The porpose of this article is to assess and comparethe needs of public health services withthe healthcare business in Indonesia in line with the increased catastrophic disease and the high prevalence of mental disorders due to economic pressures, unhealthy lifestyle, poor environmental conditions, workload and family company which result in the detriment of state finances and family economy. Meanwhile, high education has made people, with upper middle income, havegood awareness of personal hygiene and tend to seek health services that can provide information and education on current health, including in selecting the type of insurance. Most of them entered the Y gene, as tech-savvy, and want the best facilities, including in selecting hospitals, laboratories, and medicines. This research uses descriptive qualitative approach byexploring the primary data and secondary data to obtain conclusion that healthcare business is very prospective.Although this business hasa formidable challenge, it will not be diminished by the development time.In 2014,healthcare businessinpharmaceutical industry in Indonesia reached IDR 58.2 trillion, and the government has determined the pharmaceutical and medical equipment industriesas the mainstay and priorities until 2035, given the high amount of expenditures per capita on health service each year.The increased level of life satisfaction in terms of healthcareresults in the high level of satisfaction of patients and families with health providers, but the concern isstill more focused on the high price of medicines and services.
The document discusses challenges and opportunities for applying operations research (O.R.) principles to healthcare systems in emerging countries. It outlines several key issues facing healthcare delivery in these countries, including growing wealth and health disparities between urban and rural areas, increasing rates of non-communicable diseases, lack of health insurance coverage for most populations, and antiquated infrastructure. It then provides examples of how O.R. has been applied to healthcare projects in some low-income countries to improve monitoring, evaluation and resource allocation. Finally, it proposes a roadmap for applying O.R. in emerging country healthcare, focusing on improving access to medical supplies and products, hospital/clinic efficiency, disease prevention programs, public health emergencies, health
The document discusses the effects of health insurance on demand for healthcare in Oyo State, Nigeria. It finds that older people tend to use health insurance (NHIS) more than others, with 22% of older people using it. Health insurance reduces the financial burden of healthcare costs on households by making payments predictable. However, most healthcare facilities in Oyo State are privately owned, making care potentially more expensive without insurance. The study aims to determine how health insurance affects demand for healthcare in the state.
This document contains a PEST analysis of Afghanistan's healthcare industry. It identifies several key political, economic, social and technological factors impacting the industry. Politically, corruption and a lack of employment legislation hinder development. Economically, low income distribution and high inflation create challenges. Socially, traditional norms prevent access to care. Technologically, deficiencies in telecommunications and medical equipment limit services. The analysis recommends public-private partnerships, encouraging internal investment, developing a healthcare financing strategy, and promoting inter-ministerial collaboration to help improve the industry.
The health of a people to a very large extent determines their productivity and wealth. The 2010
Population and Housing Census indicates that a significant proportion of the Bunkpurugu-Yunyoo District in
Ghana (over 75%) are living below the poverty line of GH¢228.00 per annum (approximately US $120 per
annum). It then implies that approximately the same proportion or even a little above that might not be able to
access health care under the ‘cash and carry’ system. Inability to access health care will lead to poor health
status of the residents and thus lower their productivity.
Today it’s critical for providers to devote time to patient education; inform patients about their conditions and how to prevent, treat, and manage them. Proper management of chronic conditions extends well beyond episodic and infrequent visits to a provider’s office. This population health white paper discusses why patients must become responsible for their day-to-day disease management. Patients will frequently be required to self-monitor their health indicators, observe symptoms, and note behavior, but they must also adhere to complex medication regimens
Business Note East Wind No.2 - The Chinese Healthcare Challenge (Dec. 2014)Stéphane PHETSINORATH
The document summarizes China's healthcare challenges and reforms. As China modernized its economy, it neglected public healthcare investments, resulting in low spending and coverage. China now faces rising costs and diseases as its population ages. The government is implementing sweeping healthcare reforms, including expanding insurance coverage to achieve universal healthcare by 2020 and transitioning to a diagnosis-related group payment system to incentivize efficiency. The reforms aim to address inadequate care access and high costs that have plagued China's healthcare system.
"The future of healthcare in Africa: progress on five healthcare scenarios", a new report written by The Economist Intelligence Unit (EIU) and sponsored by Janssen, explores Africa's recent progress on several major healthcare challenges. The report looks at the continent's increasing focus on primary and preventive care, the empowerment of communities as healthcare providers, the extension of universal healthcare, the spread of telemedicine, and the role of international donors.
