Perils of the Commercialised Private Healthcare Sector for Patients: Analysis of Patients' Experiences from COVID-19 Pandemic in Maharashtra, India

Although the ramifications of a weakly regulated, commercialised private sector have always been prevalent, the COVID-19 pandemic has further exposed its magnitude and implications for patients in India. Although much is being studied about the health system's response to the pandemic, the recipient of the system, that is, the patient seems to be less attended in analysis. This article analyses patients' experiences while seeking healthcare from the private sector in the context of state-imposed regulations over them during the pandemic. A qualitative study was conducted in Maharashtra, India and 30 in-depth interviews of patients who faced difficulties in availing treatment from private hospitals during the pandemic were conducted using purposive sampling. The study reveals the myriad of catastrophic challenges patients faced, their vulnerability and helplessness with private hospitals during the pandemic. It demonstrates the character of ruthless privatisation that operates in health care with rampant overcharging and the failure of regulation of the private sector during the crisis. The study concludes by pointing out the need for state intervention in the regulation of the private sector and emphasises the need to strengthen the public health system and place effective accountability mechanisms with the legal instrument to safeguard people's interests from corporate privatisation. © 2023 SAGE Publications.

(How) is COVID-19 reframing interaction between the NHS and private healthcare?

In March 2020, a 'major deal' was struck between the National Health Service (NHS) and private healthcare sector to facilitate 'crisis' and 'continuity' responses to COVID-19. A further deal was struck in January 2022 to support the NHS in tackling the Omicron variant, suggesting that the pandemic was evolving, rather than definitively over. The legal basis for these deals was a Public Policy Exclusion Order, a temporary relaxation mechanism in UK competition law defined by a 'disruption period'. In a global pandemic, the 'healthcare disruption period' might be considered to be of a different scope and nature to short-term disturbances experienced in other sectors, such as groceries. This article examines the Public Policy Exclusion Orders issued in respect of health services in England and Wales, and the Collective Agreements notified under these between March 2020 and March 2021, and again in March 2022. Amid ongoing tensions surrounding 'NHS privatisation', this enables a timely analysis of whether the underlying relationship between the NHS and private healthcare may be changing in response to COVID-19, and how considerations of ethical frameworks are also relevant to this aspect of the pandemic response.Copyright © The Author(s) 2023.

Unmet needs during simultaneous crises: A study of lived experiences of employees in a private healthcare environment

During the unprecedented time when COVID-19 dramatically impacted the county and world, the healthcare industry had to quickly adapt to continue taking care of patients while providing a safe environment for employees. Unfortunately, changes within some healthcare organizations were already in motion as the pandemic grew. Therefore, the purpose of this phenomenological qualitative study was to gain a greater understanding of the unmet needs of private practice healthcare employees during a leadership transition amidst COVID-19. Examining leadership change within a private healthcare organization from February 1 through July 31, 2020, with hermeneutic phenomenology research will provide information for healthcare leaders to better understand and minimize the negative impact on employees. Interviews of eligible participants of the practice utilizing a self-selection sampling method allowed for in-depth data gathering and data saturation. Strictly adhering to Institutional Review Board standards and requirements, anonymous and confidential interviews concluded with member-checking of coded data to aid in data accuracy. Reached as a result of open, honest input from 14 of 39 eligible participants were impactful conclusions with significant application. Evaluating employees' needs in the context of Maslow's hierarchy of needs motivation theory allowed for a deeper understanding of the influence need fulfillment and deficiencies had on individuals and the organization. Increased, transparent communication was a key need for employees during a time of heightened change and stressors. However, participants' trust in the actions, decisions, and motivations of the physicians helped to reduce their overall concerns during the challenging time. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

COVID-19 and Public Health Spending; Effects on the Economic Sustainability of the Spanish Private Healthcare System.

This research analyzes the influence of COVID-19 and public health spending policies on the economic sustainability of Spanish private hospitals. Moreover, it explores the relationship between public health spending policies and the spread of COVID-19 in Spain. Private health care is an understudied sector, yet it is fundamental to the health of citizens. Moreover, the economic causes linked to the spread of the pandemic have not yet been clearly established. Therefore, this work covers a gap in the literature. Private hospital profitability was analyzed by applying ordinary least squares and panel data regressions on financial and macroeconomic data for the period 2017-2020. The spread of COVID-19 was examined by means of cluster and component analysis. The results show that the COVID-19 pandemic negatively affected the economic sustainability of Spanish private hospitals, which was also influenced by public health spending. In turn, the spread of the pandemic was mainly related to population density, but was also influenced by public health spending and the gross domestic product of the region. Therefore, policymakers must consider that it is essential to make adequate investments in the healthcare system to cope with pandemics such as COVID-19. In addition, managers can see how corporate social responsibility is a valuable strategy for maintaining hospital profitability.

