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Huang A, Xu X, Tang L, Huang L, Li J, Zhang X, Liu J, Zhou Y, Zhang B, Wang L, Zhang Q, Zhou Z, Wang Y, Wang X, Liu Q, Liu S, Yin Z, Wang F. Acceptance and willingness to pay for DTaP-HBV-IPV-Hib hexavalent vaccine among parents: A cross-sectional survey in China. Hum Vaccin Immunother 2024; 20:2333098. [PMID: 38619056 PMCID: PMC11020590 DOI: 10.1080/21645515.2024.2333098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/16/2024] [Indexed: 04/16/2024] Open
Abstract
DTaP-HBV-IPV-Hib hexavalent vaccine has been used in high-income countries for many years to prevent diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis, and invasive Haemophilus influenzae type b disease. Currently, no hexavalent vaccines have been approved for use in China. Evidence of parental acceptance and interest in hexavalent vaccines can help policy makers and manufacturers make decisions about entering the vaccine market and the immunization program in China. We measured parental acceptance and willingness-to-pay (WTP) for a hexavalent vaccine to provide such evidence. We conducted a cross-sectional survey of children's caregivers in 16 vaccination clinics in seven cities in China and obtained information on socio-demographics, knowledge of disease, confidence in vaccines, previous vaccination experience, and acceptance of and WTP for hexavalent vaccine. Multivariate logistic regression was used to determine factors influencing acceptance, and multivariate tobit regression was used to identify factors impacting WTP. Between April 28 and June 30, 2023, a total of 581 parents of children aged 0-6 years participated in the survey; 435 (74.87%, 95% CI:71.3%-78.4%) parents indicated acceptance of hexavalent vaccine. Residence location, parents' education level, experience paying for vaccination, and disease knowledge scores were key factors affecting parents' choices for vaccination. Mean (SD) and median (IQR) willingness to pay for full 4-dose course vaccination were 2266.66 (1177.1) CNY and 2400 (1600-2800) CNY. Children's age (p < .001), parents' education level (p = .024), and perceived price barriers (p < .001) were significantly associated with WTP. Parents have high acceptance and willingness to pay for hexavalent vaccine. The less money parents have to pay out of pocket, the more willing they can be to accept the vaccine. Therefore, acceptance may increase even further if the vaccine is covered by medical insurance, provided free of charge by the government, or if its price is reduced. Our results provide reference for optimizing and adjusting immunization strategies in China.
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Affiliation(s)
- Aodi Huang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xia Xu
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lin Tang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lifang Huang
- Department of National Immunization Programe, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Jun Li
- Department of National Immunization Programe, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Xue Zhang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiajie Liu
- Department of National Immunization Programe, Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Yang Zhou
- Department of National Immunization Programe, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Bingling Zhang
- Department of National Immunization Programe, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Lei Wang
- Department of National Immunization Programe, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Qian Zhang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zemei Zhou
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu Wang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoqi Wang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qianqian Liu
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Siyu Liu
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zundong Yin
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fuzhen Wang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
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Chen T, Wei Y, Wang W, Yu Y, Shen X. Evaluating community-embedded elder care: A case study of supply and demand in Hangzhou, China. J Eval Clin Pract 2024; 30:1143-1152. [PMID: 38812124 DOI: 10.1111/jep.14028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/13/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION With China's urbanization and demographic shifts significantly affecting elder care, this study examines the alignment of community-based elder care services in Hangzhou's Hemu Community. It addresses the gap in understanding how these services meet the needs of an aging population in a rapidly changing social context. METHODS A comprehensive mixed-methods approach was utilized, involving interviews with community residents, observations of elder care service operations and thorough document analysis. The objective was to evaluate the adequacy, utilization and satisfaction levels concerning these elder care services. RESULTS The research identified that, although the services generally meet the community's needs, there are notable challenges in content specificity, quality assurance and promotional efforts. These challenges lead to resistance among older adults. Additionally, issues with service visibility and the lack of robust feedback mechanisms were noted. CONCLUSION This study highlights the critical need for a cooperative strategy involving government, community organizations, social entities and businesses in enhancing elder care services. It suggests that improvements in service visibility, content quality and targeted promotion are crucial to address the evolving needs of the aging population and to reduce reluctance in service utilization.
