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Open Access
Article
Publication date: 23 March 2020

Yara Ahmed, Racha Ramadan and Mohamed Fathi Sakr

This paper aims to evaluate the progressivity of health-care financing in Egypt by assessing all five financing sources individually and then combining them to analyze the equity…

5334

Abstract

Purpose

This paper aims to evaluate the progressivity of health-care financing in Egypt by assessing all five financing sources individually and then combining them to analyze the equity of the whole financing system.

Design/methodology/approach

Lorenz dominance analysis and Kakwani progressivity index were applied on data from 2010/2011 Household Income, Expenditure, and Consumption Survey and the National Health Accounts 2011 using Stata to evaluate the progressivity of each source of health-care finance and the financing system overall.

Findings

The data show that Egypt’s health-care system, which is largely financed by out-of-pocket (OOP) payments, is slightly regressive, with an overall Kakwani index of −0.079. The overall regressive effect was the result of three regressive sources (OOP payments, an earmarked cigarette tax and direct taxes), one proportional finance source (social health insurance) and two slightly progressive sources (indirect taxes and private health insurance). This shows that the burden of financing health care falls more on the poor. These results signal the need for reform of health-care financing in Egypt to reduce dependence on OOP payments to achieve more equitable financing.

Originality/value

The paper seeks to augment the literature on health-care financing in Egypt by calculating specific progressivity estimates for all five sources of financing the Egyptian health-care system and analyzing the overall equity of this financing system. It will, therefore, provide a benchmark for monitoring the equity of finance in the Egyptian health-care system in future studies and allow one to assess the impact of implemented financing reforms in the future on the level of progressivity of health system financing.

Details

Journal of Humanities and Applied Social Sciences, vol. 3 no. 1
Type: Research Article
ISSN: 2632-279X

Keywords

Article
Publication date: 5 October 2020

Nirjhar Nigam, Sondes Mbarek and Afef Boughanmi

Financing investments in a knowledge-intensive sector may be more difficult as there is a greater degree of uncertainty and asymmetries of information. This paper aims to examine…

1554

Abstract

Purpose

Financing investments in a knowledge-intensive sector may be more difficult as there is a greater degree of uncertainty and asymmetries of information. This paper aims to examine whether a company’s intellectual capital (human capital, relational capital and structural capital) can serve as a quality signal in the financing of health care startups with new business models.

Design/methodology/approach

The study constructed a manual database using several paid and unpaid databases. This paper collected random data from 204 startups that obtained funding during the 2014–2017 period and used signaling theory to examine the factors that impact access to external financing for Indian health care technology startups.

Findings

This paper found that venture capitalists partly base their financing decisions on the relational capital of the startup represented by startups’ age and the average number of website visits, the presence of a syndicate of investors. Human capital variables and structural variables do not show much significant impact. This paper also find some business models show a negative impact on financing implying that investors are reluctant to invest in new technologies that carry more uncertainty and take a longer time to become profitable.

Research limitations/implications

Before concluding this paper, it is important to acknowledge the limitations of the study and some implications for future research purposes. First, the study is conducted on only 204 startups from India, and as such, it suffers from a small sample size, like many other comparable survey-based studies in entrepreneurship. Second, the results are obtained with respect to data collected from Indian startups and represent the Indian context which limits the generalization on a global level.

Practical implications

The results suggest that years of experience and prior relevant experience, do not actually impact the financing of a new venture. These results are crucial as India has a unique demographic advantage over other countries in relation to age. If young minds are adequately nurtured, this can result in innovation, entrepreneurship and job creation (which still remains as a foremost challenge for India).

Social implications

From a policy perspective, a number of implications emerge from the current study. There is a need for ameliorating the capacity of the education system in providing top-quality support including a greater focus on entrepreneurship courses and to replicate the education delivery model from top foreign institutes. The government should take this opportunity to revive the system of education and follow the methodology of elite institutes and to develop entrepreneurship spirit in other colleges and schools.

Originality/value

Financing the investments of young startups with new business models in knowledge-based sectors may be more difficult. In this paper, this paper demonstrates that startups have to effectively use and manage their intellectual assets to achieve sustainable competitive advantage. The findings of the paper emphasize the role of intellectual capital in securing financing through venture capital.

Details

Journal of Knowledge Management, vol. 25 no. 1
Type: Research Article
ISSN: 1367-3270

Keywords

Article
Publication date: 7 October 2020

Chukwuedo Susan Oburota and Olanrewaju Olaniyan

The purpose of this paper is to decompose the inequities induced by the Nigerian health care financing sources and their effect on the income distribution. Inequities in health…

Abstract

Purpose

The purpose of this paper is to decompose the inequities induced by the Nigerian health care financing sources and their effect on the income distribution. Inequities in health care financing sources are of immense policy concern particularly in developing countries such as Nigeria, where high-level income inequality exists, and the cost of medical care is generally financed out-of-pocket (OOP) due to limited access to health insurance.

