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PubMed2001

Private employers don't need formal risk adjustment.

This paper lays down a set of hypotheses to explain why private employers do not use formal risk adjustment. The theme running through these hypotheses is simple: private employers don't need formal adjustment because they have better tools for dealing with adverse selection than formal risk adjustment provides. Open enrollment provisions, premium negotiations, and restricting employees' choices of health plans are mechanisms superior to formal risk adjustment for dealing with problems caused by adverse selection.

Community Participation↗
PubMed1991

Private hospitals and medical ethics.

The majority of hospitals in the United Kingdom are public authority hospitals administered according to the National Health Service Act 1977. However, there exist throughout the country a variety of independent hospitals run either as charities or for commercial gain. Elizabeth Macdonald examines the private hospitals' duty of care and the ethical basis from which it stems. She suggests mechanisms to monitor and support ethical standards in private hospitals.

England↗
PubMedDate not supplied

Does privatization serve the public interest?

"Does Privatization Serve the Public Interest?" ask John B. Goodman and Gary W. Loveman. Supporters of privatization claim that it will bring more efficiency and better quality. Critics, however, argue that other values--the broader public interest--must be accounted for. The authors draw a valuable lesson from the debate over corporate takeovers: the form of ownership is less important than the establishment of managerial accountability.

Economic Competition↗
PubMed1992

Retail versus private dental practices: do the patients differ?

Using a consumer-oriented framework, the authors contrast private dental patrons and retail dental patrons in terms of demographic characteristics, choice criteria, and patronage behavior in selecting a dental care provider. Assessments are made of these consumers' attitudes and perceptions toward various dental practice attributes or characteristics. Differences are found across several attributes, but dimensions of quality service, reputation, and competence are not distinguishing characteristics between the two dental patron groups. These results provide some insights and interesting debate about the image and general marketing practice of private dentists and retail dental facilities.

Data Collection↗
PubMed1992

More states 'go private' to provide services.

Faced with mounting budget deficits, more states are taking a look at privatization--the closing or downsizing of state-operated psychiatric, rehabilitation and acute-care facilities--as a way of trimming outlays. Officials believe those services often can be provided more cost-effectively in the private sector, a solution that's preferable to reducing services or raising taxes.

Hospitals, State↗
PubMed1993

Public-private partnership organizations in health care: cooperative strategies and models.

Value-adding partnerships have emerged as a preferred strategy of private health care providers to achieve high-quality, low-cost provider status. This same strategy can be applied by public sector providers through the creation of public-private partnership organizations (3POs). Strategies to build 3POs between local governments and their medical communities currently under development are outlined. The conceptual and practical aspects of implementing 3POs are presented.

Attitude of Health Personnel↗
PubMed1994

Patient satisfaction in VA medical centers and private sector hospitals: a comparison.

For the first time, we have data that can validly compare the satisfaction level of inpatients in Department of Veterans Affairs (VA) medical centers and private sector hospitals. It shows the satisfaction levels to be very similar. Since the VA will soon be changing its survey, this has been a very short time window. It may never recur. In addition to the general finding, there are some interesting comparisons regarding specific questions. For example, satisfaction with VA physicians, who are salaried and assigned to patients, is just as high as satisfaction with private physicians who are paid by fee and selected by the patient. This would seem to be critical information in the debate over U.S. health care reform.

Health Services Research↗
PubMed1997

Private-label manufacturing.

Private, or own-brand, labelling of products is an attractive proposition for manufacturers who may have unique products but lack access to particular markets, or distributors who may have a strong brand identity but lack a suitable product. However, care must be taken to ensure that private-labelled products comply with the Medical Device Directive and confusion may arise over who takes responsibility for compliance issues. This article looks at the alternative proposals for resolving this confusion and at some of the requirements for compliance.

Equipment and Supplies↗
PubMed1998

Establishing private duty in a Medicare world.