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Affiliation(s)
- Tianhao Chen
- Development Strategy and Cooperation Center, Zhejiang Lab, Hangzhou, China
- Zhejiang Laboratory of Philosophy and Social Sciences - Laboratory of Intelligent Society and Governance, Zhejiang Lab, Hangzhou, China
| | - Yujun Wei
- Development Strategy and Cooperation Center, Zhejiang Lab, Hangzhou, China
- Zhejiang Laboratory of Philosophy and Social Sciences - Laboratory of Intelligent Society and Governance, Zhejiang Lab, Hangzhou, China
| | - Wenyan Wang
- College of Education, Zhejiang University, Hangzhou, China
| | - Yayang Yu
- FESCO Adecco Zhejiang, Hangzhou, China
| | - Xinyi Shen
- China Search (Asia) Limited, Prosperity Millennia Plaza, Quarry Bay, Hong Kong, China
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Zanga R. Regulation and participation of the private sector in the pursuit of universal health coverage: Challenges and strategies for health systems. J Family Med Prim Care 2024; 13:2123-2129. [PMID: 38948620 PMCID: PMC11213391 DOI: 10.4103/jfmpc.jfmpc_1697_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 07/02/2024] Open
Abstract
The 1978 Alma Ata Declaration established recommendations for health systems, which significantly impacted low-income countries. These guidelines marked improvements in access to health, coverage and financial equity, especially in Latin American countries. Objectives This paper focuses on the role of the private sector (including for-profit and non-profit organizations) in achieving Universal Health Coverage (UHC). It examines their involvement in the management, service delivery, resource investment and financing of primary health care (PHC) within the sustainable development goals (SDGs). Methods The study covers a review of health systems, emphasizing the influence of private institutions on public health, and evaluates how private sector experiences contribute to system functions and progress towards UHC. Results The findings indicate the crucial role of the private sector in global health systems, notably expanded in several countries. Private actors are essential to improve access and coverage, particularly in countries with low health indicators. The article highlights the importance of primary care physicians understanding these dynamics since their management is vital in implementing public policies for UHC.
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Affiliation(s)
- Rosendo Zanga
- Policies and System of Health Program, School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile
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Yang R, Sun S. Campaign Governance and Partnerships: Unraveling COVID-19 Vaccine Promotion Efforts in China's Neighborhoods. Risk Manag Healthc Policy 2023; 16:2915-2929. [PMID: 38164293 PMCID: PMC10758253 DOI: 10.2147/rmhp.s441874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024] Open
Abstract
Background COVID-19 vaccine promotion helps counter vaccine hesitancy and raise vaccine acceptance. Therefore, the Chinese state created collaborative infrastructures of COVID-19 vaccine promotion programs to promote stakeholder engagement and unload the burden of policy practitioners. However, partnerships in COVID-19 vaccine promotion programs have been underrepresented. Methods To address this lacuna, we qualitatively explored how partnerships in the COVID-19 vaccine promotion campaign (CVPC) were organized in China's neighborhoods. Specifically, we recruited participants via personal networks, referrals from acquaintances, and snowballing approaches, and conducted the qualitative thematic analysis following interviews with 62 Chinese stakeholders. Results This study indicates that to promote partnerships in CVPCs, neighborhood managers formed leadership in CVPCs, expanded the collaborative network, trained Health Promotion Practitioners (HPPs), and coordinated with HPPs to shape partnership agreements, produced COVID-19 vaccine promotional materials and advertised COVID-19 vaccines via diverse media tools. Although coproduction of CVPCs to a certain extent promoted state-society interaction in neighborhoods and state responsiveness to public demands, partners' disagreements on strategies applied by states for promoting COVID-19 vaccines eroded partnerships in CVPCs. Conclusion To construct a robust partnership in CVPCs, depoliticizing CVPCs and creating shared values among stakeholders in CVPCs are expected. Our study will not only deepen global audiences' understanding of CVCPs in China but also offer potential neighborhood-level solutions for implementing local and global health promotion efforts.