Design/methodology/approach

The Duclos et al. decomposition model provided the theoretical framework for the study. Data were obtained from two waves of the Nigeria General Household Survey (GHS) panel, 2012–13 and 2015–16. The analysis covered 3,999 households in 2012–13 and 4,051 households in 2015–16. Two measures of health care financing: OOP payment and health insurance contribution (HIC) were used. The ability to pay measure was household consumption expenditure.

Findings

The major inequity issue induced by the OOP payments was vertical inequity. HICs created the problems of vertical inequity, horizontal inequity and reranking among households. Overall both health care financing options were associated with the worsening of income inequality both at the national and sectorial levels in the country. The operations of the NHIS need to be improved to ensuring improved health care coverage for the poor.

Originality/value

This paper fulfills an identified need to determine the income redistributive effects (REs) of the social health insurance (SHI) contribution at the national, urban and rural locations overtime.

Details

International Journal of Social Economics, vol. 47 no. 11
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 1 February 1997

Victor C.W. Wong and Sammy W.S. Chiu

Analyses the features, strategies and characteristics of health‐care reforms in the People’s Republic of China. Since the fourteenth Central Committee of the Chinese Communist…

990

Abstract

Analyses the features, strategies and characteristics of health‐care reforms in the People’s Republic of China. Since the fourteenth Central Committee of the Chinese Communist Party held in 1992, an emphasis has been placed on reform strategies such as cost recovery, profit making, diversification of services, and development of alternative financing strategies in respect of health‐care services provided in the public sector. Argues that the reform strategies employed have created new problems before solving the old ones. Inflation of medical cost has been elevated very rapidly. The de‐linkage of state finance bureau and health service providers has also contributed to the transfer of tension from the state to the enterprises. There is no sign that quasi‐public health‐care insurance is able to resolve these problems. Finally, co‐operative medicine in the rural areas has been largely dismantled, though this direction is going against the will of the state. Argues that a new balance of responsibility has to be developed as a top social priority between the state, enterprises and service users in China in order to meet the health‐care needs of the people.

Details

International Journal of Public Sector Management, vol. 10 no. 1/2
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 1 March 2005

Rute Abreu, Fátima David and David Crowther

Health care is an essential need of the society and it is an integral part thereof. In this sense, everybody is entitled to medical services to provide health and well‐being that…

Abstract

Health care is an essential need of the society and it is an integral part thereof. In this sense, everybody is entitled to medical services to provide health and well‐being that improves lifestyle. Policymakers and researchers focus substantial attention on hospitals and public spending of financial resources, because they recognise the political power and the general collective obligation of preserving a health care for the present and future generations. The empirical analysis used a sample based in the 31 corporate hospitals that belong to the Portuguese health care system as a National Health Service in the period 2002–2003. The disclosure of information allows comparability and identifies similarities between the hospitals in the sample. Relevant organizational variables were managed statistically through the multivariate analysis. The geographical analysis shows inequalities of the distribution of hospitals facilities in Portugal, with marked concentration in the urban coastal areas, affected by the number of persons that live there. The financial analysis is supported in the Portuguese Official Accounting Plan that follows the same accounting trend of corporations. So, the disclosure and the accountability system are not opened up to a new field for accounting in health care based in the Health Official Accounting Plan. The research shows implications at the operational level, the efficiency and the effectiveness of the health care strategy with differences between hospitals. The authors believe that, as complex organizations, hospitals must based their disclosure police in transparency to allow patients to identify their own orientations that should be driven mainly by corporate social responsibility as a public service and not by the economic perspective of a business. This research confirms that as a global strategy for the health care system, corporate social responsibility is urgently needed. As a finite resource, the health should demand a permanent attention from society, as well as the Government in accomplishment prevention and monitoring systems, with a view to the defence of a sustainable health care system. More than merely investing efforts in fighting for political changes, without any advantage for society it is crucial to invest in prevention of the quality of life as a basic requirement to honour the corporate social responsibility in hospitals. Especially needed are health care improvements and infrastructures. In summary, the health care system exists as a fundamental element that assures life and high standards of living, so it should be available to everybody and for everybody…

Details

Social Responsibility Journal, vol. 1 no. 3/4
Type: Research Article
ISSN: 1747-1117

Article
Publication date: 24 July 2007

Randolph K. Quaye

The purpose of this paper is to explore, 14 years since the introduction of market reforms, the extent to which changes have altered the nature of Sweden's health care financing…

708

Abstract

Purpose

The purpose of this paper is to explore, 14 years since the introduction of market reforms, the extent to which changes have altered the nature of Sweden's health care financing, examine how these changes have affected the views of Sweden's physicians, and to judge the impact of these reforms on the delivery and quality of care.

Design/methodology/approach

Swedish physicians', Federation of County Council members' and health economists' views, were explored. The data were obtained from in‐depth interviews with 31 respondents in the summer of 2005. The sample was drawn from Stockholm County and the Skane Region.

Findings

The respondents generally believed that the Swedish health care system basic structure had remained intact and that several early 1990s reforms, to introduce financial incentives into health care system, had worked well. The diagnostic‐related groups system, though not popular among some health care providers, seemed to have worked for the purposes intended. The majority of Swedish physicians interviewed expressed general satisfaction with their work. Several praised the internal reforms as contributing to more stable health care expenditures, which are low compared with other countries. A majority of respondents supported the care guarantee provisions.