The document discusses challenges and opportunities for applying operations research (O.R.) principles to healthcare systems in emerging countries. It outlines several key issues facing healthcare delivery in these countries, including growing wealth and health disparities between urban and rural areas, increasing rates of non-communicable diseases, lack of health insurance coverage for most populations, and antiquated infrastructure. It then provides examples of how O.R. has been applied to healthcare projects in some low-income countries to improve monitoring, evaluation and resource allocation. Finally, it proposes a roadmap for applying O.R. in emerging country healthcare, focusing on improving access to medical supplies and products, hospital/clinic efficiency, disease prevention programs, public health emergencies, health
The document discusses the effects of health insurance on demand for healthcare in Oyo State, Nigeria. It finds that older people tend to use health insurance (NHIS) more than others, with 22% of older people using it. Health insurance reduces the financial burden of healthcare costs on households by making payments predictable. However, most healthcare facilities in Oyo State are privately owned, making care potentially more expensive without insurance. The study aims to determine how health insurance affects demand for healthcare in the state.
This document contains a PEST analysis of Afghanistan's healthcare industry. It identifies several key political, economic, social and technological factors impacting the industry. Politically, corruption and a lack of employment legislation hinder development. Economically, low income distribution and high inflation create challenges. Socially, traditional norms prevent access to care. Technologically, deficiencies in telecommunications and medical equipment limit services. The analysis recommends public-private partnerships, encouraging internal investment, developing a healthcare financing strategy, and promoting inter-ministerial collaboration to help improve the industry.
The health of a people to a very large extent determines their productivity and wealth. The 2010
Population and Housing Census indicates that a significant proportion of the Bunkpurugu-Yunyoo District in
Ghana (over 75%) are living below the poverty line of GH¢228.00 per annum (approximately US $120 per
annum). It then implies that approximately the same proportion or even a little above that might not be able to
access health care under the ‘cash and carry’ system. Inability to access health care will lead to poor health
status of the residents and thus lower their productivity.
Today it’s critical for providers to devote time to patient education; inform patients about their conditions and how to prevent, treat, and manage them. Proper management of chronic conditions extends well beyond episodic and infrequent visits to a provider’s office. This population health white paper discusses why patients must become responsible for their day-to-day disease management. Patients will frequently be required to self-monitor their health indicators, observe symptoms, and note behavior, but they must also adhere to complex medication regimens
Business Note East Wind No.2 - The Chinese Healthcare Challenge (Dec. 2014)Stéphane PHETSINORATH
The document summarizes China's healthcare challenges and reforms. As China modernized its economy, it neglected public healthcare investments, resulting in low spending and coverage. China now faces rising costs and diseases as its population ages. The government is implementing sweeping healthcare reforms, including expanding insurance coverage to achieve universal healthcare by 2020 and transitioning to a diagnosis-related group payment system to incentivize efficiency. The reforms aim to address inadequate care access and high costs that have plagued China's healthcare system.
"The future of healthcare in Africa: progress on five healthcare scenarios", a new report written by The Economist Intelligence Unit (EIU) and sponsored by Janssen, explores Africa's recent progress on several major healthcare challenges. The report looks at the continent's increasing focus on primary and preventive care, the empowerment of communities as healthcare providers, the extension of universal healthcare, the spread of telemedicine, and the role of international donors.
This document provides an overview of health financing, including:
1. It defines health financing and outlines its key principles of raising revenues, pooling risks, and purchasing health services efficiently.
2. It describes different models of health care financing including social health insurance, out-of-pocket payments, and community-based insurance.
3. It discusses the global scenario of health spending, challenges in low and middle income countries, and the need to reduce out-of-pocket costs and improve access to healthcare.
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
The document discusses alternative sustainable financing options for primary health care services in Kenya. It notes that while the Kenyan government is committed to providing quality primary health care, budgetary allocations to health care have declined and out-of-pocket spending is high. User fees intended to increase cost recovery have negatively impacted access to care. The study examines alternative financing mechanisms that could help mitigate these trends, such as pooling funds to protect the poor from catastrophic costs, establishing taxes specifically for health care, and issuing bonds for health infrastructure. However, identifying the poor and providing safety nets like waivers will be important for the success of any new mechanisms.
