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Article
Publication date: 8 January 2020

Ajantha Sisira Kumara and Ramanie Samaratunge

The purpose of this paper is to explore the determinants of health insurance ownership of individuals in the Sri Lankan labor force and to examine how insurance ownership…

Abstract

Purpose

The purpose of this paper is to explore the determinants of health insurance ownership of individuals in the Sri Lankan labor force and to examine how insurance ownership impacts healthcare utilization.

Design/methodology/approach

The authors first used logit model to explore determinants of health insurance ownership. The authors then employed propensity score matching method to estimate impact of insurance ownership on healthcare utilization. Data were obtained from national survey of self-reported health in Sri Lanka – 2014 (n=59,276). National survey of self-reported health in Sri Lanka – 2014 was conducted by the Department of Census and Statistics from January to December 2014.

Findings

Results showed that individuals with higher educational attainments, headed by literate-heads, based in urban sector, employed in formal sector, and with health adversities and higher degree of risk propensity are more inclined to have a health cover. Health insurance ownership reduces the likelihood of utilizing public facilities while increasing the likelihood of utilizing private facilities for non-communicable diseases (NCDs) and acute illnesses. Welfare consequences of expanding insurance ownership are doubtful due to oligopolistic private healthcare market and adverse selection issue faced by insurers in Sri Lanka.

Originality/value

This is the first study examining health insurancehealthcare utilization nexus based on Sri Lanka-wide microdata. Also, the study applies bias-corrected matching methods to establish causal links between two constructs. Without being so generalized, healthcare utilization is examined in terms of NCD care and Acute illnesses care, which improves robustness of results and leads to evidence-based healthcare policies.

Peer review

The peer review history for this paper is available at: https//publons.com/publon/10.1108/IJSE-05-2019-0333.

Details

International Journal of Social Economics, vol. 47 no. 2
Type: Research Article
ISSN: 0306-8293

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Article
Publication date: 14 April 2014

Robert Salvino, Michael Tasto and Gregory Randolph

– The purpose of this paper is to examine the long-run impact of federal government healthcare subsidies on the level of entrepreneurship as measured by self-employment.

Abstract

Purpose

The purpose of this paper is to examine the long-run impact of federal government healthcare subsidies on the level of entrepreneurship as measured by self-employment.

Design/methodology/approach

Using annual healthcare and employment data from 1948 through 1999, the paper empirically examines the relationship between the growth in employer-provided healthcare and the rate of self-employment as a share of the non-agriculture, civilian labor force.

Findings

The regression results imply that there is a consistent effect that has appeared over time – where federal healthcare subsidies have disproportionately benefitted larger firms, contributing to the decline in the rate of self-employment, within-firm innovation, and factor mobility over time.

Research limitations/implications

The research in this study is limited by the examination of self-employment only and a constant institutional structure across all states, only varying across time for the entire USA. In addition, an empirical study looking at how the value of healthcare benefits have changed over time – vs the sole question in this study that depends upon whether or not an individual is covered or not would be very useful in determining the true effect on an entrepreneur.

Social implications

Reducing or removing the layers of healthcare subsidies would bring about an increase in the transparency of the wage-productivity relationship and a more efficient allocation of labor and entrepreneurial ability across firm sizes.

Originality/value

This paper presents empirical evidence supporting specific improvements to national healthcare policy at a time when such policy is undergoing significant change with consequences for entrepreneurial decision making.

Details

Journal of Entrepreneurship and Public Policy, vol. 3 no. 1
Type: Research Article
ISSN: 2045-2101

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Article
Publication date: 25 September 2019

Bishwajit Nayak, Som Sekhar Bhattacharyya and Bala Krishnamoorthy

Social health insurance framework of any country is the national identifier of the country’s policy for taking care of its population which cannot access or afford quality…

Abstract

Purpose

Social health insurance framework of any country is the national identifier of the country’s policy for taking care of its population which cannot access or afford quality healthcare. The purpose of this paper is to highlight the strategic imperatives of digital technology for the inclusive social health models for the BoP customers.

Design/methodology/approach

A qualitative exploratory study using in-depth personal interviews with 53 Indian health insurance CXOs was conducted with a semi-structured questionnaire. Using MaxQDA software, the interview transcripts were analyzed by means of thematic content analysis technique and patterns identified based on the expert opinions.

