Abstract:
BACKGROUND:Demand side financing (DSF) is a widely employed strategy to enhance utilization of healthcare. The impact of DSF on health care seeking in general and that of maternal care in particular is already known. Yet, its effect on financial access to care, out-of-pocket spending (OOPS) and provider motivations is not considerably established. Without such evidence, DSFs may not be recommendable to build up any sustainable healthcare delivery approach. This study explores the above aspects on India's Janani Suraksha Yojana (JSY) program. METHODS:This study employed design and was conducted in three districts of Orissa, selected through a three-stage stratified sampling. The quantitative method was used to review the Health Management Information System (HMIS). The qualitative methods included focus groups discussions with beneficiaries (n = 19) and community intermediaries (n = 9), and interviews (n = 7) with Ministry of Health officials. HMIS data enabled to review maternal healthcare utilization. Group discussions and interviews explored the perceived impact of JSY on in-facility delivery, OOPS, healthcare costs, quality of care and performance motivation of community health workers. RESULTS:The number of institutional deliveries, ante-and post-natal care visits increased after the introduction of JSY with an annual net growth of 18.1%, 3.6% and 5% respectively. The financial incentive provided partial financial risk-protection as it could cover only 25.5% of the maternal healthcare cost of the beneficiaries in rural areas and 14.3% in urban areas. The incentive induced fresh out-of-pocket spending for some mothers and it could not address maternal care requirements comprehensively. An activity-based community worker model was encouraging to augment maternal healthcare consumption. However, the existing level of financial incentives and systemic support were inadequate to motivate the volunteers optimally on their performance. CONCLUSION:Demand side financial incentive could enhance financial access to maternal healthcare. However, it did not adequately protect households from financial risks. An effective integration of JSY with similar social protection or financial risk-protection measures may protect mothers substantially from potential out-of-pocket spending. Further, this integrated approach may help upholding more awareness on maternal health rights and entitlements. It can also address maternal health beyond 'maternal healthcare' and ensure sustainability through pooled financial and non-financial resources.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Gopalan SS,Durairaj Vdoi
10.1186/1472-6963-12-319subject
Has Abstractpub_date
2012-09-15 00:00:00pages
319issn
1472-6963pii
1472-6963-12-319journal_volume
12pub_type
杂志文章abstract:BACKGROUND:Healthcare reforms initiated in the early 2000s in Québec involved the implementation of new modes of primary healthcare (PHC) delivery and the creation of Health and Social Services Centers (HSSCs) to support it. The objective of this article is to assess and explain the degree of PHC organizational change ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-229
更新日期:2014-05-21 00:00:00
abstract:BACKGROUND:This is the tenth in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. After more than a decade of research, there is little published evidence of active and successful disinvestment. The paucity of frameworks, m...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2506-7
更新日期:2017-09-08 00:00:00
abstract:BACKGROUND:The cost of dialysis in low and middle-Income countries has not been systematically reviewed. The objective of this article is to systematically review peer-reviewed articles on the cost of dialysis across low and middle-income countries. METHODS:PubMed and Embase databases were searched for the year 1998 t...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-015-1166-8
更新日期:2015-11-12 00:00:00
abstract:BACKGROUND:India has been at the forefront of innovations around social accountability mechanisms in improving the delivery of public services, including health and nutrition. Yet little is known about how such initiatives are faring now that they are incorporated formally into government programmes and implemented at ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3600-1
更新日期:2018-10-19 00:00:00
abstract:BACKGROUND:For Indigenous Australians, health transcends the absence of disease, and includes the health and wellbeing of their community and Country: their whole physical, cultural and spiritual environment. Stronger relationships with Country and greater involvement in cultural practices enhance the wellbeing of Indi...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3764-8
更新日期:2018-12-12 00:00:00
abstract:BACKGROUND:Over the last decade, active surveillance has proven to be a safe approach for patients with low-risk prostate cancer. Although active surveillance presents several advantages for both patients and the health care system, all eligible patients do not adopt this approach. Our goal was to evaluate the factors ...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-018-3273-9
更新日期:2018-06-08 00:00:00
abstract:BACKGROUND:The National Guideline for Assessment, Treatment and Social Rehabilitation of Persons with Concurrent Substance Use and Mental Health Disorders, launched in 2012, is to be implemented in mental health services in Norway. Audit and feedback (A&F) is commonly used as the starting point of an implementation pro...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-018-2862-y
更新日期:2018-01-31 00:00:00
abstract:BACKGROUND:African Vaccination Week (AVW) is an initiative of the Member States of the African Region aimed at promoting vaccination and ensuring equity and access to its benefits. The initiative has proven to be particularly effective in reaching populations with limited access to regular health services as well as pr...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0989-7
更新日期:2015-09-02 00:00:00
abstract:BACKGROUND:Sexually transmissible infection (STI) and blood-borne virus (BBV) diagnoses data are a core component of the Australian National Notifiable Diseases Surveillance System (NNDSS). However, the NNDSS data alone is not enough to understand STI and BBV burden among priority population groups, like Aboriginal and...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05388-y
更新日期:2020-08-20 00:00:00
abstract:BACKGROUND:In contrast to the acute hospital sector, there have been relatively few implementations of integrated electronic health record (EHR) systems into specialist mental health settings. The National Programme for Information Technology (NPfIT) in England was the most expensive IT-based transformation of public s...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-484
更新日期:2012-12-31 00:00:00
abstract:BACKGROUND:Risperidone long-acting injection (LAI) is mostly administered twice weekly to people with schizophrenia by nurses at community mental health centres (CMHC) or through mobile outreach visits. This study estimates the cost of resource utilisation associated with the administration of risperidone LAI and the p...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-236
更新日期:2011-09-26 00:00:00
abstract:BACKGROUND:There is a growing number of adolescents and young adults living with HIV (YPLHIV) who require the transfer of care from pediatric/ adolescent clinics to adult Antiretroviral therapy (ART) clinics. A successful transition is critical for optimum health outcomes, yet facilities may lack infrastructure, human ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05701-9
