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This paper aims to draw theoretical insight from Sen’s capability-approach and attempts to examine the effectiveness of health-insurance-schemes in reducing out-of-pocket-expenditure (OOPE) and catastrophic-health-expenditure (CHE) in India.

Data were extracted from the National-Sample-Survey-Organization, 71st round on Health-2014. Generalized-linear-regression-model was used to investigate the impact of social-protection-schemes on OOPE and CHE.

A notable segment of the Indian population is still not covered under any health-insurance-schemes. The majority of the insured population was covered by publicly-financed-health-insurance-schemes (PFHIs), with a trivial-share of private-insurance. Households from 16–59 age-group, urban, literate, richest, southern-regions, using private-facilities and having ear and skin ailments have reported higher insurance coverage. Reimbursement was higher among elderly, literates, middle-class, central-regions, using private-facilities/insurance and for infections. Access to PFHIs significantly reduces the risk of OOPE and CHE. Unavailability of reimbursement exposes the population to a higher risk of CHE.

Being a study based on secondary data sources, its applicability may vary as per the other social indicators.

Extending insurance-coverage alone cannot answer the widespread inequalities in health care. Rather, an efficiently managed reimbursement-mechanism could condense OOPE and CHE by enhancing the capability of the population to confront the undue financial burden.

Extending the health-insurance-coverage to the entire population requires a better understanding of the underlying-dynamics and health-care needs and must make health-care affordable by enhancing the overall capability.

This research brings a theoretical and conceptual analysis for improving the health-insurance coverage among the community as a public health strategy.

This study aims to present the results of inductively coupled plasma mass spectrometry (ICP-MS) determination of economically significant metals including rare-earth elements and Y (REY), Co + Ni + Cu obtained from the Fe-Mn deposits (FMD) of different areas selected along the Atlantic Ocean.

The description of the instrumental part of the analysis was shown in detail, including the choice of the acquisition mode and other settings of the quadrupole ICP-MS Agilent 7700x, which allow to eliminate spectral overlaps as much as possible and to achieve good precision and accuracy of the measurement. The accuracy of the obtained results was controlled by analysis of certified reference materials (CRM) of Fe-Mn nodules of the US Geological Survey – NOD-A-1 and NOD-P-1, as well as the Russian CRM samples of Fe-Mn nodule OOPE 603 (SDO-6) and ore crust OOPE 604 (SDO-7). Statistical processing of the analysis results demonstrated the acceptability of chosen sample preparation technique and ICP-MS tunes for the determination of REY in FMD.

The performed analytical research allowed giving a geochemical characteristic of studied FMD. The precision for the elements to be determined according to the relative standard deviation (RSD) was within 5.0%.

To move away from the subjective visual assessment of the analytical results quality in terms of absence (or presence) of the REE sawtooth distribution, an original objective mathematical method was proposed.

The public healthcare system faces challenges and limitations regarding the supply and delivery of healthcare services. The private healthcare system is expensive and only affordable for some. Due to the increasing population, developing countries face a greater degree of demand–supply mismatch. The existing healthcare services in developing countries need to be more sustainable due to high out-of-pocket expenditures and low-income levels. The research design used in this chapter is a case study approach based on qualitative data. The study focuses on two objectives: (1) to have a detailed understanding of the nature of healthcare cooperatives in Spain and their contribution to meeting healthcare requirements; and (2) to make suggestions and recommendations for an improved and sustainable healthcare cooperative for developing countries. Inspired by the healthcare cooperative model of Spain and keeping in mind the ground reality of the lack of healthcare facilities and services accessible and affordable in developing countries, the authors have developed a conceptual framework with the foundation of an insurance cooperative. The Spain Model is sustainable for developing countries as it serves the interest of all income brackets, not leaving the low-income population behind. Concepts like cooperative worker insurance embedded in the model can ensure that the beneficiaries receive timely and good quality health services at an affordable price. It empowers individuals by allowing them to make small amounts of investments as premiums to secure a hopeful future for a healthy life.

In this study, we attempt to estimate the disability costs of households employing the Standard of Livings (SoL) approach and evaluate the impact of the Universal health system reform implemented in Turkey in 2008.

