare, census Medicaid, census other), and acuity index. Independent variables primarily reflect private equity ownership. The study was analyzed using ordinary least squares, gamma distribution with log link, logit with binomial family link, and logistic regression. Private equity nursing homes have higher operating margin as well as total margin; they also report higher operating revenues and costs. No significant differences in payer mix are noted. Results suggest that private equity delivers superior financial performance compared with other investor-owned nursing homes. However, causes for concern remain particularly with the long-term financial sustainability of these facilities.

  2. The Influence of Private Speech on Writing Development: A Vygotskian Perspective.

    ERIC Educational Resources Information Center

    Schimmoeller, Margaret A.

    This paper presents a portion of a larger study testing assumptions from Lev Vygotsky's spontaneous private speech theory and the relationship between private speech (overt self-talk) and writing development. Sixteen kindergarten and first-grade children were observed over time in natural classroom settings to note changes in private speech and…

  3. Inmate Recidivism as a Measure of Private Prison Performance

    ERIC Educational Resources Information Center

    Spivak, Andrew L.; Sharp, Susan F.

    2008-01-01

    The growth of the private corrections industry has elicited interest in the comparative performance of state and private prisons. One way to measure the service quality of private prisons is to examine inmates' postrelease performance. Current empirical evidence is limited to four studies, all conducted in Florida. This analysis replicates and…

  4. Private Agricultural Extension System in Kenya: Practice and Policy Lessons

    ERIC Educational Resources Information Center

    Muyanga, Milu; Jayne, T. S.

    2008-01-01

    Private extension system has been at the centre of a debate triggered by inefficient public agricultural extension. The debate is anchored on the premise that the private sector is more efficient in extension service delivery. This study evaluates the private extension system in Kenya. It employs qualitative and quantitative methods. The results…

  5. Analysis of the Choice for Public and Private Education.

    ERIC Educational Resources Information Center

    Gemello, John M.; Osman, Jack W.

    Key factors influencing the decision to attend private school are identified in this paper. It looks at the factors accounting for varying rates of private school attendance and estimates the responsiveness of such attendance to government support. It studies the variation in private school attendance rates at three levels: across states, across…

  6. College Success among Students Graduating from Public and Private High Schools

    ERIC Educational Resources Information Center

    Monto, Martin A.; Dahmen, Jessica

    2009-01-01

    This study compares the college freshman grade point averages of public and private high school graduates attending a "more selective" private university. Though graduates of public high schools had slightly lower SAT scores than graduates of private high schools, their end-of-freshman-year grade point averages were somewhat higher…

  7. The Determinants of Private Tutoring Participation and Attendant Expenditures in Korea

    ERIC Educational Resources Information Center

    Jung, Jin Hwa; Lee, Kyung Hee

    2010-01-01

    With the growing worldwide prevalence of private tutoring, the causes and effects of private tutoring have been drawing increasing attention both academically and policy wise. This study intends to draw policy implications by investigating the determinants of private tutoring participation of school-aged children and expenditures per child for…

  8. The Public Good in English Private School Governance

    ERIC Educational Resources Information Center

    Boyask, Ruth

    2015-01-01

    There exist some rare private schools that attempt to mitigate the anti-democratic qualities of the private schooling sector in England. This article reports on a study of private schools that aim to promote equality and participation through some aspects of their operations. It considers to what extent the governance structures within the schools…

  9. Ethics in clinical drug trial research in private practice.

    PubMed

    Beran, R G; Beran, M E

    2006-09-01

    Private clinics and clinicians have been involved in clinical drug trials for approximately two decades. This paper reviews the ethical consideration inherent in this process. Involvement of a single community based, private, Australian neurological clinic in the conduct of trials was audited. Changes in ethical considerations were analysed. The clinic previously audited its clinical trial involvement, starting with pharmaceutical company orchestrated trials. These were vetted by hospital based ethics committees (ECs) which then refused to review private research. A private EC accommodating NH & MRC standards was formed to assess private research. Indemnity concerns forced return to institutional ECs with government guaranteed indemnification. Trials evolved to investigator initiated, company sponsored studies thence a company asking the clinic to devise, sponsor and manage a trial. The latter relegated trial co-ordination to the clinic which would control publication thereby creating new ethical standards. Private practice trial involvement evolved from reluctant inclusion to a pivotal role in privately sponsored studies. Access to ECs is government endorsed and publication is independent for investigator-sponsored trials. There has been modification of standard operating procedures and enhanced ethical standards.

  10. Assessment of knowledge and practice of private practitioners regarding tuberculosis control in Ethiopia.

    PubMed

    Yimer, Solomon A; Holm-Hansen, Carol; Bjune, Gunnar

    2012-01-12

    Ethiopia has a growing private health sector. In recent years, the directly observed treatment short course (DOTS) strategy was initiated in selected private health facilities in the country. The objective of the present study was to assess knowledge and practice of private practitioners in tuberculosis (TB) control in Amhara Region, Ethiopia. An institution-based cross-sectional study was conducted among 112 private practitioners selected from all private health facilities in the region. The study was conducted between May and August 2008 and data was collected using a semi-structured questionnaire. Group differences were analyzed using the chi-square test. Fifty-nine (52.7%) of the private practitioners suspected TB in patients with three weeks' duration of cough. Only 37 (33.0%) of the private practitioners were able to precisely list the correct treatment regimens for all categories as recommended in the National Tuberculosis and Leprosy Control Program guidelines. The correct frequency of TB treatment monitoring was provided by 44 (50%) of the respondents. Overall 44 (39.3%) of the private practitioners did not have satisfactory knowledge about the directly observed treatment short course (DOTS) strategy. Those who attended DOTS training during the two years prior to the survey were more likely to have satisfactory knowledge compared to those who did not receive training (OR 4.45, 95% CI: 1.33, 14.87, p < 0.02). A significant proportion of private practitioners did not have satisfactory knowledge and practice about DOTS. The provision of regular DOTS refresher courses improves TB management for patients in the region.

  11. 75 FR 66822 - Study on Extraterritorial Private Rights of Action

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-29

    ... Extraterritorial Private Rights of Action AGENCY: Securities and Exchange Commission. ACTION: Request for Comments... and thereafter conduct a study to determine the extent to which private rights of action under the... United States to bring actions under Section 10(b) in cases involving transnational securities fraud...

  12. Tuberculosis Notification by Private Sector' Physicians in Tehran.

    PubMed

    Ahmadi, Ayat; Nedjat, Saharnaz; Gholami, Jaleh; Majdzadeh, Reza

    2015-01-01

    A small proportion of physicians adhere to tuberculosis (TB) notification regulations, particularly in the private sector. In most developing countries, the private sector has dominance over delivering services in big cities. In such circumstances deviation from the TB treatment protocol is frequently happening. This study sought to estimate TB notification in the private sector and settle on determinants of TB notification by private sector physicians. A population-based study has been conducted; private physicians at their clinics were interviewed. The total number of 443 private sectors' physicians has been chosen by the stratified random sampling method. Appropriate descriptive analysis was used to describe the study's participants. Logistic regression was used for bivariable and multivariable analysis. The response rate of the study was 90.06 (399%). Among responders, who had stated that they were suspicious of TB over the recent year, 62 (16.45%) stated that they reported cases of TB at least once during the same period. Having reporting requirements and the number of visited patients was significantly related to TB suspicious (odds ratio = 2.84, confidence interval: 1.62-5, P < 0.01). Workplace and access to relevant resources are associated with TB notification (P < 0.05). In poor resource settings with a high burden of TB, the public health administration can promote notification activities in the private sector by simple and quick interventions. It seems that a considerable fraction of private sector physicians, not all of them, will notify TB if they are provided with primary information and primary resources. To optimize the TB notification, however, intersectoral interventions are more likely to be successful.

  13. Analyzing State and Private School Students' Achievement Goal Orientation Levels in Terms of Some Variables

    ERIC Educational Resources Information Center

    Türkçapar, Ünal

    2015-01-01

    The purpose of this study is to investigate the state and private school students' achievement goal orientation levels in terms of some variables. Quantitative survey method was used in this study. Study group in this research consists of 201 students who are studying at state and private school in Kahramanmaras during the 2014-2015 academic year.…

  14. Stunting and weight statuses of adolescents differ between public and private schools in urban Gambia.

    PubMed

    Juwara, Alimatou; Huang, Nicole; Chien, Li-Ying; Chen, Hsin-Jen

    2016-07-01

    This study assessed the disparity in nutritional status of adolescents between public and private schools in urban Gambia. This is a school-based cross-sectional study in six private and six public upper basic schools in urban Gambia. This study recruited 491 students from public and 469 students from private schools (13-15 years of age). The prevalence of stunting (WHO height-for-age Z < -2SD) was 13.4 % for public school students and 4.5 % for private schools. After adjustment for children's sex, age, and family socioeconomic status, the differences in prevalence of stunting and underweight were significant between public and private schools. Private school students are more likely to be overweight/obese (WHO BMI-for-age Z > +1SD) (OR = 2.85, 95 % CI 1.55-5.22), but less likely to be thin (BMI-for-age Z < -2SD) (OR = 0.61 [0.39-0.96]), compared to public school students. Children from lower income families had lower odds for overweight/obese than normal weight, compared to those from higher income families (OR = 0.34 [0.15-0.76]). Public and private schools in urban regions of the Gambia may face different nutritional challenges due to differences in school environment and resources.

  15. Private health insurance in South Korea: an international comparison.

    PubMed

    Shin, Jaeun

    2012-11-01

    The goal of this study is to present the historical and policy background of the expansion of private health insurance in South Korea in the context of the National Health Insurance (NHI) system, and to provide empirical evidence on whether the increased role of private health insurance may counterbalance government financing, social security contributions, out-of-pocket payments, and help stabilize total health care spending. Using OECD Health Data 2011, we used a fixed effects model estimation. In this model, we allow error terms to be serially correlated over time in order to capture the association of private health insurance financing with three other components of health care financing and total health care spending. The descriptive observation of the South Korean health care financing shows that social security contributions are relatively limited in South Korea, implying that high out-of-pocket payments may be alleviated through the enhancement of NHI benefit coverage and an increase in social security contributions. Estimation results confirm that private health insurance financing is unlikely to reduce government spending on health care and social security contributions. We find evidence that out-of-pocket payments may be offset by private health insurance financing, but to a limited degree. Private health insurance financing is found to have a statistically significant positive association with total spending on health care. This indicates that the duplicated coverage effect on service demand may cancel out the potential efficiency gain from market initiatives driven by the active involvement of private health insurance. This study finds little evidence for the benefit of private insurance initiatives in coping with the fiscal challenges of the South Korean NHI program. Further studies on the managerial interplay among public and private insurers and on behavioral responses of providers and patients to a given structure of private-public financing are warranted to formulate the adequate balance between private health insurance and publicly funded universal coverage. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. Quality of physical resources of health facilities in Indonesia: a panel study 1993-2007.

    PubMed

    Diana, Aly; Hollingworth, Samantha A; Marks, Geoffrey C

    2013-10-01

    The merits of mixed public and private health systems are debated. Although private providers have become increasingly important in the Indonesian health system, there is no comprehensive assessment of the quality of private facilities. This study examined the quality of physical resources of public and private facilities in Indonesia from 1993 to 2007. Data from the Indonesian Family Life Surveys in 1993, 1997, 2000 and 2007 were used to evaluate trends in the quality of physical resources for public and private facilities, stratified by urban/rural areas and Java-Bali/outer Java-Bali regions. The quality of six categories of resources was measured using an adapted MEASURE Evaluation framework. Overall quality was moderate, but higher in public than in private health facilities in all years regardless of the region. The higher proportion of nurses and midwives in private practice was a determinant of scope of services and facilities available. There was little improvement in quality of physical resources following decentralization. Despite significant increases in public investment in health between 2000 and 2006 and the potential benefits of decentralization (2001), the quality of both public and private health facilities in Indonesia did not improve significantly between 1993 and 2007. As consumers commonly believe the quality is better in private facilities and are increasingly using them, it is essential to improve quality in both private and public facilities. Implementation of minimum standards and effective partnerships with private practice are considered important.

  17. Investigation of privatization by level crossing approach

    NASA Astrophysics Data System (ADS)

    Vahabi, M.; Jafari, G. R.

    2009-09-01

    Privatization - a political as well as an economic policy - is generally defined as the transfer of a property or the responsibility for it from the public to the private sector. But privatization is not merely the transfer of the ownership and efficiency of the market should be considered. A successful privatization program induces better profitability and efficiency, higher output, more investment, etc. The main method of privatization is through introducing new stocks to the market to motivate competition. However, for a successful privatization the capability of a market for absorbing the new stock should also be considered. Without paying attention to this aspect, privatization through the introduction of new stocks may lead to reduced market efficiency. We study, based on the complexity theory and in particular the concept of Level Crossing, the effect of the stages of the development, activity, risk, and the waiting times for special events on the privatization.

  18. Privacy Issues and the Private Sector,

    DTIC Science & Technology

    1976-07-01

    GUIDE represents a large portion of the private sector of this country; at the moment, of course, the recordkeeping processes of non-Federal...the Privacy Protection Study Commission to examine the private sector and non-Federal government. The Commission is to recommend to Congress and the...President first, what aspects of the 1974 Act should be applied to the private sector ; secondly, to recommend to Congress and the President what further legislative safeguards are indicated for the private sector .

  19. Private Schools and National Policy: A Comparative Study of Australia and the U.S.A.

    ERIC Educational Resources Information Center

    Jones, Thomas A.

    This paper summarizes the findings of a questionnaire study comparing government aid to private schools in Australia and the United States. The study drew questions from those raised in a hearing of the Senate Committee on finance about tax credits for private schools. The paper covers the answers of ten Australian respondents, given in the form…

  20. The Labor Market Impacts of the Private Retirement System. Studies in Public Welfare, Paper No. 11.

    ERIC Educational Resources Information Center

    Taggart, Robert

    After giving an overview of the private retirement system and considering deferred wages and labor costs, the study explores the extent of the influence of private pensions on early retirement and on job opportunities of older persons, and the influence of lengthy job tenure requirements on worker mobility. The study weakens the case for…

  1. The NCES Private-Public School Study: Findings Are Other than They Seem

    ERIC Educational Resources Information Center

    Peterson, Paul E.; Llaudet, Elena

    2007-01-01

    On July 14, 2006, the U.S. Department of Education's National Center for Education Statistics (NCES) released a study that compared the performance in reading and math of 4th and 8th graders attending private and public schools. According to the NCES study, students attending private schools performed better than students attending public schools.…

  2. Academic Staff Retention in Private Higher Education Institute--Case Study of Private Colleges in Kuala Lumpur

    ERIC Educational Resources Information Center

    Manogharan, Melissa Wane; Thivaharan, Thinagaran; Rahman, Radziah Abd

    2018-01-01

    This case study attempts to identify the reasons for high turnover of academic staff in private higher institutions especially in small colleges. Three small colleges that shared almost the same type of background were being selected to participate in this study. The academic coordinator from these three institutions was interviewed. This case…

  3. Do racial disparities in private transfers help explain the racial wealth gap? New evidence from longitudinal data.

    PubMed

    McKernan, Signe-Mary; Ratcliffe, Caroline; Simms, Margaret; Zhang, Sisi

    2014-06-01

    How do private transfers differ by race and ethnicity, and do such differences explain the racial and ethnic disparity in wealth? Using the Panel Study of Income Dynamics, this study examines private transfers by race and ethnicity in the United States and explores a causal relationship between private transfers and wealth. Panel data and a family-level fixed-effect model are used to control for the endogeneity of private transfers. Private transfers in the form of financial support received and given from extended families and friends, as well as large gifts and inheritances, are examined. We find that African Americans and Hispanics (both immigrant and nonimmigrant) receive less in both types of private transfers than whites. Large gifts and inheritances, but not net financial support received, are related to wealth increases for African American and white families. Overall, we estimate that the African American shortfall in large gifts and inheritances accounts for 12 % of the white-black racial wealth gap.

  4. Tolerant indirect reciprocity can boost social welfare through solidarity with unconditional cooperators in private monitoring.

    PubMed

    Okada, Isamu; Sasaki, Tatsuya; Nakai, Yutaka

    2017-08-29

    Indirect reciprocity is an important mechanism for resolving social dilemmas. Previous studies explore several types of assessment rules that are evolutionarily stable for keeping cooperation regimes. However, little is known about the effects of private information on social systems. Most indirect reciprocity studies assume public monitoring in which individuals share a single assessment for each individual. Here, we consider a private monitoring system that loosens such an unnatural assumption. We explore the stable norms in the private system using an individual-based simulation. We have three main findings. First, narrow and unstable cooperation: cooperation in private monitoring becomes unstable and the restricted norms cannot maintain cooperative regimes while they can in public monitoring. Second, stable coexistence of discriminators and unconditional cooperators: under private monitoring, unconditional cooperation can play a role in keeping a high level of cooperation in tolerant norm situations. Finally, Pareto improvement: private monitoring can achieve a higher cooperation rate than does public monitoring.

  5. Quantum subsystems: Exploring the complementarity of quantum privacy and error correction

    NASA Astrophysics Data System (ADS)

    Jochym-O'Connor, Tomas; Kribs, David W.; Laflamme, Raymond; Plosker, Sarah

    2014-09-01

    This paper addresses and expands on the contents of the recent Letter [Phys. Rev. Lett. 111, 030502 (2013), 10.1103/PhysRevLett.111.030502] discussing private quantum subsystems. Here we prove several previously presented results, including a condition for a given random unitary channel to not have a private subspace (although this does not mean that private communication cannot occur, as was previously demonstrated via private subsystems) and algebraic conditions that characterize when a general quantum subsystem or subspace code is private for a quantum channel. These conditions can be regarded as the private analog of the Knill-Laflamme conditions for quantum error correction, and we explore how the conditions simplify in some special cases. The bridge between quantum cryptography and quantum error correction provided by complementary quantum channels motivates the study of a new, more general definition of quantum error-correcting code, and we initiate this study here. We also consider the concept of complementarity for the general notion of a private quantum subsystem.

  6. Evaluation of Immunization Knowledge, Practices, and Service-delivery in the Private Sector in Cambodia

    PubMed Central

    Soeung, Sann Chan; Grundy, John; Morn, Cheng; Samnang, Chham

    2008-01-01

    A study of private-sector immunization services was undertaken to assess scope of practice and quality of care and to identify opportunities for the development of models of collaboration between the public and the private health sector. A questionnaire survey was conducted with health providers at 127 private facilities; clinical practices were directly observed; and a policy forum was held for government representatives, private healthcare providers, and international partners. In terms of prevalence of private-sector provision of immunization services, 93% of the private inpatient clinics surveyed provided immunization services. The private sector demonstrated a lack of quality of care and management in terms of health workers’ knowledge of immunization schedules, waste and vaccine management practices, and exchange of health information with the public sector. Policy and operational guidelines are required for private-sector immunization practices that address critical subject areas, such as setting of standards, capacity-building, public-sector monitoring, and exchange of health information between the public and the private sector. Such public/private collaborations will keep pace with the trends towards the development of private-sector provision of health services in developing countries. PMID:18637533

  7. An Exploration of Teaching Practices of Private, Public, and Public-Private EFL Teachers in Iran

    ERIC Educational Resources Information Center

    Gholami, Javad; Sarkhosh, Mehdi; Abdi, Heidar

    2016-01-01

    This study investigates the practices of public (high) school, private language institute, and public-private teachers. In particular, it aims at addressing the role of contextual factors, the variations teachers introduce to cope with them, and the degree of sustainable behaviour among these three groups of teachers. High school teachers…

  8. Evaluating the Effects of Governmental Regulations on South Korean Private Cram Schools

    ERIC Educational Resources Information Center

    Choi, Jaesung; Cho, Rosa Minhyo

    2016-01-01

    Using two nationally representative datasets, this paper examines how the imposition of a curfew on private cram schools affects the consumption of private tutoring services as well as the time use patterns of Korean high school students. To identify the impact of the curfew, this study capitalizes on inter-city/province variation in private cram…

  9. Private Speech Use in Arithmetical Calculation: Contributory Role of Phonological Awareness in Children with and without Mathematical Difficulties

    ERIC Educational Resources Information Center

    Ostad, Snorre A.

    2013-01-01

    The majority of recent studies conclude that children's private speech development (private speech internalization) is related to and important for mathematical development and disabilities. It is far from clear, however, whether private speech internalization itself plays any causal role in the development of mathematical competence. The main…

  10. Policies on Private Education: An Economics Analysis

    ERIC Educational Resources Information Center

    Fengqiao, Yan

    2009-01-01

    Basic principles and analytical methods of economics are used to conduct a preliminary study of state policies for private education in China. It is evident that if public policy is to exert a positive effect on private education, the government must formulate policies at a higher level for private education and give equal attention to choice,…

  11. The Expansion of Private Loans in Postsecondary Education. Stats in Brief. NCES 2012-184

    ERIC Educational Resources Information Center

    Woo, Jennie H.

    2011-01-01

    This Statistics in Brief examines private loans by institution sector, tuition amount, student characteristics, and level. This study attempts to answer the following questions: (1) How did undergraduate borrowing from private sources change from 2003-04 to 2007-08 and who obtained private loans?; (2) To what extent did undergraduates combine…

  12. [Knowledge of emergency contraception among adolescents in public and private Brazilian high schools].

    PubMed

    Chofakian, Christiane Borges do Nascimento; Borges, Ana Luiza Vilela; Fujimori, Elizabeth; Hoga, Luiza Akiko Komura

    2014-07-01

    This study aimed to analyze the level of knowledge concerning emergency contraception among adolescents in public and private high schools. This was a cross-sectional study with 705 students 15 to 19 years of age enrolled in public and private high schools in a municipality in São Paulo State, Brazil. The authors used stratified probabilistic sampling by type of school and systematic sampling by class. Sexual initiation and use of emergency contraception were reported by 24.9% of private school students and 32% of public school students. The mean score on knowledge was 3.87 (SD = 2.12) in public schools and 5.14 (SD = 2.00) in private schools. Multiple linear regression analysis showed that higher scores on knowledge concerning emergency contraception were associated with: enrollment in private schools, female gender, older adolescents, sexual initiation, previous use of emergency contraception, and knowing someone who had used the method. The study concludes that few adolescents are properly informed about the method and that many harbor persistent misconceptions.

  13. Quality Assurance Challenges and Opportunities Faced by Private Universities in Zimbabwe

    ERIC Educational Resources Information Center

    Garwe, Evelyn Chiyevo

    2014-01-01

    The study sought to provide an understanding of the quality assurance challenges and opportunities faced by private universities in Zimbabwe. The study analyzed the factors determining provision of quality higher education in private universities and the resultant effects of failing to achieve the minimum acceptable standards. The author employed…

  14. Pharmacy students in private institutions of higher education: motivating factors when studying pharmacy and influences on university choice.

    PubMed

    Loo, Jason S E; Lim, Shiao Wei; Ng, Yew Keong; Tiong, John J L

    2017-12-01

    To identify factors influencing the decisions of Malaysian first-year pharmacy undergraduate students in private higher education when choosing to pursue a degree in pharmacy as well as their choice of private university. This cross-sectional study employed a validated, self-administered questionnaire which was administered to 543 first-year pharmacy students from nine different private universities. Factor analysis was utilised to extract key factors from the responses. Descriptive and inferential statistics were used to analyse the data. Eight factors motivating students' decision to study pharmacy emerged from the responses, accounting for 63.8% of the variance observed. Students were primarily motivated by intrinsic interests, with work conditions and profession attributes also exerting significant influence. In terms of choice of private university, nine factors were identified, accounting for 73.8% of the variance observed. The image of the school and university were most influential factors in this context, followed by university safety, programme attributes and financial factors. First-year pharmacy students in the private higher education sector are motivated by intrinsic interest when choosing to study pharmacy over other courses, while their choice of private university is influenced primarily by the image of the school and university. © 2017 Royal Pharmaceutical Society.

  15. The Role of Private Health Sector for Tuberculosis Control in Debre Markos Town, Northwest Ethiopia.

    PubMed

    Reta, Alemayehu; Simachew, Addis

    2018-01-01

    Tuberculosis has been declared to be a global epidemic. Despite all the effort, only less than half the annual estimated cases are reported by health authorities to the WHO. This could be due to poor reporting from the private sector. In Ethiopia, tuberculosis has also been a major public health problem. The aim of this study was to assess the role of the private health sector in tuberculosis control in Debre Markos. An institution based cross-sectional descriptive study was carried out in private health facilities. A total of 260 tuberculosis suspects attending the private clinics were interviewed. Focus group discussion, checklist, and structured questionnaire were used. Majority of the private clinics were less equipped, poorly regulated, and owned by health workers who were self-employed on a part-time basis. Provider delay of 4 and more months was significantly associated higher likelihood of turning to a private provider (OR = 2.70, 95% CI = (1.20, 6.08)). There is significant delay among tuberculosis patients. Moreover, there is poor regulation of the private health sector by public health authorities. The involvement of the private sector in tuberculosis control should be limited to identification and refer to tuberculosis cases and suspects.

  16. The Generalizability of Private Sector Research on Software Project Management in Two USAF Organizations: An Exploratory Study

    DTIC Science & Technology

    2003-03-01

    private sector . Researchers have also identified software acquisitions as one of the major differences between the private sector and public sector MIS. This indicates that the elements for a successful software project in the public sector may be different from the private sector . Private sector project success depends on many elements. Three of them are user interaction with the project’s development, critical success factors, and how the project manager prioritizes the traditional success criteria.

  17. A comparative study of school based violence and strategies for control in public and private secondary schools in Osun State.

    PubMed

    Omisore, A G; Omisore, B; Adelekan, B; Afolabi, O T; Olajide, F O; Arije, O O; Agunbiade, O I

    2012-01-01

    Violence is universal; it occurs in schools (both public and private). The study aim was to assess the rates of violence as well as existing violence prevention strategies in public and private schools in Osun state. A cross sectional study was conducted among 800 secondary school students (599 in public and 201 in private schools) selected by multistage sampling technique using quantitative and qualitative methods of data collection. The mean age for all the respondents was 14.26 years +/- 2.001 Males make up about 51% of the respondents in both public and private schools. Respondents from public schools assaulted other students and staff with a weapon more than their colleagues in private schools (24.7% and 9.7% against 12.9% and 6.5% respectively). The commonest violence 'prevention' strategy in both schools was punishment for violent acts (>90%). Respondents in public schools perpetrated and experienced virtually all forms of school-related violence more than those in private, schools. There were mild differences in existing violence prevention strategies in both schools. School connectedness seems to be a major factor in the differential rates of violence between both groups of schools.

  18. Analysis of the cost and efficiency relationship: experience in the Turkish pay for performance system.

    PubMed

    Gok, Mehmet Sahin; Altındağ, Erkut

    2015-06-01

    This paper analyzes the effects of the pay for performance (PFP) system on the efficiencies of public and private hospitals in Turkey. In order to evaluate these effects, we examine the relationship between hospital efficiency and health care costs in Turkey, and address the impact of the PFP system on the efficiencies of public and private hospitals. In an effort to analyze the efficiencies of public and private hospitals, this study uses data envelopment analysis. The Malmquist Productivity Index is also used to analyze the patterns of efficiency change for the study years from 2001 to 2008. This study shows that health care costs and hospital efficiency are negatively correlated for private hospitals, while they are positively correlated for public hospitals. In other words, increased health care costs might reduce efficiency in private hospitals in contrast to public hospitals. Our findings also indicate that average efficiencies of public hospitals tend to increase, particularly during the implementation period of PFP system. The efficiency trend of private hospitals, conversely, decreased in the latter periods of the PFP system. Suggestions for improvement are provided to the health care policy makers regarding the impact of health care reforms on public and private hospitals.

  19. Satisfaction with joint replacement in public versus private hospitals: a cohort study.

    PubMed

    Adie, Sam; Dao, Alan; Harris, Ian A; Naylor, Justine M; Mittal, Rajat

    2012-09-01

    In Australia, the majority of total knee and hip replacement surgeries occur in the private sector. Outcome-based research needs to be inclusive of this sector if the findings are intended to reflect the broader picture. This study compares outcomes up to 1 year post knee and hip replacement between patients treated in the public and private sectors. A prospective, observational study was performed in four high-volume joint replacement centres: two public, two private. Experienced orthopaedic surgeons contributed via their public and private practices. Knee and hip patients were recruited preoperatively. Self-reported questionnaires were completed preoperatively and at 6 and 12 months post-operatively. The primary outcome was satisfaction with surgery. Secondary outcomes included Oxford score, and SF-36 physical and mental component summary scores. Regression modelling was performed to adjust for potential confounders. Three hundred and thirty-one patients (184 public, 147 private; 215 knees, 116 hips) were recruited, with 6- and 12-month follow-up rates of 95% and 89%, respectively. Satisfaction rates were high in both public and private patients (approximately 90%) at 6 and 12 months, but private patients were less likely to be satisfied after adjusting for the strong effect of patient expectation. For both hip and knee cohorts, no between-sector differences were found in either the magnitude or rate of improvement in Oxford score or quality of life post-operatively. Joint replacement outcomes are similar for patients treated in public and private hospitals. Surgeons should manage patient expectation prior to surgery, particularly in private patients. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  20. Private health care expenditure and quality in Beveridge systems: cross-regional differences in the Italian NHS.

    PubMed

    Del Vecchio, Mario; Fenech, Lorenzo; Prenestini, Anna

    2015-03-01

    Private health care expenditure ranges from 15% to 30% of total healthcare spending in OECD countries. The literature suggests that there should be an inverse correlation between quality of public services and private expenditures. The main objective of this study is to explore the association between quality of public healthcare and private expenditures in the Italian Regional Healthcare Systems (RHSs). The institutional framework offered by the Italian NHS allows to investigate on the differences among the regions while controlling for institutional factors. The study uses micro-data from the ISTAT Household Consumption Survey (HCS) and a rich set of regional quality indicators. The results indicate that there is a positive and significant correlation between quality and private spending per capita across regions. The study also points out the strong association between the distribution of private consumption and income. In order to account for the influence of income, the study segmented data in three socio-economic classes and computed cross-regional correlations of RHSs quality and household healthcare expenditure per capita, within each class. No correlation was found between the two variables. These findings are quite surprising and call into question the theory that better quality of public services crowds out private spending, or, at the very least, it undermines the simplistic notions that higher levels of private spending are a direct consequence of poor quality in the public sector. This suggests that policies should avoid to simplistically link private spending with judgements or assessments about the functioning or efficacy of the public system and its organizations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Public and private health insurance in Germany: the ignored risk selection problem.

    PubMed

    Grunow, Martina; Nuscheler, Robert

    2014-06-01

    We investigate risk selection between public and private health insurance in Germany. With risk-rated premiums in the private system and community-rated premiums in the public system, advantageous selection in favor of private insurers is expected. Using 2000 to 2007 data from the German Socio-Economic Panel Study (SOEP), we find such selection. While private insurers are unable to select the healthy upon enrollment, they profit from an increase in the probability to switch from private to public health insurance of those individuals who have experienced a negative health shock. To avoid distorted competition between the two branches of health care financing, risk-adjusted transfers from private to public insurers should be instituted. Copyright © 2013 John Wiley & Sons, Ltd.

  2. Lessons in Success: A Multi-Campus Study of Factors Influencing Academic Accomplishment among High-Achieving African American Students at Private Liberal Arts Colleges

    ERIC Educational Resources Information Center

    Johnson, Ryan A.

    2013-01-01

    The purpose of this study was to explore the academic experiences of highly successful African-American male graduates of small, private liberal arts colleges using a qualitative approach. Fourteen highly successful alumni from selective, private colleges were purposefully selected for the study, including seven African-American males and seven…

  3. Comparison of Navy and Private-Sector Construction Costs

    DTIC Science & Technology

    1997-09-01

    contracts are comparable to private - sector construction costs. This report compares those costs. The report includes a description of the methodology...costs of complying with federal contracting requirements as compared with the costs of similar projects completed under typical private - sector contracts...The study found that the costs of facilities constructed under Navy contracts compare favorably to private - sector construction costs for similar

  4. Comparative Aspects of Management Observed by Heads of Public and Private Schools

    ERIC Educational Resources Information Center

    Imran, Muhammad

    2010-01-01

    The major purpose of the research was to compare the management aspects in public and private schools. All the heads of secondary schools of public and private sector of the Punjab province, Pakistan constituted population of the study. A sample of 216 head teachers (fifty percent from public sector schools and fifty percent private schools) was…

  5. The Development of Private Higher Education in a Mature Market: A New Zealand Case Study

    ERIC Educational Resources Information Center

    Xiaoying, Ma; Abbott, Malcolm

    2008-01-01

    Since 1989, when it became legally possible for private higher education to operate in New Zealand, the sector has grown to become a significant part of the country's higher education system. This paper explores the private penetration, traces the changes that have occurred in private higher education, and evaluate the sector's position in New…

  6. Exit and Entry: Why Parents in Utah Left Public Schools and Chose Private Schools

    ERIC Educational Resources Information Center

    Bukhari, Patras; Randall, E. Vance

    2009-01-01

    This study explored the factors that influenced parental decisions to exit a public school and enroll their children in a private school. It also explored why parents chose the specific private school their child attends and the level of satisfaction they have with their private school choice. The key reasons for leaving public education were: (a)…

  7. Privatization and subsidization in a leadership duopoly

    NASA Astrophysics Data System (ADS)

    Ferreira, Fernanda A.

    2017-07-01

    In this paper, we consider a competition in both mixed and privatized markets, in which the firms set prices in a sequential way. We study the effects of optimal production subsidies in both mixed and privatized duopoly.

  8. Reputation Effects in Public and Private Interactions

    PubMed Central

    Ohtsuki, Hisashi; Iwasa, Yoh; Nowak, Martin A.

    2015-01-01

    We study the evolution of cooperation in a model of indirect reciprocity where people interact in public and private situations. Public interactions have a high chance to be observed by others and always affect reputation. Private interactions have a lower chance to be observed and only occasionally affect reputation. We explore all second order social norms and study conditions for evolutionary stability of action rules. We observe the competition between “honest” and “hypocritical” strategies. The former cooperate both in public and in private. The later cooperate in public, where many others are watching, but try to get away with defection in private situations. The hypocritical idea is that in private situations it does not pay-off to cooperate, because there is a good chance that nobody will notice it. We find simple and intuitive conditions for the evolution of honest strategies. PMID:26606239

  9. Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK.

    PubMed

    Bishop, Felicity L; Barlow, Fiona; Coghlan, Beverly; Lee, Philippa; Lewith, George T

    2011-05-27

    The aim of this study was to compare patients' experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS). Consumerism was used as a theoretical framework to explore patients' experiences. Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture. Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and "just added extras": physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete information. Patients used and experienced acupuncture differently in the NHS compared to the private sector. Eight different faces of consumerist behaviour were identified, but six were dominant: consumer as chooser, consumer as pragmatist, consumer as patient, consumer as earnest explorer, consumer as victim, and consumer as citizen. The decision to use acupuncture in either the private sector or the NHS was rarely well-informed: NHS and private patients both had misconceptions about acupuncture in the other sector. Future research should evaluate whether the differences we identified in patients' experiences across private and public healthcare are common, whether they translate into significant differences in clinical outcomes, and whether similar faces of consumerism characterise patients' experiences of other interventions in the private and public sectors.

  10. Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK

    PubMed Central

    2011-01-01

    Background The aim of this study was to compare patients' experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS). Consumerism was used as a theoretical framework to explore patients' experiences. Methods Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture. Results Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and "just added extras": physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete information. Conclusions Patients used and experienced acupuncture differently in the NHS compared to the private sector. Eight different faces of consumerist behaviour were identified, but six were dominant: consumer as chooser, consumer as pragmatist, consumer as patient, consumer as earnest explorer, consumer as victim, and consumer as citizen. The decision to use acupuncture in either the private sector or the NHS was rarely well-informed: NHS and private patients both had misconceptions about acupuncture in the other sector. Future research should evaluate whether the differences we identified in patients' experiences across private and public healthcare are common, whether they translate into significant differences in clinical outcomes, and whether similar faces of consumerism characterise patients' experiences of other interventions in the private and public sectors. PMID:21619572

  11. Does Private Tutoring Improve Students' National College Entrance Exam Performance?--A Case Study from Jinan, China

    ERIC Educational Resources Information Center

    Zhang, Yu

    2013-01-01

    With the increasing attention on improving student achievement, private tutoring has been expanding rapidly worldwide. However, the evidence on the effect of private tutoring is inconclusive for education researchers and policy makers. Employing a comprehensive dataset collected from China in 2010, this study tries to identify the effect of…

  12. A Qualitative Content Analysis of Sexual Abuse Prevention and Awareness Programming in Texas Private School Athletics

    ERIC Educational Resources Information Center

    Naterman, Shane

    2014-01-01

    The purpose of this study is to determine to what extent private school athletic administrators have implemented programming specifically aimed at combatting the problem of childhood sexual abuse in sport. The study examined published policies and procedures overseen by private school athletic administrators to determine to what extent their…

  13. Determinants of Demand for Private Supplementary Tutoring in China: Findings from a National Survey

    ERIC Educational Resources Information Center

    Liu, Junyan; Bray, Mark

    2017-01-01

    Private tutoring has expanded and intensified in China. However, no government statistical data or other empirical studies fully capture its extent and characteristics. This paper analyses private tutoring received by students in Grades 1-12 as indicated by a nationwide representative survey entitled China Family Panel Studies. The paper employs a…

  14. Existing and Potential Incentives for Practicing Sustainable Forestry on Non-industrial Private Forest Lands

    Treesearch

    John L. Greene; Michael A. Kilgore; Michael G. Jacobson; Steven E. Daniels; Thomas J. Straka

    2007-01-01

    This study examined the compatibility between sustainable forestry practices and the framework of public and private financial incentive programs directed toward nonindustrial private forest (NIPF) owners. The incentives include tax, cost-share, and other types of programs. The study consisted of four components: a literature review, a mail survey of selected...

  15. African American Students in Private, Independent Schools: Parents and School Influences on Racial Identity Development

    ERIC Educational Resources Information Center

    DeCuir-Gunby, Jessica T.; Martin, Pamela P.; Cooper, Shauna M.

    2012-01-01

    Although much research has focused on the public school experiences of African American students, few studies exist that explore their race-related experiences within an independent, private school context. Studies have suggested that, while private, independent schools may elevate the quality of African American students' education, many of these…

  16. Faculty and Administrator Perspectives of Merit Pay Compensation Systems in Private Higher Education: A Mixed Methods Analysis

    ERIC Educational Resources Information Center

    Power, Anne L.

    2013-01-01

    The purpose of this explanatory sequential mixed methods study is to explore faculty and administrator perspectives of faculty merit pay compensation systems in private, higher education institutions. The study focuses on 10 small, private, four-year institutions which are religiously affiliated. All institutions are located in Nebraska, Iowa, and…

  17. An Exploratory Study on Factors Affecting Private College Non-Viability in Korea

    ERIC Educational Resources Information Center

    Choi, Bo Young

    2017-01-01

    Korean private colleges, especially institutions which depend largely on tuition revenue, are in danger due to the decrease in the college-aged population affecting their student enrollment. Given that private institutions become nonviable at different points in time, this study examines the effects of covariates on the occurrence as well as the…

  18. 78 FR 64259 - U.S. Department of State Advisory Committee on Private International Law (ACPIL)-Online Dispute...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... DEPARTMENT OF STATE [Public Notice 8508] U.S. Department of State Advisory Committee on Private International Law (ACPIL)--Online Dispute Resolution (ODR) Study Group The Office of the Assistant Legal Adviser for Private International Law, Department of State, hereby gives notice that the ACPIL ODR Study Group...

  19. Prevalence for Private Tuition among Parents, Teachers and Pupils in Public Primary Schools in Machakos County

    ERIC Educational Resources Information Center

    Kirigwi, Lucy Wambui; Maithya, Redempta

    2016-01-01

    Private tuition refers to tutoring offered outside mainstream teaching. The study sought to establish the difference in prevalence for private tuition among parents, teachers and pupils in public primary schools in Machakos County. The study employed descriptive survey design. The target populations were all teachers, parents and pupils of public…

  20. Culture, Motivation, and Vocational Decision-Making of Australian Senior High School Students in Private Schools

    ERIC Educational Resources Information Center

    Jung, Jae Yup; McCormick, John; Gregory, Gary; Barnett, Kerry

    2011-01-01

    The purpose of this study was to investigate the roles of culture and motivation in the occupational decisions of senior high school students attending private schools. A theoretical framework guided the study. A questionnaire was administered to 492 Grade 11 students attending a stratified random sample of six independent (private) schools…

  1. The dominance of the private sector in the provision of emergency obstetric care: studies from Gujarat, India.

    PubMed

    Salazar, Mariano; Vora, Kranti; De Costa, Ayesha

    2016-07-07

    India has experienced a steep rise in institutional childbirth. The relative contributions of public and private sector facilities to emergency obstetric care (EmOC) has not been studied in this setting. This paper aims to study in three districts of Gujarat state, India:(a) the availability of EmOC facilities in the public and private sectors; (b) the availability and distribution of human resources for birth attendance in the two sectors; and (c) to benchmark the above against 2005 World Health Report benchmarks (WHR2005). A cross-sectional survey of obstetric care facilities reporting 30 or more births in the last three months was conducted (n = 159). Performance of EmOC signal functions and availability of human resources were assessed. EmOC provision was dominated by private facilities (112/159) which were located mainly in district headquarters or small urban towns. The number of basic and comprehensive EmOC facilities was below WHR2005 benchmarks. A high number of private facilities performed C-sections but not all basic signal functions (72/159). Public facilities were the main EmOC providers in rural areas and 40/47 functioned at less than basic EmOC level. The rate of obstetricians per 1000 births was higher in the private sector. The private sector is the dominant EmOC provider in the state. Given the highly skewed distribution of facilities and resources in the private sector, state led partnerships with the private sector so that all women in the state receive care is important alongside strengthening the public sector.

  2. Insurance coverage and socioeconomic differences in patient choice between private and public health care providers in China.

    PubMed

    Wang, Qing; Zhang, Donglan; Hou, Zhiyuan

    2016-12-01

    The private health care sector has become an increasingly important complement to China's health care system. During the health care reform in 2009, China's central government established multiple initiatives to relax constraints on the growth of the private health care sector. However, private health services have not been growing as rapidly as private health care facilities. Using data from the China Health and Retirement Longitudinal Study collected between 2011 and 2013, this study investigated patient choice between private and public providers for outpatient care and estimated its relationship with health insurance and socioeconomic status (SES). The Heckman sample selection model was applied to address the problem of selection bias caused by a lack of awareness of provider ownership. We found that 82.1% of the outpatient care users were aware of their provider's ownership, and 23.8% chose private health care providers. Although patients with health insurance and higher SES were more likely to be aware of their provider's ownership, they preferred public providers over private providers. For example, having Urban Employee Basic Medical Insurance was associated with a 16.5% lower probability of choosing private providers than no health insurance. Respondents with the highest level of household expenditure had a 7.5% lower probability of choosing private providers than those with the lowest level of expenditure. The probability of choosing private providers were significantly lower by 4.0% among respondents with an education level of junior high school and above than those with no formal education. For private providers to play an effective role in the health care system, policies that have constrained the growth of the private sector should be changed, and more effort should be directed toward equalizing health insurance coverage for both types of providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Control of tuberculosis in an urban setting in Nepal: public-private partnership.

    PubMed Central

    Newell, James N.; Pande, Shanta B.; Baral, Sushil C.; Bam, Dirgh S.; Malla, Pushpa

    2004-01-01

    OBJECTIVES: To implement and evaluate a public-private partnership to deliver the internationally recommended strategy DOTS for the control of tuberculosis (TB) in Lalitpur municipality, Nepal, where it is estimated that 50% of patients with TB are managed in the private sector. METHODS: A local working group developed a public-private partnership for control of TB, which included diagnosis by private practitioners, direct observation of treatment and tracing of patients who missed appointments by nongovernmental organizations, and provision of training and drugs by the Nepal National TB Programme (NTP). The public-private partnership was evaluated through baseline and follow-up surveys of private practitioners, private pharmacies, and private laboratories, together with records kept by the Nepal NTP. FINDINGS: In the first 36 months, 1328 patients with TB were registered in the public-private partnership. Treatment success rates were >90%, and <1% of patients defaulted. Case notification of sputum-positive patients in the study area increased from 54 per 100 000 to 102 per 100 000. The numbers of patients with TB started on treatment by private practitioners decreased by more than two-thirds, the number of private pharmacies that stocked anti-TB drugs by one-third, the number of pharmacies selling anti-TB drugs by almost two-thirds, and sales of anti-TB drugs in pharmacies by almost two-thirds. Private practitioners were happy to refer patients to the public-private partnership. Not all private practitioners had to be involved: many patients bypassed private practitioners and went directly to free DOTS centres. CONCLUSIONS: A combination of the strengths of private practitioners, nongovernmental organizations, and the public sector in a public-private partnership can be used to provide a service that is liked by patients and gives high rates of treatment success and increased rates of patient notification. Similar public-private partnerships are likely to be replicable elsewhere, as inputs are not large and no special requirements exist. PMID:15042230

  4. The States and Private Higher Education. Problems and Policies in a New Era. A Report of the Carnegie Council on Policy Studies in Higher Education.

    ERIC Educational Resources Information Center

    1977

    A study was undertaken to assess the impact of existing state policies toward private higher education on enrollments, finances, autonomy, academic freedom, and other conditions of private institutions. The study included a survey of the presidents and their staffs of 230 institutions, site visits to 28 colleges and universities in five states,…

  5. The Transformation of a Private University's School of Nursing, 1999-2009: An Historical Case Study

    ERIC Educational Resources Information Center

    Selick, Sandra A.

    2014-01-01

    The purpose of this study was to examine the transformation of the School of Nursing at a private university in a Middle Atlantic state during the years 1999 to 2009. The secondary purpose of this study was to determine the leadership style of the Director of the School of Nursing at this private university in a Middle Atlantic state that led this…

  6. Cost-efficiency of highway operations and maintenance of public-private partnerships.

    DOT National Transportation Integrated Search

    2014-08-01

    While the literature on public-private partnerships (PPPs) argues that the private sectors life-cycle : approach to design and construction results in operational cost efficiencies, empirical support is : missing. This study explored that issue by...

