The study on social impact of free health service in Sri Lanka
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The study on social impact of free health service in Sri Lanka

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Study on social impact of free health service in Sri Lanka ...

Study on social impact of free health service in Sri Lanka
Ravi Kumudesh(kumudeshr@gmail.com)

Statistical data and the sense of community show a gap of total health expenditure and public health expenditure. This gap shows the problem of sustainability of free health and has created several problems on patients who visit the government hospital for their healthcare needs and health development in community.

This study is focused to clear out the disparity of the health policy by identifying the obstacles to obtain free healthcare facilities from state sector healthcare institutions, and to clarify evidently the circulation of additional amount of money in health service other than public health expenditure creating problems of free health service.
Questioner was the instrument used in primary data collection. Responses were analyzed with income levels. Availability of hospital facilities, mode of spending, utility of private and government health facilities, aptitude on current health trends and prevention healthcare were surveyed. Secondary data analysis also carried out based on WHO reports, reports of Ministry of Health and other international reports.

Primary data indicated inadequate facilities in state hospitals. Out of admitted patients 72% were requested some drugs and laboratory tests from outside. Every respondent spends some amount of money monthly for their health needs, even among low income levels. Only 21% was alert on preventive health care. Out of the respondents who utilize the private health care services 78% pay their expenditure from out of pocket. It includes both people with high income levels as well as low income levels. Secondary data analysis could justify the present situation of the country health. Public health expenditure share of total health expenditure is always less than 50%.
The research realized that all income levels utilize private sector for their health care needs. Most of people who utilize the private sector pay their bills out of pocket. These evidences show the disparity of free health policy and the nature of persisting health care service. Complete understand on this complicated underlying reality of health should be concerned in provision of sustainable health care service.

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The study on social impact of free health service in Sri Lanka The study on social impact of free health service in Sri Lanka Presentation Transcript