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Affiliation(s)
- Ronghui Yang
- Department of Public Administration, College of Humanities, Donghua University, Shanghai, 200051, People’s Republic of China
| | - Sirui Sun
- Department of Public Administration, College of Humanities, Donghua University, Shanghai, 200051, People’s Republic of China
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Belete GT, Walle Y. Willingness to pay for medical care and its determinants in private health care facilities among Gondar city residents, Northwest Ethiopia: Cross sectional study. Heliyon 2023; 9:e21143. [PMID: 37942170 PMCID: PMC10628662 DOI: 10.1016/j.heliyon.2023.e21143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 10/05/2023] [Accepted: 10/17/2023] [Indexed: 11/10/2023] Open
Abstract
Medical care is a type of health service that mainly consists of investigation and diagnosis, treatment, rehabilitative care, and nursing care for the purpose of maintaining the structure or function of the body. A medical care payment is a sort of payment made for the diagnosis, cure, mitigation, treatment, or prevention of disease, sickness, or damage, which includes checkups and periodic exams. In low-income nations, out-of-pocket expenditures account for 60 % of overall health spending, compared to 20 % in high-income ones. Willingness to pay is perhaps the highest money that a person is willing to provide to ensure that a particular wellbeing care action is undertaken. Previous research works focused mainly on the patients' willingness to pay but not the amount they can afford. The focus of this study is to determine the level of willingness to pay, the mean amount of willingness to pay for medical care, and its major determinants. A community-based cross-section study was carried out among Gondar city residents from February 2022 to March 2022. The study participants were recruited by systematic random sampling. Four data collectors conducted interviews using a questionnaire. For analysis, the dataset was entered into Epi Info version 7 and transferred to STATA version 14. The descriptive part was summarized using summary statistics like mean, median, and standard deviation. Determinants of willingness to pay were identified using a Tobit regression model with a significance of p-value ≤ 0.05 and confidence interval (CI ≠ 0). Finally, the analyzed data was presented using tables and figures accordingly. The study involved 414 participants, with a response rate of 95.8 %. About 53.62 % of the participants were willing to pay for medical care and the average willingness to pay was 24.17 USD per year. They were more willing to pay if they were still working (β = 19.66), currently married (β = 14.49), had a family history of medical care (β = 25.74), had good knowledge (β = 36.16), had a history of medical illness (β = 16.64), lived a long distance from the health facility (β = 1.98), and had a high wealth index (β = 29.51). The willingness to pay for medical care is below the actual cost. Designing a cost-recovery strategy with multi-tiered programs assigned to the most vulnerable individuals, such as the elderly, less educated, or seriously sick, is a strategic approach of the raising demand for service uptake and accessibility.
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Affiliation(s)
- Gizachew Tilahun Belete
- Department of Optometry, School of Medicine, College of medicine and health science, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Walle
- Department of Environmental economics, School of Economics, College of business and Economics, University of Gondar, Gondar, Ethiopia
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Chen N, Bai J, Nicholas S, Maitland E, Tan J, Wang J. Preferences for private health insurance in China: A discrete choice experiment. Front Public Health 2022; 10:985582. [PMID: 36148354 PMCID: PMC9486459 DOI: 10.3389/fpubh.2022.985582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/08/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction There is limited evidence on the sustainability and optimal design of China's private health insurance market, especially from the demand-side. With the increasing medical cost burden on both patients and the social security system, policy makers need data on potential clients' demand for private health insurance. Methods A discrete choice experiment was conducted to explore potential clients' preferences for a type of government-involved private supplementary health insurance, Huimin Insurance, in China. A mixed logit model was used to evaluated participants' preferences for six attributes. Willingness to pay, subgroup analysis and interaction effects were estimated based on the initial model. Results Among the 947 participants, 883 (93.2%) were aged 18 to 59 years and 578 (61.0%) were female. Participants had a strong preference for government involvement, extensive benefit packages, high reimbursement ratio and compensation for pre-existing conditions. With respect to the attribute of deductible, participants were indifferent between the level of CNY15,000 and CNY18,000 but had strong and significant preference for the level of CNY15,000 than CNY20,000. The premium was significantly correlated with a decline in the utility of PHI. Conclusions All attributes had a significant impact on participants' preference for Huimin Insurance. Providing a reference point for the development of private health insurance in China, our results inform the optimal design of PHI, especially Huimin Insurance's products.