While India has several centers of excellence in healthcare delivery, overall infrastructure and access to healthcare is limited across much of the country. The Indian healthcare sector is large at $40 billion currently but expenditure and infrastructure are still amongst the lowest globally. However, the sector is growing rapidly at over 12% annually due to factors such as rising incomes, increasing disease burden from both infectious and lifestyle diseases, and expansion of health insurance coverage. If challenges around quality, access and regulation can be addressed, the sector is expected to reach $55 billion by 2020 and provide many new jobs.
Day 2 session 3 financing and governance v24_october2016 (1)mapc88812
The document discusses various aspects of financing for universal health coverage including:
1) Population coverage, health service coverage, and cost coverage are key dimensions of reforms for UHC.
2) In many low and middle income countries, high out-of-pocket expenditures negatively impact equity, access, and use of health services.
3) Reducing out-of-pocket costs requires addressing factors like irrational drug use and insufficient private sector regulation that contribute to cost escalation.
This document discusses healthcare in India and proposes ways to make it more affordable and accessible. It notes that healthcare costs are rising and most people rely on private healthcare, while public healthcare is underfunded and understaffed. It analyzes issues like disease burdens, the growth of private sector, health insurance schemes, use of generics, and medical tourism. It recommends increasing public spending on healthcare to at least 5% of GDP, improving infrastructure, enhancing the health workforce, and promoting primary healthcare to achieve universal coverage in an equitable manner.
Financing a tertiary level health facility in kumasi ghanaAlexander Decker
This document discusses financing of a tertiary level health facility in Kumasi, Ghana. It finds that the main sources of funding are internally generated funds (IGF), government of Ghana subventions (GoG), and donor pool funds (DPF). IGF contributes the most at 88% of total cash revenue, followed by GoG at 8.97% and DPF at 3.35%. Expenditure is categorized into personnel emoluments, administration, service delivery, and investment. Service delivery such as drugs constitutes the largest expenditure, followed by personnel emoluments, administration, and investment. Since IGF is now the most reliable source of revenue, policies and strategies must be implemented to enhance revenue mobilization in the health
The document summarizes the current state and future outlook of healthcare in India. It notes that healthcare spending in India is over $18 billion currently and expected to grow to $45 billion by 2012. Several key achievements in public health are highlighted, including the elimination of smallpox and a reduction in mortality rates. The healthcare sector is projected to require investments of $100-140 billion over the next decade. Major drivers of future growth are identified as increased health insurance penetration, a growing disease burden from lifestyle changes, greater preventative care awareness, and employer-provided health services.
An overview of the China healthcare market, its structure, trends in reform and growth drivers and constraints. Key challenges to participating in China healthcare are highlighted as are best practices of successful foreign companies playing in China healthcare.
Innovation and Development in Indian HealthcareSahana Bose
This document provides an overview of the Indian healthcare system, identifying key challenges and areas of innovation. It summarizes that India faces a healthcare crisis due to rapid population growth straining infrastructure while many remain in poverty lacking access. However, it also outlines technological advancements and private sector growth that aim to improve preventative and curative care, particularly through organizations expanding access to insurance, rural health centers, and new hospitals. The future of India's healthcare depends on continued innovation to address the needs of its vast population in both urban and underserved rural areas.
The document discusses healthcare reforms in China. It provides context on the history of China's healthcare system and challenges it currently faces. The key points are:
1. China launched a major healthcare reform plan in 2009 to provide universal coverage by 2020 through expanding insurance schemes and investing in rural health infrastructure.
2. However, China still faces challenges of lack of access to affordable care, especially in rural areas, as well as inefficient resource allocation and lack of quality care.
3. New health challenges include rising rates of chronic diseases as infectious diseases decline, and uneven health outcomes between urban and rural populations.
Health financing strategies uhc 27 09 12Vikash Keshri
This document discusses health financing strategies for universal health coverage. It begins by defining universal health coverage and providing historical perspectives. It then discusses the current state of health financing in India, including low public spending, high private out-of-pocket expenditures, and variations between states. The document outlines that achieving universal health coverage requires raising sufficient funds, removing financial barriers, and using resources efficiently. It examines strategies for generating more health resources, utilizing resources effectively to prevent waste, and proposes the key recommendations of India's High Level Expert Group on universalizing access to affordable healthcare.