  7. Private schooling and admission to medicine: a case study using matched samples and causal mediation analysis.

    PubMed

    Houston, Muir; Osborne, Michael; Rimmer, Russell

    2015-08-20

    Are applicants from private schools advantaged in gaining entry to degrees in medicine? This is of international significance and there is continuing research in a range of nations including the USA, the UK, other English-speaking nations and EU countries. Our purpose is to seek causal explanations using a quantitative approach. We took as a case study admission to medicine in the UK and drew samples of those who attended private schools and those who did not, with sample members matched on background characteristics. Unlike other studies in the area, causal mediation analysis was applied to resolve private-school influence into direct and indirect effects. In so doing, we sought a benchmark, using data for 2004, against which the effectiveness of policies adopted over the past decade can be assessed. Private schooling improved admission likelihood. This did not occur indirectly via the effect of school type on academic performance; but arose directly from attending private schools. A sensitivity analysis suggests this finding is unlikely to be eliminated by the influence of an unobserved variable. Academic excellence is not a certain pathway into medicine at university; yet applying with good grades after attending private school is more certain. The results of our paper differ from those in an earlier observational study and find support in a later study. Consideration of sources of difference from the earlier observational study suggest the causal approach offers substantial benefits and the consequences in the causal study for gender, ethnicity, socio-economic classification and region of residence provide a benchmark for assessing policy in future research.

  8. The Effects of Competition from Private Schooling on French Public School Districts in the Province of Quebec

    ERIC Educational Resources Information Center

    Caldas, Stephen J.; Bernier, Sylvain

    2012-01-01

    The Province of Quebec subsidizes nearly 50% of private education, and at the same time heavily regulates private schools. To date, no studies have been done to determine the effect of the unique nature of competition from K-12 private schools on public school education of the sort found in Quebec. The authors used multiple regression to determine…

  9. Privatization of School Food Services and Its Effect on the Financial Status of the Cafeteria Fund in Participating California Public School Districts.

    ERIC Educational Resources Information Center

    Schmieder, June; And Others

    The opportunity to increase private company revenues and the pressure to minimize losses within a public school district's cafeteria and general funds have propelled the emergence of private food-service-management companies (FSMCs). This paper presents findings of a study that examined privatization of school food services and its effect on the…

  10. How Old Is Old? Employing Elderly Teachers in the Private Sector Schools in Sri Lanka

    ERIC Educational Resources Information Center

    Madhuwanthi, L. A. P.

    2016-01-01

    The purpose of this paper is to explore why private sector schools in Sri Lanka employ elderly teachers (ETs). This paper used semi-structured in-depth interviews with 9 employers/principals in the private sector schools in Sri Lanka. The study found that the reasons for employing ETs in the private sector schools were shortfall of English medium…

  11. The Use of Private Student Loans at High-Cost Postsecondary Education Institutions in Academic Year 1997-98.

    ERIC Educational Resources Information Center

    Redd, Kenneth E.

    This study examined the use of private education loans at high-cost private colleges and universities. Responses were received from 100 of the 381 institutions who reported undergraduate tuition and fees, or professional school tuition and fees, of $14,000 or higher in 1996-1997. It was found that on most campuses private student loans play a…

  12. Age of diagnosis of congenital hearing loss: Private v. public healthcare sector.

    PubMed

    Butler, I R T; Ceronio, D; Swart, T; Joubert, G

    2015-11-01

    The age of diagnosis of congenital hearing loss is one of the most important determinants of communication outcome. A previous study by the lead author had evaluated the performance of the public health services in Bloemfontein, South Africa (SA), in this regard. This study aimed to examine whether the private health services in the same city were any better. To determine whether the age of diagnosis of congenital hearing loss (CHL) in children seen in the private healthcare sector in Bloemfontein, Free State Province, SA, was lower than that in the public healthcare system in the same city. A comparative study design was utilised and a retrospective database review conducted. Data obtained from this study in the private healthcare sector were compared with data from a previous study in the public healthcare sector using the same study design. Forty-eight children aged <6 years with disabling hearing impairment (DHI) were identified in the private healthcare sector during the study period; 33/47 (70.2%) did not undergo hearing screening at birth. The median age of diagnosis of DHI in the private healthcare sector was 2.24 years, and this was statistically significantly lower than the median age of diagnosis of 3.71 years in the public healthcare sector (p<0.0001; 95% confidence interval (CI) 0.99-2.0). The median age of diagnosis of congenital hearing loss (CHL) in the private healthcare sector was 3.01 years in children who were not screened at birth, and 1.25 years in those who were screened at birth. This difference was statistically significant (p<0.01; 95% CI 0.72-2.47). We also compared the median age of diagnosis of CHL in children from the private healthcare sector who were not screened at birth (median 3.01 years) with that in children in the public healthcare sector (median 3.71 years). This difference was statistically significant (p<0.01; 95% CI 0.41-1.56). Children in the Free State are diagnosed with CHL at a younger age in the private healthcare sector than in the public healthcare sector. With the social and economic benefits of early intervention in cases of DHI well established internationally, SA healthcare providers in both the public and private sectors need to develop screening, diagnostic and (re)habilitation services for children with hearing impairment.

  13. Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional study.

    PubMed

    Adejumo, Olusola Adedeji; Daniel, Olusoji James; Otesanya, Andrew Folarin; Adejumo, Esther Ngozi

    2016-09-01

    Despite several studies on health system delay (HSD) among tuberculosis (TB) patients in Nigeria, no study has compared HSD in private and public health facilities. This study assessed the determinants of HSD in public and private health facilities offering the directly observed treatment, short course (DOTS). A descriptive cross-sectional study was conducted. A total of 470 new smear-positive TB patients aged 14years and older were consecutively recruited between October 1, 2012, and December 31, 2012, from 34 (23 public and 11 private) DOTS facilities that offered treatment and microscopy services. Mann-Whitney U test and logistic regression were used to assess the determinants of HSD. The median HSD was longer at public DOTS facilities (14days; interquartile range [IQR] 10-21days) than private DOTS facilities (12.5days; IQR 10.0-14.0days, p=.002). Age and human immunodeficiency virus status were determinants of HSD at the public DOTS facilities, whereas sex and income were determinants of HSD at the private DOTS facilities. TB patients who first visited a nonhospital facility were over four times more likely (odds ratio 4.12; 95% confidence interval 2.25-7.54) to have prolonged HSD than those who first visited the government hospital when they first developed the symptoms of TB after controlling for other factors in the model. Determinants of HSD at the public and private DOTS facilities vary. Strategies to reduce HSD at both public and private DOTS facilities in Lagos State, Nigeria, are urgently needed. Copyright © 2016 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

  14. The neighborhood recreational environment and physical activity among urban youth: an examination of public and private recreational facilities.

    PubMed

    Ries, Amy V; Yan, Alice F; Voorhees, Carolyn C

    2011-08-01

    Recreational facility availability has been shown to associate positively with youth physical activity levels. Nonetheless, little is known about additional facility characteristics affecting their use for physical activity as well as differences between private and public facilities. This study examines (1) perceptions and use of public and private recreational facilities and (2) environmental and individual-level correlates of both facility use and physical activity among urban adolescents. Physical activity was assessed using accelerometry, objective measures of facility availability were obtained using Geographical Information Systems data, and facility use and perceptions were measured with a survey (N = 327). Adolescents were more likely to use public than private facilities despite perceiving that private facilities were of higher quality. Adolescents' use of both public and private facilities was associated with perceived (but not objective) availability, perceived quality, and use by friends and family. Public, but not private, facility use was associated with physical activity. This study reveals the importance of public facilities to the physical activity of urban youth.

  15. [Prenatal care in public and private health services: a population-based survey in Rio Grande, Rio Grande do Sul State, Brazil].

    PubMed

    Cesar, Juraci A; Sutil, Andréa T; Santos, Gabriela B dos; Cunha, Carolina F; Mendoza-Sassi, Raúl A

    2012-11-01

    This study aimed to evaluate public and private prenatal care for women in Rio Grande, Rio Grande do Sul State, Brazil. Women who gave birth at the two local maternity hospitals from January 1 to December 31, 2010, answered a standardized questionnaire. The interview sites in the public sector were primary health care units with and without the Family Health Strategy (FHS) and outpatient clinics; the private sector included clinics operated by health plans and private physicians' offices. The chi-square test was used to compare proportions. The response rate was 97.2% (2,395 out of 2,464). Among the 23 target variables and indicators, seven showed a clear advantage for mothers who had received prenatal care under the FHS and six for health plan clinics and private offices. Four variables showed virtually universal coverage at all five study sites. Prenatal care showed better coverage for pregnant women treated in the private sector. Pregnant women treated under the FHS showed similar coverage to that in the private sector.

  16. The Profitability Analysis of PT. Garuda Indonesia (Persero) Tbk. Before and After Privatization

    NASA Astrophysics Data System (ADS)

    Nurasiah, I.; Anggara

    2017-03-01

    This study purposes to determine differences in the profitability of PT. Garuda Indonesia (Persero) Tbk. before and after privatization using Net Profit Margin (NPM), Return on Investmen (ROI) and Return on Equity (ROE). This research used a case study method with a qualitative approach. The data used are secondary data from official financial statements of PT. Garuda Indonesia (Persero) Tbk. periode 2008-2013, 3 years before privatization and 3 years after privatization. Data analysis was performed by reviewing the financial statement data, calculate & determine the value of profitability ratios before and after privatization, and determine the amount of the average difference before and after privatization. The result proved that the average ratio of profitability calculated by applying NPM, ROI and ROE in every year shows a decrease that caused imbalance components forming of NPM, ROI, ROE, where profit is getting down while the selling, total assets and equity increase more and more from the previous period. The implication for the next research is a research that focus on determine how long a company can emerged from the crisis by privatization decision.

  17. Contribution of the private sector healthcare service providers to malaria diagnosis in a prevention of re-introduction setting.

    PubMed

    Fernando, Sumadhya Deepika; Dharmawardana, Priyani; Epasinghe, Geethanee; Senanayake, Niroshana; Rodrigo, Chaturaka; Premaratne, Risintha; Wickremasinghe, Rajitha

    2016-10-18

    Sri Lanka is currently in the prevention of re-introduction phase of malaria. The engagement of the private sector health care institutions in malaria surveillance is important. The purpose of the study was to determine the number of diagnostic tests carried out, the number of positive cases identified and the referral system for diagnosis in the private sector and to estimate the costs involved. This prospective study of private sector laboratories within the Colombo District of Sri Lanka was carried out over a 6-month period in 2015. The management of registered private sector laboratories was contacted individually and the purpose of the study was explained. A reporting format was developed and introduced for monthly reporting. Forty-one laboratories were eligible to be included in the study and 28 participated by reporting data on a monthly basis. Excluding blood bank samples and routine testing for foreign employment, malaria diagnostic tests were carried out on 973 individuals during the 6-month period and nine malaria cases were identified. In 2015, a total of 36 malaria cases were reported from Sri Lanka. Of these, 24 (67 %) were diagnosed in the Colombo District and 50 % of them were diagnosed in private hospitals. An equal number of cases were diagnosed from the private sector and government sector in the Colombo District in 2015. The private sector being a major contributor in the detection of imported malaria cases in the country should be actively engaged in the national malaria surveillance system.

  18. Caries Risk Assessment of 12-13-year-old Government and Private School Going Children of Mysore City Using Cariogram: A Comparative Study.

    PubMed

    Naik, Sandhya P; Moyin, Shabna; Patel, Bhakti; Warad, Lata Prabhu; Punathil, Sameer; Sudeep, C B

    2018-01-01

    The aim of this study is to assess the caries risk assessment of 12-13-year-old government and private school going children of Mysore city using Cariogram. A cross-sectional examination was carried out on a total of 104 government and private schoolchildren aged 12-13 years. Ten factors from the Cariogram software(D Bratthall, Computer software, Malmo, Sweden) were included from study participant's records to complete the Cariogram. The percentage of "chances of avoiding new lesions" (caries risk) among government and private school study participants were obtained from Cariogram, and the participants were classified into five risk groups. Statistical analysis was performed using the software program Statistical Package of Social Science (version 17.0, SPSS Inc., Chicago IL, USA). Findings revealed that there is slight difference in caries risk among government and private schoolchildren, where 48% caries risk development and 52% chance to avoid dental caries were showed in government schoolchildren, and 51% caries risk development and 49% chance to avoid dental caries were showed in private schoolchildren, according to Cariogram. Decayed, missing, and filled teeth component, mutans streptococci, and Lactobacillus counts were slightly higher in private schoolchildren compared with government schoolchildren. The private schoolchildren had less favorable values than government schoolchildren for most of the caries-related factors. Cariogram can be the most modest and reliable tool for caries prediction, thus aiding in identifying different risk groups in a community so that appropriate preventive strategies can be provided to overcome new carious lesion formation.

  19. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda: implications for patient safety.

    PubMed

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus; Clarke, Siân E; Lal, Sham; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip

    2016-04-14

    Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality of care in the private sector that provides almost a half of health services in Uganda. A survey was conducted from August to October 2014 within 57 parishes in Mukono district, central Uganda. The selected parishes had a minimum of 200 households and at least one registered drug shop, pharmacy or private clinic. Data was collected using a structured questionnaire targeting one provider who was found on duty in each selected private health facility and consented to the study. The main variables were: provider characteristics, previous training received, type of drugs stocked, treatment and prevention practices for malaria among pregnant women. The main study outcome was the proportion of private health facilities who prescribe treatment of fever among pregnant women as recommended in the guidelines. A total of 241 private health facilities were surveyed; 70.5 % were registered drug shops, 24.5 % private clinics and 5.0 % pharmacies. Treatment of fever among pregnant women in accordance with the national treatment guidelines was poor: 40.7 % in private clinics, decreasing to 28.2 % in drug shops and 16.7 % at pharmacies. Anti-malarial monotherapies sulphadoxine-pyrimethamine and quinine were commonly prescribed, often without consideration of gestational age. The majority of providers (>75 %) at all private facilities prescribed SP for intermittent preventive treatment but artemisinin-based combination therapy was prescribed: 8.3, 6.9 and 8.3 % respectively at drug shops, private clinics and pharmacies for prevention of malaria in pregnancy. Few facilities had malaria treatment guidelines; (44.1 % of private clinics, 17.9 % of drug shops, and 41.7 % at pharmacies. Knowledge of people at risk of malaria, P = 0.02 and availability of malaria treatment guidelines, P = 0.03 were the factors that most influenced correct treatment of fever in pregnancy. Treatment of fever during pregnancy was poor in this study setting. These data highlight the need to develop interventions to improve patient safety and quality of care for pregnant women in the private health sector in Uganda.

  20. United States private-sector physicians and pharmaceutical contract research: a qualitative study.

    PubMed

    Fisher, Jill A; Kalbaugh, Corey A

    2012-01-01

    There have been dramatic increases over the past 20 years in the number of nonacademic, private-sector physicians who serve as principal investigators on US clinical trials sponsored by the pharmaceutical industry. However, there has been little research on the implications of these investigators' role in clinical investigation. Our objective was to study private-sector clinics involved in US pharmaceutical clinical trials to understand the contract research arrangements supporting drug development, and specifically how private-sector physicians engaged in contract research describe their professional identities. We conducted a qualitative study in 2003-2004 combining observation at 25 private-sector research organizations in the southwestern United States and 63 semi-structured interviews with physicians, research staff, and research participants at those clinics. We used grounded theory to analyze and interpret our data. The 11 private-sector physicians who participated in our study reported becoming principal investigators on industry clinical trials primarily because contract research provides an additional revenue stream. The physicians reported that they saw themselves as trial practitioners and as businesspeople rather than as scientists or researchers. Our findings suggest that in addition to having financial motivation to participate in contract research, these US private-sector physicians have a professional identity aligned with an industry-based approach to research ethics. The generalizability of these findings and whether they have changed in the intervening years should be addressed in future studies. Please see later in the article for the Editors' Summary.

  1. United States Private-Sector Physicians and Pharmaceutical Contract Research: A Qualitative Study

    PubMed Central

    Fisher, Jill A.; Kalbaugh, Corey A.

    2012-01-01

    Background There have been dramatic increases over the past 20 years in the number of nonacademic, private-sector physicians who serve as principal investigators on US clinical trials sponsored by the pharmaceutical industry. However, there has been little research on the implications of these investigators' role in clinical investigation. Our objective was to study private-sector clinics involved in US pharmaceutical clinical trials to understand the contract research arrangements supporting drug development, and specifically how private-sector physicians engaged in contract research describe their professional identities. Methods and Findings We conducted a qualitative study in 2003–2004 combining observation at 25 private-sector research organizations in the southwestern United States and 63 semi-structured interviews with physicians, research staff, and research participants at those clinics. We used grounded theory to analyze and interpret our data. The 11 private-sector physicians who participated in our study reported becoming principal investigators on industry clinical trials primarily because contract research provides an additional revenue stream. The physicians reported that they saw themselves as trial practitioners and as businesspeople rather than as scientists or researchers. Conclusions Our findings suggest that in addition to having financial motivation to participate in contract research, these US private-sector physicians have a professional identity aligned with an industry-based approach to research ethics. The generalizability of these findings and whether they have changed in the intervening years should be addressed in future studies. Please see later in the article for the Editors' Summary. PMID:22911055

  2. A Cross-National Analysis of the Student- and School-Level Factors Affecting the Demand for Private Tutoring

    ERIC Educational Resources Information Center

    Song, Kyoung-Oh; Park, Hyun-Jeong; Sang, Kyong-Ah

    2013-01-01

    Private tutoring has become a worldwide phenomenon, yet there is little empirical evidence for the main factors leading the demand for private tutoring across nations. Using data from the Third International Mathematics and Science Study of 2003, this study classified the countries into four different groups according to the proportion of student…

  3. The Private School Market in Kuwait: A Field Study on Educational Investment Behavior of Kuwaiti Families

    ERIC Educational Resources Information Center

    Alqahtani, Abdulmuhsen Ayedh

    2014-01-01

    The current study aims at exploring Kuwaiti families' educational investment behavior pursuant to the selection of a specific private school for their children from the private school market. Using the quantitative approach and the principles of marketing research, a survey was administered to a randomly selected sample of Kuwaiti families (n =…

  4. A Comparative Analysis of Social Media Usage and Academic Performance in Public and Private Senior High Schools

    ERIC Educational Resources Information Center

    Mingle, Jeffrey; Adams, Musah; Adjei, E. A.

    2016-01-01

    The study comparatively analyzed social media usage and academic performance in public and private senior high schools. The issue of social media and academic performance has been a very debatable topic with regard to its effect. This study further explores the relation between private and public schools in relation to social media use and…

  5. Assessment of Staff Retention in Private Universities in Ghana: A Study of the Perez University College, Winneba

    ERIC Educational Resources Information Center

    Kwegyir-Aggrey, Peter

    2016-01-01

    Staff turnover especially among lecturers in private universities is high due to poor and disappointing conditions of service. This negatively affects effective teaching, learning and research. The purpose of the study was to examine the causes of staff turnover in private universities, using the Perez University College in Winneba as a case…

  6. Job Satisfaction and Burnout among Greek Early Educators: A Comparison between Public and Private Sector Employees

    ERIC Educational Resources Information Center

    Tsigilis, Nikolaos; Zachopoulou, Evridiki; Grammatikopoulos, Vasilios

    2006-01-01

    The purpose of the present study was to examine perceived levels of burnout and job satisfaction of Greek early educators, across public and private sector. One hundred and seventy eight childhood educators participated in the study. 108 were working in the public sector, 67 in private sector, whereas three did not respond. Participants were…

  7. An Examination of Three Forms of Private Sector Financing of Military Facilities

    DTIC Science & Technology

    1988-09-01

    The purpose of this study was to introduce the concept of Private Sector Financing (PSF) of military facilities instead of acquiring facilities via... Private sector financing; Military construction; Leasing; Contracting out; Outleasing; Military family housing. Theses.

  8. Public or private care: where do specialists spend their time?

    PubMed

    Freed, Gary L; Turbitt, Erin; Allen, Amy

    2017-10-01

    Objectives The aim of the present study was to provide data to help clarify the public-private division of clinical care provision by doctors in Australia. Methods A secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields. The specialties were orthopaedic surgery, otolaryngology, ophthalmology, cardiology, neurology, nephrology, gastroenterology and rheumatology. Results For the specialities analysed in the present study, a large majority of the time spent in patient care was provided in the private sector. For the surgical specialties studied, on average less than 30% of clinical time was spent in the public sector. There was considerable variation among specialties in whether a greater proportion of time was spent in out-patient versus in-patient care and how that was divided between the public and private sectors. Conclusions Ensuring Australians have a medical workforce that meets the needs of the population will require assessments of the public and private medical markets, the needs of each market and the adequacy with which current physician clinical time allocation meets those requirements. By appreciating this nuance, Australia can develop policies and strategies for the current and future speciality workforce to meet the nation's needs. What is known about the topic? Australian medical specialists can split their clinical practice time between the public (e.g. public hospitals, public clinics) and private (e.g. private hospitals, private consulting rooms) sectors. For all medical specialists combined, working hours have been reported to be similar in the public and private sectors. In aggregate, 48% of specialists work across both sectors, 33% work only in public practice and 19% work only in private practice. What does this paper add? Because of the potential for significant variability across specialties, these consolidated figures may be problematic in assessing the public and private allocation of the physician workforce. Herein we provide the first speciality-specific data on the public-private mix of practice in Australia. Among the most important findings from the present study is that, for many specialists in Australia, a large majority of time is spent providing care to patients in the private sector. For the surgical specialties studied, on average less than 30% of clinical time is spent in the public sector. What are the implications for practitioners? Public policies that are designed to ensure an adequate medical workforce will need to take into account the division of time providing care in the public vs. the private sector. Public perceptions of shortages in the public sector may increase the availability of public sector positions.

  9. IDENTIFYING ELEVEN FACTORS OF SERVICE MARKETING MIX (4PS) EFFECTIVE ON TENDENCY OF PATIENTS TOWARD PRIVATE HOSPITAL.

    PubMed

    Hosseini, Seyed Mojtaba; Etesaminia, Samira; Jafari, Mehrnoosh

    2016-10-01

    One of the important factors of correct management is to identify the reasons for patient tendency toward private hospitals. This study measures these factors based on service marketing mixes. This study used a cross sectional descriptive methodology. The study was conducted during 6 months in 2015. The studied population included patients of private hospitals in Tehran. Random sampling was used (n = 200). Data was collected by an author-made questionnaire for service marketing factors. Reliability and validity of the questionnaire were confirmed. Data analysis was done using factor analysis test in SPSS 20. The results showed that constant attendance of physicians and nurses has the highest effect (0.707%) on patient tendency toward private hospitals.

  10. Public vs private administration of rural health insurance schemes: a comparative study in Zhejiang of China.

    PubMed

    Zhou, Xiaoyuan; Mao, Zhengzhong; Rechel, Bernd; Liu, Chaojie; Jiang, Jialin; Zhang, Yinying

    2013-07-01

    Since 2003, China has experimented in some of the country's counties with the private administration of the New Cooperative Medical Scheme (NCMS), a publicly subsidized health insurance scheme for rural populations. Our study compared the effectiveness and efficiency of private vs public administration in four counties in one of China's most affluent provinces in the initial stage of the NCMS's implementation. The study was undertaken in Ningbo city of Zhejiang province. Out of 10 counties in Ningbo, two counties with private administration for the NCMS (Beilun and Ninghai) were compared with two others counties with public administration (Zhenhai and Fenghua), using the following indicators: (1) proportion of enrollees who were compensated for inpatient care; (2) average reimbursement-expense ratio per episode of inpatient care; (3) overall administration cost; (4) enrollee satisfaction. Data from 2004 to 2006 were collected from the local health authorities, hospitals and the contracted insurance companies, supplemented by a randomized household questionnaire survey covering 176 households and 479 household members. In our sample counties, private administration of the NCMS neither reduced transaction costs, nor improved the benefits of enrollees. Enrollees covered by the publicly administered NCMS were more likely to be satisfied with the insurance scheme than those covered by the privately administered NCMS. Experience in the selected counties suggests that private administration of the NCMS did not deliver the hoped-for results. We conclude that caution needs to be exercised in extending private administration of the NCMS.

  11. How social context moderates the self-evaluative emotions experienced due to health risk behaviour.

    PubMed

    Grob, Judith D M; Dijkstra, Arie; de Groot, Carla

    2011-10-01

    When people are confronted with the potential negative physical outcomes of their own health risk behaviour, they experience a self-threat. This threat is felt as negative self-evaluative emotions. We hypothesise that the threat will lead to more private self-evaluative emotions (e.g. regret) in a private social context, whereas more public self-evaluative emotions (e.g. embarrassment) will be felt in a public social context with negative norms. Consistent with our hypotheses, we show that participants anticipate feeling more private self-evaluative emotions when confronted with the negative consequences of their unhealthy behaviour when alone, and more public self-evaluative emotions when in a group (Study 1). They further anticipate more public self-evaluative emotions in response to a health self-threat when the group norm is negative, and more private self-evaluative emotions when the group norm is lenient (Study 2). Finally, in a cross-sectional study amongst smokers, we show that private but not public negative self-evaluative emotions concerning their own smoking habits are positively correlated with the intent to quit smoking (Study 3). These studies show that a distinction needs to be made between public and private self-evaluative emotions, in terms of their antecedents and effects. Theoretical implications and further lines of research are discussed.

  12. Exploring the public-private and company size differences in employees' work characteristics and burnout: data analysis of a nationwide survey in Taiwan.

    PubMed

    Yeh, Wan-Yu; Yeh, Ching-Ying; Chen, Chiou-Jong

    2018-05-15

    Distinct differences exist between public-private sector organizations with respect to the market environment and operational objectives; furthermore, among private sector businesses, organizational structures and work conditions often vary between large- and small-sized companies. Despite these obvious structural distinctions, however, sectoral differences in employees' psychosocial risks and burnout status in national level have rarely been systematically investigated. Based on 2013 national employee survey data, 15,000 full-time employees were studied. Sector types were classified into "public," "private enterprise-large (LE)," and "private enterprise-small and medium (SME);" based on the definition of SMEs by Taiwan Ministry of Economic Affairs, and the associations of sector types with self-reported burnout status (measured by the Chinese version of Copenhagen Burnout Inventory) were examined, taking into account other work characteristics and job instability indicators. Significantly longer working hours and higher perceived job insecurity were found among private sector employees than their public sector counterparts. With further consideration of company size, greater dissatisfaction of job control and career prospect were found among SME employees than the other two sector type workers. This study explores the pattern of public-private differences in work conditions and employees' stress-related problems to have policy implications for supporting mechanism for disadvantaged workers in private sectors.

  13. Gender differences in French GPs' activity: the contribution of quantile regressions.

    PubMed

    Dumontet, Magali; Franc, Carine

    2015-05-01

    In any fee-for-service system, doctors may be encouraged to increase the number of services (private activity) they provide to receive a higher income. Studying private activity determinants helps to predict doctors' provision of care. In the context of strong feminization and heterogeneity in general practitioners' (GP) behavior, we first aim to measure the effects of the determinants of private activity. Second, we study the evolution of these effects along the private activity distribution. Third, we examine the differences between male and female GPs. From an exhaustive database of French GPs working in private practice in 2008, we performed an ordinary least squares (OLS) regression and quantile regressions (QR) on the GPs' private activity. Among other determinants, we examined the trade-offs within the GPs' household considering his/her marital status, spousal income, and children. While the OLS results showed that female GPs had less private activity than male GPs (-13%), the QR results emphasized a private activity gender gap that increased significantly in the upper tail of the distribution. We also find gender differences in the private activity determinants, including family structure, practice characteristics, and case-mix variables. For instance, having a youngest child under 12 years old had a positive effect on the level of private activity for male GPs and a negative effect for female GPs. The results allow us to understand to what extent the supply of care differs between male and female GPs. In the context of strong feminization, this is essential to consider for organizing and forecasting the GPs' supply of care.

  14. Regulation of private school buses in Virginia : results of a study mandated by the NTSB.

    DOT National Transportation Integrated Search

    1987-01-01

    In response to major accidents in Florida and Alabama involving privately-owned and privately-operated school buses, the National Transportation Safety Board (NTSB) issued three safety recommendations to the governors of all states and required each ...

  15. Leadership in Decentralized Schools.

    ERIC Educational Resources Information Center

    Madsen, Jean

    1997-01-01

    Summarizes a study that examined principals' leadership in three private schools and its implications for decentralized public schools. With the increase of charter and privatized managed schools, principals will need to redefine their leadership styles. Private schools, as decentralized entities, offer useful perspectives on developing school…

  16. Private and Non-Private Disc Herniation Patients: Do they Differ?

    PubMed

    Gregebo, Birgitta; Dai, Deliang; Schillberg, Birgitta; Baehr, Martin; Nyström, Bo; Taube, Adam

    2014-01-01

    In the 2006 yearly report from the Swedish National Register for Lumbar Spine Surgery it was claimed that international studies show obvious differences between private and non-private patients with regard to results from back surgery. Therefore our aim was to reveal such possible differences by comparing the two categories of patients at a private clinic. The material comprises 1184 patients operated on for lumbar disc herniation during the period of 1987 to 2007. Basic pre-operative data were obtained from the medical records and follow-up was performed by a questionnaire around 5 years post-operatively. Small but statistically significant differences between private and non-private patients were seen pre-operatively regarding the proportions of a/ men and women in the samples, b/ those with physically demanding jobs, c/ those on sick leave and d/ those with lumbar pain. Over the years the admitted private patients had a decreasing mean duration of symptoms which was not seen in the non-private patients. No apparent differences (n.s.) were seen between the two categories of patients pre-operatively regarding age, presence and level of leg pain or the proportion who smoked. Post-operative improvement in leg and lumbar pain was very similar in private and non-private patients as was satisfaction with the results and the proportion of patients returning to work. Despite small pre-operative differences concerning some variables and a significant difference in symptom duration between private and non-private disc herniation patients, the final clinical results were very similar.

  17. Examining the influence of health insurance literacy and perception on the people preference to purchase private voluntary health insurance.

    PubMed

    Mathur, Tanuj; Das, Gurudas; Gupta, Hemendra

    2018-01-01

    Most studies have associated "un-affordability" as a plausible cause for the lower take-up of private voluntary health insurance plans. However, others refuted this claim on the pretext that when people can afford "inpatient-care" from pocket then insurance premium cost is far less than those payments. Thus, economic factors remain insufficient in clearly explaining the reason for poor private voluntary health insurance take-up. An attempt is being made by shifting the focus towards non-economic factors and understanding the role of perception and health insurance literacy in transforming people preferences to invest in private voluntary health insurance plans. The study findings will conspicuously support decision-makers in developing strategy to increase the private voluntary health insurance take-up.

  18. Comparison of health literacy in privately insured and public hospital orthopaedic patients.

    PubMed

    Cosic, Filip; Porter, Tabitha; Norsworthy, Cameron; Price, Rohan; Bedi, Harvinder

    2018-05-14

    Objective The aim of the present study was to quantify and compare patient health literacy between privately insured and public orthopaedic patients. Methods As part of the present cross-sectional study, elective postoperative orthopaedic patients across two sites were recruited and asked to complete a questionnaire at the first postoperative out-patient review. Patients were divided into three groups: (1) a public group (Public); (2) a private group (Private-pre); and (3) a private group that completed the questionnaire immediately after the out-patient review (Private-post). The questionnaire consisted of six questions regarding surgical management, expected recovery time and postoperative instructions. Patients were further asked to grade their satisfaction regarding information received throughout their management. Results In all, 150 patients completed the questionnaire, 50 in each of the three groups. Patients in the Public, Private-pre and Private-post groups answered a mean 2.74, 3.24 and 4.70 of 6 questions correctly respectively. The Private-pre group was 1.46-fold more likely to demonstrate correct health literacy than the Public group, whereas the Private-post group was 2.44-fold more likely to demonstrate improved health literacy than the Private-pre group. Patient satisfaction with information received was not associated with health literacy. Conclusion Limited health literacy in orthopaedic patients continues to be an area of concern. Both private and public orthopaedic patients demonstrated poor health literacy, but private patients demonstrated significant improvement after the out-patient review. What is known about the topic? Limited health literacy is a growing public health issue worldwide, with previous literature demonstrating a prevalence of low health literacy of 26% and marginal health literacy of 20% among all patient populations. Of concern, limited health literacy has been shown to result in a range of adverse health outcomes, including increased mortality and chronic disease morbidity. It has also been associated with an increased rate of hospitalisation and use of healthcare resources. Previous work in the orthopaedic trauma setting has found poor levels of health literacy and poor understanding of diagnosis, management and prognosis in the Australian public health system. Promisingly, it has been shown that simple, targeted interventions can improve patient health literacy. What does this paper add? This study further highlights that health literacy exhibited by orthopaedic patients is poor, particularly among patients in the public healthcare system. The present study is the first to have demonstrated that health literacy is poor among patients in both the public and private healthcare systems, despite these patients having distinctly different demographics. Promisingly, the present study shows that, unlike public orthopaedic out-patient review, private orthopaedic out-patient review appears to be effective in increasing patient health literacy regarding their orthopaedic condition and its management. What are the implications for practitioners? Health literacy is essential for patients to effectively communicate with doctors and achieve good health outcomes. Healthcare professionals need to be aware that a large proportion of patients have poor health literacy and difficulty understanding health-related information, particularly pertaining to that surrounding diagnosis, management and prognosis. This study highlights the need for healthcare professionals to ensure that they communicate with patients at an appropriate level to ensure patient understanding during the pre-, peri- and postoperative stages of management. Further, healthcare professionals should be aware that there is potential to improve patient health literacy at routine out-patient review, provided that this opportunity is used as an educational resource.

  19. New Zealand consumers' perceptions of private insurance for pharmaceuticals.

    PubMed

    Ragupathy, Rajan; Babar, Zaheer-Ud-Din; Mirza, Wasif; Daiya, Mitali; Chandra, Himesh; Yousif, Ali; Girn, Maninder

    2014-01-01

    Private insurance plays a minor role in paying for pharmaceuticals in New Zealand, despite controversy about access through the public health system. The present study examines New Zealand consumers' perceptions of private insurance for pharmaceuticals. A self-administered questionnaire was completed by 433 consumers at thirty pharmacies. The questionnaire included 18 questions on demographics, insurance status, perceptions of private insurance for pharmaceuticals and confidence in the public health system. Forty six percent of respondents had private health insurance. Respondents were more likely to have private health insurance as household income increased, and confidence in the public health system decreased. (Over two thirds of respondents were either confident or very confident in the public health system). Nineteen percent had private health insurance for pharmaceuticals, and the likelihood was not affected by household income or confidence in the public health system. Sixty one percent believed private insurance for pharmaceuticals would increase availability and affordability of pharmaceuticals. However, just over half were willing to pay for private insurance for pharmaceuticals. Of these, over two thirds were only willing to pay $20 per year or less. New Zealand pharmacy consumers' willingness to pay for private insurance for pharmaceuticals is very low.

  20. Antibiotic prescribing in public and private practice: a cross-sectional study in primary care clinics in Malaysia.

    PubMed

    Ab Rahman, Norazida; Teng, Cheong Lieng; Sivasampu, Sheamini

    2016-05-17

    Antibiotic overuse is driving the emergence of antibiotic resistance worldwide. Good data on prescribing behaviours of healthcare providers are needed to support antimicrobial stewardship initiatives. This study examined the differences in antibiotic prescribing rates of public and private primary care clinics in Malaysia. We used data from the National Medical Care Survey (NMCS), a nationwide cluster sample of Malaysian public and private primary care clinics in 2014. NMCS contained demographic, diagnoses and prescribing from 129 public clinics and 416 private clinics. We identified all encounters who were prescribed antibiotic and analyse the prescribing rate, types of antibiotics, and diagnoses that resulted in antibiotic. Five thousand eight hundred ten encounters were prescribed antibiotics; antibiotic prescribing rate was 21.1 % (public clinics 6.8 %, private clinics 30.8 %). Antibiotic prescribing was higher in private clinics where they contributed almost 87 % of antibiotics prescribed in primary care. Upper respiratory tract infection (URTI) was the most frequent diagnosis in patients receiving antibiotic therapy and accounted for 49.2 % of prescriptions. Of the patients diagnosed with URTI, 46.2 % received antibiotic treatment (public 16.8 %, private 57.7 %). Penicillins, cephalosporins and macrolides were the most commonly prescribed antibiotics and accounted for 30.7, 23.6 and 16.0 % of all antibiotics, respectively. More recently available broad-spectrum antibiotics such as azithromycin and quinolones were more frequently prescribed in private clinics. Antibiotic prescribing rates are high in both public and private primary care settings in Malaysia, especially in the latter. This study provides evidence of excessive and inappropriate antibiotic prescribing for self-limiting conditions. These data highlights the needs for more concerted interventions targeting both prescribers and public. Improvement strategies should focus on reducing inappropriate prescribing.

  1. Oral Health Status among 12- and 15-Year-Old Children from Government and Private Schools in Hyderabad, Andhra Pradesh, India

    PubMed Central

    Sukhabogi, JR; Shekar, CBR; Hameed, IA; Ramana, IV; Sandhu, G

    2014-01-01

    Background: The assessment of oral health status of children in government and private schools provide data on the oral health status of children from different socio-economic background. Aim: The aim of the following study is to assess and to compare the oral hygiene status, gingival status and caries experience between children from government and private schools in Andhra Pradesh, India. Subjects and Methods: A combination of cluster and stratified random sampling was employed to select the study participants. Oral hygiene status, gingival status and caries experience was assessed and compared among 12- and 15-year-old children from three government and private schools each. The examination was carried out by three trained and calibrated investigators using a mouth mirror and explorer under natural daylight. Results: A total of 604 children (331 government and 273 private) were examined in the study. The mean oral hygiene index-simplified (OHI-S) was higher among government school children (2.9 [1.1]) compared private school children (0.6 [0.4]). The mean gingival score and mean decayed missing filled teeth were also higher among government school children compared with private school children. A significantly higher number of children in the government schools had poor oral hygiene status, moderate to severe gingivitis and caries experience. Conclusion: The prevalence of oral diseases was relatively less among children from private schools in comparison with those from government schools. Hence, the children from government schools should be given the priority compared with private school children in any school dental health programs planned on a statewide basis. PMID:25364601

  2. Perinatal mortality disparities between public care and private obstetrician-led care: a propensity score analysis.

    PubMed

    Adams, N; Tudehope, D; Gibbons, K S; Flenady, V

    2018-01-01

    To examine whether disparities in stillbirth, and neonatal and perinatal mortality rates, between public and private hospitals are the result of differences in population characteristics and/or clinical practices. Retrospective cohort study. A metropolitan tertiary centre encompassing public and private hospitals. Women accessed care from either a private obstetrician or from public models of care - predominantly midwife-led care or care shared between midwives, general practitioners, and obstetricians. A total of 131 436 births during 1998-2013: 69 037 public and 62 399 private. Propensity score matching was used to select equal-sized public and private cohorts with similar characteristics. Logistic regression analysis was then used to explore the impact of public-private differences in the use of assisted reproductive technologies, plurality, major congenital anomalies, birth method, and gestational age. Stillbirth, and neonatal and perinatal mortality rates. After controlling for maternal and pregnancy factors, perinatal mortality rates were higher in the public than in the private cohort (adjusted odds ratio, aOR 1.53; 95% confidence interval, 95% CI 1.29-1.80; stillbirth aOR 1.56, 95% CI 1.26-1.94; neonatal death aOR 1.48, 95% CI 1.15-1.89). These disparities reduced by 15.7, 20.5, and 19.6%, respectively, after adjusting for major congenital anomalies, birth method, and gestational age. Perinatal mortality occurred more often among public than private births, and this disparity was not explained by population differences. Differences in clinical practices seem to be partly responsible. The impact of differences in clinical practices on maternal and neonatal morbidity was not examined. Further research is required. Private obstetrician-led care: more obstetric intervention and earlier births reduce perinatal mortality. Background Babies born in Australian public hospitals tend to die more often than those born in private hospitals. Our aim was to determine whether this pattern is a result of public-private differences in care or merely linked with differences in the characteristics of the two groups. In Australian private hospitals, a private obstetrician almost always provides continuing care to each woman during pregnancy and birth. Public hospitals provide a number of care options, which usually involve midwives and/or a family doctor. Method The study population included 131 436 births (52.5% public; 47.5% private) from 1998-2013 at a single metropolitan centre with co-located public and private facilities. To isolate the effect of differences in care, we used a statistical technique called propensity score matching to select a public group and a private group with similar characteristics and equal size. This enabled us to compare 'apples with apples' when comparing public versus private perinatal death rates. Perinatal deaths include stillbirths and babies that die within 28 days of birth. Main findings After matching and after accounting for different patterns in the use of fertility treatments and multiple-birth pregnancies (such as twins), babies born in the public sector were approximately 1.5 times more likely to die than babies born in the private sector. This difference was reduced to 1.3 times more likely to die than babies born in the private sector after taking into account other factors that could skew the data, such as major congenital anomalies, birth method, and duration of pregnancy. Limitations This was a single-centre study, so the results may not apply to all settings. Despite our efforts to create highly similar public and private cohorts, some differences between the groups are likely to have remained and this may have affected the results. Implications Our findings suggest that private obstetrician-led care has a beneficial impact on perinatal deaths, despite, or possibly because of, higher obstetric intervention rates and earlier births in the private hospital. Further research is required. © 2017 Royal College of Obstetricians and Gynaecologists.

  3. The De-Facto Privatization of Secondary Education in Egypt: A Study of Private Tutoring in Technical and General Schools

    ERIC Educational Resources Information Center

    Sobhy, Hania

    2012-01-01

    Most secondary school students in Egypt enrol in private tutoring in almost all subjects throughout the school year. A large proportion of students have stopped attending school altogether due to their reliance on tutoring. This study of how educational markets are perpetuated at school level finds that in the technical track catering to the…

  4. Relationship between Internal Quality Audit and Quality Culture toward Implementation Consistency of ISO 9000 in Private College of Sulawesi Province, Indonesia

    ERIC Educational Resources Information Center

    Mail, Abdul; Pratikto; Suparman, Sudjito; Purnomo; Santoso, Budi

    2014-01-01

    The study aims to find out the influence of internal quality process on the growth of quality culture in private college. This study is treated toward 178 lecturers of 25 private colleges in Sulawesi, Indonesia by means of questionnaire. Confirmatory factor analysis applied to assess the reliability of validity and measurement model. Relationship…

  5. Survey of English Teaching and Learning Process in Maritme Education and Training in Indonesia: A Case Study in Private MET in Indonesia

    ERIC Educational Resources Information Center

    Dirgayasa, I Wy.

    2014-01-01

    This paper intends to evaluate the process of teaching and learning of Maritime English in private Maritime Education and Training (MET) in Indonesia. This study was conducted in three private MET such as Maritime Academy Indonesia Medan (AMI-Medan), Maritime Academy Belawan (AMB-Belawan,), and Maritime Academy Sapta Samudra Padang (AMSSP-Padang).…

  6. Private Training Providers in Australia: Their Characteristics and Training Activities. A National Vocational Education and Training Research and Evaluation Program Report

    ERIC Educational Resources Information Center

    Harris, Roger; Simons, Michele; McCarthy, Carmel

    2006-01-01

    This study examines the nature of the training activity of private registered training organisations (RTOs) offered to Australian students in 2003, based on data from a national sample of 330 RTOs. The study also provides estimates of the private sector's overall contribution to the total vocational education and training (VET) effort in Australia…

  7. Impact of Job Status and Demographic Trends on Quality Education: A Case Study of Private Universities in Pakistan

    ERIC Educational Resources Information Center

    Ali, Riasat; Khan, Abdul Majeed; Qadeer, Muhammad Zaigham; Shahzad, Saqib

    2009-01-01

    The major purpose of this paper was to examine the quality of various aspects of higher education in the private sector of Pakistan by adopting a descriptive method of research. The population of the study constituted 270 administrators, 6,180 teachers and 61,108 students in existing 54 private universities and degree-awarding institutions of…

  8. Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review

    PubMed Central

    Basu, Sanjay; Andrews, Jason; Kishore, Sandeep; Panjabi, Rajesh; Stuckler, David

    2012-01-01

    Introduction Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. Methods and Findings Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of “private sector” included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. “Competitive dynamics” for funding appeared between the two sectors, such that public funds and personnel were redirected to private sector development, followed by reductions in public sector service budgets and staff. Conclusions Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector; however, the public sector appears frequently to lack timeliness and hospitality towards patients. Please see later in the article for the Editors' Summary PMID:22723748

  9. Comparative performance of private and public healthcare systems in low- and middle-income countries: a systematic review.

    PubMed

    Basu, Sanjay; Andrews, Jason; Kishore, Sandeep; Panjabi, Rajesh; Stuckler, David

    2012-01-01

    Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of "private sector" included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. "Competitive dynamics" for funding appeared between the two sectors, such that public funds and personnel were redirected to private sector development, followed by reductions in public sector service budgets and staff. Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector; however, the public sector appears frequently to lack timeliness and hospitality towards patients.

  10. Case Studies of UMTA Private Sector Initiative Projects in Syracuse, Central New Jersey, and Atlanta

    DOT National Transportation Integrated Search

    1987-12-01

    This report documents the results of three grants awarded in 1983 by the Urban Mass Transportation Administration for Section 8 Private Sector Initiative projects. The grants were intended to encourage cooperative public and private planning for the ...

  11. Private Speech and Self-Regulation: A Commentary on Frauenglass and Diaz.

    ERIC Educational Resources Information Center

    Frawley, William; Lantolf, James P.

    1986-01-01

    Critiques an earlier article by M. Frauenglass and R. Diaz reporting their study on the interaction between private speech and cognition. Argues that their interpretation fails to regard how private speech is seen to regulate cognitive activity within Vygotskian psycholinguistic theory. (HOD)

  12. The Reproduction of Class in Canada's Elite Independent Schools.

    ERIC Educational Resources Information Center

    Maxwell, James D.; Maxwell, Mary Percival

    1995-01-01

    Maintains that although Canada's private schools attempt to reproduce dominant cultural ideology, meritocracy and recruitment have created paradoxical effects. Academic competition results in fewer private school graduates being admitted to top universities. Further studies reveal no correlation between private school and financial success. (MJP)

  13. Clients' satisfaction with quality of childbirth services: A comparative study between public and private facilities in Limuru Sub-County, Kiambu, Kenya.