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Affiliation(s)
- Nuo Chen
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Beijing, China
| | - Jing Bai
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Beijing, China
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Sydney, NSW, Australia,Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Liverpool, United Kingdom
| | - Jialong Tan
- School of Public Health, Wuhan University, Wuhan, China,*Correspondence: Jialong Tan
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Beijing, China,Center for Health Economics and Management at the School of Economics and Management, Wuhan University, Wuhan, China,Jian Wang
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Basabih M, Prasojo E, Rahayu AYS. Hospital services under public-private partnerships, outcomes and, challenges: A literature review. J Public Health Res 2022; 11:22799036221115781. [PMID: 36052099 PMCID: PMC9424887 DOI: 10.1177/22799036221115781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 07/09/2022] [Indexed: 11/30/2022] Open
Abstract
Public-private partnerships (PPP) is used to advance health service access and
quality. PPP implementation in hospitals is vital to shorten the service and
quality gap. Hospitals are the most significant health budget spender, and this
study aimed to identify the PPP effect on hospital performance indicators and
its implementation challenges. Thirty-three inclusive articles were filtered and
collected from Pubmed, ScienceDirect, Medline, and Sage Publication databases.
Results showed that various articles succeeded in implementing PPP and improving
the access and quality of health services. Several hospital performance
indicators such as diagnosis, therapy, service waiting time, length of stay,
referral rate, mortality rate, and patient satisfaction were reported to show
better results. However, there was insufficient evidence to say the same on
related financial indicators. Policy, resource, communication and trust, risk,
and evaluation monitoring were considered challenges in PPP implementation. Its
success was not only influenced by major factors such as governance model,
finance, politics, and social but also was influenced by the medical practice
model applied within the organization. This study contributed to whether PPP
affects the hospital performance indicators.
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Affiliation(s)
- Masyitoh Basabih
- Candidate Doctoral Faculty of Administrative Science, Universitas Indonesia, Depok, Indonesia
| | - Eko Prasojo
- Professor Faculty of Administrative Science, Universitas Indonesia, Depok, Indonesia
| | - Amy Yayuk Sri Rahayu
- Professor Faculty of Administrative Science, Universitas Indonesia, Depok, Indonesia
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Cheong AT, Lee PY, Shariff-Ghazali S, Salim H, Hussein N, Ramli R, Pinnock H, Liew SM, Hanafi NS, Abu Bakar AI, Mohd Ahad A, Pang YK, Chinna K, Khoo EM. Implementing asthma management guidelines in public primary care clinics in Malaysia. NPJ Prim Care Respir Med 2021; 31:47. [PMID: 34845205 PMCID: PMC8630037 DOI: 10.1038/s41533-021-00257-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/27/2021] [Indexed: 11/09/2022] Open
Abstract
Implementing asthma guideline recommendations is challenging in low- and middle-income countries. We aimed to explore healthcare provider (HCP) perspectives on the provision of recommended care. Twenty-six HCPs from six public primary care clinics in a semi-urban district of Malaysia were purposively sampled based on roles and experience. Focus group discussions were guided by a semi-structured interview guide and analysed thematically. HCPs had access to guidelines and training but highlighted multiple infrastructure-related challenges to implementing recommended care. Diagnosis and review of asthma control were hampered by limited access to spirometry and limited asthma control test (ACT) use, respectively. Treatment decisions were limited by poor availability of inhaled combination therapy (ICS/LABA) and free spacer devices. Imposed Ministry of Health programmes involving other non-communicable diseases were prioritised over asthma. Ministerial policies need practical resources and organisational support if quality improvement programmes are to facilitate better management of asthma in public primary care clinics.