The Balanced Budget Act of 1997 projects $16.2 billion in Medicare cuts over five years, which will force dramatic changes in the home care delivery system. Medicare agencies with a good public image and strong referral sources are in a strong market position to offer private-duty services. Agencies in a weak market position should immediately begin to diversify their services to succeed in this new environment. Private duty can be lucrative if agency management establishes efficient systems, maintains high standards, and thinks like entrepreneurs.

Aged↗
PubMed1998

The VA on the firing line. Veterans groups oppose privatization despite a dwindling patient population, high costs.

Demographic trends raise some uncomfortable questions for the VA and Congress. For example, should American taxpayers continue financing a government-owned and -operated healthcare system that spends $17.3 billion a year and serves a shrinking population, when the government could buy the same care in the private sector? Some say the solution is to privatize the VA.

Adult↗
PubMed1980

Private medicine: causes of the coming boom.

Many different factors have influenced the recent expansion of private medicine. In this article, Suzanne Mollo examines them in detail and looks at the future prospects for both NHS and private health care.

Beds↗
PubMed1999

Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States.

OBJECTIVE: To determine age, breed, sex, body condition score, and diet of dogs and cats examined at private veterinary practices in the United States during 1995, and estimate prevalences of the most common disorders for these animals. DESIGN: Cross-sectional study. ANIMALS: 31,484 dogs and 15,226 cats examined by veterinary practitioners at 52 private veterinary practices. PROCEDURE: Information on age, breed, sex, body condition score, diet, and assigned diagnostic codes were collected electronically from participating practices and transferred to a relational database. Prevalence estimates and frequencies for population description were generated using statistical software. RESULTS: Dental calculus and gingivitis were the most commonly reported disorders. About 7% of dogs and 10% of cats examined by practitioners during the study were considered healthy. Many conditions were common to both species (e.g., flea infestation, conjunctivitis, diarrhea, vomiting). Dogs were likely to be examined because of lameness, disk disease, lipoma, and allergic dermatitis. Cats were likely to be examined because of renal disease, cystitis, feline urologic syndrome, and inappetence. CLINICAL IMPLICATIONS: Results can be used by veterinary practitioners to better understand and anticipate health problems of importance in cats and dogs they examine and to better communicate with clients regarding the most prevalent disorders in cats and dogs.

Age Distribution↗
PubMedDate not supplied

Gains from public-private collaborations to improve community health.

In several disciplines there exists theoretical and empirical evidence to show that community affects health and behaviors; but to date such evidence has remained largely outside the health services field. In this article, the authors introduce and contribute to this evidence and then discuss how those in the healthcare sector can work to increase public-private collaborations. Telephone survey data collected in 1995 from 1,826 randomly selected residents of a Northwest urban county were used in multivariate analysis to assess the relationship between community quality and health status. Community quality was measured by residents' perceptions of community problems. Findings indicate that individual ratings of community problems predicted mental health functioning. This effect was found overall and for men and women separately. These results suggest that health is dependent on how people perceive the quality of their community. Leadership and vision can make an enormous difference in the quality of a community health system and in the cost-effectiveness of the care provided. Healthcare leaders can develop their understanding of their community and the impact of community characteristics on health through consultation with experts, input from community leaders, and visits to the neighborhoods that surround the delivery services. Community networks can be developed with the common focus of improving the community's health. Collaborative efforts between the private health sector, the public health sector, and community members can enhance social relationships and thus promote the health of residents.

Adult↗
PubMed1999

The neoliberal triad of anti-health reforms: government budget cutting, deregulation, and privatization.

This paper presents the author's experiences and perceptions of the neoliberal triad of anti-health reforms--government budget cutting, deregulation, and privatization--which have been promulgated worldwide by the World Bank and the International Monetary Fund. The causes of this phenomenon are analyzed, and specific alternative health policies are recommended. The role of epidemiology in documenting the damages to health resulting from the anti-health reforms is discussed. Finally, the paper emphasizes the need not only for national organizational strategies but for action on the international level. The opponents of privatization need to meet together, to exchange experiences, and to develop effective strategies on a world scale that can be applied in industrial and developing nations.