    PubMed

    Okumu, Clarice; Oyugi, Boniface

    2018-01-01

    This study intended to compare the clients' satisfaction with the quality of childbirth services in a private and public facility amongst mothers who have delivered within the last twenty four to seventy hours. This was a cross-sectional comparative research design with both quantitative and qualitative data collection and analysis methods. Data were collected through a focused group discussion guide and structured questionnaire collecting information on clients' satisfaction with quality of childbirth services. The study was conducted amongst women of reproductive age (WRA) between 15-49 years in Tigoni District hospital (public hospital) and Limuru Nursing home (private hospital). For quantitative data we conducted descriptive analysis and Mann-Whitney test using SPSS version 20.0 while qualitative data was manually analyzed manually using thematic analysis. A higher proportion of clients from private facility 98.1% were attended within 0-30 minutes of arrival to the facility as compared to 87% from public facility. The overall mean score showed that the respondents in public facility gave to satisfaction with the services was 4.46 out of a maximum of 5.00 score while private facility gave 4.60. The level of satisfaction amongst respondents in the public facility on pain relief after delivery was statistically significantly higher than the respondents in private facilities (U = 8132.50, p<0.001) while the level of satisfaction amongst respondents in the public facility on functional equipment was statistically significantly higher than the respondents in private facilities (U = 9206.50, p = 0.001). Moreover, level of satisfaction with the way staff responded to questions and concerns during labour and delivery was statistically significantly higher than the respondents in private facilities (U = 9964.50, p = 0.022). In overall, majority of clients from both public and private facilities expressed satisfaction with quality of services from admission till discharge in both public and private facilities and were willing to recommend other to come and deliver in the respective facilities.

  14. Working conditions of bus drivers in the private sector and bus crashes in Kandy district, Sri Lanka: a case-control study.

    PubMed

    Jayatilleke, A U; Nakahara, S; Dharmaratne, S D; Jayatilleke, A C; Poudel, K C; Jimba, M

    2009-04-01

    To explore the effects of working conditions of private-bus drivers on bus crashes in Kandy district, Sri Lanka. A case-control study was carried out from August to September 2006. All private-bus drivers registered in Kandy district and involved in crashes reported to the police between November 2005 and April 2006 (n = 63) were selected as cases. Two control groups were included: private-bus drivers working on the same routes as the case drivers (n = 90) and private-bus drivers selected randomly from other routes of the district (n = 111). Data were collected using an anonymous self-administered questionnaire. Associations between working conditions and crashes were analysed using logistic regression. A strong association was observed between drivers' disagreements about working hours and bus crashes (matched controls, adjusted odds ratio (AOR) 5.98, 95% CI 1.02 to 34.90; unmatched controls, AOR 18.74, 95% CI 2.00 to 175.84). A significant association was also observed between low salaries (

  15. Referral of children seeking care at private health facilities in Uganda.

    PubMed

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus; Clarke, Siân E; Lal, Sham; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip

    2017-02-14

    In Uganda, referral of sick children seeking care at public health facilities is poor and widely reported. However, studies focusing on the private health sector are scanty. The main objective of this study was to assess referral practices for sick children seeking care at private health facilities in order to explore ways of improving treatment and referral of sick children in this sector. A survey was conducted from August to October 2014 in Mukono district, central Uganda. Data was collected using a structured questionnaire supplemented by Focus Group Discussions and Key Informant interviews with private providers and community members. A total of 241 private health facilities were surveyed; 170 (70.5%) were registered drug shops, 59 (24.5%) private clinics and 12 (5.0%) pharmacies. Overall, 104/241 (43.2%) of the private health facilities reported that they had referred sick children to higher levels of care in the two weeks prior to the survey. The main constraints to follow referral advice as perceived by caretakers were: not appreciating the importance of referral, gender-related decision-making and negotiations at household level, poor quality of care at referral facilities, inadequate finances at household level; while the perception that referral leads to loss of prestige and profit was a major constraint to private providers. In conclusion, the results show that referral of sick children at private health facilities faces many challenges at provider, caretaker, household and community levels. Thus, interventions to address constraints to referral of sick children are urgently needed.

  16. Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study.

    PubMed

    Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Srivastava, Ashish; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

    2017-06-22

    Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes-specifically Janani Suraksha Yojana (JSY)-for maternity service delivery. Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. The major factors serving as barriers to participation of private practitioners in JSY-which emerged on thematic analysis-were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public-private partnerships under JSY. Simplifying and strengthening the processes, communication strategies and branding can help revitalise it. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study

    PubMed Central

    Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

    2017-01-01

    Objective Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes—specifically Janani Suraksha Yojana (JSY)—for maternity service delivery. Design Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Setting Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Participants Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. Results The major factors serving as barriers to participation of private practitioners in JSY—which emerged on thematic analysis—were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Conclusion Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public–private partnerships under JSY. Simplifying and strengthening the processes, communication strategies and branding can help revitalise it. PMID:28645984

  18. Estimation of the contribution of private providers in tuberculosis case notification and treatment outcome in Pakistan.

    PubMed

    Chughtai, A A; Qadeer, E; Khan, W; Hadi, H; Memon, I A

    2013-03-01

    To improve involvement of the private sector in the national tuberculosis (TB) programme in Pakistan various public-private mix projects were set up between 2004 and 2009. A retrospective analysis of data was made to study 6 different public-private mix models for TB control in Pakistan and estimate the contribution of the various private providers to TB case notification and treatment outcome. The number of TB cases notified through the private sector increased significantly from 77 cases in 2004 to 37,656 in 2009. Among the models, the nongovernmental organization model made the greatest contribution to case notification (58.3%), followed by the hospital-based model (18.9%). Treatment success was highest for the district-led model (94.1%) and lowest for the hospital-based model (74.2%). The private sector made an important contribution to the national data through the various public-private mix projects. Issues of sustainability and the lack of treatment supporters are discussed as reasons for lack of success of some projects.

  19. Factors influencing private health providers' technical quality of care for acute respiratory infections among under-five children in rural West Bengal, India.

    PubMed

    Chakraborty, Sarbani; Frick, Kevin

    2002-11-01

    In many developing countries, private health practitioners provide a significant portion of curative care for diseases which are of public health importance. Currently, health sector reform efforts in these countries are fostering increased participation of private providers in the delivery of health services, including those of public health importance. Guaranteeing good technical quality of care is critical to the process. However, little is known about private providers' technical quality of care (disease management practices) and the factors influencing these services. The purpose of this study was to contribute information on this topic. The study was conducted among private providers in rural West Bengal, India and focused on providers' disease management practices for acute respiratory infections (ARI) among under-five children. World Health Organization (WHO) guidelines for ARI case management were used as the expected standard of care. Observations of patient-provider encounters and interviews with the providers and mothers were the main sources of data. The study found that private health providers in rural West Bengal have inadequate technical quality of care. The problem was related both to low levels of performance (limited potential) and inconsistency in performance (within-provider variation). Limited potential for good technical quality for ARI among the providers was related to lack of knowledge (technical incompetence). One of the important factors influencing within-provider variation was patient load. Since rural private providers operate on a fee-for-service payment system, there are incentives related to seeing many patients. The study concluded that to bring about sustainable improvements in private providers' ARI disease management practices, training programs and interventions that improved compliance were necessary.

  20. Caries Risk Assessment of 12–13-year-old Government and Private School Going Children of Mysore City Using Cariogram: A Comparative Study

    PubMed Central

    Naik, Sandhya P.; Moyin, Shabna; Patel, Bhakti; Warad, Lata Prabhu; Punathil, Sameer; Sudeep, C. B.

    2018-01-01

    Aim: The aim of this study is to assess the caries risk assessment of 12–13-year-old government and private school going children of Mysore city using Cariogram. Materials and Methods: A cross-sectional examination was carried out on a total of 104 government and private schoolchildren aged 12–13 years. Ten factors from the Cariogram software(D Bratthall, Computer software, Malmo, Sweden) were included from study participant's records to complete the Cariogram. The percentage of “chances of avoiding new lesions” (caries risk) among government and private school study participants were obtained from Cariogram, and the participants were classified into five risk groups. Statistical analysis was performed using the software program Statistical Package of Social Science (version 17.0, SPSS Inc., Chicago IL, USA). Results: Findings revealed that there is slight difference in caries risk among government and private schoolchildren, where 48% caries risk development and 52% chance to avoid dental caries were showed in government schoolchildren, and 51% caries risk development and 49% chance to avoid dental caries were showed in private schoolchildren, according to Cariogram. Decayed, missing, and filled teeth component, mutans streptococci, and Lactobacillus counts were slightly higher in private schoolchildren compared with government schoolchildren. Conclusion: The private schoolchildren had less favorable values than government schoolchildren for most of the caries-related factors. Cariogram can be the most modest and reliable tool for caries prediction, thus aiding in identifying different risk groups in a community so that appropriate preventive strategies can be provided to overcome new carious lesion formation. PMID:29780742

  1. Bladder cancer mortality and private well use in New England: An ecological study

    USGS Publications Warehouse

    Ayotte, J.D.; Baris, D.; Cantor, K.P.; Colt, J.; Robinson, G.R.; Lubin, J.H.; Karagas, M.; Hoover, R.N.; Fraumeni, J.F.; Silverman, D.T.

    2006-01-01

    Study objective: To investigate the possible relation between bladder cancer mortality among white men and women and private water use in New England, USA, where rates have been persistently raised and use of private water supplies (wells) common. Design: Ecological study relating age adjusted cancer mortality rates for white men and women during 1985-1999 and proportion of persons using private water supplies in 1970. After regressing mortality rates on population density, Pearson correlation coefficients were computed between residual rates and the proportion of the population using private water supplies, using the state economic area as the unit of calculation. Calculations were conducted within each of 10 US regions. Setting: The 504 state economic areas of the contiguous United States. Participants: Mortality analysis of 11 cancer sites, with the focus on bladder cancer. Main results: After adjusting for the effect of population density, there was a statistically significant positive correlation between residual bladder cancer mortality rates and private water supply use among both men and women in New England (men, r=0.42; women, r=0.48) and New York/New Jersey (men, r=0.49; women, r=0.62). Conclusions: Use of well water from private sources, or a close correlate, may be an explanatory variable for the excess bladder cancer mortality in New England. Analytical studies are underway to clarify the relation between suspected water contaminants, particularly arsenic, and raised bladder cancer rates in northern New England.

  2. Strengthening referral of sick children from the private health sector and its impact on referral uptake in Uganda: a cluster randomized controlled trial protocol.

    PubMed

    Buregyeya, Esther; Rutebemberwa, Elizeus; LaRussa, Philip; Mbonye, Anthony

    2016-11-11

    Uganda's under-five mortality is high, currently estimated at 66/1000 live births. Poor referral of sick children that seek care from the private sector is one of the contributory factors. The proposed intervention aims to improve referral and uptake of referral advice for children that seek care from private facilities (registered drug shops/private clinics). A cluster randomized design will be applied to test the intervention in Mukono District, central Uganda. A sample of study clusters will implement the intervention. The intervention will consist of three components: i) raising awareness in the community: village health teams will discuss the importance of referral and encourage households to save money, ii) training and supervision of providers in the private sector to diagnose, treat and refer sick children, iii) regular meetings between the public and private providers (convened by the district health team) to discuss the referral system. Twenty clusters will be included in the study, randomized in the ratio of 1:1. A minimum of 319 sick children per cluster and the total number of sick children to be recruited from all clusters will be 8910; adjusting for a 10 % loss to follow up and possible withdrawal of private outlets. The immediate sustainable impact will be appropriate treatment of sick children. The intervention is likely to impact on private sector practices since the scope of the services they provide will have expanded. The proposed study is also likely to have an impact on families as; i) they may appreciate the importance of timely referral on child illness management, ii) the cost savings related to reduced morbidity will be used by household to access other social services. The linkage between the private and public sectors will create a potential avenue for delivery of other public health interventions and improved working relations in the two sectors. Further, improved quality of services in the private sector will improve provider confidence and hopefully more clientelle to the private practices. NCT02450630 Registration date: May/9 th /2015.

  3. Quality of private and public ambulatory health care in low and middle income countries: systematic review of comparative studies.

    PubMed

    Berendes, Sima; Heywood, Peter; Oliver, Sandy; Garner, Paul

    2011-04-01

    In developing countries, the private sector provides a substantial proportion of primary health care to low income groups for communicable and non-communicable diseases. These providers are therefore central to improving health outcomes. We need to know how their services compare to those of the public sector to inform policy options. We summarised reliable research comparing the quality of formal private versus public ambulatory health care in low and middle income countries. We selected studies against inclusion criteria following a comprehensive search, yielding 80 studies. We compared quality under standard categories, converted values to a linear 100% scale, calculated differences between providers within studies, and summarised median values of the differences across studies. As the results for for-profit and not-for-profit providers were similar, we combined them. Overall, median values indicated that many services, irrespective of whether public or private, scored low on infrastructure, clinical competence, and practice. Overall, the private sector performed better in relation to drug supply, responsiveness, and effort. No difference between provider groups was detected for patient satisfaction or competence. Synthesis of qualitative components indicates the private sector is more client centred. Although data are limited, quality in both provider groups seems poor, with the private sector performing better in drug availability and aspects of delivery of care, including responsiveness and effort, and possibly being more client orientated. Strategies seeking to influence quality in both groups are needed to improve care delivery and outcomes for the poor, including managing the increasing burden of non-communicable diseases.

  4. Predictors of Academics' Career Advancement at Malaysian Private Universities

    ERIC Educational Resources Information Center

    Arokiasamy, Lawrence; Ismail, Maimunah; Ahmad, Aminah; Othman, Jamilah

    2011-01-01

    Purpose: This paper aims to examine the influence of individual and organizational variables on the career advancement of academics in Malaysian private universities. Design/methodology/approach: A correlation study was conducted in six private universities. Data were collected using a structured self-administered questionnaire. The dependent…

  5. IDENTIFYING ELEVEN FACTORS OF SERVICE MARKETING MIX (4PS) EFFECTIVE ON TENDENCY OF PATIENTS TOWARD PRIVATE HOSPITAL

    PubMed Central

    Hosseini, Seyed Mojtaba; Etesaminia, Samira; Jafari, Mehrnoosh

    2016-01-01

    Introduction: One of the important factors of correct management is to identify the reasons for patient tendency toward private hospitals. This study measures these factors based on service marketing mixes. Patients and methods: This study used a cross sectional descriptive methodology. The study was conducted during 6 months in 2015. The studied population included patients of private hospitals in Tehran. Random sampling was used (n = 200). Data was collected by an author-made questionnaire for service marketing factors. Reliability and validity of the questionnaire were confirmed. Data analysis was done using factor analysis test in SPSS 20. Results: The results showed that constant attendance of physicians and nurses has the highest effect (0.707%) on patient tendency toward private hospitals. PMID:27999486

  6. High rates of adherence and treatment success in a public and public-private HIV clinic in India: potential benefits of standardized national care delivery systems.

    PubMed

    Shet, Anita; DeCosta, Ayesha; Heylen, Elsa; Shastri, Suresh; Chandy, Sara; Ekstrand, Maria

    2011-10-17

    The massive scale-up of antiretroviral treatment (ART) access worldwide has brought tremendous benefit to populations affected by HIV/AIDS. Optimising HIV care in countries with diverse medical systems is critical; however data on best practices for HIV healthcare delivery in resource-constrained settings are limited. This study aimed to understand patient characteristics and treatment outcomes from different HIV healthcare settings in Bangalore, India. Participants from public, private and public-private HIV healthcare settings were recruited between 2007 and 2009 and were administered structured interviews by trained staff. Self-reported adherence was measured using the visual analogue scale to capture adherence over the past month, and a history of treatment interruptions (defined as having missed medications for more than 48 hours in the past three months). In addition, CD4 count and viral load (VL) were measured; genotyping for drug resistance-associated mutations was performed on those who were in virological failure (VL > 1000 copies/ml). A total of 471 individuals were included in the analysis (263 from the public facility, 149 from the public-private facility and 59 from the private center). Private facility patients were more likely to be male, with higher education levels and incomes. More participants reported ≥ 95% adherence among public and public-private groups compared to private participants (public 97%; private 88%; public-private 93%, p < 0.05). Treatment interruptions were lowest among public participants (1%, 10%, 5% respectively, p < 0.001). Although longer clinic waiting times were experienced by more public participants (48%, compared to private 27%, public-private 19%, p < 0.001), adherence barriers were highest among private (31%) compared with public (10%) and public-private (17%, p < 0.001) participants. Viral load was detectable in 13% public, 22% private and 9% public-private participants (p < 0.05) suggesting fewer treatment failures among public and public-private settings. Drug resistance mutations were found more frequently among private facility patients (20%) compared to those from the public (9%) or public-private facility (8%, p < 0.05). Adherence and treatment success was significantly higher among patients from public and public-private settings compared with patients from private facilities. These results suggest a possible benefit of the standardized care delivery system established in public and public-private health facilities where counselling by a multi-disciplinary team of workers is integral to provision of ART. Strengthening and increasing public-private partnerships can enhance the success of national ART programs.

  7. Assessment of public vs private MSW management: a case study.

    PubMed

    Massoud, M A; El-Fadel, M; Abdel Malak, A

    2003-09-01

    Public-private partnerships in urban environmental services have witnessed increased interest in recent years primarily to reform the weak performance of the public sector, reduce cost, improve efficiency, and ensure environmental protection. In this context, successful public-private partnerships require a thorough analysis of opportunities, a deliberate attention to process details, and a continuous examination of services to determine whether they are more effectively performed by the private sector. A comparative assessment of municipal solid waste collection services in the two largest cities in Lebanon where until recently municipal solid waste collection is private in one and public in the other is conducted. While quality of municipal solid waste collection improved, due to private sector participation, the corresponding cost did not, due to monopoly and an inadequate organizational plan defining a proper division of responsibilities between the private and the public sector.

  8. Threats to private forest lands in the U.S.A.: a forests on the edge study

    Treesearch

    Mark H. Hatfield; Ronald E. McRoberts; Dacia M. Meneguzzo; Sara Comas

    2010-01-01

    The Forests on the Edge project, sponsored by the USDA Forest Service, uses geographic information systems to construct and analyze maps depicting threats to the contributions of America’s private forest lands. For this study, watersheds across the conterminous United States are evaluated with respect to the amount of their private forest land. Watersheds with at least...

  9. Implementation of prevention of mother-to-child transmission of HIV programme through private hospitals of Delhi--policy implications.

    PubMed

    Gupta, A K; Garg, C R; Joshi, B C; Rawat, N; Dabla, V; Gupta, A

    2015-01-01

    In India, programme for prevention of mother-to-child transmission (PMTCT) of HIV is primarily implemented through public health system. State AIDS Control Societies (SACSs) encourage private hospitals to set up integrated counselling and testing centres (ICTCs). However, private hospitals of Delhi did not set up ICTCs. Consequently, there is no information on PMTCT interventions in private hospitals of Delhi. This study was undertaken by Delhi SACS during March 2013 through September 2013 to assess status of implementation of PMTCT programme in various private hospitals of Delhi to assist programme managers in framing national policy to facilitate uniform implementation of National PMTCT guidelines. Out of total 575 private hospitals registered with Government of Delhi, 336 (58.4%) catering to pregnant women were identified. About 100 private hospitals with facility of antenatal care, vaginal/caesarean delivery and postnatal care and minimum 10 indoor beds were selected for study. Study sample comprised of large corporate hospitals (≥100 beds; n = 29), medium-sized hospitals (25 to <100 beds; n = 42) and small nursing homes (10 to <25 beds; n = 29). A pre-tested questionnaire was designed to obtain basic information about hospital in context to PMTCT programme. Interviews of heads of obstetrics and gynaecology and paediatric departments were conducted by trained interviewers. It was observed that in private hospitals in year 2012, out of 38,186 antenatal women tested, 52 (0.14%) were detected HIV-positive. However, against National Policy, HIV testing was done without pre/post-test counselling/or consent of women, no PMTCT protocol existed, delivery of HIV-positive women was not undertaken and no efforts were made to link HIV-positive women to antiretroviral treatment. Major intervention observed was medical termination of pregnancy, which indicates lack of awareness in private hospitals about available interventions under national programme. The role of private hospitals in management of HIV in pregnant women must be recognized and mainstreamed in HIV control efforts. There is an urgent need for capacity building of private health care providers to improve standards of practice. National AIDS Control Organization may consider establishing linkages or adopting model developed by some countries with generalized epidemic for delivering PMTCT services in private health sector.

  10. Is the practice of public or private sector doctors more evidence-based? A qualitative study from Vellore, India.

    PubMed

    Akinyemi, Oluwaseun O; Martineau, Tim; Tharyan, Prathap

    2015-06-01

    The literature on the use of evidence-based practice is sparse, both in the public and private sectors in middle-and low-income countries, and the present literature shows that physician understanding and use of evidence-based practice is poor. The study aimed to explore the perception of medical practitioners in the private for-profit, private not-for-profit and government sectors in Vellore, India, on evidence-based practice, in order to explain the factors affecting the use of evidence-based practice among the practitioners and to inform local policy and management decisions for improvement in quality of care. Qualitative methodology was employed in the study. Sixteen in-depth and two key informant interviews were carried out with medical practitioners selected by purposive sampling in the private for-profit, private not-for-profit and government sectors. The interviews explored participants' knowledge of evidence-based practice, factors affecting its use and possible ways of improving the use of evidence-based practice among physicians in all the health sectors. Data from the in-depth and key informant interviews were analyzed with the NVIVO (version 8) software package using the framework approach. Although most practitioners interviewed have heard of evidence-based practice, knowledge about evidence-based practice seems inadequate. However, doctors in the private not-for-profit sector seem to be more familiar with the concept of evidence-based practice. Also, practitioners in the private not-for profit sector appear to use medical evidence more in their practices compared to government practitioners or doctors in the private for-profit sector. Perceived factors affecting physician use of evidence-based practice include lack of personal time for literature appraisal as a result of high case load, weak regulatory system, pressure from patients, caregivers and pharmaceutical companies, as well as financial considerations. Opinions of the respondents are that use of evidence-based practice is mostly found among practitioners in the private not-for-profit health sector. Better training in evidence-based practice, improved regulatory system and greater collaboration between the public, private for-profit and private not-for-profit sectors with regards to training in evidence-based practice - literature search and critical appraisal skills - were suggested as needed to improve the present situation.

  11. Private expenditures on brand name prescription drugs after generic entry.

    PubMed

    Balaban, Dahlia Y; Dhalla, Irfan A; Law, Michael R; Bell, Chaim M

    2013-10-01

    Generic drugs offer a less expensive and therapeutically equivalent alternative to brand name drugs. Nevertheless, many Canadian private drug plans continue to pay for brand name drugs even after generics become available. The objective of this study was to quantify the excess spending resulting from this practice. We used the IMS Brogan PharmaStat database to study private-plan drug spending in Ontario from 2000 to 2009. We focused on three widely used drug classes: proton pump inhibitors (PPIs), selective serotonin reuptake inhibitors (SSRIs), and angiotensin-converting enzyme (ACE) inhibitors. For each specific molecule, we determined the difference between what private plans spent on the brand name version and what would have been spent if an available generic version of the same molecule had been purchased instead. We found that prescriptions paid for by private drug plans were often filled with brand name drugs after generics became available. This led to excess private spending of more than Can$107.8 million for these three drug classes over our study period: Can$54.4 million for PPIs, Can$32.4 million for SSRIs and Can$21.0 million for ACE inhibitors. Brand name drugs continue to be reimbursed by Canadian private drug plans at higher prices even after less expensive generic alternatives are available. By mandating generic substitution, substantial cost savings on benefit plans could be achieved.

  12. Public hospitals in financial distress: Is privatization a strategic choice?

    PubMed

    Ramamonjiarivelo, Zo; Weech-Maldonado, Robert; Hearld, Larry; Menachemi, Nir; Epané, Josué Patien; O'Connor, Stephen

    2015-01-01

    As safety net providers, public hospitals operate in more challenging environments than private hospitals. Such environments put public hospitals at greater risk of financial distress, which may result in privatization and deterioration of the safety net. The purpose of this study was to investigate whether financial distress is associated with privatization among public hospitals. We used panel data merged from the American Hospital Association Annual Survey, Medicare Cost Reports, Area Resource File, and Local Area Unemployment Statistics. Our study population consisted of all U.S. nonfederal acute care public hospitals in 1997 tracked through 2009, resulting in 6,426 hospital-year observations. The dependent variable "privatization" was defined as conversion from public status to either private not-for-profit or private for-profit status. The main independent variable, "financial distress," was based on the Altman Z-score methodology. Control variables included market and organizational factors. Two random-effects logistic regression models with state and year fixed-effects were constructed. The independent and control variables were lagged by 1 year and 2 years for Models 1 and 2, respectively. Public hospitals in financial distress had greater odds of being privatized than public hospitals not in financial distress: (OR = 4.53, p < .001) for Model 1 and (OR = 3.05, p = .001) for Model 2. Privatization eases access to resources and may provide financial relief to government entities from the burden of continuously funding a hospital operating at a loss, which in turn may help keep the hospital open and preserve access to care for the community. Privatizing a financially distressed public hospital may be a better strategic alternative than closure. The Altman Z-score could be used as a managerial tool to monitor hospitals' financial condition and take corrective actions.

  13. Indian medical students in public and private sector medical schools: are motivations and career aspirations different? - studies from Madhya Pradesh, India.

    PubMed

    Diwan, Vishal; Minj, Christie; Chhari, Neeraj; De Costa, Ayesha

    2013-09-15

    In recent years, there has been a massive growth in the private medical education sector in South Asia. India's large private medical education sector reflects the market driven growth in private medical education. Admission criteria to public medical schools are based on qualifying examination scores, while admission into private institutions is often dependent on relative academic merit, but also very much on the ability of the student to afford the education. This paper from Madhya Pradesh province in India aims to study and compare between first year medical students in public and private sector medical schools (i) motives for choosing a medical education (ii) career aspirations on completion of a medical degree (iii) willingness to work in a rural area in the short and long terms. Cross sectional survey of 792 first year medical students in 5 public and 4 private medical schools in the province. There were no significant differences in the background characteristics of students in public and private medical schools. Reasons for entering medical education included personal ambition (23%), parental desire (23%), prestigious/secure profession (25%) or a service motive (20%). Most students wished to pursue a specialization (91%) and work in urban areas (64%) of the country. A small proportion (7%) wished to work abroad. There were no differences in motives or career aspirations between students of public or private schools. 40% were willing to work in a rural area for 2 years after graduating; public school students were more willing to do so. There was little difference in background characteristics, motives for entering medicine or career aspirations between medical students in from public and private sector institutions.

  14. Health care of female outpatients in south-central India: comparing public and private sector provision.

    PubMed

    Bhatia, Jagdish; Cleland, John

    2004-11-01

    The object of this study was to compare components of quality of care provided to female outpatients by practitioners working in the private and public sectors in Karnataka State, India. Consultations conducted by 18 private practitioners and 25 public-sector practitioners were observed for 5 days using a structured protocol. Private practitioners were selected from members of the Indian Medical Association in a predominantly rural sub-district of Kolar District. Government doctors were selected from a random sample of hospitals and health centres in three sub-districts of Mysore District. A total of 451 private-sector and 650 public-sector consultations were observed; in each sector about half involved a female practitioner. The mean length of consultation was 2.81 minutes in the public sector and 6.68 minutes in the private sector. Compared with public-sector practitioners, private practitioners were significantly more likely to undertake a physical examination and to explain their diagnosis and prognosis to the patient. Privacy was much better in the private sector. One-third of public-sector patients received an injection compared with two-thirds of private patients. The mean cost of drugs dispensed or prescribed were Rupees 37 and 74 in public and private sectors, respectively. Both in terms of thoroughness of diagnosis and doctor-patient communication, the quality of care appears to be much higher in the private than in the public sector. However, over-prescription of drugs by private practitioners may be occurring.

  15. Public and private schoolteachers' differences in terms of job attitudes in Albania.

    PubMed

    Buka, Migena; Bilgiç, Reyhan

    2010-06-01

    In the present study, the attitudinal differences between public and private schoolteachers in Albania were investigated. Since the type of the organization varies, one would expect different climates for the emergence of job attitudes--mainly job satisfaction, job involvement, and organizational commitment, the most frequently studied job attitudes in the industrial and organizational psychology literature. It was hypothesized that the private schoolteachers would be more satisfied than public schoolteachers, especially due to high levels of payment and other desirable conditions. However, the public schoolteachers will be more involved than the private schoolteachers since they have to justify their continued work under the undesirable conditions. The commitment level of the private schoolteachers will be higher than the public schoolteachers since there is usually high correlation between job satisfaction and organizational commitment. Data were gathered from a total of 429 teachers working in public (n = 254) and private (n = 175) schools in Albania, in high and middle schools. The data were analyzed using multivariate analysis of covariance with age as a covariate. The results indicated that the private schoolteachers were more satisfied, as expected, revealed a weaker job involvement and were more committed to their school than their colleagues in the public sector. The results were found to be in line with previous studies conducted in the west. However, this study is believed to have a potential contribution to the literature in general, and to the Albanian local literature in particular. To the knowledge of the authors, there has been no similar study in Albania. Discussion is provided along with the limitations of the study and suggestions for future research.

  16. Patients' appraisals of public and private healthcare: a qualitative study of physiotherapy and osteopathy.

    PubMed

    Bradbury, Katherine J; Bishop, Felicity L; Yardley, Lucy; Lewith, George

    2013-10-01

    Patients have previously reported differences in their experiences of treatments received in the public and private sectors; it remains unclear whether such perceived differences are particular to or shared across different interventions. This study explored whether patients' appraisals of public and private treatments are similar when appraising a complementary therapy (osteopathy) compared to a mainstream therapy (physiotherapy). Thirty-five qualitative interviews were analysed thematically. Patients' appraisals varied by health-care sector and therapy type: physiotherapy was appraised more negatively in the National Health Service than the private sector but osteopathy was appraised similarly within both health-care sectors. Potential reasons for this are discussed.

  17. Household Expenditures on Private Tutoring: Emerging Evidence from Malaysia

    ERIC Educational Resources Information Center

    Kenayathulla, Husaina Banu

    2013-01-01

    Private tutoring has been a burgeoning phenomenon in Malaysia for decades. This study examines the determinants of private tutoring expenditures in Malaysia using the 2004/2005 Household Expenditures Survey and applies hurdle regression models to the data. The results indicate that total household expenditures, household head's level of education,…

  18. Are Small Schools and Private Schools Better for Adolescents' Emotional Adjustment?

    ERIC Educational Resources Information Center

    Watt, Toni Terling

    2003-01-01

    Uses National Longitudinal Study of Adolescent Health 1994 to determine whether adolescents benefit from small and/or private schools. Examines depression, suicide and violent dispositions. Refutes claims that students attending these schools are more emotionally adjusted. Discovers these small and/or private schools may actually be detrimental to…

  19. Private Training Providers: Their Characteristics and Training Activities. Support Document

    ERIC Educational Resources Information Center

    Harris, Roger; Simons, Michele; McCarthy, Carmel

    2006-01-01

    This document was produced by the authors based on their research for the report, "Private Training Providers: Their Characteristics and Training Activities," [ED495181] and is an added resource for further information. That study examined the nature of the training activity of private registered training organisations (RTOs) offered to…

  20. Social Welfare and the Market Economy.

    ERIC Educational Resources Information Center

    Nelson, Joel I.

    1992-01-01

    Reports on a study that questions whether private enterprise can maintain quality while reducing costs of providing social welfare services. Reviews three aspects of privatization: (1) competitive markets; (2) rationality; and (3) cost reduction. Concludes by questioning a central claim of economic theory: that free markets and private firms are…

  1. Preparedness for physiotherapy in private practice: Novices identify key factors in an interpretive description study.

    PubMed

    Atkinson, Robyn; McElroy, Theresa

    2016-04-01

    Physiotherapists in Australia deliver services to a diverse range of clients, across many settings, however little research exists examining graduate preparedness for practice, even in the populous field of private practice. To explore novice physiotherapist perspectives on preparedness for work in private practice. The qualitative approach of interpretive description was used to guide in-depth interviews with 8 novice physiotherapists from 3 universities working in 5 private practices in Melbourne. All interviews were digitally recorded, transcribed verbatim and analyzed thematically. Four main themes influencing graduate preparedness for work in private practice were identified: 1) non-curricular experiences (e.g. sports training) 2) elective curricular: practicum experiences; 3) curricular: attainment of skills specific to private practice; and 4) the private practice setting: supportive colleagues. This combination of non-curricular, curricular, and practice setting factors offered the necessary scaffolding for the graduates to report feeling prepared for work in private practice. Non-curricular activities, radiological instruction, clinical placements, building supportive colleague relations and professional development in private practice are recommended as potential means of building preparedness in novice therapists. Findings have implications for physiotherapy students, educators and private practice clinics looking to recruit new graduates. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Volunteering to Care for People with Severe Mental Illness: A Qualitative Study of the Significance of Professional and Private Life Experience.

    PubMed

    Ørtenblad, Lisbeth; Væggemose, Ulla; Gissel, Lene; Nissen, Nina Konstantin

    2018-02-06

    Challenges in recruiting volunteers encountered by psychiatric services are barely elucidated despite a general societal increase in volunteering. The aim of the study was to explore the significance of professional and private life experiences in willingness to volunteer to care for people with severe mental illness. Focus group interviews with volunteers in the Community Family Programme was conducted, followed by thematic analysis. All interviewees had professional and/or private experience of SMI, which had a major influence on their initial willingness to volunteer. Volunteering was an opportunity to pass on their experiences and to care for SMI people in ways that were not possible in their professions. The interviewees did not distinguish between the influences of professional and/or private life experiences on their willingness to volunteer. The study demonstrates the importance of professional and/or private life experiences in initial considerations about volunteering for mental health care. The consequences for recruitment practices are discussed.

  3. Data for distribution of various species of fecal coliforms in urban, rural and private drinking water sources in ten years period - A case study: Kermanshah, Iran.

    PubMed

    Davoodi, Reza; Pirsaheb, Meghdad; Karimyan, Kamaladdin; Gupta, Vinod Kumar; Takhtshahi, Ali Reza; Sharafi, Hooshmand; Moradi, Masoud

    2018-06-01

    This study was aimed to investigate the distribution of various species of fecal coliform in urban, rural and private drinking water sources of Kermanshah, in the west of Iran. For this study, data of ten years period (2006-2016) assessments of microbial quality regarding various species of Fecal coliforms was taken from health centers associated with urban, rural and private resources of Kermanshah city. A total number of 8643 samples were taken, 1851 samples from rural, 365 from urban and 4834 from private resources. The results showed that Fecal coliforms , Escherichia coli ( E. coli ) had the widest distribution in all urban, rural and private water resources (22.3%, 45.9% and 34%, respectively). Moreover, E. coli (47.5%) and Klebsiella (0.4%) had, respectively, the highest and lowest distribution in all months considered. Based on the results, E.coli exists mostly in water resources; it is therefore of particular importance in the monitoring of water resources.

  4. ClinicalTrials.gov

    MedlinePlus

    ... Terms and Conditions Disclaimer ClinicalTrials.gov is a database of privately and publicly funded clinical studies conducted ... world. ClinicalTrials.gov is a registry and results database of publicly and privately supported clinical studies of ...

  5. Health-care sector and complementary medicine: practitioners' experiences of delivering acupuncture in the public and private sectors.

    PubMed

    Bishop, Felicity L; Amos, Nicola; Yu, He; Lewith, George T

    2012-07-01

    The aim was to identify similarities and differences between private practice and the National Health Service (NHS) in practitioners' experiences of delivering acupuncture to treat pain. We wished to identify differences that could affect patients' experiences and inform our understanding of how trials conducted in private clinics relate to NHS clinical practice. Acupuncture is commonly used in primary care for lower back pain and is recommended in the National Institute for Health and Clinical Excellence's guidelines. Previous studies have identified differences in patients' accounts of receiving acupuncture in the NHS and in the private sector. The major recent UK trial of acupuncture for back pain was conducted in the private sector. Semi-structured qualitative interviews were conducted with 16 acupuncturists who had experience of working in the private sector (n = 7), in the NHS (n =3), and in both the sectors (n = 6). The interviews lasted between 24 and 77 min (median=49 min) and explored acupuncturists' experiences of treating patients in pain. Inductive thematic analysis was used to identify similarities and differences across private practice and the NHS. The perceived effectiveness of acupuncture was described consistently and participants felt they did (or would) deliver acupuncture similarly in NHS and in private practice. In both the sectors, patients sought acupuncture as a last resort and acupuncturist-patient relationships were deemed important. Acupuncture availability differed across sectors: in the NHS it was constrained by Trust policies and in the private sector by patients' financial resources. There were greater opportunities for autonomous practice in the private sector and regulation was important for different reasons in each sector. In general, NHS practitioners had Western-focussed training and also used conventional medical techniques, whereas private practitioners were more likely to have Traditional Chinese training and to practise other complementary therapies in addition to acupuncture. Future studies should examine the impact of these differences on patients' clinical outcomes.

  6. Cost-Control Mechanisms in Canadian Private Drug Plans

    PubMed Central

    Kratzer, Jillian; McGrail, Kimberlyn; Strumpf, Erin; Law, Michael R.

    2013-01-01

    Approximately 68% of Canadians receive prescription drug coverage through an employer-sponsored private plan. However, we have very limited data on the structure of these plans. This study aims to identify and describe the use of cost-control mechanisms in private drug plans in Canada and describe what private coverage looks like for the average Canadian. Using 2010 data from over 113,000 different private drug plans, provided by Applied Management Consultants, we determined the overall use of key cost-control measures, and the cost-control tools that appear to be gaining currency compared to a report on benefits coverage in 1998. We found that the use of common cost-control measures is relatively low among Canadian private benefits programs. Co-insurance is much more common in private coverage plans than co-payments. Deductibles are uncommon in Canada and, when in place, are very small. The use of annual and lifetime maximums is increasing. Canadian private benefits programs use few cost-control measures to respond to increasing costs, particularly in comparison to their public counterparts. These results suggest there are ample opportunities for greater efficiency in private sector drug coverage plans. PMID:23968672

  7. Comparison of public and private care management agencies under public long-term care insurance in Japan: a cross-sectional study.

    PubMed

    Yoshioka, Yoji; Tamiya, Nanako; Kashiwagi, Masayo; Sato, Mikiya; Okubo, Ichiro

    2010-01-01

    Long-Term Care Insurance (LTCI), which started in April 2000, allowed private business corporations to provide long-term care services which had been provided by social welfare corporations or public agencies in the previous long-term care scheme. This study compared differences in care management plans for community-dwelling frail elderly people between public care management agencies and private care management agencies. The subjects were 309 community-dwelling frail elderly people living in a suburban city with a population of approximately 55,000 and who had been using community-based long-term care services of the LTCI for 6 months from April 2000. The characteristics of the care management agencies (public/private) were identified using a claims database. After comparing profiles of users and their care mix between those managed by public agencies and by private agencies, the effect of the characteristics of care management agencies on LTCI service use was examined. Public care management agencies favored younger subjects (P = 0.003), male subjects (P = 0.006) and people with a higher need for care (P = 0.02) than private agencies. The number of service items used was significantly larger in public agencies than in their private counterparts. In multivariate regression analysis, the utilization of community-based long-term care service was significantly greater among beneficiaries managed by private agencies than those managed by public agencies (P = 0.02). Private care management agencies play an important role in promoting the use of care services, but their quality of care plans might be questionable.

  8. Creating recreation partnerships on private agricultural and forest land in the urban northeast: a case study from the great meadows of the Connecticut River

    Treesearch

    Robert L. Ryan; Juliet Hansel

    2002-01-01

    This paper explores the premise that privately owned open space is vital for meeting future recreation demands in the urban Northeast. A case study in the Great Meadows of the Connecticut River in the Hartford, Connecticut metropolitan area is used to illustrate the challenges in promoting recreational access and open space preservation in a privately-owned held...

  9. Public funding and private investment for R&D: a survey in China’s pharmaceutical industry

    PubMed Central

    2014-01-01

    Background In recent years, China has experienced tremendous growth in its pharmaceutical industry. Both the Chinese government and private investors are motivated to invest into pharmaceutical research and development (R&D). However, studies regarding the different behaviors of public and private investment in pharmaceutical R&D are scarce. Therefore, this paper aims to investigate the current situation of public funding and private investment into Chinese pharmaceutical R&D. Methods The primary data used in the research were obtained from the China High-tech Industry Statistics Yearbook (2002–2012) and China Statistical Yearbook of Science and Technology (2002–2012). We analyzed public funding and private investment in five aspects: total investment in the industry, funding sources of the whole industry, differences between provinces, difference in subsectors, and private equity/venture capital investment. Results The vast majority of R&D investment was from private sources. There is a significantly positive correlation between public funding and private investment in different provinces of China. However, public funding was likely to be invested into less developed provinces with abundant natural herbal resources. Compared with the chemical medicine subsector, traditional Chinese medicine and biopharmaceutical subsectors obtained more public funding. Further, the effect of the government was focused on private equity and venture capital investment although private fund is the mainstream of this type of investment. Conclusions Public funding and private investment play different but complementary roles in pharmaceutical R&D in China. While being less than private investment, public funding shows its significance in R&D investment. With rapid growth of the industry, the pharmaceutical R&D investment in China is expected to increase steadily from both public and private sources. PMID:24925505

  10. Public funding and private investment for R&D: a survey in China's pharmaceutical industry.

    PubMed

    Qiu, Lan; Chen, Zi-Ya; Lu, Deng-Yu; Hu, Hao; Wang, Yi-Tao

    2014-06-13

    In recent years, China has experienced tremendous growth in its pharmaceutical industry. Both the Chinese government and private investors are motivated to invest into pharmaceutical research and development (R&D). However, studies regarding the different behaviors of public and private investment in pharmaceutical R&D are scarce. Therefore, this paper aims to investigate the current situation of public funding and private investment into Chinese pharmaceutical R&D. The primary data used in the research were obtained from the China High-tech Industry Statistics Yearbook (2002-2012) and China Statistical Yearbook of Science and Technology (2002-2012). We analyzed public funding and private investment in five aspects: total investment in the industry, funding sources of the whole industry, differences between provinces, difference in subsectors, and private equity/venture capital investment. The vast majority of R&D investment was from private sources. There is a significantly positive correlation between public funding and private investment in different provinces of China. However, public funding was likely to be invested into less developed provinces with abundant natural herbal resources. Compared with the chemical medicine subsector, traditional Chinese medicine and biopharmaceutical subsectors obtained more public funding. Further, the effect of the government was focused on private equity and venture capital investment although private fund is the mainstream of this type of investment. Public funding and private investment play different but complementary roles in pharmaceutical R&D in China. While being less than private investment, public funding shows its significance in R&D investment. With rapid growth of the industry, the pharmaceutical R&D investment in China is expected to increase steadily from both public and private sources.

  11. Having Private Cancer Insurance in Korea: Gender Differences.

    PubMed

    Yoo, Ki-Bong; Noh, Jin-Won; Kwon, Young Dae; Cho, Kyoung Hee; Choi, Young; Kim, Jae-Hyun

    2015-01-01

    As coverage of public insurance is not sufficient to cover diagnosis or treatment of cancer, having private health insurance is important to prepare for unexpected expenses of cancer. The purpose of this study was to assess factors associated with having private cancer insurance, considering gender among the socio- demographic factors and health behavior. We used data from the 2011 Korea Health Panel, which included 10,871 participants aged 20 years and older. Socio-demographics, health behavior, and perceived cancer risk were the independent variables and having private cancer insurance was the dependent variable. Multivariable logistic regression analysis was used to identify factors associated with having private cancer insurance. The variables relating to middle age, higher education, higher household income, married men, and the perceived cancer risk groups of 1-10% and 11-30% were significantly associated with having private cancer insurance. Additionally, females who had private non-cancer health insurance were positively associated with the dependent variables (OR=1.36; 95% CI=1.17-1.57). Education, smoking status, exercise, and perceived cancer risk possibility were significantly associated with having private cancer insurance only among women. The men lowered the overall percentages of those having private cancer insurance (OR=0.53, 95% CI=0.45-0.63). We found that there were significant differences between men and women who had private cancer insurance. Women with private cancer insurance are more likely to follow precautionary health behavior than men. This could be interpreted as resulting from masculine ideologies. It is important to make males recognize the seriousness of the cancer risk. In general, household income was highly associated with private cancer insurance. These results reveal an inequity among the buyers of private cancer insurance in terms of economic status level, education level, and health condition.

  12. Factors associated to referral of tuberculosis suspects by private practitioners to community health centres in Bali Province, Indonesia.

    PubMed

    Artawan Eka Putra, I Wayan Gede; Utami, Ni Wayan Arya; Suarjana, I Ketut; Duana, I Made Kerta; Astiti, Cok Istri Darma; Putra, I W; Probandari, Ari; Tiemersma, Edine W; Wahyuni, Chatarina Umbul

    2013-10-28

    The contrast between the low proportion of tuberculosis (TB) suspects referred from private practitioners in Bali province and the high volume of TB suspects seeking care at private practices suggests problems with TB suspect referral from private practitioners to the public health sector. We aimed to identify key factors associated with the referral of TB suspects by private practitioners. We conducted a case-control study conducted in Bali province, Indonesia. The cases were private practitioners who had referred at least one TB suspect to a community health centre between 1 January 2007 and the start of data collection, while the controls were private practitioners who had not referred a single TB suspect in the same time. The following factors were independently associated with referral of TB suspects by private practitioners: having received information about the directly observed treatment short-course (DOTS) strategy (OR 2.0; 95% CI 1.1-3.8), ever having been visited by a district TB program officer (OR 2.1; 95% CI 1.0-4.5), availability of TB suspect referral forms in the practice (OR 2.8; 95% CI 1.5-5.2), and less than 5 km distance between the private practice and the laboratory for smear examination (OR 2.2; 95% CI 1.2-4.0). Education and exposure of private practitioners to the TB program improves referral of TB suspects from private practitioners to the national TB program. We recommend that the TB program provides all private practitioners with information about the DOTS strategy and TB suspect referral forms, and organizes regular visits to private practitioners.

  13. Factors associated to referral of tuberculosis suspects by private practitioners to community health centres in Bali Province, Indonesia

    PubMed Central

    2013-01-01

    Background The contrast between the low proportion of tuberculosis (TB) suspects referred from private practitioners in Bali province and the high volume of TB suspects seeking care at private practices suggests problems with TB suspect referral from private practitioners to the public health sector. We aimed to identify key factors associated with the referral of TB suspects by private practitioners. Methods We conducted a case-control study conducted in Bali province, Indonesia. The cases were private practitioners who had referred at least one TB suspect to a community health centre between 1 January 2007 and the start of data collection, while the controls were private practitioners who had not referred a single TB suspect in the same time. Results The following factors were independently associated with referral of TB suspects by private practitioners: having received information about the directly observed treatment short-course (DOTS) strategy (OR 2.0; 95% CI 1.1 – 3.8), ever having been visited by a district TB program officer (OR 2.1; 95% CI 1.0 – 4.5), availability of TB suspect referral forms in the practice (OR 2.8; 95% CI 1.5-5.2), and less than 5 km distance between the private practice and the laboratory for smear examination (OR 2.2; 95% CI 1.2-4.0). Conclusions Education and exposure of private practitioners to the TB program improves referral of TB suspects from private practitioners to the national TB program. We recommend that the TB program provides all private practitioners with information about the DOTS strategy and TB suspect referral forms, and organizes regular visits to private practitioners. PMID:24165352

  14. Solvent use in private research laboratories in Japan: comparison with the use in public research laboratories and on production floors in industries.