  • THE STUDY ON SOCIAL IMPACT OF FREE HEALTH SERVICE IN SRI LANKA R Kumudesh1 K Mathotaarachchi2 1In-Charge Medical Laboratory Technologist National Hospital, Colombo 2 Senior Lecturer Institute of Human Resource Advancement University of Colombo
  • Overview • • • • • • • Introduction Back ground Research questions Method and Data Collection Data Interpretation Conclusions Recommendations International Research Conference 2013 kumudeshr@gmail.com/UoC 2
  • Introduction • Better health is the basis of human happiness and well-being. • Health services are diagnosis, Treatment and heath promotion, maintenance and restoration of health. • Primary health care is the most widely concerned component International Research Conference 2013 kumudeshr@gmail.com/UoC 3
  • Background • Sri Lanka principally accepts the free health concept with government allocations • The gap of government health expenditure and the total health expenditure shows the problem of sustainability of free health • This indicates several problems at government hospitals for healthcare needs and health development in community International Research Conference 2013 kumudeshr@gmail.com/UoC 4
  • Research questions • Identify the disparity of the health policy and obstacles to obtain free healthcare facilities from state sector healthcare institutions • Identify the Health financing issues • Identify the problems related to this disparity of health policy and healthcare services International Research Conference 2013 kumudeshr@gmail.com/UoC 5
  • Method and Data collection Primary data collection • Questioner with 16 questions was the primary data collection instrument of this research. • Western province was considered • 40 OPD patients from NHSL (Colombo district), BH Nagoda(Kaluthara district) and BH Gampaha (Gampaha District) with verbal informed consent. • Estimated sample size was 120 and actual sample size was 105 and incompletely answered (for more than 50% questions) were rejected. • Over 20 years people with no gender bias. International Research Conference 2013 kumudeshr@gmail.com/UoC 6
  • Method and Data collection Secondary data collection • Collected from Annual reports, country reports and statistical reports available in data bases • Used to interpret the underlying health issues of this problem and results of primary data analysis. • World Health Organization (WHO)Statistical data and Ministry of Health reports were used to ensure the reliability and responsibility of the resource. International Research Conference 2013 kumudeshr@gmail.com/UoC 7
  • Data Presentation • Primary data represents 70% of males and 30% of females. • 21% of sample population was less than 35 years • 56% was in between 35 and 55 years. • 23% was more than 55 years. • Private sector occupied proportion was 40%. Government sector occupation was 34% • Majority of sample population represents the sub urban living style which is standing for the country status. International Research Conference 2013 kumudeshr@gmail.com/UoC 8
  • Data Presentation Count.. • Only 74 respondents (70%) had previous hospitalization experience. • Out of this, 47% have admitted in government hospital • 24% have both government and private hospital experiences. • 29% have private sector experience only. International Research Conference 2013 kumudeshr@gmail.com/UoC 9
  • Availability of facilities in hospitals Availability of drug and test facilities • Less than 20% of patients are provided all services at the hospital indicating miss match with customer expectation of quality health service. • More than 40 % move toward private sector as they were unable to fulfill their needs at the time they required , indicating poor quality service in health Reasons for moving for private sector Conference 2013 International Research kumudeshr@gmail.com/UoC 10
  • Utility of health sectors by different income levels • Lowest income level also totally not utilized free health only about 20% utilizes totally free health. Most of all income levels utilize both private and government health services. • But hospitalization in government hospitals is considerably high in all income levels • It is due to hospital charges Relationship of utility of health sectors for routine health needs at an admission is mostly by different income levels of the population unaffordable International Research Conference 2013 kumudeshr@gmail.com/UoC 11
  • Utilization of Health Services for NCD Utilization of health services for NCD  The use of preventive health care services indicates a problem in NCD policy as the utility of NCD preventive services is poor  This indicates only 28% population with NCD move towards government health sector totally which is the area more prioritized. contribution of health services for NCD International Research Conference 2013 kumudeshr@gmail.com/UoC 12
  • Out of pocket expenditure Percentage of out of pocket expenditure in different income levels • Even the people who are under 30000 monthly income also spent 80% of income for their health needs • It shows the failures for quality health service in government hospitals • Out of the respondents who utilize the private health care services 78% pay their expenditure from out of pocket. Mode of payments for health International Research Conference 2013 kumudeshr@gmail.com/UoC 13
  • Secondary Data Analysis Public health expenditure (% of Total Health expenditure) (Source: WHO National Health Account, 2010)  Public health expenditure is always less than 50% of total health expenditure during last15 years.  Only 51% of total health expenditure is spent by government funds and NGO/other donations.  44% of the total health expenditure is financed by out-of-pocket payments. Share of total health expenditure International Research (Source: WHO National Health Accounts, 2002) Conference 2013 kumudeshr@gmail.com/UoC 14
  • Government Health expenditure of total health expenditure General Government Expenditure on Health 2009 (Percentage of Total expenditure of Health) • • • • • • • • • Cuba - 92.7% (Rank 5) Japan - 82.3% (Rank 22) Maldives - 60.7% (Rank 79) Mongolia - 54.8% (Rank 92) China - 52.2% (Rank 100) Sri Lanka - 46.2% (Rank 115) Singapore - 36.6% (Rank139) Pakistan - 34.8% (Rank 143) India - 30.3% (Rank 148) GDP % of total health expenditure (1).pdf • Sri Lanka is in 115th position According to the ranking of countries by the percentage health expenditure. • Many countries even without free health policy have become front with percentage health expenditure. (Source: www.globalhealthfacts.org) International Research Conference 2013 kumudeshr@gmail.com/UoC 15
  • Conclusion • All income levels of the society utilizes private sector for their health care needs. • Most of people who utilize the private sector pay their bills out of pocket. • These evidences indirectly show the disparity of free health policy and the nature of persisting health care service. • massive complication in policy decisions with under strengthen economy and community expectation for free health service International Research Conference 2013 kumudeshr@gmail.com/UoC 16
  • Recommendations • Health financing policy planning, implementation, management, and analysis requires good knowledge of health financing issues • In order to improve the health financing system country needs to adapt for the changing situation and rearrange their health financing system. • Complete understand on this complicated underlying reality of health should be concerned in provision of sustainable health care service through realistic health planning. • Traditional health system should be replaced with new health policies to utilize resources more effectively. International Research Conference 2013 kumudeshr@gmail.com/UoC 17
  • Thank you ! International Research Conference 2013 kumudeshr@gmail.com/UoC 18