1,721,097 research outputs found
Maternal Health Financing – Issues and Options: A Study of Chiranjeevi Yojana in Gujarat
Full text linkGovernment of Gujarat announced a “Chiranjeevi Yojana” in April 2005. The objective of this scheme is to encourage private medical practitioners to provide maternity health services in remote areas which record the highest infant and maternal mortality and thereby improve the institutional delivery rate in Gujarat. The scheme was finally launched as a one year pilot project in December 2005 in five districts viz., Banaskantha, Dahod, Kutch, Panchmahal, and Sabarkantha. The private empanelled providers are reimbursed on capitation payment basis according to which they are reimbursed at a fixed rate for deliveries carried out by them. The payments are made for a batch of 100 deliveries. This is expected to take care of case-mix differences (i.e., normal or complicated deliveries) and help the providers to keep the costs below the reimbursed amounts. The scheme proposes to use a voucher system to target the people living below poverty line. The objective of this paper is to document the experience in implementing this scheme and discuss the issues in up-scaling it further.
A Study of Factors Affecting the Renewal of Health Insurance Policy
Full text linkHealth insurance policies are generally one-year policies and to remain part of the insurance poll, policyholders are required to renew their policies each year. Understanding the factors that affect the demand and renewal decisions to continue in health insurance programme is imperative for future growth and development of the insurance sector. We extend our previous work on factors affecting the decision to purchase health insurance to understand the factors affecting the renewal of insurance policy. We find the factors affecting health insurance renewal are not the same as factors affecting health insurance purchase decision. This has implications for insurance providers. The study also suggests customer satisfaction as an important factor influencing the renewal decision of policyholder.
Human resource issues and its implications for health sector reforms
Full text linkGiven the growing complexities and challenges the health sector faces, reforms in this sector are inevitable. Often health sector reforms aimed to address many of these deficiencies and ensuring effectiveness and efficiency of resource use, they focus on making the health systems responsive through strengthening financial systems, ensuring local participation and public private partnerships, and autonomy of health facilities. The reform process, among other things, intrinsically makes some fundamental assumptions some of which are as follows: high organisational commitment of health care providers, high professional commitment of health care providers, and adequate skills of health care providers. This paper examines the commitment of district level health officials in the newly carved out state of Chhattisgarh in India. Since development oriented HR practices (HRD) are powerful tools to commit people working in health sector to enhance the quality of care, we believe that health sector reforms will have to concentrate on human resource issues and practices more than ever before in near future. The papers attempts to examine the following questions: (i) what is status of professional commitment, organisational commitment and technical competencies of health officials? (ii) what are the characteristics of human resource management practices in the health sector in the state? and (iii) how these management practices are linked with professional and organisational commitment? Finally the paper discusses the implications of these to health sector reform process.
Time series analysis of private healthcare expenditures GDP: cointegration results with structural breaks
Full text linkThis paper analyses the time-series behaviour of private health expenditure and GDP to understand whether there is long-term equilibrium relationship between these two variables and estimate income elasticity of private health expenditure. The study uses cointegration analysis with structural breaks and estimates these relationships using FM OLS (fully modified ordinary least squares) method. The findings suggest that income elasticity of private health expenditures is 1.95 indicating that for every one per cent increase in per capita income the private health expenditure has gone up by 1.95 per cent. The private health expenditure was 2.4 per cent of GDP in 1960 and this has risen to 5.8 per cent in 2003. In nominal terms it has grown at the rate of 11.3 per cent since 1960 and during 1990’s the growth rate is 18 per cent per annum. The study discusses four reasons for this high growth experience. These are: (i) financing mechanisms including provider payment system, (ii) demographic trends and epidemiological transition, (iii) production function of private health services delivery system, and (iv) dwindling financing support to public health system. In developing countries where per se the need for spending on health is high, high levels of private health expenditures pose serious challenge to policy makers. The sheer size of these expenditures once it has risen to high levels can impede control of health expenditures itself. The high private health expenditures are also cause of concern because most of these expenditures are out-of-pocket, insurance mechanisms cover small segment of population, provider payment systems are primarily based on fee-for-services and the professional regulation and accountability systems are weak and non-functioning in many ways. It is not clear whether these expenditures are sustainable as it can have number of undesirable consequences making the health system high cost, unaffordable, and vulnerable to provider payment system.
Dividend Behaviour of Indian Companies Under Monetary Policy Restrictions
Full text linkIn this study we examine the dividend behaviour of Indian companies. We use GMM estimator, which is the most suitable methodology in a dynamic setting. Our results show that the Indian firms have lower target ratios and higher adjustment factors. The most significant result is that the restricted monetary policies have significant influence on the dividend behaviour of Indian firms, causing about 5-6 percent reduction in the payout ratios. The significance of macro economic policy variable suggest that monetary policy restrictions do have impact on cost of raising funds, and the information asymmetry between lenders and borrowers increases that forces companies to reduce their dividend payout.
Analysis of Public Expenditure on Health Using State Level Data
Full text linkIncreasingly the governments are facing pressures to increase budgetary allocations to social sectors. Recently there has been suggestion to increase the government budget allocations to health sector and increase it to 3 per cent of GDP. Is this feasible goal and in what time-frame? Health being State subject in India and much depends on the ability of the State governments to allocate higher budgetary support to health sector. This inter alia depends on what are current levels of spending, what target spending as per cent of income the States assume to spend on health and given fundamental relationship between income levels and public expenditures, how fast expenditures can respond to rising income levels. We present analysis of public expenditures on health using state level public health expenditure data to provide preliminary analysis on these issues. The findings suggest that at state level governments have target of allocating only about 0.43 per cent of SGDP to health and medical care. This does not include the allocations received under central sponsored programmes such as family welfare. Given this level of spending at current levels and fiscal position of state governments the goal of spending 2 to 3 per cent of GDP on health looks very ambitious task. The analysis also suggests that elasticity of health expenditure when SGDP changes in only 0.68 which suggest that for every one percent increase in state per capita income the per capita public healthcare expenditure has increased by around 0.68 per cent.
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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