    PubMed

    Hanada, Takaaki; Zaitsu, Ai; Kojima, Satoshi; Ukai, Hirohiko; Nagasawa, Yasuhiro; Takada, Shiro; Kawakami, Takuya; Ohashi, Fumiko; Ikeda, Masayuki

    2014-01-01

    Solvents used in production facility-affiliated private laboratories have been seldomly reported. This study was initiated to specify solvent use characteristics in private laboratories in comparison with the use in public research laboratories and on production floors. Elucidation of the applicability of conclusions from a public laboratory survey to private institutions is not only of scientific interest but also of practical importance. A survey on use of 47 legally stipulated organic solvents was conducted. The results were compiled for April 2011 to March 2013. Through sorting, data were available for 479 unit workplaces in private laboratories. Similar sorting for April 2012 to March 2013 was conducted for public research laboratories (e.g., national universities) and production floors (in private enterprises) to obtain 621 and 937 cases, respectively. Sampling of workroom air followed by capillary gas-chromatographic analyses for solvents was conducted in accordance with regulatory requirements. More than one solvent was usually detected in the air of private laboratories. With regard to solvent types, acetone, methyl alcohol, chloroform and hexane were prevalently used in private laboratories, and this was similar to the case of public laboratories. Prevalent use of ethyl acetate was unique to private laboratories. Toluene use was less common both in private and public laboratories. The prevalence of administrative control class 1 (i.e., an adequately controlled environment) was higher in laboratories (both private and public) than production floors. Solvent use patterns are similar in private and public laboratories, except that the use of mixtures of solvents is substantially more popular in private laboratories than in public laboratories.

  15. Performance of private sector health care: implications for universal health coverage.

    PubMed

    Morgan, Rosemary; Ensor, Tim; Waters, Hugh

    2016-08-06

    Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers-including their size, objectives, and technical competence-the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies

    PubMed Central

    Berendes, Sima; Heywood, Peter; Oliver, Sandy; Garner, Paul

    2011-01-01

    Background In developing countries, the private sector provides a substantial proportion of primary health care to low income groups for communicable and non-communicable diseases. These providers are therefore central to improving health outcomes. We need to know how their services compare to those of the public sector to inform policy options. Methods and Findings We summarised reliable research comparing the quality of formal private versus public ambulatory health care in low and middle income countries. We selected studies against inclusion criteria following a comprehensive search, yielding 80 studies. We compared quality under standard categories, converted values to a linear 100% scale, calculated differences between providers within studies, and summarised median values of the differences across studies. As the results for for-profit and not-for-profit providers were similar, we combined them. Overall, median values indicated that many services, irrespective of whether public or private, scored low on infrastructure, clinical competence, and practice. Overall, the private sector performed better in relation to drug supply, responsiveness, and effort. No difference between provider groups was detected for patient satisfaction or competence. Synthesis of qualitative components indicates the private sector is more client centred. Conclusions Although data are limited, quality in both provider groups seems poor, with the private sector performing better in drug availability and aspects of delivery of care, including responsiveness and effort, and possibly being more client orientated. Strategies seeking to influence quality in both groups are needed to improve care delivery and outcomes for the poor, including managing the increasing burden of non-communicable diseases. Please see later in the article for the Editors' Summary PMID:21532746

  17. Effect of an expansion in private sector provision of contraceptive supplies on horizontal inequity in modern contraceptive use: evidence from Africa and Asia

    PubMed Central

    2011-01-01

    Background One strategic approach available to policy makers to improve the availability of reproductive and child health care supplies and services as well as the sustainability of programs is to expand the role of the private sector in providing these services. However, critics of this approach argue that increased reliance on the private sector will not serve the needs of the poor, and could lead to increases in socio-economic disparities in the use of health care services. The purpose of this study is to investigate whether the expansion of the role of private providers in the provision of modern contraceptive supplies is associated with increased horizontal inequity in modern contraceptive use. Methods The study is based on multiple rounds of Demographic and Health Survey data from four selected countries (Nigeria, Uganda, Bangladesh, and Indonesia) in which there was an increase in the private sector supply of contraceptives. The methodology involves estimating concentration indices to assess the degree of inequality and inequity in contraceptive use by wealth groups across time. In order to measure inequity in the use of modern contraceptives, the study uses multivariate methods to control for differences in the need for family planning services in relation to household wealth. Results The results suggest that the expansion of the private commercial sector supply of contraceptives in the four study countries did not lead to increased inequity in the use of modern contraceptives. In Nigeria and Uganda, inequity actually decreased over time; while in Bangladesh and Indonesia, inequity fluctuated. Conclusions The study results do not offer support to the hypothesis that the increased role of the private commercial sector in the supply of contraceptive supplies led to increased inequity in modern contraceptive use. PMID:21854584

  18. Effect of an expansion in private sector provision of contraceptive supplies on horizontal inequity in modern contraceptive use: evidence from Africa and Asia.

    PubMed

    Hotchkiss, David R; Godha, Deepali; Do, Mai

    2011-08-19

    One strategic approach available to policy makers to improve the availability of reproductive and child health care supplies and services as well as the sustainability of programs is to expand the role of the private sector in providing these services. However, critics of this approach argue that increased reliance on the private sector will not serve the needs of the poor, and could lead to increases in socio-economic disparities in the use of health care services. The purpose of this study is to investigate whether the expansion of the role of private providers in the provision of modern contraceptive supplies is associated with increased horizontal inequity in modern contraceptive use. The study is based on multiple rounds of Demographic and Health Survey data from four selected countries (Nigeria, Uganda, Bangladesh, and Indonesia) in which there was an increase in the private sector supply of contraceptives. The methodology involves estimating concentration indices to assess the degree of inequality and inequity in contraceptive use by wealth groups across time. In order to measure inequity in the use of modern contraceptives, the study uses multivariate methods to control for differences in the need for family planning services in relation to household wealth. The results suggest that the expansion of the private commercial sector supply of contraceptives in the four study countries did not lead to increased inequity in the use of modern contraceptives. In Nigeria and Uganda, inequity actually decreased over time; while in Bangladesh and Indonesia, inequity fluctuated. The study results do not offer support to the hypothesis that the increased role of the private commercial sector in the supply of contraceptive supplies led to increased inequity in modern contraceptive use.

  19. Private Supplementary Tutoring in the Czech Republic

    ERIC Educational Resources Information Center

    Štastný, Vít

    2016-01-01

    The study contributes to the literature on private supplementary tutoring by shedding light on this phenomenon in the Czech Republic. The aim of the paper is to identify the reasons for seeking out private supplementary tutoring and to assess the factors underlying its demand. In the representative sample of 1,265 senior upper-secondary school…

  20. Reworking of School Principals' Roles in the Context of Educational Privatization: A View from Ukraine

    ERIC Educational Resources Information Center

    Kovalchuk, Serhiy; Shchudlo, Svitlana

    2014-01-01

    Educational privatization created new arrangements for funding, provision, and regulation of educational systems and their various stakeholders worldwide. This qualitative study examines the driving forces of privatization in the public education of Ukraine, focusing specifically on the professional roles of school principals who have been…

  1. Privatized Student Housing and the Decision-Making Process

    ERIC Educational Resources Information Center

    Aska, Aaron C.

    2012-01-01

    This study will examine the decision-making process used to construct privatized student housing as well as the factors that contribute to that process among public four-year institutions in New Jersey. A growing number of public universities are exploring ways to develop successful public private partnerships (P3s) in an effort to improve…

  2. Intra-Sectoral Diversity: A Political Economy of Thai Private Higher Education

    ERIC Educational Resources Information Center

    Praphamontripong, Prachayani

    2010-01-01

    Private higher education (PHE) worldwide has been a rapid development in the last several decades. The private sector will continue to grow, diversify and undoubtedly play a significant role in the political economy of higher education. Nevertheless, systematically empirical studies on the trio relationships among PHE, institutional diversity and…

  3. Privatizing Education: Can the Marketplace Deliver Choice, Efficiency, Equity, and Social Cohesion?

    ERIC Educational Resources Information Center

    Levin, Henry M., Ed.

    This collection of essays examines efforts by groups and lobbyists to move education from the public to the private sector. There are 14 papers in 7 sections: The first section, "Introduction," includes: (1) "Studying Privatization in Education" (Henry M. Levin) and (2) "Educational Vouchers and the Media" (Lee D.…

  4. Trends in Antipsychotic Drug Use by Very Young, Privately Insured Children

    ERIC Educational Resources Information Center

    Olfson, Mark; Crystal, Stephen; Huang, Cecilia; Gerhard, Tobias

    2010-01-01

    Objective: This study describes recent trends and patterns in antipsychotic treatment of privately insured children aged 2 through 5 years. Method: A trend analysis is presented of antipsychotic medication use (1999-2001 versus 2007) stratified by patient characteristics. Data are analyzed from a large administrative database of privately insured…

  5. Public-Private Partnerships in College Student Housing: Lessons from Three Institutions

    ERIC Educational Resources Information Center

    McClure, Kevin R.; Ryder, Andrew J.; DeVita, James M.

    2017-01-01

    Despite the increasing popularity of public-private partnerships, empirical research about the origins, models, and long-term outcomes of this approach to financing, constructing, and managing college student housing is scant. In this study, we sought to investigate the origins, models, and outcomes of public-private partnerships in college…

  6. Innovation in Educational Markets: An Organizational Analysis of Private Schools in Toronto

    ERIC Educational Resources Information Center

    Davies, Scott; Quirke, Linda

    2005-01-01

    This study examines whether new private schools are innovative, drawing on theories of markets and institutions. Choice advocates claim that markets spark innovation, while institutional theory suggests that isomorphic forces will limit novel school forms. Using qualitative data from third sector private schools in Toronto, three hypotheses about…

  7. What's yours, mine, and ours : overcoming intellectual property rights issues : a cross-cutting study : facilitating private-sector participation and expediting deployment

    DOT National Transportation Integrated Search

    2000-08-01

    Debate over the ownership and use of intellectual property developed jointly by the public and private sectors has caused delays in ITS deployment projects. While a fundamental business incentive of the private sector for investing in research and de...

  8. Public and Private School Costs. A Local Analysis, 1994.

    ERIC Educational Resources Information Center

    Public Policy Forum, Inc., Milwaukee, WI.

    This document presents findings of a study that identified key factors of cost-per-pupil differences between public and private school spending among selected Milwaukee area public and private schools. The analysis was limited to cost factors only, specifically, to per-pupil spending. Methodology included a review of the school budgets of 7 public…

  9. System Expertise Training Courses in Private Sector: Can They Be Given Online?

    ERIC Educational Resources Information Center

    Balci Demirci, Birim

    2014-01-01

    It is widely known that there are many schools in the private sector offering courses in Computer Technology, Computer Engineering, Information Systems and similar disciplines in addition to Universities presenting such courses. The private sector programs are extremely popular with students already studying at university as well as being of great…

  10. State Financial Assistance to Private Higher Education.

    ERIC Educational Resources Information Center

    Bivens and Associates, Inc., Dover, DE.

    This study has been directed toward the determination of the scope and nature of state financial assistance to private higher education institutions in the various states. An evaluation and analysis of the data collected for this project leads to the following conclusions: (1) Private higher education institutions in Delaware as well as in other…

  11. Private Speech Moderates the Effects of Effortful Control on Emotionality

    ERIC Educational Resources Information Center

    Day, Kimberly L.; Smith, Cynthia L.; Neal, Amy; Dunsmore, Julie C.

    2018-01-01

    Research Findings: In addition to being a regulatory strategy, children's private speech may enhance or interfere with their effortful control used to regulate emotion. The goal of the current study was to investigate whether children's private speech during a selective attention task moderated the relations of their effortful control to their…

  12. Comparisons of Young Children's Private Speech Profiles: Analogical Versus Nonanalogical Reasoners.

    ERIC Educational Resources Information Center

    Manning, Brenda H.; White, C. Stephen

    The primary intention of this study was to compare private speech profiles of young children classified as analogical reasoners (AR) with young children classified as nonanalogical reasoners (NAR). The secondary purpose was to investigate Berk's (1986) research methodology and categorical scheme for the collection and coding of private speech…

  13. The Role of Language and Private Speech in Preschoolers' Self-Regulation

    ERIC Educational Resources Information Center

    Bono, Katherine E.; Bizri, Rana

    2014-01-01

    The present study explored relations among language skills, private speech, and self-regulation in three- to five-year-old children. Language skills were assessed with a standardised measure of language ability and by teacher reports of adaptive use of language in the classroom. Private speech was measured by observing children during a…

  14. Does Mission Matter? An Analysis of Private School Achievement Differences

    ERIC Educational Resources Information Center

    Boerema, Albert J.

    2009-01-01

    Using student achievement data from British Columbia, Canada, this study is an exploration of the differences that lie within the private school sector using hierarchical linear modeling to analyze the data. The analysis showed that when controlling for language, parents' level of educational attainment, and prior achievement, the private school…

  15. Private Schooling and Labour Market Outcomes

    ERIC Educational Resources Information Center

    Green, Francis; Henseke, Golo; Vignoles, Anna

    2017-01-01

    Though a relative small part of the school sector, private schools have an important role in British society, and there are policy concerns about their negative effect on social mobility. Other studies show that individuals who have attended a private school go on to have higher levels of educational achievement, are more likely to secure a…

  16. Does Private Tutoring Increase Students' Academic Performance? Evidence from Turkey

    ERIC Educational Resources Information Center

    Berberoglu, Giray; Tansel, Aysit

    2014-01-01

    This paper investigates the effectiveness of private tutoring in Turkey. The authors introduce their study by providing some background information on the two major national examinations and three different kinds of tutoring. They then describe how they aimed to analyse whether attending private tutoring centres (PTCs) enhances Turkish students'…

  17. Addressing Quality Challenges in the Private University Sector in Bangladesh: From Policy Formulation to Institutional Implementation

    ERIC Educational Resources Information Center

    Blanco Ramírez, Gerardo; Jahirul Haque, H. M.

    2016-01-01

    Private higher education is growing, especially in developing and transitioning countries. Rapid growth frequently comes with concerns about quality. This article explores challenges and opportunities for higher education quality among private universities in Bangladesh. By presenting a vertical case study that explores interactions among actors…

  18. The Private Tutoring Industry in Taiwan: Government Policies and Their Implementation

    ERIC Educational Resources Information Center

    Zhan, Shengli

    2014-01-01

    Previous studies show that attending private tutoring has become a necessity to many primary and secondary students in East Asia. Educational policies and their effective implementation are crucial to guarantee the healthy development of the private tutoring industry and thus protect the rights of students and their families. Under the framework…

  19. Strategies for Involving the Private Sector in Job Training Programs.

    ERIC Educational Resources Information Center

    Greenwood, Katy; And Others

    This two-part report describes various strategies for involving the private sector in job training programs and summarizes a study conducted with prime sponsors of Comprehensive Employment and Training Act (CETA) programs in Texas. Included in a discussion of involving the private sector in job training programs are the following topics: the new…

  20. Role of emerging private hospitals in a post-Soviet mixed health system: a mixed methods comparative study of private and public hospital inpatient care in Mongolia.

    PubMed

    Tsevelvaanchig, Uranchimeg; Gouda, Hebe; Baker, Peter; Hill, Peter S

    2017-05-01

    The collapse of the Soviet Union in 1990 severely impacted the health sector in Mongolia. Limited public funding for the post-Soviet model public system and a rapid growth of poorly regulated private providers have been pressing issues for a government seeking to re-establish universal health coverage. However, the evidence available on the role of private providers that would inform sector management is very limited. This study analyses the current contribution of private hospitals in Mongolia for the improvement of accessibility of health care and efficiency. We used mixed research methods. A descriptive analysis of nationally representative hospital admission records from 2013 was followed by semi-structured interviews that were carried out with purposively selected key informants (N = 45), representing the main actors in Mongolia's mixed health system. Private-for-profit hospitals are concentrated in urban areas, where their financial model is most viable. The result is the duplication of private and public inpatient services, both in terms of their geographical location and the range of services delivered. The combination of persistent inpatient-oriented care and perverse financial incentives that privilege admission over outpatient management, have created unnecessary health costs. The engagement of the private sector to improve population health outcomes is constrained by a series of issues of governance, regulation and financing and the failure of the state to manage the private sector as an integral part of its health system planning. For a mixed system like in Mongolia, a comprehensive policy and plan which defines the complementary role of private providers to optimize private public service mix is critical in the early stages of the private sector development. It further supports the importance of a system perspective that combines regulation and incentives in consistent policy, rather than an isolated approach to provide regulation. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  1. Considerations of private sector obstetricians on participation in the state led "Chiranjeevi Yojana" scheme to promote institutional delivery in Gujarat, India: a qualitative study.

    PubMed

    Ganguly, Parthasarathi; Jehan, Kate; de Costa, Ayesha; Mavalankar, Dileep; Smith, Helen

    2014-11-05

    In India a lack of access to emergency obstetric care contributes to maternal deaths. In 2005 Gujarat state launched a public-private partnership (PPP) programme, Chiranjeevi Yojana (CY), under which the state pays accredited private obstetricians a fixed fee for providing free intrapartum care to poor and tribal women. A million women have delivered under CY so far. The participation of private obstetricians in the partnership is central to the programme's effectiveness. We explored with private obstetricians the reasons and experiences that influenced their decisions to participate in the CY programme. In this qualitative study we interviewed 24 purposefully selected private obstetricians in Gujarat. We explored their views on the scheme, the reasons and experiences leading up to decisions to participate, not participate or withdraw from the CY, as well as their opinions about the scheme's impact. We analysed data using the Framework approach. Participants expressed a tension between doing public good and making a profit. Bureaucratic procedures and perceptions of programme misuse seemed to influence providers to withdraw from the programme or not participate at all. Providers feared that participating in CY would lower the status of their practices and some were deterred by the likelihood of more clinically difficult cases among eligible CY beneficiaries. Some providers resented taking on what they saw as a state responsibility to provide safe maternity services to poor women. Younger obstetricians in the process of establishing private practices, and those in more remote, 'less competitive' areas, were more willing to participate in CY. Some doctors had reservations over the quality of care that doctors could provide given the financial constraints of the scheme. While some private obstetricians willingly participate in CY and are satisfied with its functioning, a larger number shared concerns about participation. Operational difficulties and a trust deficit between the public and private health sectors affect retention of private providers in the scheme. Further refinement of the scheme, in consultation with private partners, and trust building initiatives could strengthen the programme. These findings offer lessons to those developing public-private partnerships to widen access to health services for underprivileged groups.

  2. Public private mix model in enhancing tuberculosis case detection in District Thatta, Sindh, Pakistan.

    PubMed

    Ahmed, Jameel; Ahmed, Mubashir; Laghari, A; Lohana, Wasdev; Ali, Sajid; Fatmi, Zafar

    2009-02-01

    To enhance the TB case detection through Public Private Mix (PPM) model by involving private practitioners in collaboration with National TB Control Program, (NTP) in district Thatta. Private practitioners (PPs) of district Thatta involved in treatment of TB cases were requested to participate in the study. All consenting physicians were provided with training on Directly Observed Treatment Short course (DOTS) module. In addition to routine cases, TB cases diagnosed by private practitioners through sputum microscopy were also registered with the district TB control program and medicines were provided by NTP. After intervention of PPM-DOTS change in Case Detection Rate (CDR) were estimated. An increased number of sputum smear positive cases were found in the intervention period--the third quarter of 2007, from 188 to 211 and CDR from 69% to 77%. The improvement in case detection rate was significant as this moderately added to the total number of cases detected from the whole of the district Thatta during the study period. Public private mix (PPM) model was effective in increasing the CDR of TB cases in district Thatta. It is recommended that the public private partnership model in Tuberculosis case detection needs to be taken on a larger scale so as to reduce the heavy TB burden in the country.

  3. A qualitative exploration of the factors influencing the job satisfaction and career development of physiotherapists in private practice.

    PubMed

    Davies, J M; Edgar, S; Debenham, J

    2016-09-01

    The aim of this study was to investigate factors contributing to job satisfaction at different career stages, among private practice physiotherapists in Australia. Qualitative case study design utilising focus groups. Sixteen participants allocated to 3 focus groups: new graduates (n = 6), post graduates (n = 5) and practice owners (n = 5). Focus groups were transcribed verbatim and a thematic analysis was undertaken to determine themes and subthemes from each focus group. The key themes identified within each focus group included the role of peer support and mentoring, professional development, professional relationships, new graduate employment issues and career pathways within private practice. In particular, issues surrounding the new graduate experience in private practice were explored, with all groups noting lack of support and financial pressures were of concern. Findings demonstrated that new graduates are underprepared to work in private practice and modifications to the delivery of peer support, mentoring and professional development is required. Key recommendations include physiotherapy undergraduate program reform to reflect industry requirements in private practice, an increase in private practice clinical placement numbers, as well as streamlining the physiotherapy profession to improve career development pathways. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Regulating the for-profit private healthcare providers towards universal health coverage: A qualitative study of legal and organizational framework in Mongolia.

    PubMed

    Tsevelvaanchig, Uranchimeg; Narula, Indermohan S; Gouda, Hebe; Hill, Peter S

    2018-01-01

    Regulating the behavior of private providers in the context of mixed health systems has become increasingly important and challenging in many developing countries moving towards universal health coverage including Mongolia. This study examines the current regulatory architecture for private healthcare in Mongolia exploring its role for improving accessibility, affordability, and quality of private care and identifies gaps in policy design and implementation. Qualitative research methods were used including documentary review, analysis, and in-depth interviews with 45 representatives of key actors involved in and affected by regulations in Mongolia's mixed health system, along with long-term participant observation. There has been extensive legal documentation developed regulating private healthcare, with specific organizations assigned to conduct health regulations and inspections. However, the regulatory architecture for healthcare in Mongolia is not optimally designed to improve affordability and quality of private care. This is not limited only to private care: important regulatory functions targeted to quality of care do not exist at the national level. The imprecise content and details of regulations in laws inviting increased political interference, governance issues, unclear roles, and responsibilities of different government regulatory bodies have contributed to failures in implementation of existing regulations. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Experiences of selected countries in the use of public-private partnership in hospital services provision.

    PubMed

    Sadeghi, Ahmad; Barati, Omid; Bastani, Peivand; Jafari, Davood Danesh; Etemadian, Masoud

    2016-11-01

    To review the experiences of selected countries in the use of public-private partnership in the provision of hospital services. This comparative study was conducted in 2015 in Iran. To collect data, valid databases as well as articles, theses, reports and related books in the field of private-sector partnership in hospital services were employed. Using purposive sampling, countries such as the United Kingdom, Spain, Canada, Turkey, Australia and Lesotho, which had successful experiences in the field of application of the public-private partnership in hospital services, were included. Likewise, the only experience in Iran in this field was also reviewed. Studies done between 1980 and 2015 were examined. The results obtained from each country were compared. Implementing public-private partnership had great and valuable outcomes and achievements for governmental hospitals. Moreover, clinical and nonclinical service delivery, hospital utilisation and management along with building, repairing and supportive operations through public-private partnership contracts can be differently divided among the partners. Furthermore, duration of the projects ranged from 12 to 40 years in different countries, depending on the type of the model used. A successful experience in the use of the public-private partnership in the provision of hospital services was observed.

  6. Privatization of solid waste collection services: Lessons from Gaborone.

    PubMed

    Bolaane, Benjamin; Isaac, Emmanuel

    2015-06-01

    Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste management experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Physiotherapy as a disciplinary institution in modern society - a Foucauldian perspective on physiotherapy in Danish private practice.

    PubMed

    Praestegaard, Jeanette; Gard, Gunvor; Glasdam, Stinne

    2015-01-01

    In many Western countries, physiotherapy in a private context is practiced and managed within a neoliberal ideology. Little is known about how private physiotherapeutic practice functions, which is why this study aims to explore how physiotherapy is practiced from the perspective of physiotherapists in Danish private practice, within a Foucauldian perspective. This study consisted of 21 interviews with physiotherapists employed in private practice and observation notes of the clinic. Interviews and observation notes were analyzed through the lens of Foucault's concepts of discipline, self-discipline, power and resistance. Three categories were constructed: (1) the tacit transition from person to patient; (2) the art of producing docile bodies; and (3) the inhibition of freedom of action by practicing in private homes. From a Foucauldian perspective, private physiotherapeutic practices have a disciplinary function in modern society as the physiotherapists produce docile bodies through disciplinary technologies, whereby their business becomes profitable. Most patients support the physiotherapists' "regime of truth" but if they resist, they are either excluded or accepted as "abnormal" but as a necessary source of income. The physiotherapists appear to be unconscious of the bio-powers working "behind their backs" as they are subject to the Western medical logic, and the neoliberal framework that rules their businesses.

  8. Comparison of the Effects of Public and Private Health Expenditures on the Health Status: A Panel Data Analysis in Eastern Mediterranean Countries

    PubMed Central

    Homaie Rad, Enayatollah; Vahedi, Sajad; Teimourizad, Abedin; Esmaeilzadeh, Firooz; Hadian, Mohamad; Torabi Pour, Amin

    2013-01-01

    Background: Health expenditures are divided in two parts of public and private health expenditures. Public health expenditures contain social security spending, taxing to private and public sectors, and foreign resources like loans and subventions. On the other hand, private health expenditures contain out of pocket expenditures and private insurances. Each of these has different effects on the health status. The present study aims to compare the effects of these expenditures on health in Eastern Mediterranean Region (EMR). Methods: In this study, infant mortality rate was considered as an indicator of health status. We estimated the model using the panel data of EMR countries between 1995 and 2010. First, we used Pesaran CD test followed by Pesaran’s CADF unit root test. After the confirmation of having unit root, we used Westerlund panel cointegration test and found that the model was cointegrated and then after using Hausman and Breusch-Pagan tests, we estimated the model using the random effects. Results: The results showed that the public health expenditures had a strong negative relationship with infant mortality rate. However, a positive relationship was found between the private health expenditures and infant mortality rate (IMR). The relationship for public health expenditures was significant, but for private health expenditures was not. Conclusion: The study findings showed that the public health expenditures in the EMR countries improved health outcome, while the private health expenditures did not have any significant relationship with health status, so often increasing the public health expenditures leads to reduce IMR. But this relationship was not significant because of contradictory effects for poor and wealthy peoples. PMID:24596857

  9. Comparison of the effects of public and private health expenditures on the health status: a panel data analysis in eastern mediterranean countries.

    PubMed

    Homaie Rad, Enayatollah; Vahedi, Sajad; Teimourizad, Abedin; Esmaeilzadeh, Firooz; Hadian, Mohamad; Torabi Pour, Amin

    2013-08-01

    Health expenditures are divided in two parts of public and private health expenditures. Public health expenditures contain social security spending, taxing to private and public sectors, and foreign resources like loans and subventions. On the other hand, private health expenditures contain out of pocket expenditures and private insurances. Each of these has different effects on the health status. The present study aims to compare the effects of these expenditures on health in Eastern Mediterranean Region (EMR). In this study, infant mortality rate was considered as an indicator of health status. We estimated the model using the panel data of EMR countries between 1995 and 2010. First, we used Pesaran CD test followed by Pesaran's CADF unit root test. After the confirmation of having unit root, we used Westerlund panel cointegration test and found that the model was cointegrated and then after using Hausman and Breusch-Pagan tests, we estimated the model using the random effects. The results showed that the public health expenditures had a strong negative relationship with infant mortality rate. However, a positive relationship was found between the private health expenditures and infant mortality rate (IMR). The relationship for public health expenditures was significant, but for private health expenditures was not. The study findings showed that the public health expenditures in the EMR countries improved health outcome, while the private health expenditures did not have any significant relationship with health status, so often increasing the public health expenditures leads to reduce IMR. But this relationship was not significant because of contradictory effects for poor and wealthy peoples.

  10. Variation in exemptions to school immunization requirements among New York State private and public schools.

    PubMed

    Lai, Yun-Kuang; Nadeau, Jessica; McNutt, Louise-Anne; Shaw, Jana

    2014-12-12

    School immunization requirements have ensured high vaccination rates and have helped to control vaccine-preventable diseases. However, vaccine exemptions have increased in the last decade. This study compared New York State private versus public schools with respect to medical and religious exemption rates. This retrospective study utilizes New York State Department of Health Immunization Survey data from the 2003 through 2012 academic years. Schools were categorized as private or public, the former further categorized by religious affiliation. Rates of medical and religious vaccine exemptions were compared by school category. From 2003 to 2012, religious exemptions increased in private and public schools from 0.63% to 1.35% and 0.17% to 0.29% (Spearman's R: 0.89 and 0.81), respectively. Among private schools, increases in religious exemption rates during the study period were observed in Catholic/Eastern Orthodox, Protestant/Other Christian, Jewish, and secular schools (Spearman's R=0.66, 0.99, 0.89, and 0.93), respectively. Exemption rate ratios in private schools compared to public schools were 1.39 (95% CI 1.15-1.68) for medical and 3.94 (95% CI: 3.20-4.86) for religious exemptions. Among private school students, all school types except for Catholic/Eastern Orthodox and Episcopal affiliates were more likely to report religious exemptions compared to children in public schools. Medical and religious exemption rates increased over time and higher rates were observed among New York State private schools compared to public schools. Low exemption rates are critical to minimize disease outbreaks in the schools and their community. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Enhanced disease surveillance through private health care sector cooperation in Karachi, Pakistan: experience from a vaccine trial.

    PubMed Central

    Khan, Mohammad Imran; Sahito, Shah Muhammad; Khan, Mohammad Javed; Wassan, Shafi Mohammad; Shaikh, Abdul Wahab; Maheshwari, Ashok Kumar; Acosta, Camilo J.; Galindo, Claudia M.; Ochiai, Rion Leon; Rasool, Shahid; Peerwani, Sheeraz; Puri, Mahesh K.; Ali, Mohammad; Zafar, Afia; Hassan, Rumina; von Seidlein, Lorenz; Clemens, John D.; Nizami, Shaikh Qamaruddin; Bhutta, Zulfiqar A.

    2006-01-01

    INTRODUCTION: In research projects such as vaccine trials, accurate and complete surveillance of all outcomes of interest is critical. In less developed countries where the private sector is the major health-care provider, the private sector must be included in surveillance systems in order to capture all disease of interest. This, however, poses enormous challenges in practice. The process and outcome of recruiting private practice clinics for surveillance in a vaccine trial are described. METHODS: The project started in January 2002 in two urban squatter settlements of Karachi, Pakistan. At the suggestion of private practitioners, a phlebotomy team was formed to provide support for disease surveillance. Children who had a reported history of fever for more than three days were enrolled for a diagnosis. RESULTS: Between May 2003 and April 2004, 5540 children younger than 16 years with fever for three days or more were enrolled in the study. Of the children, 1312 (24%) were seen first by private practitioners; the remainder presented directly to study centres. In total, 5329 blood samples were obtained for microbiology. The annual incidence of Salmonella typhi diagnosed by blood culture was 407 (95% confidence interval (95% CI), 368-448) per 100 000/year and for Salmonella paratyphi A was 198 (95% CI, 171-227) per 100 000/year. Without the contribution of private practitioners, the rates would have been 240 per 100 000/year (95% CI, 211-271) for S. typhi and 114 (95% CI, 94-136) per 100 000/year for S. paratyphi A. CONCLUSION: The private sector plays a major health-care role in Pakistan. Our experience from a surveillance and burden estimation study in Pakistan indicates that this objective is possible to achieve but requires considerable effort and confidence building. Nonetheless, it is essential to include private health care providers when attempting to accurately estimate the burden of disease in such settings. PMID:16501718

  12. Acute appendicitis in the public and private sectors in Cape Town, South Africa.

    PubMed

    Yang, Estin; Cook, Colin; Kahn, Delawir

    2015-07-01

    South Africa has a low incidence of acute appendicitis, but poor outcomes. However, South African studies on appendicitis focus solely on public hospitals, neglecting those who utilize private facilities. This study aims to compare appendicitis characteristics and outcomes in public and private hospitals in South Africa. A prospective cohort study was conducted among two public and three private hospitals in the Cape Town metropole, from September 2013 to March 2014. Hospital records, operative notes, and histology results were reviewed for patients undergoing appendectomy for acute appendicitis. Patients were interviewed during their hospitalization and followed up at monthly intervals until normal function was attained. A total of 134 patients were enrolled, with 73 in the public and 61 in the private sector. Education and employment were higher among private sector patients. Public sector patients had a higher rupture rate (30.6 vs 13.2 %, p = 0.023). Times to presentation were not statistically different between the two cohorts. Public sector patients had longer hospital stays (5.3 vs 2.9 days, p = 0.036) and longer return to work times (23.0 vs 12.1 days, p < 0.0001). Although complication rates were similar, complications in public hospitals were more severe. Public sector patients in South Africa with appendicitis have higher rupture rates, worse complications, longer hospital stays, and longer recoveries than private sector patients. Patients with perforation had longer delays in presentation than patients without perforation.

  13. Ethnic identity, school connectedness, and achievement in standardized tests among Mexican-origin youth.

    PubMed

    Santos, Carlos E; Collins, Mary Ann

    2016-07-01

    The aim of this study was to investigate the association between school connectedness and performance in standardized test scores and whether this association was moderated by ethnic private regard. The study combines self-report data with school district reported data on standardized test scores in reading and math and free and reduced lunch status. Participants included 436 Mexican-origin youth attending a middle school in a southwestern U.S. state. Participants were on average 12.34 years of age (SD = .95) and 51.8% female and 48.2% male. After controlling for age, gender, free and reduced lunch status, and generational status, school connectedness and ethnic private regard were both positive predictors of standardized test scores in reading and math. Results also revealed a significant interaction between school connectedness and ethnic private regard in predicting standardized test scores in reading, such that participants who were low on ethnic private regard and low on school connectedness reported lower levels of achievement compared to participants who were low on ethnic private regard but high on school connectedness. At high levels of ethnic private regard, high or low levels of school connectedness were not associated with higher or lower standardized test scores in reading. The findings in this study provide support for the protective role that ethnic private regard plays in the educational experiences of Mexican-origin youth and highlights how the local school context may play a role in shaping this finding. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  14. Clients’ satisfaction with quality of childbirth services: A comparative study between public and private facilities in Limuru Sub-County, Kiambu, Kenya

    PubMed Central

    2018-01-01

    Background This study intended to compare the clients’ satisfaction with the quality of childbirth services in a private and public facility amongst mothers who have delivered within the last twenty four to seventy hours. Methods This was a cross-sectional comparative research design with both quantitative and qualitative data collection and analysis methods. Data were collected through a focused group discussion guide and structured questionnaire collecting information on clients’ satisfaction with quality of childbirth services. The study was conducted amongst women of reproductive age (WRA) between 15–49 years in Tigoni District hospital (public hospital) and Limuru Nursing home (private hospital). For quantitative data we conducted descriptive analysis and Mann-Whitney test using SPSS version 20.0 while qualitative data was manually analyzed manually using thematic analysis. Results A higher proportion of clients from private facility 98.1% were attended within 0–30 minutes of arrival to the facility as compared to 87% from public facility. The overall mean score showed that the respondents in public facility gave to satisfaction with the services was 4.46 out of a maximum of 5.00 score while private facility gave 4.60. The level of satisfaction amongst respondents in the public facility on pain relief after delivery was statistically significantly higher than the respondents in private facilities (U = 8132.50, p<0.001) while the level of satisfaction amongst respondents in the public facility on functional equipment was statistically significantly higher than the respondents in private facilities (U = 9206.50, p = 0.001). Moreover, level of satisfaction with the way staff responded to questions and concerns during labour and delivery was statistically significantly higher than the respondents in private facilities (U = 9964.50, p = 0.022). Conclusion In overall, majority of clients from both public and private facilities expressed satisfaction with quality of services from admission till discharge in both public and private facilities and were willing to recommend other to come and deliver in the respective facilities. PMID:29538385

  15. A Comparison of Concentrations of Sodium and Related Nutrients (Potassium, Total Dietary Fiber, Total and Saturated Fat, and Total Sugar) in Private-Label and National Brands of Popular, Sodium-Contributing, Commercially Pack

    USDA-ARS?s Scientific Manuscript database

    Private-label brands account for about one in four foods sold in U.S. supermarkets. They provide value to consumers due to their low cost. We know of no U.S. studies comparing the nutrition content of private-label with corresponding national-brand products. The objective of this study was to compar...

  16. Genetic Counsellors and Private Practice: Professional Turbulence and Common Values.

    PubMed

    Collis, Sarah; Gaff, Clara; Wake, Samantha; McEwen, Alison

    2017-12-27

    Genetic counsellors face tensions between past and future identities: between established values and goals, and a broadening scope of settings and activities. This study examines the advent of genetic counsellors in private practice in Australia and New Zealand from the perspectives of the small numbers working in this sector and those who have only worked in public practice. Semi-structured interviews were conducted with 16 genetic counsellors who had experience in private practice, and 14 genetic counsellors without private sector experience. Results demonstrated that circumstantial and personal factors can mitigate the challenges experienced and the amount of support desired by those who had established a private practice, and those who were employed by private companies. Notably, most participants with private sector experience perceived themselves to be viewed negatively by other genetic counsellors. Most participants without private sector experience expressed concern that the challenges they believed genetic counsellors face in private practice may impact service quality, but wished to address such concerns by providing appropriate support. Together, our results reinforce that participants in private and public sectors are strong advocates for peer support, multidisciplinary team work, and professional development. These core values, and seeking understanding of different circumstances and support needs, will enable genetic counsellors in different sectors to move forward together. Our results suggest supports that may be acted upon by members of the profession, professional groups, and training programs, in Australia, New Zealand, and overseas.

  17. The change in capacity and service delivery at public and private hospitals in Turkey: a closer look at regional differences.

    PubMed

    Aksan, Hediye A D; Ergin, Işıl; Ocek, Zeliha

    2010-11-01

    Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services.This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. The private health sector has grown enormously between 2001-2006 in Turkey including the less developed regions of the country. Given the fact that majority of people living in these underdeveloped regions are uninsured, the expansion of the private sector may not contribute in reducing the inequalities in access to health care. In fact, it may widen the existing gap for access to health between high and low income earners in these underdeveloped regions.

  18. Why not? Understanding the spatial clustering of private facility-based delivery and financial reasons for homebirths in Nigeria.

    PubMed

    Wong, Kerry L M; Radovich, Emma; Owolabi, Onikepe O; Campbell, Oona M R; Brady, Oliver J; Lynch, Caroline A; Benova, Lenka

    2018-06-01

    In Nigeria, the provision of public and private healthcare vary geographically, contributing to variations in one's healthcare surroundings across space. Facility-based delivery (FBD) is also spatially heterogeneous. Levels of FBD and private FBD are significantly lower for women in certain south-eastern and northern regions. The potential influence of childbirth services frequented by the community on individual's barriers to healthcare utilization is under-studied, possibly due to the lack of suitable data. Using individual-level data, we present a novel analytical approach to examine the relationship between women's reasons for homebirth and community-level, health-seeking surroundings. We aim to assess the extent to which cost or finance acts as a barrier for FBD across geographic areas with varying levels of private FBD in Nigeria. The most recent live births of 20,467 women were georeferenced to 889 locations in the 2013 Nigeria Demographic and Health Survey. Using these locations as the analytical unit, spatial clusters of high/low private FBD were detected with Kulldorff statistics in the SatScan software package. We then obtained the predicted percentages of women who self-reported financial reasons for homebirth from an adjusted generalized linear model for these clusters. Overall private FBD was 13.6% (95%CI = 11.9,15.5). We found ten clusters of low private FBD (average level: 0.8, 95%CI = 0.8,0.8) and seven clusters of high private FBD (average level: 37.9, 95%CI = 37.6,38.2). Clusters of low private FBD were primarily located in the north, and the Bayelsa and Cross River States. Financial barrier was associated with high private FBD at the cluster level - 10% increase in private FBD was associated with + 1.94% (95%CI = 1.69,2.18) in nonusers citing cost as a reason for homebirth. In communities where private FBD is common, women who stay home for childbirth might have mild increased difficulties in gaining effective access to public care, or face an overriding preference to use private services, among other potential factors. The analytical approach presented in this study enables further research of the differentials in individuals' reasons for service non-uptake across varying contexts of healthcare surroundings. This will help better devise context-specific strategies to improve health service utilization in resource-scarce settings.

  19. Health Resources in a 200,000 Urban Indian Population Argues the Need for a Policy on Private Sector Health Services

    PubMed Central

    Furtado, Kheya Melo; Kar, Anita

    2014-01-01

    Background: There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. Objective: This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Materials and Methods: Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Results: Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Conclusions: Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals. PMID:24963226

  20. Health resources in a 200,000 urban Indian population argues the need for a policy on private sector health services.

    PubMed

    Furtado, Kheya Melo; Kar, Anita

    2014-04-01

    There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals.

  1. The private management of public hospitals.

    PubMed Central

    Rundall, T G; Lambert, W K

    1984-01-01

    Since the public sector traditionally has provided the public goods viewed as unprofitable by the private sector, the growing trend to manage public hospitals under outside private contract raises some fundamental issues of concern. It is hypothesized here that the system maintenance and output goals of privately managed public hospitals become increasingly similar to those of investor-owned hospitals. The thesis is empirically tested using documented effects of private contract management on the operative goals of short-term, general hospitals owned by local governmental bodies. Traditionally managed public hospitals matched with the study hospitals on important characteristics serve as the control group. Costs do appear to be reduced under private contract management, but the service structure becomes somewhat altered. It is the task of public health policymakers to reconcile the cost-control and efficiency mechanisms brought about by private management with the community's right of access to comprehensive medical care. Carefully structured regionalization plans--a possible means of providing both--will require the stimulation of more government involvement during an era of cutbacks. PMID:6490379

  2. Who are more responsive? Mixed-methods comparison of public and private sector physicians in rural Bangladesh.

    PubMed

    Joarder, Taufique; George, Asha; Sarker, Malabika; Ahmed, Saifuddin; Peters, David H

    2017-11-01

    Responsiveness of physicians (ROPs) reflects the social actions by physicians to meet the legitimate expectations of health care users. Responsiveness is important since it improves understanding and care seeking by users, as well as fostering trust in health systems rather than replicating discrimination and entrenching inequality. Given widespread public and private sector health care provision in Bangladesh, we undertook a mixed-methods study comparing responsiveness of public and private physicians in rural Bangladesh. The study included in-depth interviews with physicians (n = 12, seven public, five private) and patients (n = 7, three male, four female); focus group discussions with users (four sessions, two male and two female); and observations in consultation rooms of public and private sector physicians (1 week in each setting). This was followed by structured observation of patient consultations with 195 public and 198 private physicians using the ROPs Scale, consisting of five domains (Friendliness; Respecting; Informing and guiding; Gaining trust; and Financial sensitivity). Qualitative data were analysed by framework analysis and quantitative data were analyzed using two-sample t-test, multiple linear regression, multivariate analysis of variance, and descriptive discriminant analyses. The mean responsiveness score of public sector physicians was statistically different from private sector physicians: -0.29 vs 0.29, i.e. a difference of - 0.58 (P-value < 0.01; 95% CI - 0.77, -0.39) on a normalized scale. Despite relatively higher level of responsiveness of private sector, according to qualitative findings, neither of the sectors performed optimally. Private physicians scored higher in Friendliness, Respecting and Informing and guiding; while public sector physicians scored higher in other domains. 'Respecting' domain was found as the most important. Unlike findings from other studies in Bangladesh, instead of seeing one sector as better than the other, this study identified areas of responsiveness where each sector needs improvements. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Beneficiaries of conflict: a qualitative study of people’s trust in the private health care system in Mogadishu, Somalia

    PubMed Central

    Gele, Abdi A; Ahmed, Mohamed Yusuf; Kour, Prabhjot; Moallim, Sadiyo Ali; Salad, Abdulwahab Moallim; Kumar, Bernadette

    2017-01-01

    Background In 2005, the World Health Conference called for all nations to move toward universal health coverage, which is defined as “access to adequate health care for all at an affordable price”. Despite this, an estimated 90% of Somalia’s largely impoverished population use private health care. Therefore, considering that the private health care system is the dominant health care system in Mogadishu, Somalia, exploring the accessibility to, as well as people’s trust in, the private sector is essential to help contribute an equitable and affordable health care system in the country. Methods A qualitative study using unstructured interviews was conducted in Mogadishu from August to November of 2016. A purposive sampling approach was used to recruit 23 participants, including seven medical doctors who own private health centers, eight patients, five medical students and three senior officials who work for the Ministry of Health. Data were analyzed using a thematic analysis. Results Our findings show that the private health care system in Mogadishu is not only unregulated but also expensive, with the cost of health care often unaffordable for the majority of the country’s citizens. There is evidence of prescription of inappropriate treatment, tendency to conduct unnecessary laboratory tests, excessive use of higher diagnostic technologies and overcharging – including the widespread practice of further appointments for follow-up – which inflates the costs. The study also found poor patient–provider relationship and widespread distrust of the private health care system. Conclusion The study findings underline the need for the Somali government to develop regulatory mechanisms and guidelines with the potential to guide the private health care sector to provide equitable and affordable health care to people in Mogadishu. The doctor–patient relationship has been – and remains – a keystone of care; thus, there is an urgent need for guidelines for private health care providers to treat their patients with dignity and respect. The education system, particularly the syllabus used by medical faculties, should be reviewed and improved to provide medical students with necessary knowledge, skills and attitudes to maintain patient dignity and rights. PMID:28831275

  4. Challenges of medicines management in the public and private sector under Ghana's National Health Insurance Scheme - A qualitative study.