We apply a Structural Equation Modelling (SEM), which simultaneously estimates the disability and living standard equations, including unobserved latent variables. Moreover, we apply a difference-in-differences (DiD) framework to investigate the impact of the universal health insurance (UHI) system and the Green Card programme on living standards. The empirical analysis relies on data derived from the cross-sectional Household Budget Surveys (HBS) during the period 2002–2013.

Our findings suggest a negative and significant impact of disability on SoL, where disability costs reach the 23% of the household income, which is equivalent almost to $2,600 (USD). Furthermore, the disability costs are reduced from $4,450 to $2,260 due to the UHI and the Green Card programme.

A major limitation of the study is the data structure, which is based on repeated cross-sectional surveys. By using panel data, it is possible to follow the same individual across time and to implement panel data models to control for unobserved heterogeneity and omitted-variable bias.

Disability has adverse effects on living standards. The estimation of the disability-related costs may provide a useful guide on policy planning and the design of social benefits.

The contribution of this paper is that it is the first study estimating the disability-related costs in Turkey. Furthermore, the contribution lies in the investigation of the 2008 health reform and the Green Card programme and its impact on disability costs.

The purpose of this study was to see the impact of increased out-of-pocket expenditure oh health care exerting budget pressure on households, which leads to change in dietary consumption.

It was a hospital-based cross-sectional study comprising 414 patients with a chronic or major illness attending a large tertiary care public hospital at Delhi, India. Each patient represented a household with total number of family members of 2,550 in the study. Questionnaire was used to gather data on factors responsible for changes in consumption of 12 major food items.

Moderate decrease in food consumption of a household after major illness is associated with: rural residence (p < 0.001), decrease in savings (p < 0.001), more number of household items sold (p < 0.001), education of the children affected (p < 0.001), upper socio-economic status (SES) (p < 0.001) and children started working after illness in family (p = 0.043). In addition to decrease in food items, there was also deterioration in quality of food preparation. More than 80% of the families did not change the intake of cereals (rice and wheat), pulses and sugar. Food items that were decreased by most families were fruits, followed by milk and its products, vegetables, meat and egg, oils and ghee.

This study is a subset of other two studies previously published. The authors had not been able to cover this aspect fully in those two studies but understood the importance of impact of expenditure on illness on food consumption. The authors studied change in food consumption pattern (not amount) in subjects after illness. The impact of weather changes in food consumption on the impacted nutritional status of family has not been studied. The authors only collected cross-sectional, observational data and recall bias cannot be completely ruled out and corrected. With such data, only associations could be concluded, not causality. The illness condition of a household was measured by presence of chronic disease and inpatient treatment. Such measures did not take into account the types of illness and number of episodes. Data of this study cannot capture whether food intake of family prior to illness was sufficient/in excess/deficient. The Kuppuswamy scale, mostly used in urban and peri-urban settings, was also used for rural subjects in the study, which might have resulted in impaired capture of rural SES. The authors did not assess whether families were allocated food grains by schemes like public distribution system, which might have resulted in biased decrease in food consumption. Questionnaire used was not validated.

This study demonstrates the various factors that act as barriers to proper food consumption, including non-financial factors. The policy of user fee in government is hitting poorer section, and equity and access to health are compromised. Health expenditure should be increased by public sector policies to implement uniform healthcare. There is need for more studies to identify measures that could be put in place when designing policies and interventions for the uniform distribution of benefits.

The policy of user fee in government is hitting poorer section, and equity and access to health are compromised. Health expenditure should be increased by public-sector policies to implement uniform healthcare.

Major or chronic illness affects money acquisition and priorities of expenditure, resulting in deterioration in quality of food consumption and by a household.

Leadership skills are vital for efficient delivery of health reforms. India, a low- and middle-income country, is transforming its public health care significantly. The health workforce, particularly doctors, however lacks leadership skills. This study aims to highlight the leadership skills gap and raise concerns about how India might achieve its ambitious health reforms in the lack of formal, prospective leadership training for its workforce.

This study conducted nine management development programmes between 2012 and 2020 and collected data from 416 (N = 444, 94% response rate) health-care professionals using a questionnaire. Participants were asked to inform leadership challenges that they perceived critical. A total of 47 unique challenges were identified, which were distributed across five domains of American College of Healthcare Executives Competency Assessment Tool (2020). Relevant information was also obtained from review of secondary sources including journal articles from scientific and grey literature and government websites.