Unmet needs during simultaneous crises: A study of lived experiences of employees in a private healthcare environment

During the unprecedented time when COVID-19 dramatically impacted the county and world, the healthcare industry had to quickly adapt to continue taking care of patients while providing a safe environment for employees. Unfortunately, changes within some healthcare organizations were already in motion as the pandemic grew. Therefore, the purpose of this phenomenological qualitative study was to gain a greater understanding of the unmet needs of private practice healthcare employees during a leadership transition amidst COVID-19. Examining leadership change within a private healthcare organization from February 1 through July 31, 2020, with hermeneutic phenomenology research will provide information for healthcare leaders to better understand and minimize the negative impact on employees. Interviews of eligible participants of the practice utilizing a self-selection sampling method allowed for in-depth data gathering and data saturation. Strictly adhering to Institutional Review Board standards and requirements, anonymous and confidential interviews concluded with member-checking of coded data to aid in data accuracy. Reached as a result of open, honest input from 14 of 39 eligible participants were impactful conclusions with significant application. Evaluating employees' needs in the context of Maslow's hierarchy of needs motivation theory allowed for a deeper understanding of the influence need fulfillment and deficiencies had on individuals and the organization. Increased, transparent communication was a key need for employees during a time of heightened change and stressors. However, participants' trust in the actions, decisions, and motivations of the physicians helped to reduce their overall concerns during the challenging time. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Prevailing Over the Pandemic: An Overview on Private Healthcare

The global pandemic brought by COVID-19 immediately took effects, with no warning for big and small businesses in all fields. Government measures for coping with this crisis forced businesses to adapt and make quick decisions regarding their activities and resource management against sudden decreases in revenues. While the national healthcare system has been put to a challenge, private healthcare had its own hit, financially wise. Due to legal obligation, dentistry had to seize all non-emergency-related activities, but practices in other private medical fields had to make their own choice whether to close their gates or not, especially when protection against infection was imperative. Managing this kind of crisis has been challenging, especially related to human resource management and to handling the shift of financial resources, from redirecting own funds to accessing any possible national financial help. The aim of this study is to discover how the organisational life was affected in private medical practices during the pandemic and how the issues of profitability and treating patients via means that are consistent with their state of health were intertwined. Using the feedback provided by managers and workers in private healthcare through qualitative research (21 interviews concerning significant challenges, major fears and future recovery measures) has made possible for this study to put a light on the pressure of surviving as a competitive business in times of constraint, in the need to provide care while not deteriorating quality of service and patient satisfaction. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The role of general practitioners in managing the COVID-19 pandemic in a private healthcare system.

BACKGROUND: The canton of Vaud's public health authorities, in Switzerland, invited general practitioners (GPs) to participate in managing suspected COVID-19 patients and continue caring for their non-COVID-19 patients. However, this course of action was not mandatory. The present study's objective was to describe and understand how involved GPs were in dealing with the COVID-19 pandemic's first wave. METHODS: This mixed-methods study combined a retrospective quantitative survey and a qualitative explanatory investigation. All of the canton's GPs were invited to participate in the quantitative survey via an online questionnaire including sections on: specific organization regarding COVID-19 activities and suspected COVID-19 patients, activities relating to non-COVID-19 patients, consequences on the practice's professional staff, and opinions about the public health authorities' pandemic crisis management. The qualitative investigation involved interviews with 10 volunteer GPs. RESULTS: The participation rate was 41%. One third of GPs chose not to reorganize their practice for the specific management of suspected COVID-19 patients. The number of weekly activities and interventions decreased by over 50% at 44% of practices, mostly due to a lack of patients. Even in an extraordinary crisis, GPs maintained their choice of whether to become involved, as their private and independent status allowed them to do. However, those who chose to be involved felt frustrated that the public health authorities did not recognize them as major health providers in the management of the pandemic. CONCLUSION: This study illustrated the complexity and limitations of a primary care system based completely on private healthcare providers.