Findings

A framework for the strategic imperatives of digital technology in social health insurance emerged from the study highlighting three key themes for technology implementation in the social health insurance sector – analytics for risk management, cost optimization for operations and enhancement of customer experience. The study results provide key insights about how insurers can enhance the coverage of BoP population by leveraging technology.

Social implications

The framework would help health insurers and policymakers to select strategic choices related to technology that would enable creation of inclusive health insurance models for BoP customers.

Originality/value

The absence of specific studies highlighting the strategic digital imperatives in social health insurance creates a unique value proposition for this framework which can help health insurers in developing a convergence in their risk management and customer delight objectives and assist the government in the formulation of a sustainable social health insurance framework.

Details

International Journal of Sociology and Social Policy, vol. 39 no. 9/10
Type: Research Article
ISSN: 0144-333X

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Article
Publication date: 1 June 2010

Lars Norén

This paper sets out to examine how private health insurance (PHI) supports the private interests of consumers of healthcare services. The focus is on how insurance

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991

Abstract

Purpose

This paper sets out to examine how private health insurance (PHI) supports the private interests of consumers of healthcare services. The focus is on how insurance companies promote PHI to consumers.

Design/methodology/approach

Using interviews with insurance company marketing managers and others, the paper is a case study on the introduction of PHI in Sweden.

Findings

The interviewed insurance company managers argue that PHI supports two types of consumers' private economic interests. One type is the employers' interest in managing their total health‐related costs for their employees and the promise of PHI to reduce these costs. The second type relates to the interests of employees, particularly sports professionals, in managing economic risks and the promise of PHI to limit such risks.

Research limitations/implications

The paper focuses on how insurance companies promote PHI to consumers. There is no exploration of how PHI policyholders actually use their insurance. The study focuses on Sweden where private companies are the major PHI policyholders. In other European countries, PHI may be adapted to other consumer groups in order to develop other private interests. The paper points to the value of short waiting times in public healthcare.

Originality/value

The paper provides valuable insights for academics and practitioners who are interested in how the private interests of consumers may affect the healthcare sector.

Details

International Journal of Public Sector Management, vol. 23 no. 4
Type: Research Article
ISSN: 0951-3558

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Article
Publication date: 16 May 2016

Goce Gavrilov, Elena Vlahu- Gjorgievska and Vladimir Trajkovik

Information systems play a significant role in the improving of health and healthcare, as well as in the planning and financing of health services. Fund’s Information…

Abstract

Purpose

Information systems play a significant role in the improving of health and healthcare, as well as in the planning and financing of health services. Fund’s Information System is an essential component of the information infrastructure that allows assessment of the impact of changes in health insurance and healthcare for the population. The purpose of this paper is to give a brief overview of the affection of e-services and electronic data exchange (between Fund’s information systems and other IT systems) at the quality of service for insured people and savings funds.

Design/methodology/approach

The authors opted for an exploratory study using the e-services implemented in Health Insurance Fund (HIF) of Macedonia and data which were complemented by documentary analysis, including brand documents and descriptions of internal processes. In this paper is presented an analysis of the financial aspects of some e-services in HIF of Macedonia by using computer-based information systems and calculating the financial implications on insured people, companies and healthcare providers.

Findings

The analysis conducted in this paper shows that the HIF’s e-services would have a positive impact for the insured people, healthcare providers and companies when fulfilling their administrative obligations and exercising their rights.

Originality/value

The analysis presented in this paper can serve as a valuable input for the healthcare authorities in making decisions related to introducing e-services in healthcare. These enhanced e-services will improve the quality service of the HIF.

Details

Journal of Health Organization and Management, vol. 30 no. 3
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 5 December 2016

Chhavi Sodhi and Pushpendra Singh

The purpose of this paper is to present a historical overview of the health service sector in India. The development in the healthcare sector from the late eighteenth…

Abstract

Purpose

The purpose of this paper is to present a historical overview of the health service sector in India. The development in the healthcare sector from the late eighteenth century into current times is examined from the prism of the role played by British and US healthcare systems in influencing change in the Indian setup.