    PubMed

    Ashigbie, Paul G; Azameti, Devine; Wirtz, Veronika J

    2016-01-01

    Ghana established its National Health Insurance Scheme (NHIS) in 2003 with the goal of ensuring more equitable financing of health care to improve access to health services. This qualitative study examines the challenges and consequences of medicines management policies and practices under the NHIS as perceived by public and private service providers. This study was conducted in health facilities in the Eastern, Greater Accra and Volta regions of Ghana between July and August 2014. We interviewed 26 Key Informants (KIs) from a purposively selected sample of public and private sector providers (government and mission hospitals, private hospitals and private standalone pharmacies), pharmaceutical suppliers and NHIS district offices. Data was collected using semi-structured interview guides which covered facility accreditation, reimbursement practices, medicines selection, purchasing and pricing of medicines, and utilization of medicines. Codes for data analysis were developed based on the study questions and also in response to themes that emerged from the transcripts and notes. Most KIs agreed that the introduction of the NHIS has increased access to and utilization of medicines by removing cost barriers for patients; however, some pointed out the increased utilization could also be corollary to moral hazard. Common concerns across all facilities were the delays in receiving NHIS reimbursements, and low reimbursement rates for medicines which result in providers asking patients to pay supplementary fees. KIs reported important differences between private and public sectors including weak separation of prescribing and dispensing and limited use of drugs and therapeutic committees in the private sector, the disproportionate effects of unfavorable reimbursement prices for medicines, and inadequate participation of the private sector providers (especially pharmacies and licensed chemical sellers) in the NHIS. Health providers generally perceive the NHIS to have had a largely positive impact on access to medicines. However, concerns remain about equity in access to medicines and the differences in quality of pharmaceutical care delivered by private and public providers. Routine monitoring of medicines use during the implementation of health insurance schemes is important to identify and address the potential consequences of medicines policies and practices under the scheme.

  5. Beneficiaries of conflict: a qualitative study of people's trust in the private health care system in Mogadishu, Somalia.

    PubMed

    Gele, Abdi A; Ahmed, Mohamed Yusuf; Kour, Prabhjot; Moallim, Sadiyo Ali; Salad, Abdulwahab Moallim; Kumar, Bernadette

    2017-01-01

    In 2005, the World Health Conference called for all nations to move toward universal health coverage, which is defined as "access to adequate health care for all at an affordable price". Despite this, an estimated 90% of Somalia's largely impoverished population use private health care. Therefore, considering that the private health care system is the dominant health care system in Mogadishu, Somalia, exploring the accessibility to, as well as people's trust in, the private sector is essential to help contribute an equitable and affordable health care system in the country. A qualitative study using unstructured interviews was conducted in Mogadishu from August to November of 2016. A purposive sampling approach was used to recruit 23 participants, including seven medical doctors who own private health centers, eight patients, five medical students and three senior officials who work for the Ministry of Health. Data were analyzed using a thematic analysis. Our findings show that the private health care system in Mogadishu is not only unregulated but also expensive, with the cost of health care often unaffordable for the majority of the country's citizens. There is evidence of prescription of inappropriate treatment, tendency to conduct unnecessary laboratory tests, excessive use of higher diagnostic technologies and overcharging - including the widespread practice of further appointments for follow-up - which inflates the costs. The study also found poor patient-provider relationship and widespread distrust of the private health care system. The study findings underline the need for the Somali government to develop regulatory mechanisms and guidelines with the potential to guide the private health care sector to provide equitable and affordable health care to people in Mogadishu. The doctor-patient relationship has been - and remains - a keystone of care; thus, there is an urgent need for guidelines for private health care providers to treat their patients with dignity and respect. The education system, particularly the syllabus used by medical faculties, should be reviewed and improved to provide medical students with necessary knowledge, skills and attitudes to maintain patient dignity and rights.

  6. Differences in public and private sector adoption of telemedicine: Indian case study for sectoral adoption.

    PubMed

    Sood, Sanjay P; Negash, Solomon; Mbarika, Victor W A; Kifle, Mengistu; Prakash, Nupur

    2007-01-01

    Telemedicine is the use of communication networks to exchange medical information for providing healthcare services and medical education from one site to another. The application of telemedicine is more promising in economically developing countries with agrarian societies. The American Telemedicine Association (ATA) identifies three healthcare services: clinical medical services, health and medical education, and consumer health information. However, it is not clear how these services can be adopted by different sectors: public and private. This paper looks at four Indian case studies, two each in public and private sectors to understand two research questions: Are there differences in telemedicine adoption between public and private hospitals. If there are differences: What are the differences in telemedicine adoption between public and private sectors? Authors have used the extant literature in telemedicine and healthcare to frame theoretical background, describe the research setting, present the case studies, and provide discussion and conclusions about their findings. Authors believe that as India continues to develop its telemedicine infrastructures, especially with continued government support through subsidies to private telemedicine initiatives, its upward trend in healthcare will continue. This is expected to put India on the path to increase its life expectancy rates, especially for it rural community which constitute over 70% of its populace.

  7. Case management lessons from a public/private partnership to finance long-term care.

    PubMed

    Mahoney, K

    1992-01-01

    In June of 1987, Connecticut's State Task Force on Private and Public Responsibilities for Financing Long-Term Care for the Elderly released its final report. This Governor's Commission, concluding that neither the private nor the public sector had much short-term hope of solving this difficult problem alone, recommended the creation of a public/private partnership. As this partnership was forged, some unique insights were gained into the functions of case management. This case study shows how case management can help coordinate the private and public roles, but it also raises some research questions which must be tackled before case management can fulfill its promise to help stretch and conserve scarce resources.

  8. Analysis of Out Door Patients' Prescriptions According to World Health Organization (WHO) Prescribing Indicators Among Private Hospitals in Western India.

    PubMed

    Shelat, Prakash R; Kumbar, Shivaprasad Kalakappa

    2015-03-01

    Prescription is document through which doctor, patient and pharmacist are communicated. Many a times if these documents are not properly written or misinterpreted it can affect management of patients. WHO established prescribing indicators to analyse prescription and promoted rational use of drugs and better management of patients. To study the prescription pattern according to WHO prescribing indicators among private hospitals. The observational, prospective study carried out at different private hospitals at metro city in Western India to study the prescription pattern among private hospital. Study was conducted at different private hospitals of metro city. A total of 250 prescriptions of outdoor patients from various departments of private hospitals were collected for a period of three months (August to October) 2012 and evaluated. The study was analysed using Z-test. Patient details like age and gender was not written in all (100%) prescriptions. It was noticed that dose, direction of drug and duration of treatment was not completely written in 90%, 74% and 80% of prescriptions respectively. Abbreviations were used in all (100%) prescriptions. Doctor's medical registration number was mentioned in 0% prescriptions. Total 869 drugs were prescribed in 250 prescriptions. Average number of drug prescribed was 3.38±1.79 (Mean±SD). It was reported that Group II (3 to 4 encoutner) was significantly higher as compared to Group I (less than or equal to 2 encoutner) and Group III( more than four encounter). It was significantly (p<0.05) prescribed brand name prescriptions (93.33%) as compared to generic name prescriptions (6.7%). Percentage of encounter with antibiotics and injections was 54% and 18% respectively. Approximately 70% drugs were prescribed according to Essential Medicine List (EML) of State. Antibiotics accounted 30% of prescribed drugs which was significantly higher as compared to other group of prescribed drugs. Our study revealed that prescription errors were most commonly observed at private hospitals and antibiotics was commonly prescribed in private sector. Therefore, strict policy to good prescribing practice and strict antibiotic policy in outdoor patients are required to promote rational use of drugs.

  9. Technical quality of delivery care in private- and public-sector health facilities in Enugu and Lagos States, Nigeria.

    PubMed

    Hirose, Atsumi; Yisa, Ibrahim O; Aminu, Amina; Afolabi, Nathanael; Olasunmbo, Makinde; Oluka, George; Muhammad, Khalilu; Hussein, Julia

    2018-06-01

    Private-sector providers are increasingly being recognized as important contributors to the delivery of healthcare. Countries with high disease burdens and limited public-sector resources are considering using the private sector to achieve universal health coverage. However, evidence for the technical quality of private-sector care is lacking. This study assesses the technical quality of maternal healthcare during delivery in public- and private-sector facilities in resource-limited settings, from a systems and programmatic perspective. A summary index (the skilled attendance index, SAI), was used. Two-staged cluster sampling with stratification was used to select representative samples of case records in public- and private-sector facilities in Enugu and Lagos States, Nigeria. Information to assess criteria was extracted, and the SAI calculated. Linear regression models examined the relationship between SAI and the private and public sectors, controlling for confounders. The median SAI was 54.8% in Enugu and 85.7% in Lagos. The private for-profit sector's SAI was lower than and the private not-for-profit sector's SAI was higher than the public sector in Enugu [coefficient = -3.6 (P = 0.018) and 12.6 (P < 0.001), respectively]. In Lagos, the private for-profit sector's SAI was higher and the private not-for-profit sector's SAI was lower than the public sector [3.71 (P = 0.005) and -3.92 (P < 0.001)]. Results indicate that the technical quality of private for-profit providers' care was poorer than public providers where the public provision of care was weak, while private for-profit facilities provided better technical quality care than public facilities where the public sector was strong and there was a relatively strong regulatory body. Our findings raise important considerations relating to the quality of maternity care, the public-private mix and needs for regulation in global efforts to achieve universal healthcare.

  10. Engaging the private sector in malaria surveillance: a review of strategies and recommendations for elimination settings.

    PubMed

    Bennett, Adam; Avanceña, Anton L V; Wegbreit, Jennifer; Cotter, Chris; Roberts, Kathryn; Gosling, Roly

    2017-06-14

    In malaria elimination settings, all malaria cases must be identified, documented and investigated. To facilitate complete and timely reporting of all malaria cases and effective case management and follow-up, engagement with private providers is essential, particularly in settings where the private sector is a major source of healthcare. However, research on the role and performance of the private sector in malaria diagnosis, case management and reporting in malaria elimination settings is limited. Moreover, the most effective strategies for private sector engagement in malaria elimination settings remain unclear. Twenty-five experts in malaria elimination, disease surveillance and private sector engagement were purposively sampled and interviewed. An extensive review of grey and peer-reviewed literature on private sector testing, treatment, and reporting for malaria was performed. Additional in-depth literature review was conducted for six case studies on eliminating and neighbouring countries in Southeast Asia and Southern Africa. The private health sector can be categorized based on their commercial orientation or business model (for-profit versus nonprofit) and their regulation status within a country (formal vs informal). A number of potentially effective strategies exist for engaging the private sector. Conducting a baseline assessment of the private sector is critical to understanding its composition, size, geographical distribution and quality of services provided. Facilitating reporting, referral and training linkages between the public and private sectors and making malaria a notifiable disease are important strategies to improve private sector involvement in malaria surveillance. Financial incentives for uptake of rapid diagnostic tests and artemisinin-based combination therapy should be combined with training and community awareness campaigns for improving uptake. Private sector providers can also be organized and better engaged through social franchising, effective regulation, professional organizations and government outreach. This review highlights the importance of engaging private sector stakeholders early and often in the development of malaria elimination strategies.

  11. Staff retention after the privatization of township-village health centers: a case study from the Haimen City of East China.

    PubMed

    Huang, Jiayan; Shi, Lu; Chen, Yingyao

    2013-04-12

    Township-village health centers in rural areas play an important role in health service system in China. In East China's Jiangsu Province, the City of Haimen privatized all 25 township-village health centers in 2002. This study assesses the effect of privatization on staff retention among these health centers. This is a retrospective study based on 10-year administrative data from Haimen City. Three waves of administrative data were collected in 2000 (2 years before privatization), 2005 (3 years after privatization) and 2009 (7 years after privatization) for all health care providers in Haimen City, including 3 county hospitals, 6 central township health centers (CTHC) and 25 township-village health centers (TVHC). The effect of privatization on TVHCs' staff retention was evaluated in comparison with the other two types of health care providers. We conducted focus groups with people from Haimen Bureau of Health and various health care providers to help understand the context of these administrative statistics. Each township-village health centers had an average of 40 staff members before the privatization, and the majority of those staff members were their permanent staff. In 2005, three years after the privatization, a substantial amount of staff decrease (from 39.7 staff members per TVHC to 27.5 per TVHC) occurred in these township-village health centers. From 2000 to 2009, the total payroll in TVHCs decreased by almost 29%, while the number of their permanent staff members and nurses decreased by more than 40%. Among the two types of health care providers that did not go through a privatization, those central township health centers had no significant change on their payroll size during this period whereas the county hospitals' average payroll size actually increased by 20%, especially for the number of doctors. In addition, the average salary and caseload in TVHC showed similar decreasing trends from 2000 to 2009, while no such trends can be observed among the other two types of providers that did not undergo privatization. The privatization of township-village health center could have adverse effects on their staff retention, a phenomenon that occurs with a decrease in salary and caseload in these centers. To ensure that these health institutions keep providing health care for rural communities, a stronger social safety net and stronger financing of rural health insurance might be helpful in their staff retention.

  12. Staff retention after the privatization of township-village health centers: a case study from the Haimen City of East China

    PubMed Central

    2013-01-01

    Background Township-village health centers in rural areas play an important role in health service system in China. In East China’s Jiangsu Province, the City of Haimen privatized all 25 township-village health centers in 2002. This study assesses the effect of privatization on staff retention among these health centers. Methods This is a retrospective study based on 10-year administrative data from Haimen City. Three waves of administrative data were collected in 2000 (2 years before privatization), 2005 (3 years after privatization) and 2009 (7 years after privatization) for all health care providers in Haimen City, including 3 county hospitals, 6 central township health centers (CTHC) and 25 township-village health centers (TVHC). The effect of privatization on TVHCs’ staff retention was evaluated in comparison with the other two types of health care providers. We conducted focus groups with people from Haimen Bureau of Health and various health care providers to help understand the context of these administrative statistics. Results Each township-village health centers had an average of 40 staff members before the privatization, and the majority of those staff members were their permanent staff. In 2005, three years after the privatization, a substantial amount of staff decrease (from 39.7 staff members per TVHC to 27.5 per TVHC) occurred in these township-village health centers. From 2000 to 2009, the total payroll in TVHCs decreased by almost 29%, while the number of their permanent staff members and nurses decreased by more than 40%. Among the two types of health care providers that did not go through a privatization, those central township health centers had no significant change on their payroll size during this period whereas the county hospitals’ average payroll size actually increased by 20%, especially for the number of doctors. In addition, the average salary and caseload in TVHC showed similar decreasing trends from 2000 to 2009, while no such trends can be observed among the other two types of providers that did not undergo privatization. Conclusion The privatization of township-village health center could have adverse effects on their staff retention, a phenomenon that occurs with a decrease in salary and caseload in these centers. To ensure that these health institutions keep providing health care for rural communities, a stronger social safety net and stronger financing of rural health insurance might be helpful in their staff retention. PMID:23587296

  13. 'Waiting for' and 'waiting in' public and private hospitals: a qualitative study of patient trust in South Australia.

    PubMed

    Ward, Paul R; Rokkas, Philippa; Cenko, Clinton; Pulvirenti, Mariastella; Dean, Nicola; Carney, A Simon; Meyer, Samantha

    2017-05-05

    Waiting times for hospital appointments, treatment and/or surgery have become a major political and health service problem, leading to national maximum waiting times and policies to reduce waiting times. Quantitative studies have documented waiting times for various types of surgery and longer waiting times in public vs private hospitals. However, very little qualitative research has explored patient experiences of waiting, how this compares between public and private hospitals, and the implications for trust in hospitals and healthcare professionals. The aim of this paper is to provide a deep understanding of the impact of waiting times on patient trust in public and private hospitals. A qualitative study in South Australia, including 36 in-depth interviews (18 from public and 18 from private hospitals). Data collection occurred in 2012-13, and data were analysed using pre-coding, followed by conceptual and theoretical categorisation. Participants differentiated between experiences of 'waiting for' (e.g. for specialist appointments and surgery) and 'waiting in' (e.g. in emergency departments and outpatient clinics) public and private hospitals. Whilst 'waiting for' public hospitals was longer than private hospitals, this was often justified and accepted by public patients (e.g. due to reduced government funding), therefore it did not lead to distrust of public hospitals. Private patients had shorter 'waiting for' hospital services, increasing their trust in private hospitals and distrust of public hospitals. Public patients also recounted many experiences of longer 'waiting in' public hospitals, leading to frustration and anxiety, although they rarely blamed or distrusted the doctors or nurses, instead blaming an underfunded system and over-worked staff. Doctors and nurses were seen to be doing their best, and therefore trustworthy. Although public patients experienced longer 'waiting for' and 'waiting in' public hospitals, it did not lead to widespread distrust in public hospitals or healthcare professionals. Private patients recounted largely positive stories of reduced 'waiting for' and 'waiting in' private hospitals, and generally distrusted public hospitals. The continuing trust by public patients in the face of negative experiences may be understood as a form of exchange trust norm, in which institutional trust is based on base-level expectations of consistency and minimum standards of care and safety. The institutional trust by private patients may be understood as a form of communal trust norm, whereby trust is based on the additional and higher-level expectations of flexibility, reduced waiting and more time with healthcare professionals.

  14. Public and private pregnancy care in Reggio Emilia Province: an observational study on appropriateness of care and delivery outcomes.

    PubMed

    Bonvicini, Laura; Candela, Silvia; Evangelista, Andrea; Bertani, Daniela; Casoli, Morena; Lusvardi, Annarella; Messori, Antonella; Giorgi Rossi, Paolo

    2014-02-17

    In industrialized countries, improvements have been made in both maternal and newborn health. While attention to antenatal care is increasing, excessive medicalization is also becoming more common.The aim of this study is to compare caesarean section (CS) frequency and ultrasound scan utilization in a public model of care involving both midwives and obstetricians with a private model in which care is provided by obstetricians only. Observational population-based study. Reggio Emilia Province. 5957 women resident in the province who delivered between October 2010 and November 2011. CS frequency and ultrasound scan utilization, stillbirths, and other negative perinatal outcomes. Women in the study were searched in the public family and reproductive health clinic medical records to identify those cared for in the public system. Outcomes of the two antenatal care models were compared through multivariate logistic regression adjusting for maternal characteristics and, for CS only, by stratifying by Robson's Group. Compared to women cared for in private services (N = 3,043), those in public service (N = 2,369) were younger, less educated, more frequently non-Italian, and multiparous. The probability of CS was slightly higher for women cared for by private obstetricians than for those cared for in the public system (31.8% vs. 27.1%; adjusted odds ratio: 1.10; 95% CI: 0.93-1.29): The probability of having more than 3 ultrasound scans was higher in private care (89.6% vs. 49.8%; adjusted odds ratio: 5.11; 95% CI: 4.30-6.08). CS frequency was higher in private care for all Robson's classes except women who underwent CS during spontaneous labour. Among negative perinatal outcomes only a higher risk of pre-term birth was observed for pregnancies cared for in private services. The public model provides less medicalized and more guidelines-oriented care than does the private model, with no increase in negative perinatal outcomes.

  15. Curriculum Development Program in a Privately-Managed Public Preschool in Taiwan: Overcoming Difficulties and Establishing a Process Pattern

    ERIC Educational Resources Information Center

    Lin, Chia-Fen

    2016-01-01

    Preschool curriculum reform is currently underway in Taiwan. Privately-managed public preschools (PMPPs) currently play the role of bellwethers because they stand halfway between public and private preschools, and serve as testing grounds for curriculum reforms promoted by the government. This study originated from Curriculum Development Program…

  16. Using Institutional Selection Factors to Develop Recruiting Profiles: Marketing Small, Private Colleges and Universities to Prospective Student Athletes

    ERIC Educational Resources Information Center

    Johnson, Gary R.; Jubenville, Colby; Goss, Benjamin

    2009-01-01

    The purpose of this study was to identify important college choice factors for entering freshmen student athletes at small, private higher education institutions that compete in an National Association of Intercollegiate Athletics-member athletic conference representing small, private schools across the southeastern United States. Using Gabert,…

  17. An Exploratory Qualitative Study of Italian High School Students Who Receive Private Tutoring in Mathematics

    ERIC Educational Resources Information Center

    Rega, Andrea

    2012-01-01

    My purpose for this exploratory qualitative research was to gain insights into the perceptions of high school students in Italy who receive private tutoring in mathematics, about their experience and expectations. Little prior research from the perspective of the students has been conducted. Results suggest that some students use private tutoring…

  18. Private forest investment and long-run sustainable harvest volumes.

    Treesearch

    Ralph J. Alig; Darius M. Adams; John T. Chmelik; Pete Bettinger

    1999-01-01

    Private timberlands in the United States have the biological potential to provide larger quantities of timber on a sustainable basis than they do today. Most opportunities for increasing growth and harvest lie on nonindustrial private lands in the South. Past studies, based on fixed scenarios of future prices, also suggest that many of these opportunities for...

  19. Promoting High Quality Education at Small Private Universities: Leadership Challenges and Strategies

    ERIC Educational Resources Information Center

    Ngo, Kim Lien Thi

    2010-01-01

    The problem: The purpose of this study was to explore the characteristics, roles, and contributions of non-profit, small private universities to the overall quality of higher education in the United States, as well as leadership challenges and strategies in promoting a total quality education at small private higher education institutions. …

  20. Private Water Well Education for Adult Residents of Oklahoma

    ERIC Educational Resources Information Center

    Robbins, Sharon M.

    2012-01-01

    The scope of this study involved an investigation into the education of the adult residents of Oklahoma regarding private water wells. The groundwater supply for the private resident is directly connected to a shared water source. This source of water can become contaminated by simple lack of education and proper maintenance of the well. Without…

  1. External Affiliations and Diversity: Chile's Private Universities in International Perspective. PROPHE Working Paper Series. WP No. 4

    ERIC Educational Resources Information Center

    Bernasconi, Andres

    2004-01-01

    The expansion of private sectors of higher education has usually been regarded as a factor of diversification in higher education systems. Some of this differentiation has been associated, but without systematic study, to the affiliation of private institutions with organizations outside the field of higher education. This article reports the…

  2. 78 FR 36816 - U.S. Department of State Advisory Committee on Private International Law (ACPIL): Public Meeting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-19

    ... DEPARTMENT OF STATE [Public Notice 8358] U.S. Department of State Advisory Committee on Private International Law (ACPIL): Public Meeting of the Study Group on Family Law The Office of the Assistant Legal Adviser for Private International Law, Department of State, hereby gives notice of a public meeting of the...

  3. 77 FR 75696 - U.S. Department of State Advisory Committee on Private International Law (ACPIL): Public Meeting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-21

    ... DEPARTMENT OF STATE [Public Notice 8131] U.S. Department of State Advisory Committee on Private International Law (ACPIL): Public Meeting of the Study Group on Family Law The Office of the Assistant Legal Adviser for Private International Law, Department of State, hereby gives notice of a public meeting of the...

  4. The Debate of Evolution versus Intelligent Design: Is Critical Thinking Occurring among K-12 Students?

    ERIC Educational Resources Information Center

    Hoodman, Kyle Nathan

    2010-01-01

    This study investigates how evolution versus intelligent design is handled in the public, private Christian, private Jewish, and Christian Home-school K-12 settings through a review of the current literature and by interviewing teachers in these educational venues. Fourteen public, private, and homeschool educators responded to an interview…

  5. Procedural "Due Process" Remedies Available to Nontenured Faculty in Private Postsecondary Education in New England in 1979.

    ERIC Educational Resources Information Center

    Begin, Richard L.

    The status of judicial theory regarding private responsibility for granting procedural due process, and the extent to which policies in New England's private postsecondary institutions adhered to judicial requirements for due process in nontenured faculty terminations were studied. A review of the literature, research methodology, and definition…

  6. Comparative Study of Pupils' Academic Performance between Private and Public Primary Schools

    ERIC Educational Resources Information Center

    Adeyemi, Sunday B.

    2014-01-01

    This paper compares pupils' academic performance between the private and public primary schools. The sample, made up of 240 pupils were randomly selected from the private and public primary schools in Ilesa East and West Local Government Council Areas of Osun State, Nigeria. Two instruments were used. A structured questionnaire and Pupils'…

  7. Paying for Financial Expertise: Privatization Policies and Shifting State Responsibilities in the School Facilities Industry

    ERIC Educational Resources Information Center

    Rivera, Marialena D.

    2018-01-01

    In an era of expanding global educational privatization and shifting policies on how to fund educational facilities in many states in the US, this study engages the lenses of critical policy analysis and fiscal sociology to examine educational privatization in the school facilities industry in California. Employing critical policy document…

  8. University Entrepreneurship in a Developing Country: The Case of the P. Universidad Catolica de Chile, 1985-2000

    ERIC Educational Resources Information Center

    Bernasconi, Andres

    2005-01-01

    Privatization in higher education is usually understood either as the surge of private institutions or as universities' growing reliance on private sources of funding or otherwise operating more like firms. Joining the growing literature on university entrepreneurship, this is a case study on the less examined problem of entrepreneurial…

  9. Private University and Community College Strategic Alliances: The Case for Cooperation.

    ERIC Educational Resources Information Center

    Fincher, Mark

    2002-01-01

    Reviews the literature on community colleges and private universities, applying principles of strategic management to these environments. States that private universities have the flexibility to offer a specialized program of study at a premium price, while community colleges are better able to offer low-cost services to a large group of students.…

  10. Exploring a public-private partnership new-graduate physiotherapy recruitment program: a qualitative study.

    PubMed

    Schmidt, David; Dmytryk, Neil

    2014-12-01

    Difficulty in attracting allied health staff to rural areas is well known. In 2012, a small rural health facility and local private practice created an informal public-private partnership to recruit two new-graduate physiotherapists. Graduates were employed part-time in both the public and private sectors. This qualitative case study employed an appreciative enquiry framework to explore this partnership model. Three focus groups were held, and a combination of content and thematic analysis was used to derive and organise themes arising from the data. A regional public health service and private physiotherapy practice in the Bega Valley region of south-eastern New South Wales, Australia. New-graduate and second-year physiotherapists (n = 5), private sector managers (n = 3), and public sector managers (n = 4). Perceived benefits of the partnership model and improvements that could be made to further develop the model. Organisational benefits of a shared public-private role included the ability to attract high-quality applicants to difficult-to-fill positions, reduced the risk of new-graduate attrition due to social isolation, enhanced networking between sectors, and enhanced staff skill development through a broad range of clinical and non-clinical experiences. The model relied on management flexibility and has potential to expand to other areas and professions. Dedicated funding support, targeted recruitment strategies and increased planning to ease the transition into the workplace would further enhance the model. An informal public-private partnership to overcome established workforce shortages has proven successful to the benefit of the new graduates and both the public and private sectors. © 2014 National Rural Health Alliance Inc.

  11. Privatization of solid waste collection services: Lessons from Gaborone

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bolaane, Benjamin, E-mail: bolaaneb@mopipi.ub.bw; Isaac, Emmanuel, E-mail: eisaac300@gmail.com

    Highlights: • We compared efficiency and effectiveness of waste collection by the public and private sector. • Public sector performs better than private sector in some areas and vice versa. • Outsourcing waste collection in developing countries is hindered by limited capacity on contractual issues. • Outsourcing collection in developing countries is hampered by inadequate waste information. • There is need to build capacity in the public sector of developing countries to support outsourcing. - Abstract: Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste managementmore » experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process.« less

  12. How to create a public-private partnership: a replicable project associated with business continuity.

    PubMed

    Hahn, Daniel

    2010-07-01

    In an age of political turmoil and mistrust of governments, having an outlet for creative problem solving that involves all aspects of communities during disasters is critical. Additionally, there is a need for outlets that save taxpayer money for particular projects, such as road construction or infrastructure protection. Public-private partnerships are one way to accomplish these goals. Utilised correctly, a public-private partnership is a win-win situation for all participants. This paper will make the case for the continued support from all sectors for public-private partnerships. A description of public-private partnerships will be given to show the broad spectrum of opportunities for such a partnership. In addition, a case study of a public-private partnership called SAFER Santa Rosa is explored as the programme is oriented towards disasters, but keeps the community engaged all year round. Finally, an example is presented of an initiative that not only exemplifies the spirit of public-private partnerships, but has attracted international recognition because it is simple, replicable, cost-effective and valuable to both the private sector and the public sector. The Business Emergency Response Toolkit bag is a true public-private success story. It is hoped that the reader will be able to replicate the ideas discussed herein in their own community.

  13. Do elections matter for private-sector healthcare management in Brazil? An analysis of municipal health policy.

    PubMed

    McGregor, Alecia J; Siqueira, Carlos Eduardo; Zaslavsky, Alan M; Blendon, Robert J

    2017-07-12

    This study analyzed several political determinants of increased private-sector management in Brazilian health care. In Brazil, the poor depend almost exclusively on the public Unified Health System (the SUS), which remains severely underfunded. Given the overhead costs associated with privately contracted health services, increased private management is one driver of higher expenditures in the system. Although left parties campaign most vocally in support of greater public control of the SUS, the extent to which their stated positions translate into health care policy remains untested. Drawing on multiple publicly available data sources, we used linear regression to analyze how political party-in-power and existing private sector health care contracting affect the share of privately managed health care services and outsourcing in municipalities. Data from two election periods-2004 to 2008 and 2008 to 2012-were analyzed. Our findings showed that although private sector contracting varies greatly across municipalities, this variation is not systematically associated with political party in power. This suggests that electoral politics plays a relatively minor role in municipal-level health care administration. Existing levels of private sector management appear to have a greater effect on the public-private makeup of the Brazilian healthcare system, suggesting a strong role of path dependence in the evolution of Brazilian health care delivery. Despite campaign rhetoric asserting distinct positions on privatization in the SUS, factors other than political party in power have a greater effect on private-sector health system management at the municipal-level in Brazil. Given the limited effect of elections on this issue, strengthening participatory bodies such as municipal health councils may better enfranchise citizens in the fundamental debate over public and private roles in the health care sector.

  14. Strategies to Improve Private-Well Water Quality: A North Carolina Perspective

    PubMed Central

    Pieper, Kelsey J.

    2017-01-01

    Background: Evidence suggests that the 44.5 million U.S. residents drawing their drinking water from private wells face higher risks of waterborne contaminant exposure than those served by regulated community water supplies. Among U.S. states, North Carolina (N.C.) has the second-largest population relying on private wells, making it a useful microcosm to study challenges to maintaining private-well water quality. Objectives: This paper summarizes recommendations from a two-day summit to identify options to improve drinking-water quality for N.C. residents served by private wells. Methods: The Research Triangle Environmental Health Collaborative invited 111 participants with knowledge of private-well water challenges to attend the Summit. Participants worked in small groups that focused on specific aspects and reconvened in plenary sessions to formulate consensus recommendations. Discussion: Summit participants highlighted four main barriers to ensuring safe water for residents currently relying on private wells: (1) a database of private well locations is unavailable; (2) racial disparities have perpetuated reliance on private wells in some urbanized areas; (3) many private-well users lack information or resources to monitor and maintain their wells; and (4) private-well support programs are fragmented and lack sufficient resources. The Summit produced 10 consensus recommendations for ways to overcome these barriers. Conclusions: The Summit recommendations, if undertaken, could improve the health of North Carolinians facing elevated risks of exposure to waterborne contaminants because of their reliance on inadequately monitored and maintained private wells. Because many of the challenges in N.C. are common nationwide, these recommendations could serve as models for other states. https://doi.org/10.1289/EHP890 PMID:28728142

  15. A Comparative Evaluation of Public Health Centers with Private Health Training Centers on Primary Healthcare Parameters in India: a Study by Data Envelopment Analysis Technique

    PubMed Central

    Davey, Sanjeev; Raghav, Santosh Kumar; Singh, Jai Vir; Davey, Anuradha; Singh, Nirankar

    2015-01-01

    Background: The evaluation of primary healthcare services provided by health training centers of a private medical college has not been studied in comparison with government health facilities in Indian context. Data envelopment analysis (DEA) is one such technique of operations research, which can be used on health facilities for identifying efficient operating practices and strategies for relatively efficient or inefficient health centers by calculating their efficiency scores. Materials and Methods: This study was carried out by DEA technique by using basic radial models (constant ratio to scale (CRS)) in linear programming via DEAOS free online Software among four decision making units (DMUs; by comparing efficiency of two private health centers of a private medical college of India with two public health centers) in district Muzaffarnagar of state Uttar Pradesh. The input and output records of all these health facilities (two from private and two from Government); for 6 months duration from 1st Jan 2014 to 1st July 2014 was taken for deciding their efficiency scores. Results: The efficiency scores of primary healthcare services in presence of doctors (100 vs 30%) and presence of health staff (100 vs 92%) were significantly better from government health facilities as compared to private health facilities (P < 0.0001). Conclusions: The evaluation of primary healthcare services delivery by DEA technique reveals that the government health facilities group were more efficient in delivery of primary healthcare services as compared to private training health facilities group, which can be further clarified in by more in-depth studies in future. PMID:26435598

  16. Comparison of Responsiveness Level in Iranian Public and Private Physiotherapy Clinics: a Cross-Sectional Multi-center Study.

    PubMed

    Torabipour, Amin; Gharacheh, Laleh; Lorestani, Leila; Salehi, Reza

    2017-09-01

    Responsiveness is a main goal of health systems. Responsiveness focus on the non-medical aspects of health services delivery. This study was aimed to assess responsiveness level in public and private physiography clinics. In this multicenter cross sectional study, 403 patients refers to 16 public and 64 private physical therapy clinics were studied randomly in Ahvaz, Iran, from 2013 to 2014. Data were collected based on a valid health system responsiveness questionnaire that was developed by WHO. Health system responsiveness questionnaire for outpatients care includes seven components and 25 questions. Statistical relationship between responsiveness level of centers and patients characteristics was analyzed using Pearson coefficient, Independent t-test and one-way ANOVA. Out of 403 patients, 299 (74.19%) patients were women. The mean (±SD) age of the patients was 42(±14.18) years and 92.1% of patients were 65> years. Responsiveness status in private and public physiotherapy clinics was assessed excellent (26.93±5.2) and very well (21.08±5.8) respectively. In private clinics, the mean score of communication dimension (3.96±1) and autonomy dimension (3.95±0.9) was higher than other dimensions. In public clinics the mean score of dignity (3.30±0.8), autonomy (3.16±0.9), and prompt attention (3.12±1) was higher than other areas respectively. In public and private clinics, quality of basic amenities area had the lowest score. The results showed that the some patients and center characteristics such as gender and work shift were factors affecting assessment of responsiveness. Responsiveness level in private centers was better than publics.

  17. Assessment of knowledge about childhood autism among medical students from private and public universities in Karachi.

    PubMed

    Shaukat, Farah; Fatima, Ambreen; Zehra, Nosheen; Hussein, Mohammed Amirali Ghulam; Ismail, Ozair

    2014-11-01

    To assess the knowledge about childhood autism among fourth year medical students in public and private medical universities of a metropolitan city. The cross-sectional descriptive study was conducted in Karachi from January to August 2012. Two medical universities--one each from public and private sectors--were selected using non-probability convenience sampling technique. Fourth year medical students present at the time of data collection were included in the study. Data collection was done by Knowledge About Childhood Autism Among Health Worker questionnaire from fourth year medical students. Data was analysed using SPSS 20. Of the 157 students in the study, 62(39.6%) were males and 95(60.4%) were females; 84(43.5%) were from public medical university and 73(46.5%) were from private university. Total mean score obtained out of the maximum 25 was 12.30±4.71. The mean score obtained by public medical students was 12.40±4.69 and 12.1±4.76 by those of private university. The scores reflected shortcoming in knowledge about childhood autism among the study population. In order to bridge knowledge deficit, awareness-generation activities must be held more frequently.

  18. Just between us: Exclusive communications in online social networks.

    PubMed

    Carpenter, Jordan; Green, Melanie; Laflam, Jeff

    2018-01-01

    Social media websites such as Facebook are used for relationship development and maintenance often through self-disclosure and sharing of personal information. However, not all forms of social media communication may be equally suitable for this task. This paper explores users' norms about the appropriateness of using private vs. public Facebook messages to communicate different kinds of personal information, and the effectiveness of these types of communication in building relationships. Study 1, a survey, revealed that users endorse conflicting expectations about preferences for receiving information publicly or privately. Study 2, a field experiment testing the effects of private versus public Facebook communications on actual relationship development using participants' own Facebook pages, suggested that private messages lead to greater closeness.

  19. Assessing the Contributions of Private Health Facilities in a Pioneer Private-Public Partnership in Childhood Immunization in Nigeria

    PubMed Central

    Oluoha, Chukwuemeka; Ahaneku, Hycienth

    2014-01-01

    The vision of Nigeria’s immunization program is to reach and sustain routine immunization coverage of greater than 90% for all vaccines by 2020. In order to achieve this, Abia state embarked on a unique private-public partnership (PPP) between private health facilities and the Abia state ministry of health. The aim of this partnership was to collaborate with private health facilities to provide free childhood immunization services in the state - the first of its kind in Nigeria. This is a retrospective study of the 2011 Abia state, Nigeria monthly immunization data. In the 4 local governments operating the PPP, 45% (79/175) of the health facilities that offered immunization services in 2011 were private health facilities and 55% (96/175) were public health facilities. However, 21% of the immunization services took place in private health facilities while 79% took place in public health facilities. Private health facilities were shown to have a modest contribution to immunization in the 4 local governments involved in the PPP. Efforts should be made to expand PPP in immunization nationally to improve immunization services in Nigeria. PMID:28299112

  20. Private payer telehealth reimbursement in the United States.

    PubMed

    Antoniotti, Nina M; Drude, Kenneth P; Rowe, Nancy

    2014-06-01

    Significant information is available about government-reimbursed telehealth services such as Medicare and Medicaid across the United States. Although currently 20 states mandate reimbursement for telehealth services and some private insurers have voluntarily covered those services in other states, relatively little is known about telehealth provider experiences with reimbursement from private insurance payers. To investigate this, the American Telemedicine Association's (ATA's) Telemental Health Special Interest Group (SIG), the Policy Group, and the Business and Finance SIG, with the help of ATA staff, conducted a national private payer reimbursement online survey in 2012 using Survey Monkey™ (Palo Alto, CA) ( www.surveymonkey.com/ ). Survey responses were received from respondents in 46 of the 50 states. The survey found that telehealth services are being reimbursed by private payers but that progress in reimbursement has been relatively slow compared with earlier surveys. Key findings from this study were that government payers as well as several major private payers are highly influential in payment policies for telehealth private payers, that private payers have administrative rules regarding telehealth reimbursement that are barriers to services and reimbursement, and that some providers would benefit from being better informed about billing and coding for telehealth services and how to advocate for telehealth services reimbursement.

  1. Privatization and the allure of franchising: a Zambian feasibility study.

    PubMed

    Fiedler, John L; Wight, Jonathan B

    2003-01-01

    Efforts to privatize portions of the health sector have proven more difficult to implement than had been anticipated previously. One common bottleneck encountered has been the traditional organizational structure of the private sector, with its plethora of independent, single physician practices. The atomistic nature of the sector has rendered many privatization efforts difficult, slow and costly-in terms of both organizational development and administration. In many parts of Africa, in particular, the shortages of human and social capital, and the fragile nature of legal institutions, undermine the appeal of privatization. The private sector is left with inefficiencies, high prices and costs, and a reduced effective demand. The result is the simultaneous existence of excess capacity and unmet need. One potential method to improve the efficiency of the private sector, and thereby enhance the likelihood of successful privatization, is to transfer managerial technology--via franchising--from models that have proven successful elsewhere. This paper presents a feasibility analysis of franchizing the successful Bolivian PROSALUD system's management package to Zambia. The assessment, based on PROSALUD's financial model, demonstrates that technology transfer requires careful adaptation to local conditions and, in this instance, would still require significant external assistance.

  2. Dietary habits and physical activity levels in Jordanian adolescents attending private versus public schools.

    PubMed

    Tayyem, R F; Al-Hazzaa, H M; Abu-Mweis, S S; Bawadi, H A; Hammad, S S; Musaiger, A O

    2014-07-08

    The present study examined differences in dietary habits and physical activity levels between students attending private and public high schools in Jordan. A total of 386 secondary-school males and 349 females aged 14-18 years were randomly recruited using a multistage, stratified, cluster sampling technique. Dietary habits and physical activity level were self-reported in a validated questionnaire. The prevalence of obesity was significantly higher among adolescents in private (26.0%) than in public schools (16.7%). The frequency of breakfast intake was significantly higher among adolescents in private schools, whereas French fries and sweets intake was significantly higher in public schools. Television viewing showed a significant interaction with school type by sex. A higher rate of inactivity was found among students attending private schools. Despite a slightly better overall dietary profile for students in private schools, they had a higher rate of overweight and obesity compared with those in public schools.

  3. Characteristics of private partners in Chiranjeevi Yojana, a public-private-partnership to promote institutional births in Gujarat, India - Lessons for universal health coverage.

    PubMed

    Iyer, Veena; Sidney, Kristi; Mehta, Rajesh; Mavalankar, Dileep; De Costa, Ayesha

    2017-01-01

    The Chiranjeevi Yojana (CY) is a Public-Private-Partnership between the state and private obstetricians in Gujarat, India, since 2007. The state pays for institutional births of the most vulnerable households (below-poverty-line and tribal) in private hospitals. An innovative remuneration package has been designed to disincentivise unnecessary cesareans. This study examines characteristics of private facilities which participated in the program. We conducted a cross-sectional survey of all facilities which had conducted any births between June 2012 and April 2013 in three districts. We identified 111 private and 47 public facilities. Ninety of the 111 private facilities did caesarean sections in the last three months and were eligible to participate in the CY program. Of these, 40 (44%) participated in the CY program. We conducted descriptive and bivariate analyses followed by a Poisson regression model to estimate prevalence ratios of facility characteristics that predicted participation. We found that facilities participating in the CY program had a significantly higher likelihood of being general facilities (PR 1.9, 95% CI 1.3-2.9), or conducting lower proportion of cesarean births (PR 2.1, 95% CI 1.2-3.5) or having obstetricians new in private practice (PR 1.9, 95% CI 1.2-3.1) or being less expensive (PR 1.8, 95% CI 1.1-3.0). But none of these factors retained significance in a multi variable model. Private obstetricians who participate in the CY program tend to be new to private practice, provide general services, conduct fewer caesareans and are also less expensive. This is advantageous to the PPP and widens the target beneficiary groups that can be serviced by the PPP. The state should design remuneration packages with the aim of attracting relatively new obstetricians to set up practices in more remote areas. It is possible that the CY remuneration package design is effective in keeping caesarean rates in check, and needs to be studied further.

  4. High Blood Pressure among Students in Public and Private Schools in Maceió, Brazil.

    PubMed

    Ferreira, Haroldo S; Lúcio, Glícia Maris A; Assunção, Monica L; Silva, Bárbara Coelho V; Oliveira, Juliana S; Florêncio, Telma Maria M T; Geraldes, Amandio Aristides R; Horta, Bernardo L

    2015-01-01

    The prevalence of hypertension in childhood is increasing, and investigation of its distribution is important for planning timely interventions. This study assessed the prevalence of high blood pressure (HBP) and associated factors in students between 9 and 11 years of age enrolled in public and private schools in Maceió, Brazil. A cross-sectional study was performed in a probabilistic sample of students (10.3 ± 0.5 years). The students were selected from a systematic sampling of 80 schools (40 public and 40 private). To maintain similar proportions of students existing in public and private schools in Maceió, 21 and 14 students were randomly selected from each public and private school, respectively. The prevalence ratio (PR) was estimated using Poisson regression. A total of 1,338 students were evaluated (800 from public schools and 538 from private schools). No differences were observed between school types in terms of student age and gender (p > 0.05). The prevalence of obesity (19.9% vs. 9.0%; PR = 2.2; 95% CI = 1.67-2.92) and hypertension (21.2% vs. 11.4%; PR = 1.86; 95% CI = 1.45-2.40) were higher in private schools. The association between high blood pressure and type of school (public or private) remained statistically significant even after adjustment for obesity (PR = 1.53; 95% CI = 1.19-1.97). (a) students from private schools have higher socioeconomic status, BMI, and HBP prevalence compared to those of public school; (b) among the evaluated students, the prevalence of obesity only partially explained the higher prevalence of high blood pressure among students from private schools. Other factors related to lifestyle of children from private schools may explain the higher prevalence of HBP. This results show the need to implement measures to promote healthy lifestyles in the school environment, since children with HBP are more likely to become hypertensive adults. Therefore, early detection and intervention in children with HBP is an important action for the prevention of hypertension in adulthood.

  5. High Blood Pressure among Students in Public and Private Schools in Maceió, Brazil

    PubMed Central

    Ferreira, Haroldo S.; Lúcio, Glícia Maris A.; Assunção, Monica L.; Silva, Bárbara Coelho V.; Oliveira, Juliana S.; Florêncio, Telma Maria M. T.; Geraldes, Amandio Aristides R.; Horta, Bernardo L.

    2015-01-01

    The prevalence of hypertension in childhood is increasing, and investigation of its distribution is important for planning timely interventions. This study assessed the prevalence of high blood pressure (HBP) and associated factors in students between 9 and 11 years of age enrolled in public and private schools in Maceió, Brazil. A cross-sectional study was performed in a probabilistic sample of students (10.3 ± 0.5 years). The students were selected from a systematic sampling of 80 schools (40 public and 40 private). To maintain similar proportions of students existing in public and private schools in Maceió, 21 and 14 students were randomly selected from each public and private school, respectively. The prevalence ratio (PR) was estimated using Poisson regression. A total of 1,338 students were evaluated (800 from public schools and 538 from private schools). No differences were observed between school types in terms of student age and gender (p > 0.05). The prevalence of obesity (19.9% vs. 9.0%; PR = 2.2; 95% CI = 1.67–2.92) and hypertension (21.2% vs. 11.4%; PR = 1.86; 95% CI = 1.45–2.40) were higher in private schools. The association between high blood pressure and type of school (public or private) remained statistically significant even after adjustment for obesity (PR = 1.53; 95% CI = 1.19–1.97). In conclusion: (a) students from private schools have higher socioeconomic status, BMI, and HBP prevalence compared to those of public school; (b) among the evaluated students, the prevalence of obesity only partially explained the higher prevalence of high blood pressure among students from private schools. Other factors related to lifestyle of children from private schools may explain the higher prevalence of HBP. This results show the need to implement measures to promote healthy lifestyles in the school environment, since children with HBP are more likely to become hypertensive adults. Therefore, early detection and intervention in children with HBP is an important action for the prevention of hypertension in adulthood. PMID:26599324

  6. Comparison of the capacity between public and private health facilities to manage under-five children with febrile illnesses in Uganda.