The impact of the COVID-19 epidemic on primary care in South-eastern France: implementation of a real-time monitoring system based on regional health insurance system data.

BACKGROUND: The spring 2020 COVID-19 epidemic severely impacted France's healthcare system. The associated lockdown (17 March- 11 May 2020) and the risk of exposure to SARS-CoV-2 led patients to change their use of healthcare. This article presents the development and implementation of a real-time system to monitor i) private doctors' activity in South-eastern France, and ii) changes in prescription of drugs for people with diabetes, mental health disorders and for certain vaccines from Mars 2020 to October 2020. METHODS: Data extracted from the regional healthcare insurance databases for 2019 and 2020 were used to construct indicators of healthcare use. They were calculated on a weekly basis, starting from week 2 2020 and compared for the same period between 2019 and 2020. RESULTS: Private doctors' activity decreased during the spring 2020 lockdown (by 23 % for general practitioners and 46 % for specialists), followed by an almost complete return to normal after it ended until week 41. Over the same period, a huge increase in teleconsultations was observed, accounting for 30 % of private doctors' consultations at the height of the crisis. The start of the lockdown was marked by a peak in drug prescriptions, while vaccinations declined sharply (by 39 % for the measles, mumps and rubella (MMR) vaccine in children under 5 years old, and by 54 % for human papillomavirus vaccine in girls aged 10-14 years old). CONCLUSION: The ongoing COVID-19 epidemic may lead to health consequences other than those directly attributable to the disease itself. Specifically, lockdowns and foregoing healthcare could be very harmful at the individual and population levels. The latter issue is a concern for French public authorities, which have implemented actions aimed at encouraging patients to immediately seek treatment. However, the COVID-19 crisis has also created opportunities, such as the roll-out of teleconsultation and tele-expertise. The indicators described here as part of the monitoring system can help public decision-makers to become more responsive and to implement tailored actions to better meet the general population's healthcare needs.

Public and private sectors collective response to combat COVID-19 in Malaysia.

Over the last year, the dangerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly around the world. Malaysia has not been excluded from this COVID-19 pandemic. The resurgence of COVID-19 cases has overwhelmed the public healthcare system and overloaded the healthcare resources. Ministry of Health (MOH) Malaysia has adopted an Emergency Ordinance (EO) to instruct private hospitals to receive both COVID-19 and non-COVID-19 patients to reduce the strain on public facilities. The treatment of COVID-19 patients at private hospitals could help to boost the bed and critical care occupancy. However, with the absence of insurance coverage because COVID-19 is categorised as pandemic-related diseases, there are some challenges and opportunities posed by the treatment fees management. Another major issue in the collaboration between public and private hospitals is the willingness of private medical consultants to participate in the management of COVID-19 patients, because medical consultants in private hospitals in Malaysia are not hospital employees, but what are termed "private contractors" who provide patient care services to the hospitals. Other collaborative measures with private healthcare providers, e.g. tele-conferencing by private medical clinics to monitor COVID-19 patients and the rollout of national vaccination programme. The public and private healthcare partnership must be enhanced, and continue to find effective ways to collaborate further to combat the pandemic. The MOH, private healthcare sectors and insurance providers need to have a synergistic COVID-19 treatment plans to ensure public as well as insurance policy holders have equal opportunities for COVID-19 screening tests, vaccinations and treatment.

Private Health Sector in India-Ready and Willing, Yet Underutilized in the Covid-19 Pandemic: A Cross-Sectional Study.

Background: The private medical sector is a resource that must be estimated for efficient inclusion into public healthcare during pandemics. Methods: A survey was conducted among private healthcare workers to ascertain their views on the potential resources that can be accessed from the private sector and methods to do the same. Results: There were 213 respondents, 80% of them being doctors. Nearly half (47.4%) felt that the contribution from the private medical sector has been suboptimal. Areas suggested for improved contributions by the private sector related to patient care (71.8%) and provision of equipment (62.4%), with fewer expectations (39.9%) on the research front. Another area of deemed support was maintaining continuity of care for non-COVID patients using virtual consultation services (77.4%), tele-consultation being the preferred option (60%). 58.2% felt that the Government had not involved the private sector adequately; and 45.1% felt they should be part of policy-making. Conclusion: A streamlined pathway to facilitate the private sector to join hands with the public sector for a national cause is the need of the hour. Through our study, we have identified gaps in the current contribution by the private sector and identified areas in which they could contribute, by their own admission.