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Affiliation(s)
- Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
| | - Ping Yein Lee
- UM eHealth Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sazlina Shariff-Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Malaysian Research Institute on Ageing™, Universiti Putra Malaysia, Serdang, Malaysia
| | - Hani Salim
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Norita Hussein
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rizawati Ramli
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Azainorsuzila Mohd Ahad
- Klinik Kesihatan Lukut, Ministry of Health Malaysia, Port Dickson, Negeri Sembilan, Malaysia
| | - Yong Kek Pang
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Burnett A, Paudel P, Massie J, Kong N, Kunthea E, Thomas V, Fricke TR, Lee L. Parents' willingness to pay for children's spectacles in Cambodia. BMJ Open Ophthalmol 2021; 6:e000654. [PMID: 33718614 PMCID: PMC7908283 DOI: 10.1136/bmjophth-2020-000654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/03/2022] Open
Abstract
Background/aim To determine willingness to pay for children's spectacles, and barriers to purchasing children's spectacles in Cambodia. Methods We conducted vision screenings, and eye examinations as indicated, for all consenting children at 21 randomly selected secondary schools. We invited parents/guardians of children found to have refractive problems to complete a willingness to pay for spectacles survey, using a binary-with-follow-up technique. Results We conducted vision screenings on 12 128 secondary schoolchildren, and willingness to pay for spectacles surveys with 491 parents/guardians (n=491) from Kandal and Phnom Penh provinces in Cambodia. We found 519 children with refractive error, 7 who had pre-existing spectacles and 14 recommended spectacles for lower ametropias. About half (53.2%; 95% CI 44.0% to 62.1%) of parents/guardians were willing to pay KHR70 000 (US$17.5; average market price) or more for spectacles. Mean willingness-to-pay price was KHR74 595 (US$18.6; 95% CI KHR64 505 to 86 262; 95% CI US$16.1 to US$21.6) in Phnom Penh and KHR55 651 (US$13.9; 95% CI KHR48 021 to 64 494; 95% CI US$12.0 to US$16.1) in Kandal province. Logistic regression suggested parents/guardians with college education (OR 6.8; p<0.001), higher household incomes (OR 8.0; p=0.006) and those wearing spectacles (OR 2.2; p=0.01) were more likely to be willing to pay ≥US$17.5. The most common reasons for being unwilling to pay US$17.5 were related to cost (58.8%). The most common barrier to spectacle wear was fear that spectacles weaken children's eyes (36.0%). Conclusions With almost half of parents/guardians unwilling to pay for spectacles at the current average market price, financial support through a subsidised spectacle scheme might be required for children to access spectacles in Cambodia.