    PubMed

    Buregyeya, Esther; Rutebemberwa, Elizeus; LaRussa, Phillip; Lal, Sham; Clarke, Sîan E; Hansen, Kristian S; Magnussen, Pascal; Mbonye, Anthony K

    2017-05-02

    Public health facilities are usually the first to receive interventions compared to private facilities, yet majority of health seeking care is first done with the latter. This study compared the capacity to manage acute febrile illnesses in children below 5 years in private vs public health facilities in order to design interventions to improve quality of care. A survey was conducted within 57 geographical areas (parishes), from August to October 2014 in Mukono district, central Uganda. The survey comprised both facility and health worker assessment. Data were collected on drug stocks, availability of treatment guidelines, diagnostic equipment, and knowledge in management of malaria, pneumonia and diarrhoea, using a structured questionnaire. A total of 53 public and 241 private health facilities participated in the study. While similar proportions of private and public health facilities stocked Coartem, the first-line anti-malarial drug, (98 vs 95%, p = 0.22), significantly more private than public health facilities stocked quinine (85 vs 53%, p < 0.01). Stocks of obsolete anti-malarial drugs, such as chloroquine, were reported in few public and private facilities (3.7 vs 12.5%, p = 0.06). Stocks of antibiotics-amoxycillin and gentamycin were similar in both sectors (≥90% for amoxicillin; ≥50 for gentamycin). Training in malaria was reported by 65% of public health facilities vs 56% in the private sector, p = 0.25), while, only 21% in the public facility and 12% in the private facilities, p = 0.11, reported receiving training in pneumonia. Only 55% of public facilities had microscopes. Malaria treatment guidelines were significantly lacking in the private sector, p = 0.01. Knowledge about first-line management of uncomplicated malaria, pneumonia and diarrhoea was significantly better in the public facilities compared to the private ones, though still sub-optimal. Deficiencies of equipment, supplies and training exist even in public health facilities. In order to significantly improve the capacity to handle acute febrile illness among children under five, training in proper case management, availability of supplies and diagnostics need to be addressed in both sectors.

  7. Public perception of drinking water from private water supplies: focus group analyses

    PubMed Central

    Jones, Andria Q; Dewey, Catherine E; Doré, Kathryn; Majowicz, Shannon E; McEwen, Scott A; Waltner-Toews, David; Henson, Spencer J; Mathews, Eric

    2005-01-01

    Background Over four million Canadians receive their drinking water from private water supplies, and numerous studies report that these supplies often exceed the minimal acceptable standards for contamination. Canadians in rural areas test their water intermittently, if at all, and treatment of water from private supplies is not common. Understanding the perceptions of drinking water among residents served by private systems will enable public health professionals to better target education and outreach activities, and to address the needs and concerns of residents in their jurisdictions. The purpose of this study was to explore the drinking water perceptions and self-described behaviours and needs of participants served by private water systems in the City of Hamilton, Ontario (Canada). Methods In September 2003, three focus group discussions were conducted; two with men and women aged 36–65 years, and one with men and women 20–35 years of age. Results Overall, participants had positive perceptions of their private water supplies, particularly in the older age group. Concerns included bacterial and chemical contamination from agricultural sources. Testing of water from private supplies was minimal and was done less frequently than recommended by the provincial government. Barriers to water testing included the inconvenience of the testing process, acceptable test results in the past, resident complacency and lack of knowledge. The younger participants greatly emphasized their need for more information on private water supplies. Participants from all groups wanted more information on water testing, and various media for information dissemination were discussed. Conclusion While most participants were confident in the safety of their private water supply, the factual basis for these opinions is uncertain. Improved dissemination of information pertaining to private water supplies in this population is needed. Observed differences in the concerns expressed by users of different water systems and age groups may suggest the need for targeted public education strategies. These focus groups provided significant insight into the public perception of private water supplies and the need for public health outreach activities; however, to obtain a more representative understanding of the perceptions in this population, it is important that a larger scale investigation be performed. PMID:16336678

  8. Public perceptions of drinking water: a postal survey of residents with private water supplies

    PubMed Central

    Jones, Andria Q; Dewey, Catherine E; Doré, Kathryn; Majowicz, Shannon E; McEwen, Scott A; David, Waltner-Toews; Eric, Mathews; Carr, Deborah J; Henson, Spencer J

    2006-01-01

    Background In Canada, the legal responsibility for the condition of private water supplies, including private wells and cisterns, rests with their owners. However, there are reports that Canadians test these water supplies intermittently and that treatment of such water is uncommon. An estimated 45% of all waterborne outbreaks in Canada involve non-municipal systems. An understanding of the perceptions and needs of Canadians served by private water supplies is essential, as it would enable public health professionals to better target public education and drinking water policy. The purpose of this study was to investigate the public perceptions of private water supplies in the City of Hamilton, Ontario (Canada), with the intent of informing public education and outreach strategies within the population. Methods A cross-sectional postal survey of 246 residences with private water supplies was conducted in May 2004. Questions pertained to the perceptions of water quality and alternative water sources, water testing behaviours and the self-identified need for further information. Results Private wells, cisterns or both, were the source of household water for 71%, 16% and 13% of respondents, respectively. Although respondents rated their water quality highly, 80% also had concerns with its safety. The most common concerns pertained to bacterial and chemical contamination of their water supply and its potential negative effect on health. Approximately 56% and 61% of respondents used in-home treatment devices and bottled water within their homes, respectively, mainly due to perceived improvements in the safety and aesthetic qualities compared to regular tap water. Testing of private water supplies was performed infrequently: 8% of respondents tested at a frequency that meets current provincial guidelines. Two-thirds of respondents wanted more information on various topics related to private water supplies. Flyers and newspapers were the two media reported most likely to be used. Conclusion Although respondents rated their water quality highly, the majority had concerns regarding the water from their private supply, and the use of bottled water and water treatment devices was extensive. The results of this study suggest important lines of inquiry and provide support and input for public education programs, particularly those related to private water testing, in this population. PMID:16608511

  9. Women, Capitalism and Feminisation: Workers' Experiences in Private and Non-Profit Childcare Centres.

    ERIC Educational Resources Information Center

    Nuttall, J. G.

    Research indicates that staff in non-profit child care centers, compared to those in private centers, tend to receive higher wages, express greater job satisfaction and commitment, and are better trained and more experienced in child care. This study presents results of a survey of 32 staff members in 2 private and 3 non-profit centers in New…

  10. The High Return to Private Schooling in a Low-Income Country. Africa Growth Initiative. Working Paper 5

    ERIC Educational Resources Information Center

    Bold, Tessa; Kimenyi, Mwangi; Mwabu, Germano; Sandefur, Justin

    2013-01-01

    Existing studies from the United States, Latin America and Asia provide scant evidence that private schools dramatically improve academic performance relative to public schools. Using data from Kenya--a poor country with weak public institutions--we find a large effect of private schooling on test scores, equivalent to one full standard deviation.…

  11. SEMATECH, A Case Study: Analysis of a Government-Industry Partnership

    DTIC Science & Technology

    1993-09-23

    profit potential in the private market. Often, public sector technologies do not. Commercial technologies must be technically and economically...and Private Spending .................. 80 ix I. INTRODUCTION AND BACKGROUND Critics proclaim the Semiconductor Manufacturing Technology Initiative...in the R&D market and in the product market." (Katz and Ordover, 1990, p. 150) Technological spillovers result primarily from private R&D investment

  12. From Scratch to Notch: Understanding Private Tutoring Metamorphosis in the Philippines from the Perspectives of Cram School and Formal School Administrators

    ERIC Educational Resources Information Center

    de Castro, Belinda V.; de Guzman, Allan B.

    2014-01-01

    Although there is considerable anecdotal evidence that the scale of private tutoring is substantial in the Philippines, attempts to document its existence is limited. Using phenomenological inquiry, this study aimed to provide a more eidetic portrait of private tutoring transformation in the Philippines from the perspectives and collective…

  13. Fundraising Practices of the University of California, the California State University, and California Private Universities

    ERIC Educational Resources Information Center

    Karsevar, Kent J.

    2012-01-01

    Factors such as a declining tax revenues and an underperforming economy have been justifying the need for additional external private funding to meet the increasing needs of a growing California higher education system and ethnically diverse student body. The purpose of this study was to examine ways in which California private higher education…

  14. Transformational Leadership Characteristics of College and University Presidents of Private, Title III and Title V-Eligible Institutions

    ERIC Educational Resources Information Center

    Hempowicz, Christine D.

    2010-01-01

    The purpose of this study was to investigate the transformational leadership characteristics of college and university presidents of private Title III and Title V-eligible institutions. Private institutions of higher education comprise approximately half of the total post-secondary institutions in the U.S. However, they are at greater risk for…

  15. Private Tutoring in Eastern Europe and Central Asia: Policy Choices and Implications

    ERIC Educational Resources Information Center

    Silova, Iveta

    2010-01-01

    Private tutoring has become increasingly visible in Eastern Europe and Central Asia since the collapse of the socialist bloc in the early 1990s. Yet, this unprecedented growth of private tutoring, in its varied forms and arrangements, has remained largely unnoticed by policymakers in the region. Based on the data from the cross-national studies of…

  16. The Impact of Private Schools on Educational Attainment in the State of São Paulo

    ERIC Educational Resources Information Center

    Stern, Jonathan M. B.

    2015-01-01

    This study uses a comprehensive dataset on secondary school students in Brazil to examine the impact of private school enrollment on educational attainment in São Paulo. The results show that private school students (across all levels of tuition) perform better than their public school counterparts on Brazil's high school exit exam, even after…

  17. On the Public-Private School Achievement Debate. Faculty Research Working Papers Series

    ERIC Educational Resources Information Center

    Peterson, Paul E.; Llaudet, Elena

    2006-01-01

    On July 14, 2006, the U. S. Department of Education's National Center for Education Statistics (NCES) released a study that compared the performance in reading and math of 4th and 8th-graders attending private and public schools. Using information from a nationwide, representative sample of public and private school students collected in 2003 as…

  18. Negotiating between Family, Peers and School: Understanding the World of Government School and Private School Students

    ERIC Educational Resources Information Center

    Sucharita, V.

    2014-01-01

    The present paper, based on an ethnographic study of a government school and a low-cost private school in Andhra Pradesh, India, argues that the students of a government school and a private school have two different worlds and are socialised differently. As children progress from childhood to adolescence, the transition is accompanied by…

  19. A Comparison of SERVQUAL and I-P Analysis: Measuring and Improving Service Quality in Egyptian Private Universities

    ERIC Educational Resources Information Center

    Mostafa, Mohamed M.

    2006-01-01

    The overall purpose of this research is to further our understanding of how students perceive service quality in Egypt's private universities. The paper also tests the SERVQUAL dimensions in higher education within an Arab, non-Western context. A sample of 508 students from four private universities in Egypt participated in the study. Student…

  20. Private College Mergers and State Policy: A Case Study of New York. State Policy and Private College Distress.

    ERIC Educational Resources Information Center

    Chambers, Gail S.

    The regulation of the college merger process in New York, including its effects on a recent merger between private institutions, is examined. New York's higher education policy formation process and the laws and policies that make college mergers possible are considered. The merger of Eisenhower College and Rochester Institute of Technology…

  1. Comparing School-Level to Private Higher Education: Using the Dominican Republic as a Pioneer Study. PROPHE Working Paper Series. WP No. 8

    ERIC Educational Resources Information Center

    Mendoza, Ancell Scheker

    2007-01-01

    This working paper reviews concepts and categories developed in private higher education research, analyzing their applicability to lower levels of education. Most specifically and prominently, the paper uses the three waves of private growth identified in Latin American higher education--Catholic, elite, and demand-absorbing--and categories of…

  2. Private Prayer and Optimism in Middle-Aged and Older Patients Awaiting Cardiac Surgery

    ERIC Educational Resources Information Center

    Ai, Amy L.; Peterson, Christopher; Bolling, Steven F.; Koenig, Harold

    2002-01-01

    Purpose: This study investigated the use of private prayer among middle-aged and older patients as a way of coping with cardiac surgery and prayer's relationship to optimism. Design and Methods: The measure of prayer included three aspects: (a) belief in the importance of private prayer, (b) faith in the efficacy of prayer on the basis of previous…

  3. The "Big Bang" in Public and Private Faculty Salaries

    ERIC Educational Resources Information Center

    Rippner, Jennifer A.; Toutkoushian, Robert K.

    2015-01-01

    The gap between average faculty salaries at public and private institutions has been growing wider over the past 40 years, yet little is known about the nature and causes of the gap. This study uses data on more than 1,000 institutions to examine institutional average faculty salaries and how they have changed for public and private institutions.…

  4. Patterns and Correlates of Tic Disorder Diagnoses in Privately and Publicly Insured Youth

    ERIC Educational Resources Information Center

    Olfson, Mark; Crystal, Stephen; Gerhard, Tobias; Huang, Cecilia; Walkup, James T.; Scahill, Lawrence; Walkup, John T.

    2011-01-01

    Objective: This study examined the prevalence and demographic and clinical correlates of children diagnosed with Tourette disorder, chronic motor or vocal tic disorder, and other tic disorders in public and private insurance plans over the course of a 1-year period. Method: Claims were reviewed of Medicaid (n = 10,247,827) and privately (n =…

  5. Students' Attitudes toward Campus Environment: A Comparative Study of Public and Private Universities in Kenya

    ERIC Educational Resources Information Center

    Chepchieng, Micah C.; Kiboss, Joel K.; Sindabi, Aggrey; Kariuki, Mary W.; Mbugua, Stephen N.

    2006-01-01

    One of the serious problems facing education in Kenya's public universities has been a persistent student disturbance. Private universities on the other hand, seem to have established a reputation of having minimal incidence of student disturbances. As such private universities are known to have had a good record of student conduct. This may be…

  6. Accelerated Christian Education: A Case Study of the Use of Race in Voucher-Funded Private Christian Schools

    ERIC Educational Resources Information Center

    Scaramanga, Jonny; Reiss, Michael J.

    2018-01-01

    President Donald Trump has promised an expansion of voucher programs for private schools in the United States. Private Christian schools are likely beneficiaries of such an expansion, but little research has been conducted about the curricula they use or their suitability for public funds. This article describes and critiques the depiction of race…

  7. Strengthening the Strength of Public-Private Partnership Model in Education: A Case Study of Durbar High School in Nepal

    ERIC Educational Resources Information Center

    Rajbhandari, Mani Man Singh

    2011-01-01

    Public-Private Partnership (PPP) model in education is being importantly valuable in developing countries in enriching the strength pf public schools that government appears to be heavy and slow. PPP model however, initiate developmental program that encourage teachers motivation to teach. This further allows private and local community group…

  8. Family Business/Entrepreneurial Studies: A Small Private Liberal Arts College Approach

    ERIC Educational Resources Information Center

    Bledsoe, M. Tony

    2004-01-01

    The Center for Women's Business Research reports that, "As of 2002, there are an estimated 10.1 million privately-held majority or 50% women-owned businesses in the U.S., accounting for 46% of all privately-held firms. These firms generate $2.3 trillion in sales and employ 18.2 million workers." Further it states, "In North…

  9. Private Higher Education in Africa: The Case of Monash South Africa

    ERIC Educational Resources Information Center

    Setswe, G.

    2013-01-01

    The aim of this paper was to review the contribution of private institutions to higher education in Africa and use Monash South Africa as a case study. A literature search was conducted to gain perspective on the current situation with respect to private higher education institutions in Africa and how they are perceived in relation to public…

  10. Does Private School Competition Improve Public School Performance? The Case of Nepal

    ERIC Educational Resources Information Center

    Thapa, Amrit

    2013-01-01

    Using data from the survey of the Ministry of Education, Nepal-2005 for school leaving certificate (SLC) exam, this paper attempts to estimate the impact of private school competition on public school performance for the case of Nepal. The study uses the number of private schools in the neighborhood as a measure of competition. The identification…

  11. Examination of cyberbullying experiences among Turkish students from different school types.

    PubMed

    Topçu, Cigdem; Erdur-Baker, Ozgür; Capa-Aydin, Yeşim

    2008-12-01

    The purpose of this study was to examine the nature of cyberbullying experiences among public and private school students in Turkey. One hundred eighty-three participants between the ages of 14 and 15 were recruited for the study. Participants were asked to respond to questionnaires measuring demographic information, usage frequency of Internet-mediated communication tools (IMCT), and cyberbullying experience (as a victim and as a bully). Participants who reported cyberbullying victimization were also asked how they felt and whether they sought help after such experiences. Results indicated that public school students were more likely than private school students to report being cyberbullies and cybervictims despite that private school students were more likely than public school students to report more frequent usage of IMCT. The findings of the logistic regression analyses indicated that usage frequency of IMCT was a significant predictor of cyberbullying/victimization for public school students but not for private school students. While victims from private school revealed that they did not mind the cyberbullying experience because they thought it was a joke, victims from public school reported that they felt angry when they experienced cyberbullying. Both public and private schools indicated that friends were their first choice for help.

  12. Health characteristics associated with gaining and losing private and public health insurance: a national study.

    PubMed

    Jerant, Anthony; Fiscella, Kevin; Franks, Peter

    2012-02-01

    Millions of Americans lack or lose health insurance annually, yet how health characteristics predict insurance acquisition and loss remains unclear. To examine associations of health characteristics with acquisition and loss of private and public health insurance. Prospective observational analysis of 2000 to 2007 Medical Expenditure Panel Survey data for persons aged 18 to 63 on entry, enrolled for 2 years. We modeled year 2 private and public insurance gain and loss. year 2 insurance status [none (reference), any private insurance, or public insurance] among those uninsured in year 1 (N=13,022), and retaining or losing coverage in year 2 among those privately or publicly insured in year 1 (N=47,239). age, sex, race/ethnicity, education, income, region, urbanity, health status, health conditions, year 1 health expenditures, year 1 and 2 employment status, and (in secondary analyses) skepticism toward medical care and insurance. In adjusted analyses, lower income and education were associated with not gaining and with losing private insurance. Poorer health status was associated with public insurance gain. Smoking and being overweight were associated with not gaining private insurance, and smoking with losing private coverage. Secondary analyses adjusting for medical skepticism yielded similar findings. Social disadvantage and poorer health status are associated with gaining public insurance, whereas social advantage, not smoking, and not being overweight are associated with gaining private insurance, even when adjusting for attitudes toward medical care. Private insurers seem to benefit from relatively low health risk selection.

  13. Treatment practices in pulmonary tuberculosis by private sector physicians of Meerut, Uttar Pradesh.

    PubMed

    Yadav, A; Garg, S K; Chopra, H; Bajpai, S K; Bano, T; Jain, S; Kumar, A

    2012-01-01

    Majority of the qualified medical practitioners in the country are in the private sector and more than half of patients with tuberculosis (TB) seek treatment from them. The present study was conducted with the objective of assessing the treatment modalities in pulmonary tuberculosis by the private physicians in Meerut City, Uttar Pradesh, India. A cross-sectional study was carried out covering all the private physicians (graduates and postgraduates in Medicine and Chest Diseases) registered under the Indian Medical Association, Meerut Branch (n = 154). The physicians were interviewed by a pre-designed and pre-tested questionnaire about the treatment modalities practiced by them. Only 43.5% private physicians had attended any Revised National Tuberculosis Control Programme (RNTCP) training in the past five years. Only 33.1% of them were aware of the International Standards of Tuberculosis Care (ISTC). Fifty-three different regimens were used to treat the patients. Majority of physicians (76%) prescribed daily regimens while 24% administered both daily and intermittent treatment. None of the private physicians prescribed exclusive intermittent regimen. Eighty-seven different treatment regimens were used for the treatment of multidrug-resistant TB (MDR-TB) with none of them prescribing standard treatment under RNTCP. As majority of private practitioners do not follow RNTCP guidelines for treating TB, there is an urgent need for their continued education in this area.

  14. The role of private developers in local infrastructure provision in Malaysia

    NASA Astrophysics Data System (ADS)

    Salleh, Dani; Okinono, Otega

    2016-08-01

    Globally, the challenge of local infrastructure provision has attracted much debate amongst different nations including Malaysia, on how to achieve an effective and efficient infrastructural management. This approach therefore, has intensified the efforts of local authorities in incorporating private developers in their developmental agenda in attaining a sustainable infrastructural development in local areas. Basically, the knowledge of the need for adequate provision of local infrastructure is well understood by both local and private authorities. Likewise, the divergent opinions on the usage of private delivery services. Notwithstanding the common perception, significant loopholes have been identified on the most appropriate and ideal approach and practices to adopt in enhancing local infrastructure development. The study therefore examined the role of private developers in local infrastructure provision and procedure adopted by both local authorities and the privates sector in local infrastructure development. Data was obtained using the questionnaire through purposive sampling, administered to 22 local authorities and 16 developers which was descriptively analysed. Emanating from the study findings, the most frequently approved practices by local authorities are joint venture and complete public delivery systems. Likewise, negotiation was identified as a vital tool for stimulating the acquisition of local infrastructure provision. It was also discovered the one of the greatest challenge in promoting private sector involvement in local infrastructure development is due to unregulated-procedure. The study therefore recommends, there is need for local authorities to adopt a collective and integrated approach, nevertheless, cognisance and priority should be given to developing a well-structured and systematic process of local infrastructure provision and development.

  15. Distribution of physical therapists working on public and private establishments in different levels of complexity of health care in Brazil.

    PubMed

    Costa, Larissa R; Costa, José L R; Oishi, Jorge; Driusso, Patricia

    2012-01-01

    The Brazilian Health System is organized on a regional and hierarchical form with three levels of complexity of health care. The Primary Care represents the first element of a continuing health care process, complemented by specialized actions. However, the centrality of the specialized care is still a problem in Brazil, especially in the private sector. Studies on the distribution of professionals in the health system allowing the formulation of appropriate policies are needed. To investigate the distribution of physical therapists in the levels of complexity of health care and between public and private establishments, according to data from the National Register of Health Service Providers (NRHSP). A descriptive cross-sectional study was performed considering NRHSP-national bank data collected in March 2010 and demographic census 2010 data. Data were analyzed through descriptive statistics techniques. We identified 53,181 registries of physical therapists, 60% linked to the private sector. Only 13% of all entries were linked to primary care. The predominance in specialized care occurred in the public sector (65%) and private sector (100%). The specialized establishments of private sector linked to the southeast region (16,043) were the main sites of physical therapists. Only the public sector in the south had a majority in the Primary Care. When considering the sizes of the cities, there is focus on specialist care in bigger cities. This study identified the concentration of physical therapists in the specialized care, mostly in metropolis and big cities and in the private sector, with restricted to participation in the primary care.

  16. Lost opportunity cost of surgical training in the Australian private sector.

    PubMed

    Aitken, R James

    2012-03-01

    To meet Australia's future demands, surgical training in the private sector will be required. The aim of this study was to estimate the time and lost opportunity cost of training in the private sector. A literature search identified studies that compared the operation time required by a supervised trainee with a consultant. This time was costed using a business model. In 22 studies (34 operations), the median operation duration of a supervised trainee was 34% longer than the consultant. To complete a private training list in the same time as a consultant list, one major case would have to be dropped. A consultant's average lost opportunity cost was $1186 per list ($106,698 per year). Training in rooms and administration requirements increased this to $155,618 per year. To train 400 trainees in the private sector to college standards would require 54,000 training lists per year. The consultants' national lost opportunity cost would be $137 million per year. The average lost hospital case payment was $5894 per list, or $330 million per year nationally. The total lost opportunity cost of surgical training in the private sector would be about $467 million per year. When trainee salaries, other specialties and indirect expenses are included, the total cost will be substantially greater. It is unlikely that surgeons or hospitals will be prepared to absorb these costs. There needs to be a public debate about the funding implications of surgical training in the private sector. © 2012 The Author. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  17. [Study of public and private hospital care on a population basis, 1986-1996].

    PubMed

    Rocha, J S; Simões, B J

    1999-02-01

    The last decade saw the creation and implementation of the Brazilian National Health System (NHS)--public, universal and equalitarian--with the objective of offering wide coverage to meet the population's health needs. The objective of the study was the assessment of the evolution of public and private hospital care on a populational basis during the period of the implementation of the NHS. The 984,142 inpatients of the general hospitals of Ribeirão Preto, Brazil, during the period 1986 to 1996 were studied and those of them living in their own municipal district were selected. The inpatients are classified according to the financing system as private, pre-payment and NHS; the social situation of the patients and the profile of hospital morbidity are analysed. In the period studied a continuous growth in the number of hospitalizations is observed, both in absolute numbers and in coefficient per thousand inhabitants, increasing from 43,773 to 55,844 inpatients per year. Though when the categories of the hospitalizations are studied, it is seen that private inpatients present a reduction both in absolute numbers and as a coefficient from 3,181 (7.3%) to 2,215 (3.9%); the NHS inpatients decrease in absolute numbers and in a percentage by a third at the end of the period--falling from 33,254 (76.0%) to 29,373 (51.7%). On the other hand the pre-payment inpatient system triplicates in absolute numbers and duplicates by rate for inhabitant--from 7,338 (16.8%) to 25,256 (44.4%). The NHS hospital care attends mainly unskilled and semi-skilled manual workers; the professionals, technicians, non manual and skilled manual workers being assisted by the private services. The hospital morbidity of NHS inpatients is different from that of the private inpatient systems. The health policy in that period, limiting NHS financing, repressing demand and discouraging the private providers to work with NHS inpatients led to negative selectivity. The result was an increase in difference between standards of care as between the public and private services.

  18. Trends in cataract surgical rate and resource utilisation in Egypt.

    PubMed

    Elbieh, Islam; Bascaran, Covadonga; Blanchet, Karl; Foster, Allen

    2018-06-08

    To describe cataract services in Egypt and explore resources and practices in public and private sectors. The study was conducted between June and August 2015. All facilities in the country providing cataract services were contacted to obtain information on surgeries performed in 2014. Hospitals performing eye surgery in Quena, Sharkia, and Fayoum regions were visited and a questionnaire on resources for cataract surgery was completed. Cataract surgery was offered in the public sector by 64 government and 16 university teaching hospitals and in the private sector by 101 hospitals. Over 90% of all facilities in the country contacted participated in the study. In 2014, the national cataract surgical rate (CSR) was 3674 varying in governorates from 7579 in Ismailia to 402 in Suez. The private sector performed 70% of cataract surgeries. Analysis of three regions showed an 11.7% increase in cataract output between 2010 and 2014. The average number of cataract surgeries per unit in 2014 was 2272 in private, 1633 in university, and 824 in government hospitals. Private hospitals had 60% of human resources for eye care. Phacoemulsification was the surgical technique in 85.6% of private, 72.1% of university, and 41% of government hospitals. Reasons explaining the differences in output between public and private sectors were the lack of trainers, supervisors, and incentives. The private sector provides most of the cataract services in Egypt, resulting in inadequate services for the poor. There is a 15-fold variation in CSR between the best and least served regions. The public sector could increase cataract output by improving training, supervision, and incentives.

  19. Job attitudes and well-being among public vs. private physicians: organizational justice and job control as mediators.

    PubMed

    Heponiemi, Tarja; Kuusio, Hannamaria; Sinervo, Timo; Elovainio, Marko

    2011-08-01

    The present study examined whether there are differences in job-related attitudes and well-being among physicians working in private sector and public sector. In addition, we examined whether psychosocial factors (organizational justice and job control) could mediate these possible differences in different sectors. Cross-sectional survey data from the Finnish Health Professional Study was used. A random sample of Finnish physicians included 1522 women and 1047 men aged 25-65 years. Outcome variables were job satisfaction, organizational commitment, psychological distress, work ability and sleeping problems. Job control and organizational justice were measured using established questionnaires. Series of regression analyses were performed and the mediational effects were tested following the procedures outlined by Baron and Kenny. Physicians working in private sector had higher levels of job satisfaction and organizational commitment and lower levels of psychological distress and sleeping problems when compared with physicians working in public sector. Private physicians also had higher levels of organizational justice, which acted as a mediator behind more positive attitudes and better well-being in private sector. Private physicians had higher levels of job control but it did not act as a mediator. Private physicians feel better than public physicians and this is partly due to higher organizational justice in private sector. Public health care organizations should invest effort to increase the fairness in their organizations and management and pay more attention in improving the well-being of their employees, which could possibly increase the attractiveness of public sector as a career option.

  20. Private sector surgical training: feasibility through the lens of appendicectomy.

    PubMed

    Yap, Raymond; Cullinan, Mark

    2017-12-01

    Training in medicine and surgery has been a public hospital responsibility in Australia. Increasing specialist training needs has led to pressure on speciality societies to find additional training posts, with one utilized solution being the establishment of private hospital training. This growing use has been despite no previously published evaluations of private hospital training in Australia. This article seeks to evaluate the feasibility of surgical training in private hospitals in appendicectomy. Data were prospectively collected on registrar involvement in appendicectomy cases at a single private tertiary institution over 1 year. These data were divided into groups according to registrar involvement and analysed, looking at training caseload, operating theatre time and complications. A total of 122 cases were analysed over the study period. Registrars were more likely to have increased primary operator responsibility if they were an accredited versus unaccredited registrar (P = 0.04) and if the case was open versus laparoscopic (P < 0.001). There was an increase of 15% in total procedure time when the registrar was involved (P = 0.04). There was no significant difference in complications whether the registrar was involved or not. Training in the private sector in Australia appears feasible, with a small loss of efficiency and no increase in complications. This article hopes to further encourage implementation and evaluation of private sector training programs to expand current training positions. Further studies, in different specialty and procedural domains, are needed to assess and evaluate the ongoing feasibility of private sector training. © 2016 Royal Australasian College of Surgeons.

  1. Analysis of Policy Issues Relating to Public Investment in Private Freight Infrastructure

    DOT National Transportation Integrated Search

    1999-12-01

    The Norman Y. Mineta International Institute for Surface Transportation Policy Studies (IISTPS) at San Josi State University conducted this study to review the issues and implications involved in the investment of public funds in private freight infr...

  2. Evaluating the role of private investment in infrastructure assets.

    DOT National Transportation Integrated Search

    2015-10-01

    Public Private Partnership (P3) projects are likely to fundamentally impact entire : transportation systems. However, most studies are focused on system modeling rather than : policy analysis, and few studies have examined the impacts of P3s on real-...

  3. Lo que Piensan los Estudiantes y Profesores Sobre la Calidad de la Educacion Superior. Estudio Comparativo en 5 Instituciones de Educacion Superior--dos publicas y tres privadas--en Guadalajara, Jalisco, Mexico (What Students and Faculties Think about the Quality of Higher Education. Comparative Study of 5 Higher Education Institutions--Two Public and Three Private--in Guadalajara, Jalisco, Mexico).

    ERIC Educational Resources Information Center

    Yanez, Maria Lorena Hernandez

    This study, written in Spanish, compared attitudes of students (N=302) and faculty (N=28) at five institutions of higher education (two public and three private) in Guadalajara, Jalisco, Mexico. The study explored first, whether respondents believed there are significant quality differences between private and public universities and, second, what…

  4. What are the similarities and differences in structure and function among the three main models of community health centers in China: a systematic review.

    PubMed

    Li, Haitao; Qian, Dongfu; Griffiths, Sian; Chung, Roger Yat-Nork; Wei, Xiaolin

    2015-11-10

    There are three major models of primary care providers (Community Health Centers, CHCs) in China, i.e., government managed, hospital managed and privately owned CHCs. We performed a systematic review of structures and health care delivery patterns of the three models of CHCs. Studies from relevant English and Chinese databases for the period of 1997-2011 were searched. Two independent researchers extracted data from the eligible studies using a standardized abstraction form. Methodological quality of included articles was assessed with the Mixed Methods Appraisal Tool (MMAT). A total of 13 studies was included in the final analysis. Compared with the other two models, private CHCs had a smaller health workforce and lower share of government funding in their total revenues. Private CHCs also had fewer training opportunities, were less recognized by health insurance schemes and tended to provide primary care services of poor quality. Hospital managed CHCs attracted patients through their higher quality of clinical care, while private CHCs attracted users through convenience and medical equipment. Our study suggested that government and hospital managed CHCs were more competent and provided better primary care than privately owned CHCs. Further studies are warranted to comprehensively compare performances among different models of CHCs.

  5. Linking private, for-profit providers to public sector services for HIV and tuberculosis co-infected patients: A systematic review.

    PubMed

    Hudson, Mollie; Rutherford, George W; Weiser, Sheri; Fair, Elizabeth

    2018-01-01

    Tuberculosis (TB) is the leading cause of infectious disease deaths worldwide and is the leading cause of death among people with HIV. The World Health Organization (WHO) has called for collaboration between public and private healthcare providers to maximize integration of TB/HIV services and minimize costs. We systematically reviewed published models of public-private sector diagnostic and referral services for TB/HIV co-infected patients. We searched PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Science Direct, CINAHL and Web of Science. We included studies that discussed programs that linked private and public providers for TB/HIV concurrent diagnostic and referral services and used Review Manager (Version 5.3, 2015) for meta-analysis. We found 1,218 unduplicated potentially relevant articles and abstracts; three met our eligibility criteria. All three described public-private TB/HIV diagnostic/referral services with varying degrees of integration. In Kenya private practitioners were able to test for both TB and HIV and offer state-subsidized TB medication, but they could not provide state-subsidized antiretroviral therapy (ART) to co-infected patients. In India private practitioners not contractually engaged with the public sector offered TB/HIV services inconsistently and on a subjective basis. Those partnered with the state, however, could test for both TB and HIV and offer state-subsidized medications. In Nigeria some private providers had access to both state-subsidized medications and diagnostic tests; others required patients to pay out-of-pocket for testing and/or treatment. In a meta-analysis of the two quantitative reports, TB patients who sought care in the public sector were almost twice as likely to have been tested for HIV than TB patients who sought care in the private sector (risk ratio [RR] 1.98, 95% confidence interval [CI] 1.88-2.08). However, HIV-infected TB patients who sought care in the public sector were marginally less likely to initiate ART than TB patients who sought care from private providers (RR 0.89, 95% CI 0.78-1.03). These three studies are examples of public-private TB/HIV service delivery and can potentially serve as models for integrated TB/HIV care systems. Successful public-private diagnostic and treatment services can both improve outcomes and decrease costs for patients co-infected with HIV and TB.

  6. Private healthcare quality: applying a SERVQUAL model.

    PubMed

    Butt, Mohsin Muhammad; de Run, Ernest Cyril

    2010-01-01

    This paper seeks to develop and test the SERVQUAL model scale for measuring Malaysian private health service quality. The study consists of 340 randomly selected participants visiting a private healthcare facility during a three-month data collection period. Data were analyzed using means, correlations, principal component and confirmatory factor analysis to establish the modified SERVQUAL scale's reliability, underlying dimensionality and convergent, discriminant validity. Results indicate a moderate negative quality gap for overall Malaysian private healthcare service quality. Results also indicate a moderate negative quality gap on each service quality scale dimension. However, scale development analysis yielded excellent results, which can be used in wider healthcare policy and practice. Respondents were skewed towards a younger population, causing concern that the results might not represent all Malaysian age groups. The study's major contribution is that it offers a way to assess private healthcare service quality. Second, it successfully develops a scale that can be used to measure health service quality in Malaysian contexts.

  7. Public-private sector partnership in household waste management as perceived by residents in south-west Nigeria.

    PubMed

    Ezebilo, Eugene E; Animasaun, Emmanuel D

    2012-08-01

    In most developing countries public-private sector partnership is becoming increasingly applied in household waste management service delivery especially in urban areas to reduce cost and improve effectiveness. This paper reports a study of householders' perceptions of public-private sector partnership in provision of household waste management services in Ilorin, south-west Nigeria. A multistage random sampling technique was used to select 224 households for the study. The data generated from the survey were analysed using a binary logit model. The results show that most of the respondents were of the opinion that the public-private partnership has not been able to improve household waste management services. Time taken to visit solid waste collection point, income and marital status negatively influenced their perceptions, while activities of sanitary inspectors, occupation and gender had positive influence. The public-private partnership will be more effective and sustainable if the public sector could pay more attention to performance monitoring and accountability.

  8. Start Later, Sleep Later: School Start Times and Adolescent Sleep in Homeschool Versus Public/Private School Students.

    PubMed

    Meltzer, Lisa J; Shaheed, Keisha; Ambler, Devon

    2016-01-01

    Homeschooled students provide a naturalistic comparison group for later/flexible school start times. This study compared sleep patterns and sleep hygiene for homeschooled students and public/private school students (grades 6-12). Public/private school students (n = 245) and homeschooled students (n = 162) completed a survey about sleep patterns and sleep hygiene. Significant school group differences were found for weekday bedtime, wake time, and total sleep time, with homeschooled students waking later and obtaining more sleep. Homeschooled students had later school start times, waking at the same time that public/private school students were starting school. Public/private school students had poorer sleep hygiene practices, reporting more homework and use of technology in the hour before bed. Regardless of school type, technology in the bedroom was associated with shorter sleep duration. Later school start times may be a potential countermeasure for insufficient sleep in adolescents. Future studies should further examine the relationship between school start times and daytime outcomes, including academic performance, mood, and health.

  9. Investigating risk factors of traffic casualties at private highway-railroad grade crossings in the United States.

    PubMed

    Haleem, Kirolos

    2016-10-01

    Private highway-railroad grade crossings (HRGCs) are intersections of highways and railroads on roadways that are not maintained by a public authority. Since no public authority maintains private HRGCs, fatal and injury crashes at these locations are of concern. However, no study has been conducted at private HRGCs to identify the safety issues that might exist and how to alleviate them. This study identifies the significant predictors of traffic casualties (including both injuries and fatalities) at private HRGCs in the U.S. using six years of nationwide crashes from 2009 to 2014. Two levels of injury severity were considered, injury (including fatalities and injuries) and no injury. The study investigates multiple predictors, e.g., temporal crash characteristics, geometry, railroad, traffic, vehicle, and environment. The study applies both the mixed logit and binary logit models. The mixed logit model was found to outperform the binary logit model. The mixed logit model revealed that drivers who did not stop, railroad equipment that struck highway users, higher train speeds, non-presence of advance warning signs, concrete road surface type, and cloudy weather were associated with an increase in injuries and fatalities. For example, a one-mile-per-hour higher train speed increases the probability of fatality by 22%. On the contrary, male drivers, PM peak periods, and presence of warning devices at both approaches were associated with a fatality reduction. Potential strategies are recommended to alleviate injuries and fatalities at private HRGCs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. An Exploratory Study of the Implementation of Computer Technology in an American Islamic Private School

    ERIC Educational Resources Information Center

    Saleem, Mohammed M.

    2009-01-01

    This exploratory study of the implementation of computer technology in an American Islamic private school leveraged the case study methodology and ethnographic methods informed by symbolic interactionism and the framework of the Muslim Diaspora. The study focused on describing the implementation of computer technology and identifying the…

  11. Academic Probation: An Empirical Study of Private University Students

    ERIC Educational Resources Information Center

    Ahmed, Jashim Uddin; Chowdhury, Md. Humayun Kabir; Rahman, Sheehan; Talukder, A. K. M. Mominul Haque

    2014-01-01

    This study examines the factors contributing to academic probation in university settings and highlights the problems that students encounter in higher education institutions in Bangladesh. The study focused on students facing academic probation on two private universities in Bangladesh and analyzed students' response with respect to nine…

  12. Directory of Accredited Private Home Study Schools, 1971.

    ERIC Educational Resources Information Center

    National Home Study Council, Washington, DC.

    This directory of accredited private home study schools lists 152 schools which have met the following standards set by the National Home Study Council: competent faculty; educationally sound and up-to-date courses; careful screening of students for admission; satisfactory educational services; demonstration of ample student success and…

  13. Directory of Accredited Private Home Study Schools, 1970.

    ERIC Educational Resources Information Center

    National Home Study Council, Washington, DC.

    This directory of accredited private home study schools lists 137 schools which have met the following standards set by the National Home Study Council: competent faculty; educationally sound and up-to-date courses; careful screening of students for admission; satisfactory educational services; demonstration of ample student success and…

  14. Self-Monitoring of Attained Subgoals in Private Study.

    ERIC Educational Resources Information Center

    Morgan, Mark

    1985-01-01

    Three conditions of self-monitoring of private study were compared for their effects on academic performance and intrinsic motivation. In end-of-year examinations, a group who self-monitored subgoals outperformed groups who self-monitored either time or study or distal goals on the target course of the investigation. (Author/LMO)

  15. Role of the private sector in vaccination service delivery in India: evidence from private-sector vaccine sales data, 2009-12.

    PubMed

    Sharma, Abhishek; Kaplan, Warren A; Chokshi, Maulik; Zodpey, Sanjay P

    2016-09-01

    India's Universal Immunization Programme (UIP) provides basic vaccines free-of-cost in the public sector, yet national vaccination coverage is poor. The Government of India has urged an expanded role for the private sector to help achieve universal immunization coverage. We conducted a state-by-state analysis of the role of the private sector in vaccinating Indian children against each of the six primary childhood diseases covered under India's UIP. We analyzed IMS Health data on Indian private-sector vaccine sales, 2011 Indian Census data and national household surveys (DHS/NFHS 2005-06 and UNICEF CES 2009) to estimate the percentage of vaccinated children among the 2009-12 birth cohort who received a given vaccine in the private sector in 16 Indian states. We also analyzed the estimated private-sector vaccine shares as function of state-specific socio-economic status. Overall in 16 states, the private sector contributed 4.7% towards tuberculosis (Bacillus Calmette-Guérin (BCG)), 3.5% towards measles, 2.3% towards diphtheria-pertussis-tetanus (DPT3) and 7.6% towards polio (OPV3) overall (both public and private sectors) vaccination coverage. Certain low income states (Uttar Pradesh, Rajasthan, Madhya Pradesh, Orissa, Assam and Bihar) have low private as well as public sector vaccination coverage. The private sector's role has been limited primarily to the high income states as opposed to these low income states where the majority of Indian children live. Urban areas with good access to the private sector and the ability to pay increases the Indian population's willingness to access private-sector vaccination services. In India, the public sector offers vaccination services to the majority of the population but the private sector should not be neglected as it could potentially improve overall vaccination coverage. The government could train and incentivize a wider range of private-sector health professionals to help deliver the vaccines, especially in the low income states with the largest birth cohorts. We recommend future studies to identify strengths and limitations of the public and private health sectors in each Indian state. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Advanced psychiatric nurse practitioners' ideas and needs for supervision in private practice in South Africa.

    PubMed

    Temane, Annie M; Poggenpoel, Marie; Myburgh, Chris P H

    2014-04-07

    Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field. The aim of this study was to explore and describe advanced psychiatric nursepractitioners' ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa. A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch's method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature. The data analysis generated the following themes - that the supervisor should have or possess: (a) professional competencies, (b) personal competencies and (c) specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa. This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.

  17. The Evolution of Private Plans in Medicare.

    PubMed

    Patel, Yash M; Guterman, Stuart

    2017-12-01

    Since the 1980s, private plans have played an increasingly important role in the Medicare program. While initially created with the goals of reducing costs, improving choice, and enhancing quality, risk-based plans--now known as Medicare Advantage plans--have undergone significant policy changes since their inception; these changes have not always aligned with the original policy objectives. To examine major policy changes to Medicare risk plans and the effects of these policies on plan participation, enrollment, average premiums and cost-sharing, total costs to Medicare, and quality of care. Review of key policy documents, reports, position statements, and academic studies. Private plans have changed considerably since their introduction into Medicare. Enrollment has risen to 33 percent of all Medicare beneficiaries; 99 percent of beneficiaries have access to private plans in 2017. Recent policies have improved risk-adjustment methods, rewarded plans’ performance on quality of care, and reduced average payments to private plans to 100 percent of traditional Medicare spending. As enrollment in private plans continues to grow and as health care costs rise, policymakers should enhance incentives for private plans to meet intended goals for higher-quality care at lower cost.

  18. Barriers to use of oral rehydration salts for child diarrhea in the private sector: evidence from India.

    PubMed

    Wagner, Zachary; Shah, Manan; Sood, Neeraj

    2015-02-01

    Diarrhea is the second leading cause of child mortality in India. Most deaths are cheaply preventable with the use of oral rehydration salts (ORS), yet many health providers still fail to provide ORS to children seeking diarrheal care. In this study, we use survey data to assess whether children visiting private providers for diarrheal care were less likely to use ORS than those visiting public providers. Results suggest that children who visited private providers were 9.5 percentage points less likely to have used ORS than those who visited public providers (95% CI 5-14). We complimented these results with in-depth interviews of 21 public and 17 private doctors in Gujarat, India, assessing potential drivers of public-private disparities in ORS use. Interview results suggested that lack of direct medication dispensing in the private sector might be a key barrier to ORS use in the private sector. © The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. [The private vaccines market in Brazil: privatization of public health].

    PubMed

    Temporão, José Gomes

    2003-01-01

    The main objective of this article is to analyze the vaccines market in Brazil, which is characterized as consisting of two segments with distinct practices and logics: the public segment, focused on supply within the Unified National Health System (SUS) and the private segment, organized around private clinics, physicians' offices, and similar private health facilities. The private vaccines market segment, studied here for the first time, is characterized in relation to the supply and demand structure. Historical aspects of its structure are analyzed, based on the creation of one of the first immunization clinics in the country. The attempt was to analyze this segment in relation to its economic dimensions (imports and sales), principal manufacturers, and products marketed. It economic size proved much greater than initially hypothesized. The figures allow one to view it as one of the main segments in the pharmaceutical industry in Brazil as measured by sales volume. One detects the penetration of a privatizing logic in a sphere that has always been essentially public, thereby introducing into the SUS a new space for disregarding the principles of equity and universality.

  20. Enhancing the private provision of care through premiums for ability: the case of tuberculosis care in the Philippines.

    PubMed

    Quimbo, Stella Alabastro

    2006-11-01

    This paper examines how premiums for ability are set and how these can enhance the quality of care provided in private markets. The specific context for this study is the market for tuberculosis (TB) care in the Philippines. While the most cost- and clinically-effective treatment method known as TB Directly Observed Treatment Short Course (TB DOTS) is increasingly being provided by the public sector, few private doctors have adopted this protocol. As findings of multivariate regression analyses of private physicians' fees suggest, this low adoption rate can be partly explained by the modest premiums private doctors receive for using TB DOTS. While the public provision of TB DOTS should be pursued in earnest, this paper argues that the complementarity between public and private provision of TB DOTS should be strengthened, especially since Filipino TB patients seem to prefer private doctors. This goal can be achieved through user fees that (i) include a sufficiently large premium for physician ability and (ii) are paid through the social insurance system. Copyright (c) 2006 John Wiley & Sons, Ltd.