Originality/value

This paper points out that Sweden is showing what governments can do in a global society where access to health care is paramount. All Swedes can feel proud of a well‐planned health care system.

Details

International Journal of Health Care Quality Assurance, vol. 20 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 13 February 2009

Lloyd Ahamefule Amaghionyeodiwe

The purpose of this paper is to examine whether or not government health care spending reduces the poor‐rich differences in health status. Specifically, it aims to assess the…

1806

Abstract

Purpose

The purpose of this paper is to examine whether or not government health care spending reduces the poor‐rich differences in health status. Specifically, it aims to assess the health status of the poor vis‐à‐vis government health spending in Nigeria.

Design/methodology/approach

Regression analysis was carried out using the Ordinary Least Square method of estimation while secondary data was used.

Findings

It was found that despite the increase in most components of health care spending in Nigeria, the health status of the average Nigerian and the condition of health infrastructure has not improved appreciably. Also, the poor have significantly worse health status than the non‐poor and they (the poor) are more strongly affected by public spending on health care relative to the non‐poor. Thus, the difference in impact of spending between the poor and the non‐poor could be substantial.

Originality/value

This study provides information that will help reposition policies on government spending, especially on health care, so as to enhance and improve the heath status of the poor in Nigeria, thereby reducing the poor‐rich differences in health status.

Details

International Journal of Social Economics, vol. 36 no. 3
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 3 May 2016

Randolph K. Quaye

This paper examines the changing role of general practitioners (GPs) in Nordic countries of Sweden, Norway and Denmark. It aims to explore the “gate keeping” role of GPs in the…

Abstract

Purpose

This paper examines the changing role of general practitioners (GPs) in Nordic countries of Sweden, Norway and Denmark. It aims to explore the “gate keeping” role of GPs in the face of current changes in the health care delivery systems in these countries.

Design/methodology/approach

Data were collected from existing literature, interviews with GPs, hospital specialists and representatives of Danish regions and Norwegian Medical Association.

Findings

The paper contends that in all these changes, the position of the GPs in the medical division of labor has been strengthened, and patients now have increased and broadened access to choice.

Research limitations/implications

Health care cost and high cancer mortality rates have forced Nordic countries of Sweden, Norway and Denmark to rethink their health care systems. Several attempts have been made to reduce health care cost through market reform and by strenghtening the position of GPs. The evidence suggests that in Norway and Denmark, right incentives are in place to achieve this goal. Sweden is not far behind. The paper has limitations of a small sample size and an exclusive focus on GPs.

Practical implications

Anecdotal evidence suggests that physicians are becoming extremely unhappy. Understanding the changing status of primary care physicians will yield valuable information for assessing the effectiveness of Nordic health care delivery systems.

Social implications

This study has wider implications of how GPs see their role as potential gatekeepers in the Nordic health care systems. The role of GPs is changing as a result of recent health care reforms.

Originality/value

This paper contends that in Norway and Denmark, right incentives are in place to strengthen the position of GPs.

Details

Leadership in Health Services, vol. 29 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 1 November 2002

Rowena Jacobs and Maria Goddard

This paper examines some of the key features of social health insurance systems by drawing on experiences in Germany, Switzerland, France and The Netherlands. These countries have…

2592

Abstract

This paper examines some of the key features of social health insurance systems by drawing on experiences in Germany, Switzerland, France and The Netherlands. These countries have all implemented a variety of reforms, including some competition between health insurers in order to meet some of their health care objectives. The paper highlights some of the strengths and weaknesses inherent in these systems and how they perform on a number of criteria and suggests a number of trade‐offs which policymakers will have to grapple with to attain some of their (often competing) health system goals of efficiency, choice, solidarity and equity. This paper should provide useful information for countries with health care systems in transition or those considering adopting aspects of social health insurance systems.

Details

International Journal of Social Economics, vol. 29 no. 11
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 1 April 1994

Charles Collins, David J. Hunter and Andrew Green

A new international orthodoxy has developed on health sector reform. Thedominant theme of the orthodoxy is the alleged benefits of market stylereforms for health development. This…

826

Abstract

A new international orthodoxy has developed on health sector reform. The dominant theme of the orthodoxy is the alleged benefits of market style reforms for health development. This is shaping changes formulated, and being implemented, in the British NHS and other European health services (including Central and Eastern Europe), Latin America and a number of developing health systems in Africa and Asia. Sets out a ten‐point description of the orthodoxy. Contends that the orthodoxy is showing distinct signs of restricting the analysis and development of health management and planning. This is a matter for considerable concern as the adoption of market‐style reforms can generate unforeseen and, in some cases, negative consequences. There is clearly a need for strengthening management research and development as a basis for effective health sector reform.

Details

Journal of Management in Medicine, vol. 8 no. 2
Type: Research Article
ISSN: 0268-9235

Keywords

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