Budgets↗
PubMed1999

Treatment of bacillary pulmonary tuberculosis at the chest clinics in the private sector in Korea, 1993.

SETTING: Cohort study of bacillary pulmonary tuberculosis patients treated at private sector chest clinics in Korea. OBJECTIVE: To assess the treatment behaviour of physicians in private chest clinics and the treatment outcomes of their patients. DESIGN: 1) A retrospective analysis of a cohort of patients admitted from July through October in 1993, and 2) comparison with results from health centres under the National Tuberculosis Programme (NTP). RESULTS: Nine hundred and sixty bacillary patients (507 newly diagnosed--'new', and 453 retreatment--'old') were admitted to the study. Initial smears and cultures were not performed in 7% and 21%, and follow-up smears and cultures not done in 19% and 28%, respectively. The regimens prescribed were variable: 23 in 'new' and 72 in 'old' patients, 86 in total. Six-month short-course treatment using HRZE was prescribed for 26.2% of 'new' patients. In many instances, the planned treatment duration was excessive. The success rates (cured plus completed) for 'new' and 'old' patients were 74% and 51%, respectively. The failure rates were less than 1% in 'new' and 9% in 'old' patients. CONCLUSION: Prescribed regimens were variable in terms of drug combinations and treatment duration. Overall treatment outcome was inferior to that of the health centres under the NTP.

Adult↗
PubMed1999

Relationship between age and presbyopic addition using a sample of 3,645 examinations from a single private practice.

BACKGROUND: This study uses information collected in a private optometric practice to describe the relationship between age and the add power needed to correct presbyopia. METHODS: Computer-assisted data analysis with a database management program, Q&A, and Microsoft Excel was used to assess the relationship between age and presbyopic addition. Data collected from 3,645 examinations by one practitioner in a single private practice--over a period of approximately 23 years--were entered into the database. The patient base was primarily white and about equally divided between the sexes. The practitioner generally used the fused cross cylinder for the tentative presbyopic addition and refined this by patient preference and best visual acuity at near, all using a carefully determined near working distance. RESULTS: The presbyopic addition increased rapidly in patients from ages 40 to 50 years, the rate at age 40 being about 0.22 diopters per year and the average rate during the 40- to 50-year-old decade being about 0.12 diopters per year, or approximately 0.25 diopters every 2 years. After the patient reaches 50 years of age, the presbyopic addition increased more slowly, at the rate of approximately 0.03 diopters per year--or approximately 0.25 diopters in 8 years. CONCLUSIONS: Quantitative data taken from more than 3,600 refractions showed a nearly parabolic relationship between age and presbyopic addition from approximately the age of 40 to 75 years.

Adult↗
PubMed1999

Dental service provision in private general practice for an insured population in New South Wales, Australia.

OBJECTIVE: To determine patterns of dental services provided to a cohort of the insured population 18 years and over, in private general practice in New South Wales, Australia. BASIC RESEARCH DESIGN: A cohort study using the person-years method and Poisson regression for analysis. SETTING: Data were derived from claims records submitted by members of a health insurance fund (Government Employees Health Fund-GEHF) for rebates during the study period 1 January 1992-31 December 1995. PARTICIPANTS: There were 133,467 members aged 18 years and over from New South Wales. MAIN OUTCOME MEASURES: To determine, by age group, for those members who used private general practice and made a claim (referred to as 'patients') the annual number of visits, total number of services received per year and number of services received at a visit. RESULTS: The mean number of visits per patient was 2.4 per year with patients under 45 years making fewer visits than the 45-54 age group reference category. Mean number of services utilised per patient-year was 5.9, with services provided increasing from 3.5 for the 18-24-year-old group, reaching a plateau of approximately 6.2 for those aged 45 years or more. The number of services received per visit was 2.4 and there were no differences by age. Service mix was dominated by restorative (35%), diagnostic (27%), and preventive services (18%); with age specific variations observed. CONCLUSIONS: Age was found to be an important determinant in the use of dental services, independent of membership duration and gender.

Adult↗