دورية أكاديمية

Characteristics of private partners in Chiranjeevi Yojana, a public-private-partnership to promote institutional births in Gujarat, India - Lessons for universal health coverage.

التفاصيل البيبلوغرافية
العنوان: Characteristics of private partners in Chiranjeevi Yojana, a public-private-partnership to promote institutional births in Gujarat, India - Lessons for universal health coverage.
المؤلفون: Veena Iyer, Kristi Sidney, Rajesh Mehta, Dileep Mavalankar, Ayesha De Costa
المصدر: PLoS ONE, Vol 12, Iss 10, p e0185739 (2017)
بيانات النشر: Public Library of Science (PLoS), 2017.
سنة النشر: 2017
المجموعة: LCC:Medicine
LCC:Science
مصطلحات موضوعية: Medicine, Science
الوصف: The Chiranjeevi Yojana (CY) is a Public-Private-Partnership between the state and private obstetricians in Gujarat, India, since 2007. The state pays for institutional births of the most vulnerable households (below-poverty-line and tribal) in private hospitals. An innovative remuneration package has been designed to disincentivise unnecessary cesareans. This study examines characteristics of private facilities which participated in the program.We conducted a cross-sectional survey of all facilities which had conducted any births between June 2012 and April 2013 in three districts. We identified 111 private and 47 public facilities. Ninety of the 111 private facilities did caesarean sections in the last three months and were eligible to participate in the CY program. Of these, 40 (44%) participated in the CY program. We conducted descriptive and bivariate analyses followed by a Poisson regression model to estimate prevalence ratios of facility characteristics that predicted participation.We found that facilities participating in the CY program had a significantly higher likelihood of being general facilities (PR 1.9, 95% CI 1.3-2.9), or conducting lower proportion of cesarean births (PR 2.1, 95% CI 1.2-3.5) or having obstetricians new in private practice (PR 1.9, 95% CI 1.2-3.1) or being less expensive (PR 1.8, 95% CI 1.1-3.0). But none of these factors retained significance in a multi variable model.Private obstetricians who participate in the CY program tend to be new to private practice, provide general services, conduct fewer caesareans and are also less expensive. This is advantageous to the PPP and widens the target beneficiary groups that can be serviced by the PPP. The state should design remuneration packages with the aim of attracting relatively new obstetricians to set up practices in more remote areas. It is possible that the CY remuneration package design is effective in keeping caesarean rates in check, and needs to be studied further.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1932-6203
Relation: http://europepmc.org/articles/PMC5644975?pdf=render; https://doaj.org/toc/1932-6203
DOI: 10.1371/journal.pone.0185739
URL الوصول: https://doaj.org/article/62a29f03827043198adf7e8318e5121b
رقم الأكسشن: edsdoj.62a29f03827043198adf7e8318e5121b
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:19326203
DOI:10.1371/journal.pone.0185739