This document provides an overview of healthcare financing in India. It begins with definitions of health care financing and outlines the key functions of accumulating, mobilizing, and allocating money for health needs. It then discusses the main mechanisms of healthcare financing globally and in India, including how money is raised through taxes, insurance contributions, and other means. It also addresses how funds are pooled and how health services are paid for. The document reviews India's current healthcare financing indicators and challenges, such as low public spending and high out-of-pocket costs. It concludes with initiatives by the Government of India and recommendations to improve healthcare financing in India.
Health care financing in Saudi Arabia is provided mainly through government revenues, accounting for approximately 80% of total health care spending. Government spending on health as a percentage of the national budget has risen from 2.8% in 1970 to 6.4% in 2004. The remaining sources of health care financing include private sources such as personal out-of-pocket payments and employer-sponsored health insurance programs.
The document defines health economics as the application of economic principles to the health care system. It discusses key concepts in health economics including supply and demand of health care, costs associated with health care like fixed vs variable costs, and methods of economic evaluation used in health care planning like cost-benefit analysis. The document also outlines factors that influence health expenditures like changing demographics and disease patterns, new technologies, and rising public expectations. Overall, the document provides a broad overview of the basic concepts and scope of health economics as a field of study.
Health and health care need to be distinguished from each other for no better reason than that the former is often incorrectly seen as a direct function of the latter. Heath is clearly not the mere absence of disease. Good Health confers on a person or groups freedom from illness - and the ability to realize one's potential. Health is therefore best understood as the indispensable basis for defining a person's sense of well being. The health of populations is a distinct key issue in public policy discourse in every mature society often determining the deployment of huge society. They include its cultural understanding of ill health and well-being, extent of socio-economic disparities, reach of health services and quality and costs of care. and current bio-mcdical understanding about health and illness.
- Government health spending in India is very low at just over 1% of GDP, well below what is needed to meet the country's health needs. This has forced many people to rely on private healthcare, leading to high out-of-pocket costs that push many into poverty.
- Reforms are needed such as increasing public health spending to 3-5% of GDP, regulating the private sector, and implementing a universal health coverage program. However, challenges remain due to India's large population, infrastructure weaknesses, and need to balance fiscal priorities.
- Initiatives have been launched such as the National Rural Health Mission and health insurance programs, but more focus is needed on primary care, community participation, and direct
The document summarizes healthcare financing in India. It discusses that healthcare financing aims to ensure access to health services. The key principles are generating revenue, pooling funds for cross-subsidization between rich/poor and healthy/sick, and purchasing efficient services. In India, healthcare is financed primarily through out-of-pocket payments by households, while government expenditure is low compared to other countries. Reforms like NRHM and RSBY aim to increase public allocation to healthcare. Challenges include expanding coverage with limited resources and improving spending efficiency.
Tax-based systems finance healthcare through taxes collected from the entire population of taxpayers, allowing risks to be pooled across a large group. This subsidizes care for the poor and sick by transferring wealth from the rich and healthy. However, overuse of free services remains a problem. Pay-as-you-go user fee systems represent a market-based solution but fees disproportionately reduce access for the poor. Risk-based private insurance guarantees entitlement by collecting risk-adjusted premiums but rising costs can cause the poor and sick to lose coverage. Social health insurance compulsorily collects premiums from a broad base to ensure universal coverage unlike private systems. Donor funding significantly finances developing countries' healthcare through government systems or private organizations.
This document provides an overview of the growing healthcare sector in India. It notes that healthcare is one of India's largest sectors in terms of revenue and employment, and is expanding rapidly. Key drivers of growth include India's large and growing population, a burgeoning middle class with more disposable income, and a rise in chronic diseases as more Indians adopt unhealthy lifestyles. The pharmaceutical industry is also emerging to help meet the country's growing healthcare needs. However, infectious diseases remain a challenge and a large portion of the population still lacks adequate access to care.
