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Innovationen schaffen Qualitäts- und Kostenvorteile, mit denen Unternehmen rascher wachsen. Länder mit vielen F&E-intensiven Unternehmen spezialisieren sich auf wertschöpfungsintensive Branchen, bleiben trotz hoher Löhne wettbewerbsfähig und erzielen robusteres Wachstum. Private F&E schafft Wissen und Know-How, das nicht nur den eigenen Erfolg stär...
We study repeated games in which players learn the unknown state of the world by observing a sequence of noisy private signals. We find that for generic signal distributions, the folk theorem obtains using ex post equilibria. In our equilibria, players commonly learn the state, that is, the state becomes asymptotic common knowledge.
We study games in which principals simultaneously post mechanisms in the presence of several agents. We evaluate the role of principals' communication in these settings. As in Myerson (1982), each principal may generate incomplete information among agents by sending them private signals. We show that this channel of communication, which has not bee...
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... National Sample Survey Office (NSSO) reported that private doctors are the single source of treatment in both the urban and rural areas (5). Also, due to the exponential growth of private pharmaceuticals sector, there is an urgent need to provide handholding support to private sector to meet the challenges such as under reporting of ADRs, development of indigenous patient safety database and for mutual benefits including recognition and to avoid regulatory action (6). Engagement of healthcare professionals is key to success for Pharmacovigilance (7); Therefore, the alliance by the PvPI with public and private hospitals/academic medical institutions has resulted in establishing a robust system and tools for ADRs monitoring, reporting and assessment. ...
Responsibilities of Public and Private partners in promoting Pharmacovigilance system in Inida
... National Sample Survey Office (NSSO) reported that private doctors are the single source of treatment in both the urban and rural areas (5). Also, due to the exponential growth of private pharmaceuticals sector, there is an urgent need to provide handholding support to private sector to meet the challenges such as under reporting of ADRs, development of indigenous patient safety database and for mutual benefits including recognition and to avoid regulatory action (6). Engagement of healthcare professionals is key to success for Pharmacovigilance (7); Therefore, the alliance by the PvPI with public and private hospitals/academic medical institutions has resulted in establishing a robust system and tools for ADRs monitoring, reporting and assessment. ...
... This had led to limitation of government health services to a few selective interventions, with the understanding that the market would take care of the others (McPake and Mills 2000), the introduction of user fees, and decreased government investment, sharp decreases in the workforce and initiation of a wave of public-private partnerships (LaFond 1995;Leighton 1996;Russell and Gilson 1997). These reforms have been held responsible for weakening public health systems which became unable to perform effectively even on select vertical programmes, and which in turn resulted in a shift to use of private providers and a resulting huge rise in costs of care (Nandraj et al. 2001). These structural adjustment reforms and consequences were not confined only to India. ...
... 8 Studies suggest that 80% of the first-contact health care and nearly 50% of TB care occurs in the private sector. 9 The private sector is also very fragmented, with both unqualified (i.e., no formal medical degree) and qualified providers (a formal degree in either allopathic medicine or in alternative traditions such as Ayurveda, Unani, Siddha and Homeopathy [AYUSH]). 10,11 A recent study of 100 villages in rural Madhya Pradesh found that, among primary care providers identifying themselves as 'doctors', 65% reported having no formal medical training, while 25% had AYUSH degrees, and only 10% reported having an MBBS (Bachelor of Medicine, Bachelor of Surgery, i.e., formal allopathic medicine) degree. The quality of medical care was highly variable, and was found to be deficient on many levels. ...
... Results pertaining to the key standards, i.e., sputum examination for diagnosis (Standard 2), initiation of the recommended drug regimen among new TB cases (Standard 8), and patient support to ensure adherence (Standard 9), each with 10 or more studies, are presented here. The results pertaining to the remaining standards (1,5,10,13,18) are given in the Appendix. ...
While Indian studies have assessed care providers' knowledge and practices, there is no systematic review on the quality of tuberculosis (TB) care.
We searched multiple sources to identify studies (2000-2014) on providers' knowledge and practices. We used the International Standards for TB Care to benchmark quality of care.
Of the 47 studies included, 35 were questionnaire surveys and 12 used chart abstraction. None assessed actual practice using standardised patients. Heterogeneity in the findings precluded meta-analysis. Of 22 studies evaluating provider knowledge about using sputum smears for diagnosis, 10 found that less than half of providers had correct knowledge; 3 of 4 studies assessing self-reported practices by providers found that less than a quarter reported ordering smears for patients with chest symptoms. In 11 of 14 studies that assessed treatment, less than one third of providers knew the standard regimen for drug-susceptible TB. Adherence to standards in practice was generally lower than correct knowledge of those standards. Eleven studies with both public and private providers found higher levels of appropriate knowledge/practice in the public sector.
Available evidence suggests suboptimal quality of TB care, particularly in the private sector. Improvement of quality of care should be a priority for India.
ABSTRACT
Health is a basic component of human development, and Health sector is the lifeline for a nation's well being. Hence our Constitution through Article 21 accorded due importance to it as a primary human right.
The Indian healthcare sector is one of the largest and rapidly expanding service sectors, in terms of revenue and employment, and has emerged as one of the most challenging sectors. India’s rapid economic growth in the last two decades has not translated into development of the country and improved living conditions for the poorest.
It is estimated that 15% of India’s population, still has no access to health care services, either due to lack of availability or economic reasons. Moreover, 75% of the qualified doctors practice in urban areas and 23% in towns, while only 2% practice in rural areas.
Analysis of available qualitative and quantitative data clearly shows extremely uneven health and development progress in various parts of the country. Often this difference is so dramatic that one can hardly believe that, they are part of the same nation and have followed the same development path for the last five decades. None of the state governments in the country have the necessary funds to invest in infrastructure development of secondary or tertiary level hospitals
Deficiencies in the public sector health system in providing health services to the population are well documented. The inability of the public health sector has forced poor and deprived sections of the population to seek health services from the private sector.
Due to the prevailing situation in the government sector, there has been an unprecedented growth of the private sector. The private sector is not only India’s most unregulated sector but also it’s most potent and untapped sector. Contrary to commonly held views, private hospitals are relatively less urban-biased than the public hospitals.
Given the current ethical standards of the medical profession, and free market technology-driven operational principles, the private sector generally does not provide quality health care at a reasonable cost. India has one of the world s highest levels of private out-of-pocket financing (87 %). Such a mode of financing imposes debilitating effects on the poor. Recent studies indicate that private health care significantly affects both the cost and quality of health care services in India.
It is estimated that more than 40% of hospitalized people borrow money or sell assets to cover expenses, and 35% of hospitalized Indians fall below the poverty line because of hospital expenses. Out-of-pocket medical costs alone may push 2.2% of the population below poverty line in one year.
Several constraints exist in the health sector in India. The major challenges for the health sector include
Accessibility and coverage in rural areas,
Ineffective management of existing infrastructure,
Inadequate number and quality of health care professionals
Public-sector involvement in health care dates back to 1883, and is important to ensure fair financing and fair access. Public financing of health care is more efficient than private insurance. The health sector, with high public interaction and large societal impact affecting almost the entire population, was the second most corrupt sector in India. The prevention of corruption is a bottom-up process, beginning with people’s participation in planning, implementation, and monitoring in service delivery to overcome corruption
Inadequate and unbalanced financial outlays, over-centralized planning, low moral values, lack of accountability and dereliction of duty by medical and nursing professionals plague the system. The National Health Policy needs to be reviewed thoroughly and a total revamping and restructuring of the health infrastructure are immediately called for. This paper would look into the various aspects of improving the health sector.
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