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Affiliation(s)
- Anthea Burnett
- Public Health Division, Brien Holden Vision Institute, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Prakash Paudel
- Public Health Division, Brien Holden Vision Institute, Sydney, New South Wales, Australia
| | - Jessica Massie
- Public Health Division, Brien Holden Vision Institute, Sydney, New South Wales, Australia
| | - Neath Kong
- Public Health Division, Brien Holden Vision Institute, Phnom Penh, Cambodia
| | - Ek Kunthea
- Public Health Division, Brien Holden Vision Institute, Phnom Penh, Cambodia
| | - Varghese Thomas
- Public Health Division, Brien Holden Vision Institute, Sydney, New South Wales, Australia
| | - Tim R Fricke
- Public Health Division, Brien Holden Vision Institute, Sydney, New South Wales, Australia.,Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Ling Lee
- Public Health Division, Brien Holden Vision Institute, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Du Y, Du Y, Yao N. Patient-provider relationships in China: A qualitative study on the perspectives of healthcare students and junior professionals. PLoS One 2020; 15:e0240747. [PMID: 33085691 PMCID: PMC7577488 DOI: 10.1371/journal.pone.0240747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/01/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Mistrust and conflicts in patient-provider relationships (PPR) have become prevalent in China. The frequency of verbal and physical violence against healthcare workers has been increasing, but few interventions seem to be effective. Limited prior research has focused on the perspectives of healthcare professionals in training. This paper aimed to understand their viewpoints and conceptualize potentially actionable areas for future policy interventions. METHODS We analyzed de-identified training registration data of a convenience sample of 151 healthcare students and 38 junior professionals from 20 provinces in China. One open-ended question in the registration form asked the participant to comment on PPRs in China. We used qualitative thematic coding to analyze the narrative data. All answers were categorized into three overarching frames: patients, providers, and external agencies/regulations. Frequently mentioned themes in each frame were evaluated to generate an overall theoretical framework. FINDINGS Although fewer than 25% indicated that current PPRs are "good" or acceptable, 98% of respondents were optimistic about the future improvement of these relationships. The leading factors of PPRs mentioned as patient-relevant were eroding trust in the physician, unrealistic expectations, and ineffective communication. The provider-relevant themes highlighted were poor service quality, ineffective communication, and heavy workload. Leading themes relevant to external agencies or regulations were dysfunctional administration system, negative media reports, and disparity in healthcare resource distribution. INTERPRETATION Healthcare professionals in training had a negative view of the current situation but had confidence in future improvement. Patient, provider, and societal factors all contributed to the tension between patients and providers. All aspects of the healthcare sector should be carefully considered when contemplating policy or social interventions to improve the patient-provider relationship.
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Affiliation(s)
- Yuxian Du
- Hutchinson Institute for Cancer Outcome Research (HICOR), Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
- Data Generation and Observational Studies, Bayer Healthcare U.S. LLC, Whippany, New Jersey, United States of America
- School of Health Care Management, Shandong University, Jinan, Shandong, People’s Republic of China
| | - Yan Du
- School of Nursing, the University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Nengliang Yao
- School of Health Care Management, Shandong University, Jinan, Shandong, People’s Republic of China
- School of Medicine, University of Virginia, Charlottesville, Virginia, United States of America
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Pereira MA, Ferreira DC, Marques RC. A critical look at the Portuguese public-private partnerships in healthcare. Int J Health Plann Manage 2020; 36:302-315. [PMID: 33015900 PMCID: PMC8048432 DOI: 10.1002/hpm.3084] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 09/15/2020] [Accepted: 09/25/2020] [Indexed: 11/06/2022] Open
Abstract
The pre-conceived idea that contracts in a public-private partnership (PPP) regime, in healthcare or in any other economic sector, are, as a rule, ruinous and appealing for only a share of the stakeholders, lacks a solid basis that confirms it. This idea, outset and nurtured by the media, has been instigating the distrust of the users who, in turn, demand a more rigorous and efficient utilisation of public resources. Being Portugal in the top of countries that resort to PPPs, it is urgent to inquire if its respective contracts originated an inefficient and ineffective management of resources. It is precisely this discussion that we address in this paper, focusing our efforts in the Portuguese healthcare sector.