更新日期:2020-09-05 00:00:00
abstract:BACKGROUND:Although general practitioners (GPs) and community pharmacists (CPs) are encouraged to collaborate, a true collaborative relationship does not exist between them. Our objective was to identify and analyze factors affecting GP-CP collaboration. METHODS:This was a descriptive-exploratory qualitative study car...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-188
更新日期:2012-07-07 00:00:00
abstract:BACKGROUND:The increasing diversity of population in European Countries poses new challenges to national health systems. There is a lack of data on accessibility and use of health care services by migrants, appropriateness of the care provided, client satisfaction and problems experienced when confronting the health ca...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-207
更新日期:2008-10-07 00:00:00
abstract:BACKGROUND:The concept of frailty is rapidly gaining attention as an independent syndrome with high prevalence in older adults. Thereby, frailty is often related to certain adverse outcomes like mortality or disability. Another adverse outcome discussed is increased health care utilization. However, only few studies ex...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1360-3
更新日期:2016-04-14 00:00:00
abstract:BACKGROUND:Involving doctors in management has been intended as one of the strategies to spread organizational principles in healthcare settings. However, professionals often resist taking on relevant managerial responsibility, and the question concerning by which means to engage doctors in management in a manner that ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1394-6
更新日期:2016-05-24 00:00:00
abstract:BACKGROUND:As health systems evolve, it is essential to evaluate their impact on the delivery of health services to socially disadvantaged populations. We evaluated the delivery of primary health services for different socio-economic groups and assessed the performance of different organizational models in terms of equ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-517
更新日期:2013-12-17 00:00:00
abstract:BACKGROUND:Policy that supports rural allied health service delivery is important given the shortage of services outside of Australian metropolitan centres. The shortage of allied health professionals means that rural clinicians work long hours and have little peer or service support. Service delivery to rural and remo...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-70
更新日期:2012-03-21 00:00:00
abstract:BACKGROUND:Early identification of patients who need post-acute care (PAC) may improve discharge planning. The purposes of the study were to develop and validate a score predicting discharge to a post-acute care (PAC) facility and to determine its best assessment time. METHODS:We conducted a prospective study includin...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-154
更新日期:2008-07-22 00:00:00
abstract:BACKGROUND:Maternal and Child Health is a global priority. Access and utilization of facility-based health services remain a challenge in low and middle-income countries. Evidence on barriers to providing and accessing services omits information on the role of security within facilities. This paper explores the role of...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05747-9
更新日期:2020-09-29 00:00:00
abstract:BACKGROUND:The Italian National Health System was revised in the last 20 years, introducing new elements such as efficacy, efficiency and competitiveness. Devolution to regional authorities has created a quasi-market system where patients can choose the hospital in which to be treated. Patient mobility therefore become...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-56
更新日期:2013-02-12 00:00:00
abstract:BACKGROUND:In several health systems of advanced countries, reforms have changed primary care in the last two decades. The literature has assessed the effects of a variety of interventions and individual factors on the behavior of general practitioners (GPs). However, there has been a lack of investigation concerning t...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2467-x
更新日期:2017-08-08 00:00:00
abstract:BACKGROUND:Internationally, key health care reform elements rely on improved integration of care between the primary and secondary sectors. The objective of this systematic review is to synthesise the existing published literature on elements of current integrated primary/secondary health care. These elements and how t...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-13-528
更新日期:2013-12-20 00:00:00
abstract:BACKGROUND:Clinical networks have been established to improve patient outcomes and processes of care by implementing a range of innovations and undertaking projects based on the needs of local health services. Given the significant investment in clinical networks internationally, it is important to assess their effecti...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1096-5
更新日期:2015-11-05 00:00:00
abstract:BACKGROUND:To reduce inappropriate admissions and stays with the application of an improvement cycle in patients admitted to a University Hospital. The secondary objective is to analyze the hospital cost saved by reducing inadequacy after the implementation of measures proposed by the group for improvement. METHODS:Pr...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-361
更新日期:2012-10-17 00:00:00
abstract:BACKGROUND:Ischemic stroke is a risk associated with atrial fibrillation (AF) and is estimated to occur five times more often in afflicted patients than in those without AF. Anti-thrombotic therapy is recommended for the prevention of ischemic stroke. Risk stratification tools, such as the CHADS2, and more recently the...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2025-6
更新日期:2017-02-11 00:00:00
abstract:BACKGROUND:Adults with certain comorbid conditions have a higher risk of pneumonia than the overall population. If treatment of pneumonia is more costly in certain predictable situations, this would affect the value proposition of populations for pneumonia prevention. We estimate the economic impact of community-acquir...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-379
更新日期:2012-10-31 00:00:00
abstract::An amendment to this paper has been published and can be accessed via the original article. ...
journal_title:BMC health services research
pub_type: 已发布勘误
doi:10.1186/s12913-020-05345-9
更新日期:2020-08-12 00:00:00
abstract:BACKGROUND:Social accountability is defined as the responsibility of institutions to respond to the health priorities of a community. There is an international movement towards the education of health professionals who are accountable to communities. There is little evidence of how communities experience or articulate ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2239-7
更新日期:2017-04-12 00:00:00
abstract:BACKGROUND:Because of the increasing costs and anticipated shortage of Ear Nose and Throat (ENT) specialists in the care for hearing-impaired persons, an integrated care pathway that includes direct hearing aid provision was developed. While this direct pathway is still under investigation, in a survey we examined expe...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-57
更新日期:2007-04-19 00:00:00