Design/methodology/approach

Online databases searched were PubMed and JSTOR, using the search terms, “Indian health service system in transition”, “British influence on the Indian healthcare setup” and “American neo-liberal influence on Indian healthcare sector”. The authors then examined titles and abstracts of selected articles for short-listing relevant articles. Reference lists of selected articles were examined for further locating related studies. While this constituted the secondary literature for the current paper, reports by governmental and non-governmental organisation reports on the Indian health service system too were utilised as primary data sources.

Findings

Influenced by the British and later by the American healthcare system, the Indian healthcare network has undergone numerous changes. In the present era, the Indian healthcare system is increasingly veering towards the American model of healthcare delivery. Health is increasingly being conceived of as a commodity to be traded in the market, with the state’s role curtailed towards provisioning for and facilitating access of the weakest sections of the society through a means-tested insurance system. This has happened without adequate checks and balances on the private sector to ensure that the needs of the people accessing the system are adequately met.

Social implications

By tracing the development of the health service sector in India and the motives that guide such change, the paper depicts how the thrust of the system has altered from one providing universal healthcare services to the people, irrespective of their ability to pay, at the time of independence to commercialisation in present times. With the marketisation of healthcare, the focus has shifted from serving people to profiting from the provisioning of healthcare.

Originality/value

The paper throws light on the underlying inadequacies of the Indian healthcare setup and the need for more active participation by the government in this sector in the future if it aims to make healthcare more equitably accessible to its vast population.

Details

International Journal of Health Governance, vol. 21 no. 4
Type: Research Article
ISSN: 2059-4631

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Article
Publication date: 1 May 2005

Lamar Odom, Anthony Garcia and Pamela Milburn

To explore from an ethical paradigm the current research in support of and opposition to imposing caps on non‐economic damages as a means of addressing the healthcare crisis.

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957

Abstract

Purpose

To explore from an ethical paradigm the current research in support of and opposition to imposing caps on non‐economic damages as a means of addressing the healthcare crisis.

Design/methodology/approach

A review of peer‐ and non‐peer‐reviewed articles primarily covering the period from 2001‐2004, which addresses the rationale articulated in support of and in opposition to imposing caps on non‐economic damages. The articles are sorted into sections and critiqued: rationale for imposing caps, arguments against caps, ethical paradigms impacting caps, and conclusions.

Findings

Provides information from the various sources. Addresses the biases that may have shaped the authors' conclusions and some of the ethical paradigms that may have impacted positions. Also demonstrates that the unbiased research seems to establish a minimal nexus between caps and the proposed impact.

Research limitations/implications

Focus is exclusively on the US healthcare and judicial system. However, findings may still have implications outside the USA in countries that have similar tort laws for addressing private wrongs.

Practical implications

A useful source of information for graduate students in public policy or healthcare management courses, or legislators looking for a quick reference to research regarding this topic area.

Originality/value

This paper fulfills an identified resource for non‐biased assessment of the problem presented and provides a critical review of the reasons articulated in support of this public policy.

Details

Leadership in Health Services, vol. 18 no. 3
Type: Research Article
ISSN: 1366-0756

Keywords

Content available
Article
Publication date: 24 July 2020

Anu Helkkula, Alexander John Buoye, Hyeyoon Choi, Min Kyung Lee, Stephanie Q. Liu and Timothy Lee Keiningham

The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their…

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1598

Abstract

Purpose

The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with ASD. Parents are the main integrators of long-term educational and healthcare service for their child with ASD.

Design/methodology/approach

Design/methodology/approach included (1) a sentiment analysis of discussion forum posts from an autism message board using a rule-based sentiment analysis tool that is specifically attuned to sentiments expressed in social media and (2) a qualitative content analysis of one-on-one interviews with parents of children diagnosed with ASD, complemented with interviews with experienced educators and clinicians.

Findings

Findings reveal the link between customized service integration and long-term benefits. Both parents and service providers emphasize the need to integrate healthcare and educational service to create holistic long-term care for a child with ASD. Parents highlight the benefits of varied services, but availability or cost are burdens if the service is not publicly provided, or covered by insurance. Service providers' lack of experience with ASD and people's ignorance of the challenges of ASD are burdens.