  1. A comparison of private and public dental students' perceptions of extramural programming.

    PubMed

    Ayers, Curt S; Abrams, Richard A; McCunniff, Michael D; Goldstein, Benjamin R

    2003-04-01

    This project was undertaken to compare the opinions of private and public dental school students' perceptions concerning extramural programming, which is defined as any aspect of the curriculum in which undergraduate dental students provide dental care outside the main dental facility. A survey instrument was used to collect data from undergraduate students at a private (N = 267; 88.4 percent response rate) and at a public (N = 213; 67.2 percent response rate) dental school. When asked to rate the value of various extramural sites in making them a better dentist, both groups rated private dental offices the most valuable and prisons the least valuable. When questioned about the amount of time students should spend each year in extramural programming, private students, overall, desired 34 percent more time than did public students. When asked what percentage of the total time spent in extramural programming students should spend providing various categories of dental care, public school students thought 26 percent more time should be spent rendering preventive services/health education than did the private students. The private students indicated a stronger desire (13 percent more) for rendering clinical services than did public students. Both private and public students were most likely to enter group private practice after graduation. The increasing interest in community-based programs makes the information gained from this study useful for future curriculum planning.

  2. Private dental visits per dentist in Spain from 1987 to 1997. An analysis from the Spanish national Health Interview Surveys.

    PubMed

    Bravo, Manuel

    2002-10-01

    In view of the sharp increase in the number of dentists in Spain, the aim of the present study was to analyse changes in the private dentist workload in Spain over the period 1987-97. Data were taken from censuses of the population and of dental practitioners, and from the Spanish National Health Interview Surveys. The percentage of people that had visited the dentist in the 3 months prior to the survey was calculated, and of these, the percentage whose last visit was private. The total number of visits made by those people was taken as the estimate of total private visits in Spain during 3 months. Total private activity in 1 year was derived by multiplying this estimate by four. Annual private activity was then divided by the number of dentists. From 1987 to 1997, the Spanish population grew 2.5% (from 38.7 to 39.7 million) and the number of dentists increased by 136.1% (from 6373 to 15,044). The total annual number of private dental visits (+/-SE) was 35.7 +/- 1.0 million in 1987, and 48.9 +/- 2.0 million in 1997 - a 36.8% increase. Thus, the mean number of private dental visits per dentist decreased 42.0% (from 5610 +/- 152 to 3251 +/- 133). A significant reduction in private dental visits per dentist is taking place in Spain.

  3. The change in capacity and service delivery at public and private hospitals in Turkey: A closer look at regional differences

    PubMed Central

    2010-01-01

    Background Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services. This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Methods Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Results Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. Conclusions The private health sector has grown enormously between 2001-2006 in Turkey including the less developed regions of the country. Given the fact that majority of people living in these underdeveloped regions are uninsured, the expansion of the private sector may not contribute in reducing the inequalities in access to health care. In fact, it may widen the existing gap for access to health between high and low income earners in these underdeveloped regions. PMID:21040539

  4. An assessment on the trustworthiness of engineers in higher tertiary institutions

    NASA Astrophysics Data System (ADS)

    Ooi Kuan, Tan; Lloyd, Ling; Mou Chuan, Cheng

    2017-10-01

    In Malaysian higher education history, the evolution from public funded to private funded and now to private non profit oriented model has been taking place since 80s. The evolution also demarcated higher learning institution into academic or research based university. As such, postgraduate studies became increasingly competitive in students intake. The evolution also created doubt to the public in term of the quality of postgraduate education offered by different classifications. This study investigates the gender specific perception and trustworthiness of engineering postgraduate students in private non profit oriented higher tertiary institution. An equally divided gender groups of 118 respondents were chosen for the study. Non-parametric statistics were used and the result showed that there was no difference and no correlation of genders in perception on teaching role and trustworthiness among the future engineers in private non profit oriented higher tertiary institution.

  5. Issues in the Empirical Study of Private Speech: A Response to Frawley and Lantolf's Commentary.

    ERIC Educational Resources Information Center

    Diaz, Rafael M.

    1986-01-01

    Responds to W. Frawley's and J. Lantolf's comments on the Frauenglass and Diaz study concerning the interaction between private speech and cognition. Argues that Vygotsky's theory predicts a positive effect on children's problem solving activity. (HOD)

  6. Adherence to malaria diagnosis and treatment guidelines among healthcare workers in Ogun State, Nigeria.

    PubMed

    Bamiselu, Oluyomi F; Ajayi, IkeOluwapo; Fawole, Olufunmilayo; Dairo, David; Ajumobi, Olufemi; Oladimeji, Abisola; Steven, Yoon

    2016-08-19

    Malaria case management remains a vital component of malaria control strategies. Despite the introduction of national malaria treatment guidelines and scale-up of malaria control interventions in Nigeria, anecdotal evidence shows some deviations from the guidelines in malaria case management. This study assessed factors influencing adherence to malaria diagnosis and treatment guidelines among healthcare workers in public and private sectors in Ogun State, Nigeria. A comparative cross-sectional study was carried out among 432 (216 public and 216 private) healthcare workers selected from nine Local Government Areas using a multistage sampling technique. A pre-tested interviewer administered questionnaire was used to collect information on availability and use of malaria Rapid Diagnostic Test (mRDT) and artemisinin combination therapy (ACT), for management of uncomplicated malaria. Adherence was defined as when choice of antimalarials for parasitological confirmed malaria cases was restricted to recommended antimalarial medicines. Association between adherence and independent variables were tested using Chi-square at 5 % level of significance. Malaria RDT was available in 81.9 % of the public health facilities and 19.4 % of the private health facilities (p = 0.001). Its use was higher among public healthcare workers (85.2 %) compared to 32.9 % in private facilities (p = 0.000). Presumptive diagnosis of malaria was higher among private healthcare workers (94.9 %) compared to 22.7 % public facilities (p = <0.0001). The main reason for non-usage of mRDT among private healthcare workers was its perceived unreliability of mRDT (40.9 %). Monotherapy including artesunate (58.3 % vs 12.5 %), amodiaquine (38.9 % vs 8.3 %) and chloroquine (26.4 % vs 4.2 %) were significantly more available in private than public health facilities, respectively. Adherence to guidelines was significantly higher among public healthcare workers (60.6 %) compared to those in private facilities (27.3 %). Availability of antimalarial medicine was the main factor that influenced treatment prescription in both healthcare settings (p = 0.27). However, drug promotion by manufactures (45.8 %) has a major influence on private healthcare workers' prescription practice. The findings of this study demonstrate significant difference between public and private healthcare workers on adherence to national malaria diagnosis and treatment guidelines. Interventions to improve private sector engagement in implementation of the guidelines, training and supply of recommended antimalarial medicines should be intensified.

  7. Physician's sociodemographic profile and distribution across public and private health care: an insight into physicians' dual practice in Brazil.

    PubMed

    Miotto, Bruno Alonso; Guilloux, Aline Gil Alves; Cassenote, Alex Jones Flores; Mainardi, Giulia Marcelino; Russo, Giuliano; Scheffer, Mário César

    2018-04-23

    The intertwined relation between public and private care in Brazil is reshaping the medical profession, possibly affecting the distribution and profile of the country's medical workforce. Physicians' simultaneous engagement in public and private services is a common and unregulated practice in Brazil, but the influence played by contextual factors and personal characteristics over dual practice engagement are still poorly understood. This study aimed at exploring the sociodemographic profile of Brazilian physicians to shed light on the links between their personal characteristics and their distribution across public and private services. A nation-wide cross-sectional study using primary data was conducted in 2014. A representative sample size of 2400 physicians was calculated based  on the National Council of Medicine database registries; telephone interviews were conducted to explore physicians' sociodemographic characteristics and their engagement with public and private services. From the 2400 physicians included, 51.45% were currently working in both the public and private services, while 26.95% and 21.58% were working exclusively in the private and public sectors, respectively. Public sector physicians were found to be younger (PR 0.84 [0.68-0.89]; PR 0.47 [0.38-0.56]), less experienced (PR 0.78 [0.73-0.94]; PR 0.44 [0.36-0.53]) and predominantly female (PR 0.79 [0.71-0.88]; PR 0.68 [0.6-0.78]) when compared to dual and private practitioners; their income was substantially lower than those working exclusively for the private (PR 0.58 [0.48-0.69]) and mixed sectors (PR 0.31 [0.25-0.37]). Conversely, physicians from the private sector were found to be typically senior (PR 1.96 [1.58-2.43]), specialized (PR 1.29 [1.17-1.42]) and male (PR 1.35 [1.21-1.51]), often working less than 20 h per week (PR 2.04 [1.4-2.96]). Dual practitioners were mostly middle-aged (PR 1.3 [1.16-1.45]), male specialists with 10 to 30 years of medical practice (PR 1.23 [1.11-1.37]). The study shows that more than half of Brazilian physicians currently engage with dual practice, while only one fifth dedicate exclusively to public services, highlighting also substantial differences in socio-demographic and work-related characteristics between public, private and dual-practitioners. These results are consistent with the international literature suggesting that physicians' sociodemographic characteristics can help predict dual practice forms and prevalence in a country.

  8. Children's Perspective of Game: A Comparison of the Public and Private Schools

    ERIC Educational Resources Information Center

    Gündüz, Nevin; Taspinar, Tugçe; Demis, Nurdan

    2017-01-01

    The purpose of this research is to determine what the game means from the perspectives of children studying at public and private schools. Four questionnaires were applied to all the third grade parents of four schools; two public and two private schools in Ankara, and questionnaires were completed and sent back by 212 parents. A total of 32…

  9. Women in Leadership: Factors That Affect the Achievement of Women in Higher Education Administration at Four-Year Public and Private Universities in Texas

    ERIC Educational Resources Information Center

    Ramirez, Dawn Marie

    2012-01-01

    The purpose of this quantitative study was to examine the factors that affect women administrators in higher education at four-year public and private universities in Texas. By comparing private and public universities, the research provided an assessment of similarities and differences of the factors impacting achievement of women in higher…

  10. Being Prepared to Lead: The Management Preparation of Academic Leaders from a Private Career College

    ERIC Educational Resources Information Center

    Freeman, Abby L.

    2011-01-01

    The purpose of this research was to determine whether academic leaders from a private career college are prepared to lead. The objective was to determine if leaders in a private career college felt they have the skills necessary to fulfill the needs of the students, faculty, employment sector, and public. This research study is a replication of a…

  11. The Relative Quality and Cost-Effectiveness of Private and Public Schools for Low-Income Families: A Case Study in a Developing Country

    ERIC Educational Resources Information Center

    Tooley, James; Dixon, Pauline; Shamsan, Yarim; Schagen, Ian

    2010-01-01

    The "mushrooming" of private schools for low-income families has been widely noted in the literature; however, very little is known about the quality of these schools. This research explored the relative quality of private unaided (recognised and unrecognised) and government schools in low-income areas of Hyderabad, India. A preliminary…

  12. Sources of Stress for Teachers Working in Private Elementary Schools and Methods of Coping with Stress

    ERIC Educational Resources Information Center

    Aydin, Bahri; Kaya, Ayça

    2016-01-01

    The aim of this study is to determine the sources of stress for classroom teacher and branch teachers working in private elementary schools and methods that are used by them in order to cope with the stress. In this research, qualitative and quantitative methods have been used jointly. The group consisted of 258 private elementary school teachers…

  13. Public Sector/Private Sector Interaction in Providing Information Services. Report to the NCLIS from the Public Sector/Private Sector Task Force.

    ERIC Educational Resources Information Center

    National Commission on Libraries and Information Science, Washington, DC.

    The results of a 2-year study on the interactions between government and private sector information activities are presented in terms of principles and guidelines for federal policy to support the development and use of information resources, products, and services, and to implement the principles. Discussions address sources of conflict between…

  14. Does the Affiliation of Universities to External Organizations Foster Diversity in Private Higher Education? Chile in Comparative Perspective

    ERIC Educational Resources Information Center

    Bernasconi, Andres

    2006-01-01

    The expansion of private sectors of higher education has usually been regarded as a factor of diversification in higher education systems. Some of this differentiation has been found to arise from the affiliation of private institutions with organizations outside the field of higher education. This article reports the results of a study of this…

  15. Test Score Gaps between Private and Government Sector Students at School Entry Age in India

    ERIC Educational Resources Information Center

    Singh, Abhijeet

    2014-01-01

    Various studies have noted that students enrolled in private schools in India perform better on average than students in government schools. In this paper, I show that large gaps in the test scores of children in private and public sector education are evident even at the point of initial enrollment in formal schooling and are associated with…

  16. Is Private Production of Public Services Cheaper Than Public Production? A Meta-Regression Analysis of Solid Waste and Water Services

    ERIC Educational Resources Information Center

    Bel, Germa; Fageda, Xavier; Warner, Mildred E.

    2010-01-01

    Privatization of local government services is assumed to deliver cost savings, but empirical evidence for this from around the world is mixed. We conduct a meta-regression analysis of all econometric studies examining privatization of water distribution and solid waste collection services and find no systematic support for lower costs with private…

  17. Is the association between high strain work and depressive symptoms modified by private life social support: a cohort study of 1,074 Danish employees?

    PubMed Central

    2014-01-01

    Background Previous studies have shown that psychosocial working conditions characterized by high psychological demands and low decision latitude (i.e., high strain work) are associated with increased risk of depressive symptoms. Little is known, however, concerning how this association may be modified by factors outside the working environment. This article examines the modifying role of private life social support in the relation between high strain work and the development of severe depressive symptoms. Methods Data were questionnaire-based, collected from a cross-occupational sample of 1,074 Danish employees. At baseline, all participants were free of severe depressive symptoms, measured by the Mental Health Inventory. High strain work was defined by the combination of high psychological demands at work and low control, measured with multi-dimensional scales. Private life social support was operationalized as the number of life domains with confidants and dichotomized as low (0–1 domains) or high (2 or more domains). Using logistic regression we examined the risk of onset of severe depressive symptoms, adjusting for sex, age, occupational position, and prior depressive symptoms. Results Separately, neither high strain work nor low private life social support statistically significantly predicted depressive symptoms. However, participants with joint exposure to high strain work and low private life social support had an Odds ratio (OR) for severe depressive symptoms of 3.41 (95% CI: 1.36-8.58), compared to participants with no work strain and high private life social support. There was no increased risk for participants with high strain work and high private life social support (OR = 1.32, 95% CI: 0.65-2.68). The interaction term for departure from additivity was, however, not statistically significant (p = 0.18). Conclusions Our findings suggest that high strain work may increase risk of depressive symptoms in individuals with low private life social support, although the effect-modification was statistically non-significant. Larger studies are needed to further establish the role of private life social support in the relation between high strain work and depression. PMID:25005843

  18. Is the association between high strain work and depressive symptoms modified by private life social support: a cohort study of 1,074 Danish employees?

    PubMed

    Madsen, Ida E H; Jorgensen, Anette F B; Borritz, Marianne; Nielsen, Martin L; Rugulies, Reiner

    2014-07-08

    Previous studies have shown that psychosocial working conditions characterized by high psychological demands and low decision latitude (i.e., high strain work) are associated with increased risk of depressive symptoms. Little is known, however, concerning how this association may be modified by factors outside the working environment. This article examines the modifying role of private life social support in the relation between high strain work and the development of severe depressive symptoms. Data were questionnaire-based, collected from a cross-occupational sample of 1,074 Danish employees. At baseline, all participants were free of severe depressive symptoms, measured by the Mental Health Inventory. High strain work was defined by the combination of high psychological demands at work and low control, measured with multi-dimensional scales. Private life social support was operationalized as the number of life domains with confidants and dichotomized as low (0-1 domains) or high (2 or more domains). Using logistic regression we examined the risk of onset of severe depressive symptoms, adjusting for sex, age, occupational position, and prior depressive symptoms. Separately, neither high strain work nor low private life social support statistically significantly predicted depressive symptoms. However, participants with joint exposure to high strain work and low private life social support had an Odds ratio (OR) for severe depressive symptoms of 3.41 (95% CI: 1.36-8.58), compared to participants with no work strain and high private life social support. There was no increased risk for participants with high strain work and high private life social support (OR = 1.32, 95% CI: 0.65-2.68). The interaction term for departure from additivity was, however, not statistically significant (p = 0.18). Our findings suggest that high strain work may increase risk of depressive symptoms in individuals with low private life social support, although the effect-modification was statistically non-significant. Larger studies are needed to further establish the role of private life social support in the relation between high strain work and depression.

  19. Is the clinicopathological pattern of colorectal carcinoma similar in the state and private healthcare systems of South Africa? Analysis of a Durban colorectal cancer database.

    PubMed

    Ntombela, Xolani H; Zulu, Babongile Mw; Masenya, Molikane; Sartorius, Ben; Madiba, Thandinkosi E

    2017-10-01

    Previous state hospital-based local studies suggest varying population-based clinicopathological patterns of colorectal cancer (CRC). Patients diagnosed with CRC in the state and private sector hospitals in Durban, South Africa over a 12-month period (January-December 2009) form the basis of our study. Of 491 patients (172 state and 319 private sector patients), 258 were men. State patients were younger than private patients. Anatomical site distribution was similar in both groups with minor variations. Stage IV disease was more common in state patients. State patients were younger, presented with advanced disease and had a lower resection rate. Black patients were the youngest, presented with advanced disease and had the lowest resection rate.

  20. Exploring health insurance services in Sudan from the perspectives of insurers

    PubMed Central

    Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud

    2018-01-01

    Background: It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. Methods: This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. Results: The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers’ affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. Conclusion: In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance. The quality of services provided by Social Health Insurance and Private Health Insurance was described as good, but no insurance in Sudan measured customer satisfaction as yet. PMID:29348914

  1. Exploring health insurance services in Sudan from the perspectives of insurers.

    PubMed

    Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud

    2018-01-01

    It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers' affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance. The quality of services provided by Social Health Insurance and Private Health Insurance was described as good, but no insurance in Sudan measured customer satisfaction as yet.

  2. Health care consumers’ perspectives on pharmacist integration into private general practitioner clinics in Malaysia: a qualitative study

    PubMed Central

    Saw, Pui San; Nissen, Lisa M; Freeman, Christopher; Wong, Pei Se; Mak, Vivienne

    2015-01-01

    Background Pharmacists are considered medication experts but are underutilized and exist mainly at the periphery of the Malaysian primary health care team. Private general practitioners (GPs) in Malaysia are granted rights under the Poison Act 1952 to prescribe and dispense medications at their primary care clinics. As most consumers obtain their medications from their GPs, community pharmacists’ involvement in ensuring safe use of medicines is limited. The integration of a pharmacist into private GP clinics has the potential to contribute to quality use of medicines. This study aims to explore health care consumers’ views on the integration of pharmacists within private GP clinics in Malaysia. Methods A purposive sample of health care consumers in Selangor and Kuala Lumpur, Malaysia, were invited to participate in focus groups and semi-structured interviews. Sessions were audio recorded and transcribed verbatim and thematically analyzed using NVivo 10. Results A total of 24 health care consumers participated in two focus groups and six semi-structured interviews. Four major themes were identified: 1) pharmacists’ role viewed mainly as supplying medications, 2) readiness to accept pharmacists in private GP clinics, 3) willingness to pay for pharmacy services, and 4) concerns about GPs’ resistance to pharmacist integration. Consumers felt that a pharmacist integrated into a private GP clinic could offer potential benefits such as to provide trustworthy information on the use and potential side effects of medications and screening for medication misadventure. The potential increase in costs passed on to consumers and GPs’ reluctance were perceived as barriers to integration. Conclusion This study provides insights into consumers’ perspectives on the roles of pharmacists within private GP clinics in Malaysia. Consumers generally supported pharmacist integration into private primary health care clinics. However, for pharmacists to expand their capacity in providing integrated and collaborative primary care services to consumers, barriers to pharmacist integration need to be addressed. PMID:25834411

  3. 75 FR 82029 - Privately Owned Vehicle Mileage Reimbursement Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ... use of privately owned automobiles (POA), POAs when Government owned automobiles (GOA) are authorized... annual standard automobile study conducted by the Internal Revenue Service, as well as conducting...

  4. Medicare overpayments to private plans, 1985-2012: shifting seniors to private plans has already cost Medicare US$282.6 billion.

    PubMed

    Hellander, Ida; Himmelstein, David U; Woolhandler, Steffie

    2013-01-01

    Previous research has documented Medicare overpayments to the private Medicare Advantage (MA) plans that compete with traditional fee-for-service Medicare. This research has assessed individual categories of overpayment for, at most, a few years. However, no study has calculated the total overpayments to private plans since the program's inception. Prior to 2004, selective enrollment of healthier seniors was the major source of excess payments. We estimate this has added US$41 billion to Medicare's costs since 1985. Medicare adopted a risk-adjustment scheme in 2004, but this has not curbed private plans' ability to game the payment system. This has added US$122.5 billion to Medicare's costs since 2004. Congress mandated increased payment to private plans in the 2003 Medicare Modernization Act, which was mitigated, to a degree, by the subsequent Affordable Care Act. In total, we find that Medicare has overpaid private insurers by US$282.6 billion since 1985. Risk adjustment does not work in for-profit MA plans, which have a financial incentive, the data, and the ingenuity to game whatever system Medicare devises. It is time to end Medicare's costly experiment with privatization. The U.S. needs to adopt a single-payer national health insurance program with effective methods for controlling costs.

  5. 78 FR 76626 - Privately Owned Vehicle Mileage Reimbursement Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-18

    ... use of privately owned automobiles (POA), POAs when Government owned automobiles (GOA) are authorized... reviewing the annual standard automobile study contracted for by the Internal Revenue Service, as well as conducting independent automobile, motorcycle, and aircraft studies that evaluate various factors, such as...

  6. 77 FR 76487 - Privately Owned Vehicle Mileage Reimbursement Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ... owned automobiles (POA), POAs when Government owned automobiles (GOA) are authorized, privately owned... annual standard automobile study contracted for by the Internal Revenue Service, as well as conducting independent automobile, motorcycle, and aircraft studies that evaluate various factors, such as the cost of...

  7. Associations From Pictures.

    ERIC Educational Resources Information Center

    Pettersson, Rune

    A picture can be interpreted in different ways by various persons. There is often a difference between a picture's denotation (literal meaning), connotation (associative meaning), and private associations. Two studies were conducted in order to observe the private associations that pictures awaken in people. One study deals with associations made…

  8. Microfinance investments in quality at private clinics in Uganda: a case-control study.

    PubMed

    Seiber, Eric E; Robinson, Amara L

    2007-10-18

    Small private-sector health care providers can play an important role in meeting the developing country health care needs, but a lack of credit can prove major constraint to small-provider expansion. This study examines the potential of small, microfinance loans to strengthen the private health sector and improve access to quality preventive and curative health services in Uganda. This study estimates logistic regressions using 2,387 client exit interviews to assess the impact of microfinance loans on perceived quality and the viability and sustainability of small, private clinics. The study finds perceived quality improved with loan recipients' clients being more likely to choose clinics on the basis of drug availability, fair charges, cleanliness, and confidentiality. In addition, the assessment found evidence of increased client flows, but the changes produced mixed results for sustainability with respondents being only half as likely to "always" visit a particular clinic. The results indicate that the microfinance program improved perceived quality at loan recipient clinics, especially as reliable drug outlets.

  9. De facto Privatization and Inequalities in Educational Opportunity in the Transition to Secondary School in Rural Malawi.

    PubMed

    Grant, Monica J

    2017-09-01

    There has been a recent, rapid de facto privatization of education in many African countries, as the number of private secondary schools operating in the region grew. The majority of these schools are "low-cost" private schools where tuition and fees are set as low as possible to cover operating costs and still generate profit. Proponents of low-cost private schools argue that these schools have proliferated in impoverished areas to meet unmet demand for access to education and where private schools may offer better quality than locally available public schools. Theories of inequality of educational opportunity suggest that if private schools offer better quality education, students from more advantaged families will be more likely to enroll at these institutions, potentially exacerbating educational inequality in the region. This analysis uses data from a school-based longitudinal survey, the Malawi Schooling and Adolescent Study, to examine socio-economic inequalities in the transition to secondary school and on-time enrollment in upper secondary. My findings indicate that youth from non-poor households are not only more likely to enroll in secondary school than poor youth, but they are also more likely to substitute enrollment in private schools for enrollment in second-tier government schools. Enrollment at private schools, however, does not yield schooling advantages; relative to both tiers of government secondary schooling, students who initially enrolled at private schools were the least likely to enroll on time in upper secondary school. These patterns suggest that these schooling circumstances may yield less segregation of opportunity than might otherwise be assumed.

  10. The modal transfer analysis by adding transport costs. Case study: The use of bus and private vehicle student Institut Teknologi Sumatera

    NASA Astrophysics Data System (ADS)

    Muliarto, H.; Alhamidi; Syahbandi, M.

    2017-06-01

    Since the last two years the Institut Teknologi Sumatera to accept new students in large numbers. Increasing the number of students is directly proportional to the increase of private vehicles that enter the campus it is not in line with the policy of the Institut Teknologi Sumatera as Smart, Friendly, and Forest Campus. Institut Teknologi Sumatera as Smart, Friendly, and Forest Campus fact has made some deal with mass public transport, Damri, to provide bus transportation to the Institut Teknologi Sumatera, but the number of bus users is still inferior to the number of private vehicle users. This study was conducted to see the modal transfer of the entire academic community ITERA, from private cars to public transport such as buses, with the addition of transportation costs in the form of parking rates. This study shows the dominant displacement can occur if the respondent charged parking fees of IDR 4.000. Besides the displacement mode of transportation from using private vehicles be using the bus can occur if Trans Lampung fix three systems including bus departure and arrival schedules, facility service providers that support, and the addition of the Bus Trans Lampung.

  11. Evaluation of self-esteem in nursing teachers at public and private universities.

    PubMed

    Terra, Fábio de Souza; Marziale, Maria Helena Palucci; Robazzi, Maria Lúcia do Carmo Cruz

    2013-01-01

    The aim of this study was to evaluate the self-esteem of Nursing faculty in public and private universities and compare the measures presented by two groups of teachers. This descriptive, correlational, cross-sectional quantitative study was conducted with 71 teachers from two universities (public and private) from a municipality in the south of the State of Minas Gerais. After pilot testing and validation, A questionnaire and the Rosenberg Self-Esteem Scale were used. It was found that most teachers had high self-esteem, with no significant difference between the two groups. When the continuous scores on this scale were analyzed, there was a significant difference between universities, showing that the private university teachers had lower self-esteem scores. The Rosenberg Self-Esteem Scale showed high value for coefficient alpha. It was concluded that self-esteem was high predominantly in the studied teachers, but those from the private university had lower scores. These data may help institutions to reflect on the issue and invest in building healthy environments, with the worker/teacher of Nursing as the protagonist, which represents advancement in the knowledge of the subject in the field of Nursing.

  12. HRM Practices in Public and Private Universities of Pakistan: A Comparative Study

    ERIC Educational Resources Information Center

    Iqbal, Muhammad Zafar; Arif, Muhammad Irfan; Abbas, Furrakh

    2011-01-01

    The purpose of this study was to compare the HRM practices of public and private universities in Punjab province of Pakistan. The data for the study was collected through a questionnaire comprising 30 items mainly related to job definition, training and development, compensation, team work, employee's participation and performance appraisal. The…

  13. The Limits of Multistakeholder Governance: The Case of the Global Partnership for Education and Private Schooling

    ERIC Educational Resources Information Center

    Menashy, Francine

    2017-01-01

    This study investigates collective decision making within a multistakeholder partnership through a case study of the Global Partnership for Education (GPE). Analyzed through the theoretical framework of sociological institutionalism, this study applies the issue of private schooling as a lens to understand policy-related decision making between…

  14. Tracking Job Growth in Private Industry.

    ERIC Educational Resources Information Center

    Greene, Richard

    1982-01-01

    Summarizes the findings and methodology of some of the recent innovative labor market studies in the private sector. Emphasis is placed on the micro-data study of the job creation process at Massachusetts Institute of Technology. Similar studies at the University of California at Berkeley and at the Brookings Institution are also summarized. (CT)

  15. Greek Organization Membership and Collegiate Outcomes at an Elite, Private University

    ERIC Educational Resources Information Center

    Walker, Jay K.; Martin, Nathan D.; Hussey, Andrew

    2015-01-01

    In this study, we use detailed survey and institutional data from a prospective panel study of students attending a highly selective, private university to examine the effects of fraternity or sorority membership on a range of collegiate outcomes. Previous research has given insufficient attention to selection issues inherent in the study of…

  16. Mandarin Chinese Immersion Program for Preschool Children in an Urban Private School in California: A Case Study

    ERIC Educational Resources Information Center

    Cao, Yuan

    2013-01-01

    This study enlisted language immersion practitioners in highlighting and exploring the issues and challenges that accompany language immersion education. Comprehensive focused personal interviews of preschool Mandarin Chinese language immersion educators in a private school provided the basis of the study. The research literature reviewed…

  17. Investigating Students' Attitudes towards Private Sector Work during Study in Saudi Arabia

    ERIC Educational Resources Information Center

    Al-asqah, Amnah

    2018-01-01

    Purpose: The purpose of this paper is to identify the students' attitudes towards private sector work during study. Design/methodology/approach: This study used a comprehensive social survey (including questionnaire and interviewing) distributed to experts in departments and colleges in King Saud University and Princess Nora University. Findings:…

  18. Private or salaried practice: how do young general practitioners make their career choice? A qualitative study.

    PubMed

    Kinouani, Shérazade; Boukhors, Gary; Luaces, Baptiste; Durieux, William; Cadwallader, Jean-Sébastien; Aubin-Auger, Isabelle; Gay, Bernard

    2016-09-01

    Young French postgraduates in general practice increasingly prefer salaried practice to private practice in spite of the financial incentives offered by the French government or local communities to encourage the latter. This study aimed to explore the determinants of choice between private or salaried practice among young general practitioners. A qualitative study was conducted in the South West of France. Semi-structured interviews of young general practitioners were audio-recorded until data saturation. Recordings were transcribed and then analyzed according to Grounded Theory by three researchers working independently. Sixteen general practitioners participated in this study. For salaried and private doctors, the main factors governing their choice were occupational factors: working conditions, need of varied scope of practice, quality of the doctor-patient relationship or career flexibility. Other factors such as postgraduate training, having worked as a locum or self-interest were also determining. Young general practitioners all expected a work-life balance. The fee-for-service scheme or home visits may have discouraged young general practitioners from choosing private practice. National health policies should increase the attractiveness of ambulatory general practice by promoting the diversification of modes of remuneration and encouraging the organization of group exercises in multidisciplinary medical homes and community health centers.

  19. Comparing public and private hospitals in China: evidence from Guangdong.

    PubMed

    Eggleston, Karen; Lu, Mingshan; Li, Congdong; Wang, Jian; Yang, Zhe; Zhang, Jing; Quan, Hude

    2010-03-23

    The literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care. We analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes. Compared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation). Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix. In combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital performance and protect vulnerable patients, regardless of hospital ownership type.

  20. Comparing public and private hospitals in China: Evidence from Guangdong

    PubMed Central

    2010-01-01

    Background The literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care. Methods We analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes. Results Compared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation). Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix. Conclusions In combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital performance and protect vulnerable patients, regardless of hospital ownership type. PMID:20331886

  1. Public and private pregnancy care in Reggio Emilia Province: an observational study on appropriateness of care and delivery outcomes

    PubMed Central

    2014-01-01

    Background In industrialized countries, improvements have been made in both maternal and newborn health. While attention to antenatal care is increasing, excessive medicalization is also becoming more common. The aim of this study is to compare caesarean section (CS) frequency and ultrasound scan utilization in a public model of care involving both midwives and obstetricians with a private model in which care is provided by obstetricians only. Methods Design: Observational population-based study. Setting: Reggio Emilia Province. Population: 5957 women resident in the province who delivered between October 2010 and November 2011. Main outcome measures: CS frequency and ultrasound scan utilization, stillbirths, and other negative perinatal outcomes. Women in the study were searched in the public family and reproductive health clinic medical records to identify those cared for in the public system. Outcomes of the two antenatal care models were compared through multivariate logistic regression adjusting for maternal characteristics and, for CS only, by stratifying by Robson’s Group. Results Compared to women cared for in private services (N = 3,043), those in public service (N = 2,369) were younger, less educated, more frequently non-Italian, and multiparous. The probability of CS was slightly higher for women cared for by private obstetricians than for those cared for in the public system (31.8% vs. 27.1%; adjusted odds ratio: 1.10; 95% CI: 0.93–1.29): The probability of having more than 3 ultrasound scans was higher in private care (89.6% vs. 49.8%; adjusted odds ratio: 5.11; 95% CI: 4.30–6.08). CS frequency was higher in private care for all Robson’s classes except women who underwent CS during spontaneous labour. Among negative perinatal outcomes only a higher risk of pre-term birth was observed for pregnancies cared for in private services. Conclusions The public model provides less medicalized and more guidelines-oriented care than does the private model, with no increase in negative perinatal outcomes. PMID:24533853

  2. Orthodontic treatment need among young Saudis attending public versus private dental practices in Riyadh

    PubMed Central

    Al-Jobair, Asma M; Baidas, Laila F; Al-Hamid, Anfal A; Al-Qahtani, Sara G; Al-Najjar, Amani T; Al-Kawari, Huda M

    2016-01-01

    Objective To assess and compare the severity of malocclusion and orthodontic treatment need among young Saudis receiving free treatment at public dental practices versus those paying for treatment at private practices. Materials and methods This retrospective study evaluated the records of 300 patients (179 females, 121 males; age 13–21 years) treated at orthodontic clinics from 2013 through 2015. The public sample was selected from orthodontic clinics at the College of Dentistry, King Saud University (KSU); the private sample was selected from five private orthodontic clinics in Riyadh, Saudi Arabia. The records were examined for the severity of malocclusion and for orthodontic treatment need using the Dental Health Component of the Index of Orthodontic Treatment Need. The prevalence of each occlusal discrepancy and the Dental Health Component grade were recorded. The severity of malocclusion and orthodontic treatment need were compared between practice types, age groups, and sexes with the chi-square test. Results Displacement, increased overjet, and Class II and III malocclusion were the most common orthodontic problems in this study. Patients attending public clinics at KSU generally had more severe malocclusion than the patients attending private clinics. Seventy-seven percent of orthodontically treated patients at KSU clinics were in great need of treatment, compared with 58.5% of patients treated at private clinics (P=0.003). Among the patients with great treatment need, approximately 62% of male patients and 70% of patients ≤16 years of age were treated at KSU clinics, compared with 38% and 48%, respectively, treated at private clinics (P<0.0001). Conclusion Young Saudis receiving free orthodontic treatment at public clinics at KSU had more severe malocclusion with greater need of orthodontic treatment than the patients paying for treatment at private clinics. PMID:27843351

  3. Orthodontic treatment need among young Saudis attending public versus private dental practices in Riyadh.

    PubMed

    Al-Jobair, Asma M; Baidas, Laila F; Al-Hamid, Anfal A; Al-Qahtani, Sara G; Al-Najjar, Amani T; Al-Kawari, Huda M

    2016-01-01

    To assess and compare the severity of malocclusion and orthodontic treatment need among young Saudis receiving free treatment at public dental practices versus those paying for treatment at private practices. This retrospective study evaluated the records of 300 patients (179 females, 121 males; age 13-21 years) treated at orthodontic clinics from 2013 through 2015. The public sample was selected from orthodontic clinics at the College of Dentistry, King Saud University (KSU); the private sample was selected from five private orthodontic clinics in Riyadh, Saudi Arabia. The records were examined for the severity of malocclusion and for orthodontic treatment need using the Dental Health Component of the Index of Orthodontic Treatment Need. The prevalence of each occlusal discrepancy and the Dental Health Component grade were recorded. The severity of malocclusion and orthodontic treatment need were compared between practice types, age groups, and sexes with the chi-square test. Displacement, increased overjet, and Class II and III malocclusion were the most common orthodontic problems in this study. Patients attending public clinics at KSU generally had more severe malocclusion than the patients attending private clinics. Seventy-seven percent of orthodontically treated patients at KSU clinics were in great need of treatment, compared with 58.5% of patients treated at private clinics ( P =0.003). Among the patients with great treatment need, approximately 62% of male patients and 70% of patients ≤16 years of age were treated at KSU clinics, compared with 38% and 48%, respectively, treated at private clinics ( P <0.0001). Young Saudis receiving free orthodontic treatment at public clinics at KSU had more severe malocclusion with greater need of orthodontic treatment than the patients paying for treatment at private clinics.

  4. Large regional differences in incidence of arthroscopic meniscal procedures in the public and private sector in Denmark.

    PubMed

    Hare, Kristoffer Borbjerg; Vinther, Jesper Høeg; Lohmander, L Stefan; Thorlund, Jonas Bloch

    2015-02-24

    A recent study reported a large increase in the number of meniscal procedures from 2000 to 2011 in Denmark. We examined the nation-wide distribution of meniscal procedures performed in the private and public sector in Denmark since different incentives may be present and the use of these procedures may differ from region to region. We included data on all patients who underwent an arthroscopic meniscal procedure performed in the public or private sector in Denmark. Data were retrieved from the Danish National Patient Register on patients who underwent arthroscopic meniscus surgery as a primary or secondary procedure in the years 2000 to 2011. Hospital identification codes enabled linkage of performed procedures to specific hospitals. Yearly incidence of meniscal procedures per 100,000 inhabitants was calculated with 95% CIs for public and private procedures for each region. Incidence of meniscal procedures increased at private and at public hospitals. The private sector accounted for the largest relative and absolute increase, rising from an incidence of 1 in 2000 to 98 in 2011. In 2011, the incidence of meniscal procedures was three times higher in the Capital Region than in Region Zealand. Our study identified a large increase in the use of meniscal procedures in the public and private sector in Denmark. The increase was particularly conspicuous in the private sector as its proportion of procedures performed increased from 1% to 32%. Substantial regional differences were present in the incidence and trend over time of meniscal procedures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. The choice and preference for public-private health care among urban residents in China: evidence from a discrete choice experiment.

    PubMed

    Tang, Chengxiang; Xu, Judy; Zhang, Meng

    2016-10-18

    Public health care dominated the services provision in China before 1980s. However, the number of private health care providers in China has been increasing since then. The growth of private hospitals escalated after a market-oriented reform was implemented in 2001. Through an experimental approach, this study aims to a better understanding of the dynamic change in preference of health care utilisation among the residents in urban China. Based on a discrete choice experiment (DCE) from a random sample of respondents in urban China, the study evaluated preference over health care attributes affecting individuals' choice for the utilisation of hospital health care. The marginal willingness-to-pay for five health care attributes was estimated, including public/private provision of health care, by analysing mixed logit and latent class models. The results indicated a significantly negative marginal willingness-to-pay for private health care, which was interpreted as representing people's previous interactions with the health care system. The latent class model further suggested preference heterogeneity across our sample. We found that Hukou type, a typical indicator of socioeconomic background, was significantly related to respondents' preference for health care utilisation. Permanent urban residents (urban Hukou) valued private health care less; in contrast rural migrants (rural Hukou) were more likely to be indifferent between public/private provision. Urban residents in China showed a high disposition to obtain health care from the public providers of health care. Our results have implications in the context of the Chinese government attempts to expand the private health care sector in the short term. Policy makers need to consider residents' preference for health care in health policy development as the preference can only change in the long term.

  6. Effect of privatization of the drug distribution system on drug prices in Malaysia.

    PubMed

    Babar, Z D; Izham, M I M

    2009-08-01

    Previous studies on anti-infective and cardiovascular drugs have shown extraordinary price increases following privatization of the Malaysian drug distribution system. Therefore, it was felt that there was a need to undertake a full-scale study to evaluate the effect of privatization of the Malaysian drug distribution system on drug prices. To compare pre-privatization drug prices with post-privatization drug prices, and to compare the prices with international reference prices (IRPs). Five hundred and sixty-four drugs were listed in price lists for 1994, 1995-1996, 1997-2000 and 2001-2003. The 1994 data were taken as the pre-privatization prices, and all other lists were considered to be post-privatization prices. The pre-privatization prices (1994) were compared with those in 1995-1996. The prices in 1995-1996 were compared with those in 1997-2000, and the 1997-2000 prices were compared with those in 2001-2003. Furthermore, the 2001-2003 prices were compared with the median IRPs taken from Management Sciences for Health. The prices increased by 10.42% in 1995-1996, decreased by 3.37% in 1997-2000, and increased by 64.04% in 2001-2003. The increase in prices does not follow any pricing formula but is influenced by free market principles. The commonly used generic drugs showed enormously higher prices compared with the IRPs. Some of the prices increased several hundred-fold compared with the previous year, showing that no pricing formula has been followed. Increasing prices over the years may lead to higher expenditures and a hurdle to drug accessibility. A rational pricing structure is needed for transparent pricing, and government involvement and the formation of a medicine pricing policy seems vital.

  7. Insurance status and time to completion of surgery for breast cancer.

    PubMed

    Solomon, Matthew; Cochrane, Colin T; Grieve, David A

    2016-01-01

    The aim of this study was to compare the time to re-operation, following inadequate loco-regional surgery for breast cancer, between the public and private sectors of the Sunshine Coast region. A retrospective review was performed of the medical records of all female patients undergoing guide wire-localized, breast-conserving surgery at Nambour General Hospital and in the local private sector from January 2009 until April 2010. The dates of initial consultation, operation, post-operative consultation and any subsequent reoperation were recorded. One hundred and seventeen public sector patients and 113 private sector patients were identified during the study period. Thirty-seven public patients (32%) and 46 private patients (41%) required re-operation. This difference was not significant (χ(2) = 2.06, degrees of freedom (df) = 1, P = 0.15). The mean time and standard error from the initial consultation to the first operation and re-operation in the public sector was 26 (2.3) and 62 (3.8) days, and in the private sector was 12 (1.2) and 30 (4.4) days, respectively P < 0.001. On average, 70% of public patients and 96% of private patients completed the surgical component of their breast cancer management within the Queensland Health-recommended time frame of 30 days (χ(2) = 26, df = 1, P < 0.001). While experiencing similar rates of re-operative surgery in breast cancer management in the public and private sectors, the private sector deals with this issue in a more time efficient manner. An opportunity for intervention by quarantining theatre time is explored to improve the public sector time management. © 2015 Royal Australasian College of Surgeons.

  8. Comparing the knowledge, attitude and practices of health care workers in public and private primary care facilities in Lagos State on Ebola virus disease.

    PubMed

    Idris, Bilqisu Jibril; Inem, Victor; Balogun, Mobolanle

    2015-01-01

    The West African sub-region is currently witnessing an outbreak of EVD that began in December 2013. The first case in Nigeria was diagnosed in Lagos, at a private medical facility in July 2014. Health care workers are known amplifiers of the disease. The study aimed to determine and compare EVD knowledge, attitude and practices among HCWs in public and private primary care facilities in Lagos, Nigeria. This was a comparative cross-sectional study. Seventeen public and private primary care facilities were selected from the 3 senatorial districts that make up Lagos State. 388 respondents from these facilities were selected at random and interviewed using a structured questionnaire. Proportion of respondents with good knowledge and practice among public HCWs was 98.5% and 93.8%; and among private HCW, 95.9% and 89.7%. Proportion of respondents with positive attitude was 67% (public) and 72.7% (private). Overall, there were no statistically significant differences between the knowledge, attitude and preventive practices of public HCWs and that of private HCWs, (p≤0.05). Timely and intense social mobilization and awareness campaigns are the best tools to educate all segments of the community about public health emergencies. There exists significant surmountable gaps in EVD knowledge, negative attitude and sub-standard preventive practices that can be eliminated through continued training of HCW and provision of adequate material resources.

  9. The contribution of health selection to occupational status inequality in Germany - differences by gender and between the public and private sectors.

