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Health Sector Regulations

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Project log

Denny John
added a research item
Background Quality management in healthcare is critical for hospitals and everyone in the loop —from physicians to support staff—needs to be aware of and involved in this process. Objectives To assess the perception of employees about the quality management system (QMS) implemented at a tertiary care eye hospital in north India and to use it to identify scope for further improvement. Methods This cross-sectional mixed-method study involved both questionnaire-based survey and an in-depth interview by a third party. The questionnaire had 12 questions to assess the changes in culture, infrastructure, environment, system, operation theatre and outpatient department. Employees shared their opinion about improvements brought by the QMS in eight years. Respondents were divided into five groups based on their job description: (i) doctors, (ii) technical staff (nursing/operation theatre/laboratory), (iii) optometrists/opticians/audiologists, (iv) patient care executives and (v) human resources/administration/others. Results Of the 73 employees interviewed, 94.5% perceived an improved treatment and care process and 91.8% perceived improved treatment results. According to 83.6% of the employees, they were encouraged to report patient safety concerns and 71.2% saw improved incidence and adverse event management. The QMS has increased patient satisfaction according to 83%, while 91.8% felt it improved the profile of the hospital. The employees stated no negative effects of the QMS except a long waiting time of the patients and the duplication of paperwork. Conclusion QMS has brought many positive changes across the hospital. Still, there is scope to reduce the patient waiting time and paperwork duplication.
Denny John
added 4 research items
The objective of the baseline survey was to gather information on morbidity; costs associated with hospitalisation and out-patient care; and understand knowledge, attitude and practices of people with regard to malaria and maternal health in order to structure a Community-Based Health Insurance (CBHI) scheme in Kalahandi district of Orissa.
The objective of the baseline survey was to gather information on demographic characteristics of the surveyed blocks; costs associated with out-patient care, hospitalisation, and maternity; understand involuntary non-treatment in order to structure a Community- Based Health Insurance (CBHI) scheme in Rajnandgaon district of state of Chhattisgarh. Another objective of the study is to have baseline indicators for a before-and-after evaluation in comparison with endline study at the end of 18-months of project period.
Denny John
added a research item
Background: In 2013, the Government of Chhattisgarh announced a policy guaranteeing access to free generic medicines in all the public health facilities. This study was conducted with the objectives of evaluating the prescribing patterns of physicians in public health facilities with regard to generic medicines, and whether the prescribed generic medicines were made available to patients. Materials and methods: This cross-sectional study was conducting from December 2013-October 2014, using exit interviews of patients. Out of the total 27 districts of the state, 15 districts were selected, and one district hospital, three community health centers, and three primary health centers were selected from each of these districts, as per logistics feasibility. Descriptive statistics in the form of frequencies and percentages were calculated. Results: During the data collection period, a total of 1290 prescriptions were reviewed from 100 public health facilities. Around 68.89% of the medicines prescribed were generic and were from the 2013 generic drugs list. Around 58.28% of the prescribed generic medicines were available to the patients from these public health facilities, and the rest of the medicines were procured from private pharmacies. Conclusion: Chhattisgarh has made considerable progress in increasing access of generic medicines to patients in public health facilities. Our study shows that for the year 2013-14, about 58% of the prescribed medicines were available in various public health facilities. There is opportunity to further improve the state financial allocation for generic medicines, to improve supply chain and logistics for better distribution, and to mandate that physicians in these facilities prescribe generic medicines.
Ramesh Bhat
added 2 research items
The February 2017 order by the National Pharmaceutical Pricing Authority (NPPA) for fixing the price ceiling for cardiac stents—a device that normalises blood supply to the heart—brings to fore the old debate on the influence of business in healthcare in India. In view of the increasing number of catheterisation laboratories in the country, and the rise in the use of cardiac stents, this article discusses, inter alia: (a) the role of price controls in controlling costs in health care; (b) the role and interaction of economic regulations and related market forces in managing healthcare costs; (c) the importance of costing systems and outcomes-based measurements in managing healthcare costs; and (d) the contribution of evidence-based policymaking in managing healthcare costs. The paper suggests that India needs greater transparency in costing systems and outcomes-based measurements, and that evidence-based policymaking is an imperative.