A Study on Emerging Challenges & Opportunities for Indian Banking Sectorinventionjournals
Banking sector is treated as a backbone of a nation as it plays multifarious role for the all total growth of a developing country like India. The banking industry in India has a huge canvas of history, which covers the traditional banking Practices from the time of Britishers to the reforms period, nationalization to privatization of banks and now increasing numbers of foreign banks in India. Therefore, Banking in India has been through a long journey. Banking industry in India has also achieved a new height with the changing times. The use of technology has brought a revolution in the working style of the banks. Nevertheless, the fundamental aspects of banking i.e. trust and the confidence of the people on the institution remain the same. Here commercial banks cater to short and medium term financing requirements, while national level and state level financial institutions meet longer-term requirements. Banking industry in India has also achieved anew height with the changing times. Most of banks provide various services such as Mobile banking, SMS & Net banking and ATMs to their customers for their convenience. The use of technology has brought a revolution in the working style of the banks. Banking today has transformed into a technology intensive and customer friendly model with a focus inconvenience. However, changing dynamics of banking business also brings new kind of risk exposure
Changing Pattern of Rural-Urban Fringe Life of Tamluk Town, W.B., India (A Ca...inventionjournals
Before the formation of the peripheral Ward No.- 20 in Tamluk Municipality, most of the land use was-agricultural land, fallow land, water bodies etc. But now the picture of the land use is changing rapidly. Ward no.-20 lies between 22º17’07’’N to 22º16’28’’N and 87º54’15’’E to 87º55’21’’E latitude and longitude respectively. Objectives: i) To study migration and occupation of Ward No.-20. ii) To study decadal change of urban life of Ward No.-20. Primary data have been collected by schedule survey of households. Out of 771 households 10% (i.e. 78) households of Ward No.-20 have been randomly selected for the study. Secondary data have been collected from Tamluk Municipality office. Cadastral map is collected from DLRO. Urban life is measured with some indicators. Findings: i) At present 73.08% of the total sample houses are CCC in nature. ii) Public Transport and market facility are poor. Iii) 98.72% of family depends upon water supply as a source of drinking water. 87.18% of family depends upon water supply as a source of bathing water. 73.08% of family depends upon water supply as a source of washing water. Suggestion: Water Supply will create crisis in future. Pond may be used for bathing and washing. Attention should be given to provide tertiary economic activities (market and public transport).
This document provides an overview of health financing, including:
1. It defines health financing and outlines its key principles of raising revenues, pooling risks, and purchasing health services efficiently.
2. It describes different models of health care financing including social health insurance, out-of-pocket payments, and community-based insurance.
3. It discusses the global scenario of health spending, challenges in low and middle income countries, and the need to reduce out-of-pocket costs and improve access to healthcare.
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
The document discusses alternative sustainable financing options for primary health care services in Kenya. It notes that while the Kenyan government is committed to providing quality primary health care, budgetary allocations to health care have declined and out-of-pocket spending is high. User fees intended to increase cost recovery have negatively impacted access to care. The study examines alternative financing mechanisms that could help mitigate these trends, such as pooling funds to protect the poor from catastrophic costs, establishing taxes specifically for health care, and issuing bonds for health infrastructure. However, identifying the poor and providing safety nets like waivers will be important for the success of any new mechanisms.
While India has several centers of excellence in healthcare delivery, overall infrastructure and access to healthcare is limited across much of the country. The Indian healthcare sector is large at $40 billion currently but expenditure and infrastructure are still amongst the lowest globally. However, the sector is growing rapidly at over 12% annually due to factors such as rising incomes, increasing disease burden from both infectious and lifestyle diseases, and expansion of health insurance coverage. If challenges around quality, access and regulation can be addressed, the sector is expected to reach $55 billion by 2020 and provide many new jobs.
Day 2 session 3 financing and governance v24_october2016 (1)mapc88812
The document discusses various aspects of financing for universal health coverage including:
1) Population coverage, health service coverage, and cost coverage are key dimensions of reforms for UHC.
2) In many low and middle income countries, high out-of-pocket expenditures negatively impact equity, access, and use of health services.
3) Reducing out-of-pocket costs requires addressing factors like irrational drug use and insufficient private sector regulation that contribute to cost escalation.
This document discusses healthcare in India and proposes ways to make it more affordable and accessible. It notes that healthcare costs are rising and most people rely on private healthcare, while public healthcare is underfunded and understaffed. It analyzes issues like disease burdens, the growth of private sector, health insurance schemes, use of generics, and medical tourism. It recommends increasing public spending on healthcare to at least 5% of GDP, improving infrastructure, enhancing the health workforce, and promoting primary healthcare to achieve universal coverage in an equitable manner.