Practical implications

Ensuring health outcomes for a child with ASD requires an integrated service system and long-term, customer-centric service process because the scope of service covers the child's entire childhood. Customized educational and healthcare service must be allocated and budgeted early in order to reach the goal of a satisfactory service output for each child.

Originality/value

This is the first service research to focus on parents' challenges with obtaining services for their child with ASD. This paper provides service researchers and managers insight into parents' perceptions of educational and healthcare service value (i.e. benefits vs. burdens) received for their child with ASD. These insights into customer-centric perceptions of value may be useful to research and may help service providers to innovate and provide integrated service directly to parents, or indirectly to service providers, who serve children with ASD.

Details

Journal of Service Management, vol. 31 no. 5
Type: Research Article
ISSN: 1757-5818

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Article
Publication date: 4 October 2011

Lamar Odom, Richard Owen, Amina Valley and Phillip Burrell

This paper aims to explore President Obama's leadership style during passage of this major and controversial piece of legislation. Specifically it addresses the historical…

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2732

Abstract

Purpose

This paper aims to explore President Obama's leadership style during passage of this major and controversial piece of legislation. Specifically it addresses the historical development of healthcare reform in the USA, and provides an ethical analysis of President Obama's leadership in pursuing the health reform initiative.

Design/methodology/approach

Based on a review of the literature, speeches, and application of leadership and ethical theory, an analysis was done of President Obama's leadership and ethical approach to healthcare reform.

Findings

This analysis revealed that Obama's behavior was consistent with the full‐range leadership model articulated by Bass and Avolio. Moreover, his personal and strategic ethical approach to promulgating healthcare reform incorporated both deontological and teleological ethical principles.

Originality/value

This paper provides a current look at President Obama's leadership style and demonstrates how incorporating different ethical theories can result in the same outcome.

Details

Leadership in Health Services, vol. 24 no. 4
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 14 June 2011

Sameer Kumar, Neha S. Ghildayal and Ronak N. Shah

The fundamental concern of this research study is to learn the quality and efficiency of US healthcare services. It seeks to examine the impact of quality and efficiency…

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7781

Abstract

Purpose

The fundamental concern of this research study is to learn the quality and efficiency of US healthcare services. It seeks to examine the impact of quality and efficiency on various stakeholders to achieve the best value for each dollar spent for healthcare. The study aims to offer insights on quality reformation efforts, contemporary healthcare policy and a forthcoming change shaped by the Federal healthcare fiscal policy and to recommend the improvement objective by comparing the US healthcare system with those of other developed nations.

Design/methodology/approach

The US healthcare system is examined utilizing various data on recent trends in: spending, budgetary implications, economic indicators, i.e. GDP, inflation, wage and population growth. Process maps, cause and effect diagrams and descriptive data statistics are utilized to understand the various drivers that influence the rising healthcare cost. A proposed cause and effect diagram is presented to offer potential solutions, for significant improvement in US healthcare.

Findings

At present, the US healthcare system is of vital interest to the nation's economy and government policy (spending). The US healthcare system is characterized as the world's most expensive yet least effective compared with other nations. Growing healthcare costs have made millions of citizens vulnerable. Major drivers of the healthcare costs are institutionalized medical practices and reimbursement policies, technology‐induced costs and consumer behavior.

Practical implications

Reviewing many articles, congressional reports, internet websites and related material, a simplified process map of the US healthcare system is presented. The financial process map is also created to further understand the overall process that connects the stakeholders in the healthcare system. Factors impacting healthcare are presented by a cause and effect diagram to further simplify the complexities of healthcare. This tool can also be used as a guide to improve efficiency by removing the “waste” from the system. Trend analyses are presented that display the crucial relationship between economic growth and healthcare spending.

Originality/value

There are many articles and reports published on the US healthcare system. However, very few articles have explored, in a comprehensive manner, the links between the economic indicators and measures of the healthcare system and how to reform this system. As a result of the US healthcare system's complex structure, process map and cause‐effect diagrams are utilized to simplify, address and understand. This study linked top‐level factors, i.e. the societal, government policies, healthcare system comparison, potential reformation solutions and the enormity of the recent trends by presenting serious issues associated with US healthcare.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

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