    PubMed

    Kröger, H

    2016-04-01

    Estimating the size of health inequalities between hierarchical levels of job status and the contribution of direct health selection to these inequalities for men and women in the private and public sector in Germany. The study uses prospective data from the Socio-Economic Panel study on 11,788 women and 11,494 men working in the public and private sector in Germany. Direct selection effects of self-rated health on job status are estimated using fixed-effects linear probability models. The contribution of health selection to overall health-related inequalities between high and low status jobs is calculated. Women in the private sector who report very good health have a 1.9 [95% CI: 0.275; 3.507] percentage point higher probability of securing a high status job than women in poor self-rated health. This direct selection effect constitutes 20.12% of total health inequalities between women in high and low status jobs. For men in the private and men and women in the public sector no relevant health selection effects were identified. The contribution of health selection to total health inequalities between high and low status jobs varies with gender and public versus private sector. Women in the private sector in Germany experience the strongest health selection. Possible explanations are general occupational disadvantages that women have to overcome to secure high status jobs. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. Comparing the knowledge, attitude and practices of health care workers in public and private primary care facilities in Lagos State on Ebola virus disease

    PubMed Central

    Idris, Bilqisu Jibril; Inem, Victor; Balogun, Mobolanle

    2015-01-01

    Introduction The West African sub-region is currently witnessing an outbreak of EVD that began in December 2013. The first case in Nigeria was diagnosed in Lagos, at a private medical facility in July 2014. Health care workers are known amplifiers of the disease. The study aimed to determine and compare EVD knowledge, attitude and practices among HCWs in public and private primary care facilities in Lagos, Nigeria. Methods This was a comparative cross-sectional study. Seventeen public and private primary care facilities were selected from the 3 senatorial districts that make up Lagos State. 388 respondents from these facilities were selected at random and interviewed using a structured questionnaire. Results Proportion of respondents with good knowledge and practice among public HCWs was 98.5% and 93.8%; and among private HCW, 95.9% and 89.7%. Proportion of respondents with positive attitude was 67% (public) and 72.7% (private). Overall, there were no statistically significant differences between the knowledge, attitude and preventive practices of public HCWs and that of private HCWs, (p≤0.05). Conclusion Timely and intense social mobilization and awareness campaigns are the best tools to educate all segments of the community about public health emergencies. There exists significant surmountable gaps in EVD knowledge, negative attitude and sub-standard preventive practices that can be eliminated through continued training of HCW and provision of adequate material resources. PMID:26740847

  11. A qualitative study on pharmacists’ perception on integrating pharmacists into private general practitioner’s clinics in Malaysia

    PubMed Central

    2017-01-01

    Background: Private general practitioners in Malaysia largely operates as solo practices – prescribing and supplying medications to patients directly from their clinics, thus posing risk of medication-related problems to consumers. A pharmacy practice reform that integrates pharmacists into primary healthcare clinics can be a potential initiative to promote quality use of medication. This model of care is a novel approach in Malaysia and research in the local context is required, especially from the perspectives of pharmacists. Objective: To explore pharmacists’ views in integrating pharmacists into private GP clinics in Malaysia. Methods: A combination of purposive and snowballing sampling was used to recruit community and hospital pharmacists from urban areas in Malaysia to participate either in focus groups or semi-structured interviews. A total of 2 focus groups and 4 semi-structured interviews were conducted. Sessions were audio recorded, transcribed verbatim and thematically analysed using NVivo 10. Results: Four major themes were identified: (1) Limited potential to expand pharmacists’ roles, (2) Concerns about non-pharmacists dispensing medicines in private GP clinics, (3) Lack of trust from consumers and private GPs, (4) Cost implications. Participants felt that there was a limited role for pharmacists in private GP clinics. This was because the medication supply role is currently undertaken in private GP clinics without the need of pharmacists. The perceived lack of trust from consumers and private GPs towards pharmacists arises from the belief that healthcare is the GPs’ responsibility. This suggests that there is a need for increased public and GP awareness towards the capabilities of pharmacists’ in medication management. Participants were concerned about an increase in cost to private GP visits if pharmacists were to be integrated. Nevertheless, some participants perceived the integration as a means to reduce medical costs through improved quality use of medicines. Conclusion: Findings from the study provided a better understanding to help ascertain pharmacists’ views on their readiness and acceptance in a potential new model of practice. PMID:28943979

  12. An analysis of ophthalmology services in Finland - has the time come for a Public-Private Partnership?

    PubMed Central

    Tynkkynen, Liina-Kaisa; Lehto, Juhani

    2009-01-01

    Background We studied the prerequisites for Public-Private Partnership (PPP) in the context of the Finnish health care system and more specifically in the field of ophthalmology. PPP can be defined as a more or less permanent cooperation between public and private actors, through which the joint products or services are developed and in which the risks, costs and profits are shared. The Finnish eye care services system is heterogeneous with several different providers and can be regarded as sub-optimal in terms of overall resource use. What is more, the public sector is suffering from a shortage of ophthalmologists, which further decreases its possibilities to meet the present needs. As ophthalmology has traditionally been a medical specialty with a substantial private sector involvement in service provision, PPP could be a feasible policy to be used in the field. We thus ask the following research question: Is there, and to what extent, an open window of opportunity for PPP? Methods In addition to the previously published literature, the research data consisted of 17 thematic interviews with public and private experts in the field of ophthalmology. The analysis was conducted in two stages. First, a literature-based content analysis was used to explore the prerequisites for PPP. Second, Kingdon's (1995) multiple streams theory was used to study the opening of the window of opportunity for PPP. Results Public and private parties reported similar problems in the current situation but defined them differently. Also, there is no consensus on policy alternatives. Public opinion seems to be somewhat uncertain as to the attitudes towards private service providers. The analysis thus showed that although there are prerequisites for PPP, the time has not yet come for a Public-Private Partnership. Conclusion Should the window open fully, the emergence of policy entrepreneurs and an opportunity for a win-win situation between public and private organizations are required. PMID:19900293

  13. The development of a framework for high-quality, sustainable and accessible rural private therapy under the Australian National Disability Insurance Scheme.

    PubMed

    Dew, Angela; Barton, Rebecca; Ragen, Jo; Bulkeley, Kim; Iljadica, Alexandra; Chedid, Rebecca; Brentnall, Jennie; Bundy, Anita; Lincoln, Michelle; Gallego, Gisselle; Veitch, Craig

    2016-12-01

    The Australian National Disability Insurance Scheme (NDIS) will provide people with individual funding with which to purchase services such as therapy from private providers. This study developed a framework to support rural private therapists to meet the anticipated increase in demand. The study consisted of three stages utilizing focus groups, interviews and an online expert panel. Participants included private therapists delivering services in rural New South Wales (n = 28), disability service users (n = 9) and key representatives from a range of relevant consumer and service organizations (n = 16). We conducted a thematic analysis of focus groups and interview data and developed a draft framework which was subsequently refined based on feedback from stakeholders. The framework highlights the need for a 'rural-proofed' policy context in which service users, therapists and communities engage collaboratively in a therapy pathway. This collaborative engagement is supported by enablers, including networks, resources and processes which are influenced by the drivers of time, cost, opportunity and motivation. The framework identifies factors that will facilitate delivery of high-quality, sustainable, individualized private therapy services for people with a disability in rural Australia under the NDIS and emphasizes the need to reconceptualize the nature of private therapy service delivery. Implications for Rehabilitation Rural private therapists need upskilling to work with individuals with disability who have individual funding such as that provided by the Australian National Disability Insurance Scheme. Therapists working in rural communities need to consider alternative ways of delivering therapy to individuals with disability beyond the traditional one-on-one therapy models. Rural private therapists need support to work collaboratively with individuals with disability and the local community. Rural private therapists should harness locally available and broader networks, resources and processes to meet the needs and goals of individuals with disability.

  14. Willingness to pay for private primary care services in Hong Kong: are elderly ready to move from the public sector?

    PubMed

    Liu, Su; Yam, Carrie H K; Huang, Olivia H Y; Griffiths, Sian M

    2013-10-01

    How to provide better primary care and achieve the right level of public-private balance in doing so is at the centre of many healthcare reforms around the world. In a healthcare system like Hong Kong, where inpatient services are largely funded through general taxation and ambulatory services out of pocket, the family doctor model of primary care is underdeveloped. Since 2008, the Government has taken forward various initiatives to promote primary care and encourage more use of private services. However, little is known in Hong Kong or elsewhere about consumers' willingness to pay (WTP) for private services when care is available in the public sector. This study assessed willingness of the Hong Kong elderly to pay for specific primary care and preventive services in the private sector, through a cross-sectional in-person questionnaire survey and focus group discussions among respondents. The survey revealed that the WTP for private services in general was low among the elderly; particularly, reported WTP for chronic conditions and preventive care both fell below the current market prices. Sub-group analysis showed higher WTP among healthier and more affluent elderly. Among other things, concerns over affordability and uncertainty (of price and quality) in the private sector were associated with this low level of WTP. These results suggest that most elderly, who are heavy users of public health services but with limited income, may not use more private services without seeing significant reduction in price. Financial incentives for consumers alone may not be enough to promote primary care or public-private partnership. Public education on the value of prevention and primary care, as well as supply-side interventions should both be considered. Hong Kong's policy-making process of the initiative studied here may also provide lessons for other countries with ongoing healthcare reforms.

  15. Cost comparison between private and public collection of residual household waste: Multiple case studies in the Flemish region of Belgium

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jacobsen, R., E-mail: ray.jacobsen@ugent.be; Buysse, J., E-mail: j.buysse@ugent.be; Gellynck, X., E-mail: xavier.gellynck@ugent.be

    2013-01-15

    Highlights: Black-Right-Pointing-Pointer The goal is to compare collection costs for residual household waste. Black-Right-Pointing-Pointer We have clustered all municipalities in order to find mutual comparable pairs. Black-Right-Pointing-Pointer Each pair consists of one private and one public operating waste collection program. Black-Right-Pointing-Pointer All cases show that private service has lower costs than public service. Black-Right-Pointing-Pointer Municipalities were contacted to identify the deeper causes for the waste management program. - Abstract: The rising pressure in terms of cost efficiency on public services pushes governments to transfer part of those services to the private sector. A trend towards more privatizing can be noticedmore » in the collection of municipal household waste. This paper reports the findings of a research project aiming to compare the cost between the service of private and public collection of residual household waste. Multiple case studies of municipalities about the Flemish region of Belgium were conducted. Data concerning the year 2009 were gathered through in-depth interviews in 2010. In total 12 municipalities were investigated, divided into three mutual comparable pairs with a weekly and three mutual comparable pairs with a fortnightly residual waste collection. The results give a rough indication that in all cases the cost of private service is lower than public service in the collection of household waste. Albeit that there is an interest in establishing whether there are differences in the costs and service levels between public and private waste collection services, there are clear difficulties in establishing comparisons that can be made without having to rely on a large number of assumptions and corrections. However, given the cost difference, it remains the responsibility of the municipalities to decide upon the service they offer their citizens, regardless the cost efficiency: public or private.« less

  16. Efficiency improvement of the investment and innovation activities in the transport facility construction field with public-private partnership involvement

    NASA Astrophysics Data System (ADS)

    Shibayeva, Marina; Serebryakova, Yelena; Shalnev, Oleg

    2017-10-01

    Growing demand to increase the investment volume in modernization and development projects for transport infrastructure define the urgency of the current study. The amount of private sector investments in the field is insufficient to implement the projects for road construction due to their significant capital intensity and long payoff period. The implementation of social significant infrastructure projects on the principles of public-private partnership is one of the key strategic directions of growth for transport facilities. The authors come up with a concept and methodology for modeling the investment and innovation activity in the transport facility construction. Furthermore, there is developed a model to find the balance between public and private sector investments in implementing construction projects for transport infrastructure with involvement of PPP (further - public-private partnership). The suggested concepts aim to improve the efficiency rate of the investment and innovation activity in the field of transport facility construction on the basis of public and private sectors collaboration.

  17. [Oral health knowledge and practices among pregnant women using health services in São Luís, Maranhão, Brazil, 2007-2008].

    PubMed

    Lopes, Fernanda Ferreira; Ribeiro, Tafnes Valverde; Fernandes, Daniela Braga; Calixto, Nayra Rodrigues de Vasconcelos; Alves, Cláudia Maria Coêlho; Pereira, Antônio Luiz Amaral; Pereira, Adriana de Fátima Vasconcelos

    2016-01-01

    to describe characteristics of oral health care during prenatal check-ups and knowledge about oral health among pregnant women using public and private health services in São Luís, Maranhão, Brazil. this is a descriptive study of 300 women interviewed in public health services and a further 300 interviewed in private health services between August 2007 and July 2008. tooth brushing frequency was similar among users of public and private services (p=0.156), while flossing (64.0% and 47.0%; p<0.001) and mouthwashing (39.7% and 27.0%; p=0.001) was more frequent among private service users in relation to public service users; most users of public services (60.3%) and private services (65.7%) were unaware of the association between oral health and pregnancy. frequency of tooth brushing was similar among pregnant women in public and private services; the effects of pregnancy on oral health were not well known.

  18. Recent trends in dental visits and private dental insurance, 1989 and 1999.

    PubMed

    Wall, Thomas P; Brown, L Jackson

    2003-05-01

    This article describes recent trends in dental visits and private dental insurance in the United States. This study is based on the analyses of data regarding dental visits and private dental insurance among the population 2 years of age or older from the 1989 and 1999 National Health Interview Surveys. Overall, the percentage of the population with a dental visit rose from 57.2 percent in 1989 to 64.1 percent in 1999, while the percentage with private dental insurance fell from 40.5 percent to 35.2 percent. Although a higher percentage of people with private dental insurance reported having a dental visit than did those without private dental insurance in both years, the increase from 1989 to 1999 in the percentage of those with a visit was larger among the uninsured. If this trend persists, a smaller portion of practicing dentist's clientele will be insured. This may affect demand for services, as well as front office operations.

  19. Hospital sector choice and support for public hospital care in New Zealand: Results from a labeled discrete choice survey.

    PubMed

    Brown, Paul; Panattoni, Laura; Cameron, Linda; Knox, Stephanie; Ashton, Toni; Tenbensel, Tim; Windsor, John

    2015-09-01

    This study uses a discrete choice experiment (DCE) to measure patients' preferences for public and private hospital care in New Zealand. A labeled DCE was administered to 583 members of the general public, with the choice between a public and private hospital for a non-urgent surgery. The results suggest that cost of surgery, waiting times for surgery, option to select a surgeon, convenience, and conditions of the hospital ward are important considerations for patients. The most important determinant of hospital choice was whether it was a public or private hospital, with respondents far more likely to choose a public hospital than a private hospital. The results have implications for government policy toward using private hospitals to clear waiting lists in public hospitals, with these results suggesting the public might not be indifferent to policies that treat private hospitals as substitutes for public hospitals. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Private speech of learning disabled and normally achieving children in classroom academic and laboratory contexts.

    PubMed

    Berk, L E; Landau, S

    1993-04-01

    Learning disabled (LD) children are often targets for cognitive-behavioral interventions designed to train them in effective use of a self-directed speech. The purpose of this study was to determine if, indeed, these children display immature private speech in the naturalistic classroom setting. Comparisons were made of the private speech, motor accompaniment to task, and attention of LD and normally achieving classmates during academic seatwork. Setting effects were examined by comparing classroom data with observations during academic seatwork and puzzle solving in the laboratory. Finally, a subgroup of LD children symptomatic of attention-deficit hyperactivity disorder (ADHD) was compared with pure LD and normally achieving controls to determine if the presumed immature private speech is a function of a learning disability or externalizing behavior problems. Results indicated that LD children used more task-relevant private speech than controls, an effect that was especially pronounced for the LD/ADHD subgroup. Use of private speech was setting- and task-specific. Implications for intervention and future research methodology are discussed.

  1. The Case for Private Speech as a Mode of Self-Formation: What Its Absence Contributes to Understanding Autism

    ERIC Educational Resources Information Center

    Shopen, Roey

    2014-01-01

    Private speech is common among 3- to 7-year-olds but rare among children with autism spectrum disorders (ASDs). Thus far, this phenomenon has only been studied in narrow cognitive contexts. This article presents a case for why the phenomenon of private speech is essential for the development of self and subjectivity and for why an analysis of…

  2. A sensitivity analysis of "Forests on the Edge: Housing Development on America's Private Forests."

    Treesearch

    Eric M. White; Ralph J. Alig; Lisa G. Mahal; David M. Theobald

    2009-01-01

    The original Forests on the Edge report (FOTE 1) indicated that 44.2 million acres of private forest land was projected to experience substantial increases in residential development in the coming decades. In this study, we examined the sensitivity of the FOTE 1 results to four factors: (1) use of updated private land and forest cover spatial data and a revised model...

  3. Federal procurement metrication appropriateness and methods

    NASA Astrophysics Data System (ADS)

    Coella, M. A.

    1982-09-01

    This study was designed to provide the USMB with a clearer understanding of the basic relationships between the Federal procurement process and private sector suppliers. This was done to gain an understanding of the ways in which Federal procurement can encourage and accommodate initiatives of the private sector and to ensure that the effects of conversion on the Federal and private sectors are understood prior to implementation of procurement decisions and actions.

  4. Does Growth in Private Schooling Contribute to Education for All? Evidence from a Longitudinal, Two Cohort Study in Andhra Pradesh, India

    ERIC Educational Resources Information Center

    Woodhead, Martin; Frost, Melanie; James, Zoe

    2013-01-01

    This paper informs debates about the potential role for low-fee private schooling in achieving Education for All goals in India. It reports "Young Lives" longitudinal data for two cohorts (2906 children) in the state of Andhra Pradesh. Eight year olds uptake of private schooling increased from 24 per cent (children born in 1994-5) to 44…

  5. Ethical Issues Raised by Private Practice Physiotherapy Are More Diverse than First Meets the Eye: Recommendations from a Literature Review

    PubMed Central

    Drolet, Marie-Josée; Williams-Jones, Bryn

    2015-01-01

    ABSTRACT Purpose: Physiotherapy in private practice differs from physiotherapy practised in a public setting in several ways, the most evident of which is the for-profit nature of private physiotherapy clinics; these differences can generate distinct and challenging ethical issues. The objectives of this article are to identify ethical issues encountered by physiotherapists in private practice settings and to identify potential solutions and recommendations to address these issues. Method: After a literature search of eight databases, 39 studies addressing ethical issues in a private practice context were analyzed. Results: A total of 25 ethical issues emerging from the included studies were classified into three main categories: (1) business and economic issues (e.g., conflicts of interests, inequity in a managed care context, lack of time affecting quality of care); (2) professional issues (e.g., professional autonomy, clinical judgment, treatment effectiveness, professional conduct); and (3) patients' rights and welfare issues (e.g., confidentiality, power asymmetries, paternalism vs. patient autonomy, informed consent). Recommendations as to how physiotherapists could better manage these issues were then identified and categorized. Conclusions: The physiotherapy community should reflect on the challenges raised by private practice so that professionals can be supported—through education, research, and good governance—in providing the best possible care for their patients. PMID:25931663

  6. Determination of aluminium and physicochemical parameters in the palm oil estates water supply at Johor, Malaysia.

    PubMed

    Siti Farizwana, M R; Mazrura, S; Zurahanim Fasha, A; Ahmad Rohi, G

    2010-01-01

    The study was to determine the concentration of aluminium (Al) and study the physicochemical parameters (pH, total dissolved solids (TDS), turbidity, and residual chlorine) in drinking water supply in selected palm oil estates in Kota Tinggi, Johor. Water samples were collected from the estates with the private and the public water supplies. The sampling points were at the water source (S), the treatment plant outlet (TPO), and at the nearest houses (H1) and the furthest houses (H2) from the TPO. All estates with private water supply failed to meet the NSDWQ for Al with mean concentration of 0.99 ± 1.52 mg/L. However, Al concentrations in all public water supply estates were well within the limit except for one estate. The pH for all samples complied with the NSDWQ except from the private estates for the drinking water supply with an acidic pH (5.50 ± 0.90). The private water supply showed violated turbidity value in the drinking water samples (14.2 ± 24.1 NTU). Insufficient amount of chlorination was observed in the private water supply estates (0.09 ± 0.30 mg/L). Private water supplies with inefficient water treatment served unsatisfactory drinking water quality to the community which may lead to major health problems.

  7. Comparing market orientation culture of businesses and schools of business: an extension and refinement.

    PubMed

    Webster, Robert L; Hammond, Kevin L; Harmon, Harry A

    2005-04-01

    This study extends previous work concerning the market orientation culture within specialty businesses and schools of business. Specifically, member schools of the Association to Advance Collegiate Schools of Business International are separated into public and private universities. Data were collected via a mailed survey to business schools holding membership. 106 public school deans and 35 private school deans responded, for a 23% response rate. Input from the deans was sought on their perceptions of the market orientation culture within the schools. Respondents' perceptions, rated on a 7-point scale, measured four dimensions of market orientation: customer orientation, competitor orientation, organizational coordination, and overall market orientation. Data for specialty businesses were drawn from a previous study. Comparison testing between the public and private business schools' deans and business managers was conducted. Analysis indicated perceived market orientation was significantly higher for deans of private business schools than public business schools. Compared with business managers, private school deans were statistically different on only one of the four dimensions, whereas public business school deans' scores were significantly different from those of business managers on all four. Compared with each other, business school deans were statistically different on three dimensions, with private school deans reporting greater market orientation.

  8. Emergency obstetric and newborn care signal functions in public and private facilities in Bangladesh.

    PubMed

    Roy, Lumbini; Biswas, Taposh Kumar; Chowdhury, Mahbub Elahi

    2017-01-01

    Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for averting maternal and neonatal mortalities. Readiness of the facilities is essential to provide all the basic and comprehensive signal functions for EmONC to ensure emergency services from the designated facilities. The study assessed population coverage and availability of EmONC services in public and private facilities in Bangladesh. An assessment was conducted in all the public and private facilities providing obstetric care in to in-patients 24 districts. Data were collected on the performance of signal functions for EmONC from the study facilities in the last three months prior to the date of assessment. Trained data-collectors interviewed the facility managers and key service providers, along with review of records, using contextualized tools. Population coverage of signal functions was assessed by estimating the number of facilities providing the signal functions for EmONC compared to the United Nations requirements. Availability was assessed in terms of the proportion of facilities providing the services by type of facilities and by district. Caesarean section (CS) delivery and blood transfusion (BT) services (the two major components of comprehensive EmONC) were respectively available in 6.4 (0.9 public and 5.5 private) and 5.6 (1.3 public and 4.3 private) facilities per 500,000 population. The signal functions for basic EmONC, except two (parental anticonvulsants and assisted vaginal delivery), were available in a minimum of 5 facilities (public and private sectors combined) per 500,000 population. A major inter-district variation in the availability of signal functions was observed in each public- and private-sector facility. Among the various types of facilities, only the public medical college hospitals had all the signal functions. The situation was poor in other public facilities at the district and sub-district levels as well as in private facilities. In the public sector, CS delivery and BT services were available in the minimum required number of facilities. However, to ensure basic EmONC services, participation of the private sector is necessary. Public-private partnership should be promoted for nationwide coverage of signal functions for EmONC in Bangladesh.

  9. Relationships among Ensemble Participation, Private Instruction, and Aural Skill Development.

    ERIC Educational Resources Information Center

    May, William V.; Elliott, Charles A.

    1980-01-01

    This study sought to determine the relationships that exist among junior high school students' participation in school performing ensembles, those skills measured by the Gaston Test of Musicality, and the number of years of private study on the piano or on ensemble instruments. (Author/SJL)

  10. Utilization of HIV-related services from the private health sector: A multi-country analysis.

    PubMed

    Wang, Wenjuan; Sulzbach, Sara; De, Susna

    2011-01-01

    Increasing the participation of the private health sector in the AIDS response could help to achieve universal access to comprehensive HIV prevention, treatment, care and support. Yet little is known about the extent to which the private health sector is delivering HIV-related services. This study uses data from the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) from 12 countries in Africa, Asia and Latin America and the Caribbean to explore use of HIV testing and STI care from the private for-profit sector, and its association with household wealth status. The analysis indicates that the private for-profit health sector is active in HIV-related service delivery, although the level of participation varies by region and country. From 3 to 45 percent of women and 6 to 42 percent of men reported the private for-profit sector as their source of the most recent HIV testing. While in some countries, use of the private for-profit health sector for HIV testing and STI care increases with wealth, in others the relationship is not clear, as there are no significant differences in using private for-profit HIV-related services between the rich and the poor. We conclude that as the global AIDS response evolves from emergency relief to sustained country programs, broader consideration of the role of the private for-profit health sector may be warranted. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Abortion services at hospitals in Istanbul.

    PubMed

    O'Neil, Mary Lou

    2017-04-01

    Despite the existence of a liberal law on abortion in Turkey, there is growing evidence that actually securing an abortion in Istanbul may prove difficult. This study aimed to determine whether or not state hospitals and private hospitals that accept state health insurance in Istanbul are providing abortion services and for what indications. Between October and December 2015, a mystery patient telephone survey of 154 hospitals, 43 public and 111 private, in Istanbul was conducted. 14% of the state hospitals in Istanbul perform abortions without restriction as to reason provided in the current law while 60% provide the service if there is a medical necessity. A quarter of state hospitals in Istanbul do not provide abortion services at all. 48.6% of private hospitals that accept the state health insurance also provide for abortion without restriction while 10% do not provide abortion services under any circumstances. State and private hospitals in Istanbul are not providing abortion services to the full extent allowed under the law. The low numbers of state hospitals offering abortions without restriction indicates a de facto privatization of the service. This same trend is also visible in many private hospitals partnering with the state that do not provide abortion care. While many women may choose a private provider, the lack of provision of abortion care at state hospitals and those private hospitals working with the state leaves women little option but to purchase these services from private providers at some times subtantial costs.

  12. Impact of the federal contraceptive coverage guarantee on out-of-pocket payments for contraceptives: 2014 update.

    PubMed

    Sonfield, Adam; Tapales, Athena; Jones, Rachel K; Finer, Lawrence B

    2015-01-01

    The Affordable Care Act requires most private health plans to cover contraceptive methods, services and counseling, without any out-of-pocket costs to patients; that requirement took effect for millions of Americans in January 2013. Data for this study come from a subset of the 1842 women aged 18-39 years who responded to all four waves of a national longitudinal survey. This analysis focuses on the 892 women who had private health insurance and who used a prescription contraceptive method during any of the four study periods. Women were asked about the amount they paid out of pocket in an average month for their method of choice. Between fall 2012 and spring 2014, the proportion of privately insured women paying zero dollars out of pocket for oral contraceptives increased substantially, from 15% to 67%. Similar changes occurred among privately insured women using injectable contraception, the vaginal ring and the intrauterine device. The implementation of the federal contraceptive coverage requirement appears to have had a notable impact on the out-of-pocket costs paid by privately insured women, and that impact has increased over time. This study measures the out-of-pocket costs for women with private insurance prior to the federal contraceptive coverage requirement and after it took effect; in doing so, it highlights areas of progress in eliminating these costs. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  13. Private or NHS General Dental Service care in the United Kingdom? A study of public perceptions and experiences.

    PubMed

    Hancock, M; Calnan, M; Manley, G

    1999-12-01

    Recent changes in the NHS General Dental Service have led to a reduction in the availability of NHS dental care and increased charges. This study explores public and user views and experiences of NHS and private dental care in the light of these changes. The study employed a combination of quantitative and qualitative methods. The first phase involved a postal survey of a random sample of adults on the electoral registers in a county in Southern England, which yielded a response rate of 55 per cent (n = 1506). Follow-up face-to-face interviews were carried out with sub-samples (n = 50) selected from survey respondents. The evidence shows greater satisfaction with certain aspects of private care than with NHS dental care and suggests that the decline in perceived quality of NHS care is less to do with the quality of dental technical skills and more to do with perceived access and availability. However, there was general support for the egalitarian principles associated with NHS dentistry, although payment for dental care by users was acceptable even though dentistry on the NHS was preferred. The shift in the balance of NHS and private dental care reflects the interests and preferences of dentists rather than of the public. It suggests, however, that a continued shift towards private practice is a trend that the public will not find acceptable, which might limit the extent of expansion of private practice.

  14. Is the public healthcare sector a more strenuous working environment than the private sector for a physician?

    PubMed

    Heponiemi, Tarja; Kouvonen, Anne; Sinervo, Timo; Elovainio, Marko

    2013-02-01

    The present study examined the differences between physicians working in public and private health care in strenuous working environments (presence of occupational hazards, physical violence, and presenteeism) and health behaviours (alcohol consumption, body mass index, and physical activity). In addition, we examined whether gender or age moderated these potential differences. Cross-sectional survey data were compiled on 1422 female and 948 male randomly selected physicians aged 25-65 years from The Finnish Health Care Professionals Study. Logistic regression and linear regression analyses were used with adjustment for gender, age, specialisation status, working time, managerial position, and on-call duty. Occupational hazards, physical violence, and presenteeism were more commonly reported by physicians working in the public sector than by their counterparts in the private sector. Among physicians aged 50 years or younger, those who worked in the public sector consumed more alcohol than those who worked in the private sector, whereas in those aged 50 or more the reverse was true. In addition, working in the private sector was most strongly associated with lower levels of physical violence in those who were older than 50 years, and with lower levels of presenteeism among those aged 40-50 years. The present study found evidence for the public sector being a more strenuous work environment for physicians than the private sector. Our results suggest that public healthcare organisations should pay more attention to the working conditions of their employees.

  15. Between hype and veracity; privatization of municipal solid waste management and its impacts on the informal waste sector.

    PubMed

    Sandhu, Kiran; Burton, Paul; Dedekorkut-Howes, Aysin

    2017-01-01

    The informal waste recycling sector has been an indispensable but ironically invisible part of the waste management systems in developing countries as India, often completely disregarded and overlooked by decision makers and policy frameworks. The turn towards liberalization of economy since 1991 in India opened the doors for privatization of urban services and the waste sector found favor with private companies facilitated by the local governments. In joining the privatization bandwagon, the local governments aim to create an image of a progressive city demonstrated most visibly through apt management of municipal solid waste. Resultantly, the long important stakeholder, the informal sector has been sidelined and left to face the adverse impacts of privatization. There is hardly any recognition of its contributions or any attempt to integrate it within the formal waste management systems. The study investigates the impacts of privatization on the waste pickers in waste recycling operations. Highlighting the other dimension of waste collection and management in urban India the study focuses on the waste pickers and small time informal scrap dealers and this is done by taking the case study of Amritsar city, which is an important historic centre and a metropolitan city in the state of Punjab, India. The paper develops an analytical framework, drawing from literature review to analyze the impacts. In conclusion, it supports the case for involving informal waste sector towards achieving sustainable waste management in the city. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Linking private, for-profit providers to public sector services for HIV and tuberculosis co-infected patients: A systematic review

    PubMed Central

    Hudson, Mollie; Rutherford, George W.; Weiser, Sheri; Fair, Elizabeth

    2018-01-01

    Background Tuberculosis (TB) is the leading cause of infectious disease deaths worldwide and is the leading cause of death among people with HIV. The World Health Organization (WHO) has called for collaboration between public and private healthcare providers to maximize integration of TB/HIV services and minimize costs. We systematically reviewed published models of public-private sector diagnostic and referral services for TB/HIV co-infected patients. Methods We searched PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Science Direct, CINAHL and Web of Science. We included studies that discussed programs that linked private and public providers for TB/HIV concurrent diagnostic and referral services and used Review Manager (Version 5.3, 2015) for meta-analysis. Results We found 1,218 unduplicated potentially relevant articles and abstracts; three met our eligibility criteria. All three described public-private TB/HIV diagnostic/referral services with varying degrees of integration. In Kenya private practitioners were able to test for both TB and HIV and offer state-subsidized TB medication, but they could not provide state-subsidized antiretroviral therapy (ART) to co-infected patients. In India private practitioners not contractually engaged with the public sector offered TB/HIV services inconsistently and on a subjective basis. Those partnered with the state, however, could test for both TB and HIV and offer state-subsidized medications. In Nigeria some private providers had access to both state-subsidized medications and diagnostic tests; others required patients to pay out-of-pocket for testing and/or treatment. In a meta-analysis of the two quantitative reports, TB patients who sought care in the public sector were almost twice as likely to have been tested for HIV than TB patients who sought care in the private sector (risk ratio [RR] 1.98, 95% confidence interval [CI] 1.88–2.08). However, HIV-infected TB patients who sought care in the public sector were marginally less likely to initiate ART than TB patients who sought care from private providers (RR 0.89, 95% CI 0.78–1.03). Conclusion These three studies are examples of public-private TB/HIV service delivery and can potentially serve as models for integrated TB/HIV care systems. Successful public-private diagnostic and treatment services can both improve outcomes and decrease costs for patients co-infected with HIV and TB. PMID:29634772

  17. Nutrition Knowledge and Attitude Change of Students Studying in State and Private Secondary Schools

    ERIC Educational Resources Information Center

    Kivrak, Ali Osman; Altin, Mehmet

    2018-01-01

    The aim of this study is to analyse the changes in nutrition knowledge and attitudes of secondary school students depending on certain socio-demographic factors. The universe of the study is composed of 521 students, including 142 female and 379 male students studying in the secondary school and the sampling group in Konya province private and…

  18. A Case Study: Motivating and Supporting Faculty Members Who Teach Online Courses in a Private University

    ERIC Educational Resources Information Center

    Mann, Cristen

    2013-01-01

    The purpose of this qualitative case study was to explore how faculty members teaching online courses at one private university perceived the types of pedagogical training and support they needed in order to effectively facilitate online courses. Building on the theoretical foundation of andragogy, the study of adult education, this study explored…

  19. Development of a Program to Enhance Curriculum and Learning Management Competency of Private Primary School Teachers

    ERIC Educational Resources Information Center

    Panichpongsapak, Ratthasart; Tesaputa, Kowat; Sri-ampai, Anan

    2016-01-01

    The aims of this research were: (1) to study the factors and indicators to enhance curriculum and learning management competency of private primary school teachers; (2) to study current situations and desirable situations and techniques; (3) to develop a program; and (4) to study the effects of a program. The study comprised 4 phases: Phase…

  20. Secure multiparty computation of a comparison problem.

    PubMed

    Liu, Xin; Li, Shundong; Liu, Jian; Chen, Xiubo; Xu, Gang

    2016-01-01

    Private comparison is fundamental to secure multiparty computation. In this study, we propose novel protocols to privately determine [Formula: see text], or [Formula: see text] in one execution. First, a 0-1-vector encoding method is introduced to encode a number into a vector, and the Goldwasser-Micali encryption scheme is used to compare integers privately. Then, we propose a protocol by using a geometric method to compare rational numbers privately, and the protocol is information-theoretical secure. Using the simulation paradigm, we prove the privacy-preserving property of our protocols in the semi-honest model. The complexity analysis shows that our protocols are more efficient than previous solutions.

  1. Systems development and difficulties in implementing procedures for elder abuse prevention among private community general support centers in Japan.

    PubMed

    Nakanishi, Miharu; Nakashima, Taeko; Yamaoka, Yukako; Hada, Keiko; Tanaka, Hideaki

    2014-01-01

    The present study examines differences in systems development and difficulties in implementing procedures for elder abuse prevention in 1,119 private and 606 public community general support centers under the public long-term care insurance program in Japan. The private community general support centers showed more difficulty implementing procedures than the public community general support centers. Controlling for the type of municipality, progress in systems development did not differ between the private and public community general support centers. Further research should examine how the characteristics of municipal governments are related to systems development in community general support centers.

  2. The Turkish commercial health insurance industry.

    PubMed

    Kisa, A

    2001-08-01

    Turkey has experienced significant development in the private health insurance market since 1991. Improvements in private health services, increased public awareness, and insufficient service delivery by the social security organizations have encouraged more people to buy private health insurance. The number of people covered by private health insurance has reached 600,000, forming a $200 million market. The Turkish insurance industry is targeting 6-8 million insurance holders before the year 2005. This study examines the structure of the commercial health insurance industry of Turkey and gives the latest policy and legal changes made in the insurance market by the Turkish government to affect supply and demand.

  3. Private health insurance: New measures of a complex and changing industry

    PubMed Central

    Arnett, Ross H.; Trapnell, Gordon R.

    1984-01-01

    Private health insurance benefit payments are an integral component of estimates of national health expenditures. Recent analyses indicate that the insurance industry has undergone significant changes since the mid-1970's. As a result of these study findings and corresponding changes to estimating techniques, private health insurance estimates have been revised upward. This has had a major impact on national health expenditure estimates. This article describes the changes that have occurred in the industry, discusses some of the implications of those changes, presents a new methodology to measure private health insurance and the resulting estimate levels, and then examines concepts that underpin these estimates. PMID:10310950

  4. Outsourcing in private healthcare organisations: a Greek perspective.

    PubMed

    Moschuris, Socrates J; Kondylis, Michael N

    2007-01-01

    The purpose of this paper is to present a study carried out to investigate the extent of outsourcing, the decision-making process, the impact of outsourcing, and the future trend of outsourcing in private healthcare organisations in Greece. A survey instrument was designed and mailed to a random sample of 100 private healthcare organisations in Greece. A total of 25 usable questionnaires were received, representing a response rate of 25 percent. The survey instrument focused on the extent to which private healthcare organisations outsource services, the decision-making process for choosing an external service provider, the impact of outsourcing, and the future trend of outsourcing. Private healthcare organisations in Greece outsource a variety of activities. Cost savings, customisation, and customer satisfaction are the main factors affecting the outsourcing decision. The cooperation with a contract service provider has led to an improvement in customer satisfaction and to a cost reduction. Most users are highly satisfied with the performance of these companies and believe that there will be a future increase in the usage of these services. The paper provides a framework regarding outsourcing in private healthcare organisations. This research fills the gap in the area of outsourcing in private healthcare organisations in Greece.

  5. [On the issues of private-public partnership in health care: the case of organization of optometric service)].

    PubMed

    2011-01-01

    The article deals with the issue of private-public partnership in health care. It is demonstrated that in many countries health care system condition is characterized by increase of problems in organization, financing and provision of medical sanitary care. The exponent up growth of aggregate costs of health care, medical services financing occurs. The system of public and municipal health care has no adequate resources to efficiently function without interaction with private organizations. The reason is that most of the suppliers of medical services are not public or municipal belonging. It is necessary to provide inter-financing of curative preventive care at the expense of funds of public and private economic sectors within a framework of full-scale implementation health care the mechanisms of private-public partnership. The studies in this field are to be organized on the example of organizational specificity of optometric service which is positioned concurrently in public and private sectors. This approach makes it possible to reveal feasible ways of implementation of the private-public partnership institution to enhance quality and accessibility of medical care to population in the conditions of concurrent model of health care and globalization challenges.

  6. Trends in the distribution of health care financing across developed countries: the role of political economy of states.

    PubMed

    Calikoglu, Sule

    2009-01-01

    Since the 1980s, major health care reforms in many countries have focused on redefining the boundaries of government through increasing emphasis on private sources of finance and delivery of health care. Apart from managerial and financial choices, the reliance on private sources reflects the political character of a country. This article explores whether the public-private mix of health care financing differs according to political traditions in a sample of 18 industrialized countries, analyzing a 30-year period. The results indicate that despite common trends in all four political traditions during the study period, the overall levels of expenditure and the rates of growth in public and private expenditures were different. Christian democratic countries had public expenditure levels as high as those in social democracies, but high levels of private expenditure differentiated them from the social democracies. Christian democratic countries also relied on both private insurance and out-of-pocket payments, while private insurance expenditures were very limited in social democratic countries. The level of public spending increased at much higher rates among ex-authoritarian countries over the 30 years, bringing these countries to the level of liberal countries by 2000.

  7. Neural correlates of informational cascades: brain mechanisms of social influence on belief updating

    PubMed Central

    Klucharev, Vasily; Rieskamp, Jörg

    2015-01-01

    Informational cascades can occur when rationally acting individuals decide independently of their private information and follow the decisions of preceding decision-makers. In the process of updating beliefs, differences in the weighting of private and publicly available social information may modulate the probability that a cascade starts in a decisive way. By using functional magnetic resonance imaging, we examined neural activity while participants updated their beliefs based on the decisions of two fictitious stock market traders and their own private information, which led to a final decision of buying one of two stocks. Computational modeling of the behavioral data showed that a majority of participants overweighted private information. Overweighting was negatively correlated with the probability of starting an informational cascade in trials especially prone to conformity. Belief updating by private information was related to activity in the inferior frontal gyrus/anterior insula, the dorsolateral prefrontal cortex and the parietal cortex; the more a participant overweighted private information, the higher the activity in the inferior frontal gyrus/anterior insula and the lower in the parietal-temporal cortex. This study explores the neural correlates of overweighting of private information, which underlies the tendency to start an informational cascade. PMID:24974396

  8. Assessment of the impact of market regulation in Mali on the price of essential medicines provided through the private sector.

    PubMed

    Maïga, Diadié; Williams-Jones, Bryn

    2010-10-01

    In 1998, the government of Mali adopted a national pharmaceutical policy aimed at promoting a supply system for generic essential medicines that would guarantee equal access for all citizens. Distribution and delivery is a shared responsibility of both public and private sectors (wholesalers and pharmacies). To influence private sector behaviour, the national policy uses a combination of government regulation and market forces. In 2006, the government issued a decree fixing maximum prices in the private sector for 107 prescription drugs from the national list of 426 essential medicines. The current study assessed the impact of this intervention on the evolution of market prices (wholesale and retail), and the subsequent availability and public access to essential medicines in Mali. A cross-sectional descriptive survey was conducted in February and May 2006, and January 2009, with 16 wholesalers and 30 private drugstores in Bamako, Mali. The overall availability of essential medicines at private wholesalers (p=1) and pharmacies (p=0.53) was identical before and after the enforcement of the 2006 decree fixing maximum drug prices. Contrary to concerns expressed by wholesalers and pharmacies, and the other stakeholders, the decree did not impact negatively on availability of essential medicines. In fact, median wholesale prices in 2009 were 25.6% less than those fixed by the decree. In private pharmacies, retail prices were only 3% more expensive than the recommended prices, compared with being 25.5% more expensive prior to enforcement of the decree. The study shows that prices of essential medicines in Mali have evolved favourably towards the prices recommended by the government decree. Further, the study contributes to mounting evidence that market regulation by governments does not necessarily negatively affect drug availability; in fact, given the reduction in prices, the study shows that Malians arguably have better access to more affordable essential medicines. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Policies to Spur Energy Access. Executive Summary; Volume 1, Engaging the Private Sector in Expanding Access to Electricity; Volume 2, Case Studies to Public-Private Models to Finance Decentralized Electricity Access

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Walters, Terri; Rai, Neha; Esterly, Sean

    Government policy is one of the most important factors in engaging the private sector in providing universal access to electricity. In particular, the private sector is well positioned to provide decentralized electricity products and services. While policy uncertainty and regulatory barriers can keep enterprises and investors from engaging in the market, targeted policies can create opportunities to leverage private investment and skills to expand electricity access. However, creating a sustainable market requires policies beyond traditional electricity regulation. The report reviews the range of policy issues that impact the development and expansion of a market for decentralized electricity services from establishingmore » an enabling policy environment to catalyzing finance, building human capacity, and integrating energy access with development programs. The case studies in this report show that robust policy frameworks--addressing a wide range of market issues--can lead to rapid transformation in energy access. The report highlights examples of these policies in action Bangladesh, Ethiopia, Mali, Mexico, and Nepal.« less

  10. Start Later, Sleep Later: School Start Times and Adolescent Sleep in Homeschool vs. Public/Private School Students

    PubMed Central

    Meltzer, Lisa J.; Shaheed, Keisha; Ambler, Devon

    2014-01-01

    Homeschool students provide a naturalistic comparison group for later/flexible school start times. This study compared sleep patterns and sleep hygiene for homeschool students and public/private school students (grades 6-12). Public/private school students (n=245) and homeschool students (n=162) completed a survey about sleep patterns and sleep hygiene. Significant school group differences were found for weekday bedtime, wake time, and total sleep time, with homeschool students waking later and obtaining more sleep. Homeschool students had later school start times, waking at the same time that public/private school students were starting school. Public/private school students had poorer sleep hygiene practices, reporting more homework and use of technology in the hour before bed. Regardless of school type, technology in the bedroom was associated with shorter sleep duration. Later school start times may be a potential countermeasure for insufficient sleep in adolescents. Future studies should further examine the relationship between school start times and daytime outcomes, including academic performance, mood, and health. PMID:25315902

  11. [Privatization of health care management through Social Organizations in the city of São Paulo, Brazil: description and analysis of regulation].

    PubMed

    Contreiras, Henrique; Matta, Gustavo Corrêa

    2015-02-01

    The article describes and discusses privatization of the municipal health system in São Paulo, Brazil, from an administrative and political perspective. The methodology consisted of a literature review and analysis of legislation and public documents. The study showed that although legislation governing the so-called "Social Organizations" (OS) in Brazil dates to the year 2006, half of the administrative privatization is still regulated by a previous provisional instrument in the form of an "agreement" ("convênio" in Portuguese). In 2011, 61% of services were administered by private organizations, which received 44% of the health budget in 2012. The twenty participating organizations include five of the ten largest health care companies in Brazil. Inspection agencies have detected flaws in the management contracts, but the "agreements" (convênios) are subject to less rigorous control and have proven invisible to inspection. Finally, the legal framework is unstable. The study uses the experience in São Paulo as the basis for discussing the political versus technical nature of private management in the Brazilian Unified National Health System (SUS).

  12. Academic Leadership in a Private University: An Iranian Case Study

    ERIC Educational Resources Information Center

    Hamidifar, Fatemeh; Ebrahimi, Mansoureh

    2016-01-01

    This study explores effective academic leadership as well as hindrances within Iran's private higher educational institutions. The author employed a qualitative approach that utilized purposive sampling to collect and analyze data. Findings were categorized into three classes comprising the (i) setting of direction, (ii) organizational and (iii)…

  13. Private Landowners Rate Forest Certification

    Treesearch

    Richard P. Vlosky

    1999-01-01

    Dr. Richard Vlosky, Associate Professor of Forest Products Marketing, School of Forestry, Wildlife, and Fisheries at the Louisiana State University Agricultural Center in Baton Rouge recently cotlducted a study that identifies Louisiana non-indi1strial private forest attitudes toward third-party forestry certification. This study was suported by a grant...

  14. Surveillance on University Students' Living Behaviors in the Private Residence, Prathumthani, Thailand

    ERIC Educational Resources Information Center

    Luckanavanich, Suwannee

    2011-01-01

    The purpose of this study was to investigate the relationship among lifestyles, personal relationship (friendship and romantic relationship), and living behaviors shared with closed friends and romantic friends. The study undertook a quantitative research of university students' living behaviors in the private residence. A survey questionnaire was…

  15. Flauto: An Ethnographic Study of a Highly Successful Private Studio

    ERIC Educational Resources Information Center

    Montemayor, Mark

    2008-01-01

    This study examined the instructional settings, pedagogical techniques, interpersonal dynamics and personal characteristics of a teacher and her adolescent students in a renowned private flute studio. Using ethnographic techniques including observations and interviews, four main themes emerged that seem to contribute to the satisfaction of the…

  16. Likelihood of Timber Management on Nonindustrial Private Forests: Evidence From Research Studies

    Treesearch

    Ralph J. Alig; Karen J. Lee; Robert J. Moulton

    1990-01-01

    Research on timber management tendencies by nonindustrial private forest owners, while sometimes conflicting, provides useful information to support policy analyses of timber supply and investment behavior. Numerous research studies regarding tree planting, intermediate stand treatments, and timber harvesting are reviewed. Conclusive research findings include that: (1...

  17. Impact of Accreditation on Public and Private Universities: A Comparative Study

    ERIC Educational Resources Information Center

    Dattey, Kwame; Westerheijden, Don F.; Hofman, Wiecher H. Adriaan

    2014-01-01

    Based on two cycles of assessments for accreditation, this study assesses the differential impacts of accreditation on public and private universities in Ghana. Analysis of the evaluator reports indicates no statistically significant difference--improvement or deterioration--between the two cycles of evaluations for both types of institutions. A…

  18. Leadership in New Hampshire Independent Schools: An Examination of Trust and Openness to Change

    ERIC Educational Resources Information Center

    D'Entremont, John P.

    2016-01-01

    The study of leadership is extensive in business and public education. Research on headmaster leadership in private schools is limited. This mixed methods study aimed to determine if exemplary private school headmaster leadership practices builds faculty trust creating an openness to change. The sample in the study consisted of five National…

  19. On the Edge: A Study of Small Private Colleges That Have Made a Successful Financial Turnaround

    ERIC Educational Resources Information Center

    Carey, Amy Bragg

    2014-01-01

    This article describes a qualitative study that involved two small private universities, examining their process of transformation from institutions headed toward closure to institutions that underwent a successful turnaround. The primary questions that guided the study included the issues and circumstances that led to the need for a turnaround,…

  20. Promoting Effective Assessment for Learning Methods to Increase Student Motivation in Schools in India

    ERIC Educational Resources Information Center

    Panesar-Aguilar, Sunddip; Aguilar, Erick

    2017-01-01

    This qualitative study explored how using effective assessment can engage learners and motivate student learning in the Dehradun, Noida, Delhi, and Trivandrum regions in India. The study randomly sampled 26 teachers from six private schools. Private schools were used in this study since such schools allot substantial funds to support ongoing…

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