Financing a tertiary level health facility in kumasi ghanaAlexander Decker
This document discusses financing of a tertiary level health facility in Kumasi, Ghana. It finds that the main sources of funding are internally generated funds (IGF), government of Ghana subventions (GoG), and donor pool funds (DPF). IGF contributes the most at 88% of total cash revenue, followed by GoG at 8.97% and DPF at 3.35%. Expenditure is categorized into personnel emoluments, administration, service delivery, and investment. Service delivery such as drugs constitutes the largest expenditure, followed by personnel emoluments, administration, and investment. Since IGF is now the most reliable source of revenue, policies and strategies must be implemented to enhance revenue mobilization in the health
The document summarizes the current state and future outlook of healthcare in India. It notes that healthcare spending in India is over $18 billion currently and expected to grow to $45 billion by 2012. Several key achievements in public health are highlighted, including the elimination of smallpox and a reduction in mortality rates. The healthcare sector is projected to require investments of $100-140 billion over the next decade. Major drivers of future growth are identified as increased health insurance penetration, a growing disease burden from lifestyle changes, greater preventative care awareness, and employer-provided health services.
An overview of the China healthcare market, its structure, trends in reform and growth drivers and constraints. Key challenges to participating in China healthcare are highlighted as are best practices of successful foreign companies playing in China healthcare.
Innovation and Development in Indian HealthcareSahana Bose
This document provides an overview of the Indian healthcare system, identifying key challenges and areas of innovation. It summarizes that India faces a healthcare crisis due to rapid population growth straining infrastructure while many remain in poverty lacking access. However, it also outlines technological advancements and private sector growth that aim to improve preventative and curative care, particularly through organizations expanding access to insurance, rural health centers, and new hospitals. The future of India's healthcare depends on continued innovation to address the needs of its vast population in both urban and underserved rural areas.
The document discusses healthcare reforms in China. It provides context on the history of China's healthcare system and challenges it currently faces. The key points are:
1. China launched a major healthcare reform plan in 2009 to provide universal coverage by 2020 through expanding insurance schemes and investing in rural health infrastructure.
2. However, China still faces challenges of lack of access to affordable care, especially in rural areas, as well as inefficient resource allocation and lack of quality care.
3. New health challenges include rising rates of chronic diseases as infectious diseases decline, and uneven health outcomes between urban and rural populations.
Health financing strategies uhc 27 09 12Vikash Keshri
This document discusses health financing strategies for universal health coverage. It begins by defining universal health coverage and providing historical perspectives. It then discusses the current state of health financing in India, including low public spending, high private out-of-pocket expenditures, and variations between states. The document outlines that achieving universal health coverage requires raising sufficient funds, removing financial barriers, and using resources efficiently. It examines strategies for generating more health resources, utilizing resources effectively to prevent waste, and proposes the key recommendations of India's High Level Expert Group on universalizing access to affordable healthcare.
This document provides an overview of healthcare financing in India. It begins with definitions of health care financing and outlines the key functions of accumulating, mobilizing, and allocating money for health needs. It then discusses the main mechanisms of healthcare financing globally and in India, including how money is raised through taxes, insurance contributions, and other means. It also addresses how funds are pooled and how health services are paid for. The document reviews India's current healthcare financing indicators and challenges, such as low public spending and high out-of-pocket costs. It concludes with initiatives by the Government of India and recommendations to improve healthcare financing in India.
Health care financing in Saudi Arabia is provided mainly through government revenues, accounting for approximately 80% of total health care spending. Government spending on health as a percentage of the national budget has risen from 2.8% in 1970 to 6.4% in 2004. The remaining sources of health care financing include private sources such as personal out-of-pocket payments and employer-sponsored health insurance programs.
The document defines health economics as the application of economic principles to the health care system. It discusses key concepts in health economics including supply and demand of health care, costs associated with health care like fixed vs variable costs, and methods of economic evaluation used in health care planning like cost-benefit analysis. The document also outlines factors that influence health expenditures like changing demographics and disease patterns, new technologies, and rising public expectations. Overall, the document provides a broad overview of the basic concepts and scope of health economics as a field of study.