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Affiliation(s)
- Miguel A Pereira
- CEG-IST, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal.,CERIS, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - Diogo C Ferreira
- CERIS, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - Rui C Marques
- CERIS, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
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Wang C, Ouyang Y, Liu H, Xu C, Xiao H, Hu Y, Li Y, Zhong D. Surgery simulation teaching based on real reconstruction aid versus traditional surgical live teaching in the acquisition of an adult total hip arthroplasty surgical technique for developmental dysplasia of the hip: a randomized comparative study. BMC MEDICAL EDUCATION 2020; 20:228. [PMID: 32690056 PMCID: PMC7370451 DOI: 10.1186/s12909-020-02135-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND A simulation and model (SM) teaching aid using 3D printing was developed to improve a training course for total hip arthroplasty of adult developmental dysplasia of the hip (adult DDH-THA). We named this new method Surgery Simulation Teaching based on a Real Reconstruction Aid (RRA-SST). A prospective randomized comparison was performed with the traditional surgical live teaching method to evaluate the training effectiveness of RRA-SST for adult DDH-THA. METHODS Twenty-six trainees, who were already practicing but were not experienced, participated in the study. We randomly divided the trainees into two groups: Group A (n = 13) received RRA-SST and group B (n = 13) received traditional surgical live teaching. A surgery simulation test and a questionnaire were used for evaluation. Next, each group received training with the other teaching method, and then the test and questionnaire were used again for evaluation. RESULTS After the first test, the RRA-SST method was shown to produce better results than the traditional surgical live teaching method. After the second test, the results showed the training effect in both groups reached the same level, which was level as Group A RRA-SST results. Analysis of the questionnaire results showed that the training effect of RRA-SST was higher than that of traditional surgical live teaching, from multiple perspectives. CONCLUSIONS The use of RRA-SST improved participant performance according to simulation assessment. RRA-SST can be helpful for trainees who are already practicing but not experienced when developing proficiency in adult DDH-THA surgical techniques.
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Affiliation(s)
- Chenggong Wang
- Office of teaching affairs, Xiangya Hospital, Central South University, Changsha, Hunan China
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Yang Ouyang
- Office of teaching affairs, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Hua Liu
- Office of teaching affairs, Xiangya Hospital, Central South University, Changsha, Hunan China
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Can Xu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Han Xiao
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Yihe Hu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Yusheng Li
- Office of teaching affairs, Xiangya Hospital, Central South University, Changsha, Hunan China
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Da Zhong
- Office of teaching affairs, Xiangya Hospital, Central South University, Changsha, Hunan China
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan China
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Yang J, Song L, Yao X, Cheng Q, Cheng Z, Xu K. Evaluating the Intention and Behaviour of Private Sector Participation in Healthcare Service Delivery via Public-Private Partnership: Evidence from China. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:5834532. [PMID: 32015796 PMCID: PMC6988663 DOI: 10.1155/2020/5834532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/30/2019] [Indexed: 11/18/2022]
Abstract
Private sector participation in the healthcare market via public-private partnership (PPP) could be considered an available approach to narrow down the medical resource gap and improve the operational efficiency of healthcare facilities. Accordingly, this study aims to examine the influence and relative importance among critical factors for the intention and behaviour of the private sector towards participation in Chinese healthcare market (CHM) via PPP. We defined five hypotheses from previous literature and built a theoretical model based on modified theory of planned behaviour. Then, covariance-based structural equation modelling was applied to analyse the questionnaires provided by 248 respondents from construction companies, real estate developers, pharmaceutical companies, private hospitals, asset management companies, and medical industry property investment companies in China. Results indicated that attitude towards behaviour (β = 0.466, P < 0.001), subjective norm (β = 0.167, P < 0.05), perceived behavioural control (β = 0.231, P < 0.01), and facilitating conditions (β = 0.305, P < 0.001) are positively significant to behavioural intention; behavioural intention also shows a strong linkage with behaviour (β = 0.931, P < 0.001). Findings provide reference for governments and public authorities to exert additional efforts in implementing appropriate measures that will stimulate the private sector's motivation to participate in CHM via PPP.
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Affiliation(s)
- Jie Yang
- School of Management Engineering, Shandong Jianzhu University, Jinan 250101, Shandong, China
| | - Lingchuan Song
- School of Management Engineering, Shandong Jianzhu University, Jinan 250101, Shandong, China
| | - Xiaoyi Yao
- School of Business, University of Leicester, Leicester LE3 5EB, UK
| | - Qian Cheng
- School of Management Engineering, Shandong Jianzhu University, Jinan 250101, Shandong, China
| | - Zichao Cheng
- Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing 100069, China
| | - Ke Xu
- School of Management Engineering, Shandong Jianzhu University, Jinan 250101, Shandong, China
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