Majority of participants (85.36%) had never attended any management training and were from public sector (56.1%). Mean total experience was 18 years. Top 5 challenges were lack of motivation (54.26%), communication (52.38%), contracts management (48.31%), leadership skills (47.26%) and retention of workforce (45.56%). Maximum challenges (29) were in domain of business skills and knowledge, followed by knowledge of health-care environment (9), leadership, professionalism, and communication and relationship management (3 each).

In absence of the leadership training, senior health professionals particularly doctors in India, suffer leadership challenges. Efforts should be made to strengthen leadership capacity in Indian health-care system to advance the country’s ongoing national health reforms.

The purpose of this paper is to explore how and why information and communication technologies (ICT) are enrolled in the Indian healthcare sector for reasons over and above perceived efficiency gains.

The paper explores qualitative field data collected in the Indian states of Karnataka and Andhra Pradesh, and the city of New Delhi from an epistemological perspective of interpretivism. New institutional theory is employed to illustrate the mythical and ceremonial roles that ICT for development play in legitimizing development initiatives.

The analysis challenges the simplistic view that implementing health management information systems will translate directly to efficiency gains.

This paper furthers the theoretical understanding of how ICT, as social and material phenomena, function empirically beyond instruments of technical rationality. One limitation of the research is the relatively short duration of the fieldwork. A wider scope in the metrics used to evaluate success in development initiatives that implement ICT is called for.

Practical implications of this paper focus on the need to move away from simple deterministic visions of ICT for development towards an approach based on acknowledging outcome indeterminacy with regard to the consequences of ICT implementation in the Indian healthcare sector, and thus the need for genuine feedback loops.

This paper will be valuable to institutional and information systems theorists, and development practitioners. A framework is provided to unpack the institutional context that drives some of the inefficiency in the Indian healthcare sector.

This study aims to shed some light on the subject matter of the exploration of public medical coverage and elderly done as such far across the world. To achieve this objective, a comprehensive bibliometric examination was used to investigate papers published between the years 1960 and 2020. An aggregate of 366 papers was selected and analysed for the same. The investigation endeavours to recognise the journals with outstanding performance in this field, distribution of papers concerning the year of their publication, most referred to papers. Then various maps depicting bibliometric networks are provided, namely, the joint-authorship network map, inter-country joint-authorship network map and keyword co-occurrence network map.

To achieve the objective of this study, the Scopus database was used for comprehending the vast magnitude of information about numerous papers included in this paper. VOSviewer has been used to create a joint-authorship network map, inter-country joint-authorship network map and keywords concurrences network map.

The result of this investigation demonstrates that the highest number of publications came out in the year 2019, the most notable journal is Journal of Aging and Social Policy, and the most referred to research paper is about long-term care insurance (LTCI) in Japan. The USA is the most productive nation with the most elevated number of papers published under its name. Tamiya N. has teamed up with the highest number of authors, which is 29. Again the USA is the nation that participated with the highest number of authors of different countries in the research paper.

This paper accord with the current writing on public health insurance and elderly. A much far-reaching and solid image of this sector is given using the bibliometric analysis technique. The authors keen on directing future exploration on this topic can take guidance from the results of this study.

The purpose of this paper is to present an exploration of the leadership competencies developed by UK GPs through having undertaken international work and the ability to transfer these competencies back to the UK.

The approach taken is a cross-sectional survey.

A total of 439 UK-based, ranging from GP specialty trainees to retired GPs who had worked overseas, responded to an online survey of UK general practice and international work. Doctors were asked to report competency development through international work using the domains of the Medical Leadership Competency Framework (MLCF). The most common competencies developed, to a “moderate or significant” degree, related to “personal qualities” (89 per cent) and “working in teams” (87 per cent). To a lesser extent Doctors developed competencies in “setting direction” (60 per cent), “managing services” (59 per cent), and “service improvement” (56 per cent), and found these competencies harder to transfer back to the UK. A common reason for limited transfer of competency was the lack of leadership opportunities for Doctors when returning to UK locum roles. Overseas posts were more common in low/middle income countries, and these Doctors reported a greater range of leadership roles, including in health policy, management and teaching, compared to high-income countries. Most doctors felt that they were able to develop their clinical skills overseas whilst relatively few Doctors performed research, especially in high-income countries.

To the authors' knowledge this is the first cross-sectional survey exploring the international work of UK GPs and leadership development using the MLCF domains.