Health and health care need to be distinguished from each other for no better reason than that the former is often incorrectly seen as a direct function of the latter. Heath is clearly not the mere absence of disease. Good Health confers on a person or groups freedom from illness - and the ability to realize one's potential. Health is therefore best understood as the indispensable basis for defining a person's sense of well being. The health of populations is a distinct key issue in public policy discourse in every mature society often determining the deployment of huge society. They include its cultural understanding of ill health and well-being, extent of socio-economic disparities, reach of health services and quality and costs of care. and current bio-mcdical understanding about health and illness.
- Government health spending in India is very low at just over 1% of GDP, well below what is needed to meet the country's health needs. This has forced many people to rely on private healthcare, leading to high out-of-pocket costs that push many into poverty.
- Reforms are needed such as increasing public health spending to 3-5% of GDP, regulating the private sector, and implementing a universal health coverage program. However, challenges remain due to India's large population, infrastructure weaknesses, and need to balance fiscal priorities.
- Initiatives have been launched such as the National Rural Health Mission and health insurance programs, but more focus is needed on primary care, community participation, and direct
The document summarizes healthcare financing in India. It discusses that healthcare financing aims to ensure access to health services. The key principles are generating revenue, pooling funds for cross-subsidization between rich/poor and healthy/sick, and purchasing efficient services. In India, healthcare is financed primarily through out-of-pocket payments by households, while government expenditure is low compared to other countries. Reforms like NRHM and RSBY aim to increase public allocation to healthcare. Challenges include expanding coverage with limited resources and improving spending efficiency.
Tax-based systems finance healthcare through taxes collected from the entire population of taxpayers, allowing risks to be pooled across a large group. This subsidizes care for the poor and sick by transferring wealth from the rich and healthy. However, overuse of free services remains a problem. Pay-as-you-go user fee systems represent a market-based solution but fees disproportionately reduce access for the poor. Risk-based private insurance guarantees entitlement by collecting risk-adjusted premiums but rising costs can cause the poor and sick to lose coverage. Social health insurance compulsorily collects premiums from a broad base to ensure universal coverage unlike private systems. Donor funding significantly finances developing countries' healthcare through government systems or private organizations.
This document provides an overview of the growing healthcare sector in India. It notes that healthcare is one of India's largest sectors in terms of revenue and employment, and is expanding rapidly. Key drivers of growth include India's large and growing population, a burgeoning middle class with more disposable income, and a rise in chronic diseases as more Indians adopt unhealthy lifestyles. The pharmaceutical industry is also emerging to help meet the country's growing healthcare needs. However, infectious diseases remain a challenge and a large portion of the population still lacks adequate access to care.
A Study on Emerging Challenges & Opportunities for Indian Banking Sectorinventionjournals
Banking sector is treated as a backbone of a nation as it plays multifarious role for the all total growth of a developing country like India. The banking industry in India has a huge canvas of history, which covers the traditional banking Practices from the time of Britishers to the reforms period, nationalization to privatization of banks and now increasing numbers of foreign banks in India. Therefore, Banking in India has been through a long journey. Banking industry in India has also achieved a new height with the changing times. The use of technology has brought a revolution in the working style of the banks. Nevertheless, the fundamental aspects of banking i.e. trust and the confidence of the people on the institution remain the same. Here commercial banks cater to short and medium term financing requirements, while national level and state level financial institutions meet longer-term requirements. Banking industry in India has also achieved anew height with the changing times. Most of banks provide various services such as Mobile banking, SMS & Net banking and ATMs to their customers for their convenience. The use of technology has brought a revolution in the working style of the banks. Banking today has transformed into a technology intensive and customer friendly model with a focus inconvenience. However, changing dynamics of banking business also brings new kind of risk exposure
Changing Pattern of Rural-Urban Fringe Life of Tamluk Town, W.B., India (A Ca...inventionjournals
Before the formation of the peripheral Ward No.- 20 in Tamluk Municipality, most of the land use was-agricultural land, fallow land, water bodies etc. But now the picture of the land use is changing rapidly. Ward no.-20 lies between 22º17’07’’N to 22º16’28’’N and 87º54’15’’E to 87º55’21’’E latitude and longitude respectively. Objectives: i) To study migration and occupation of Ward No.-20. ii) To study decadal change of urban life of Ward No.-20. Primary data have been collected by schedule survey of households. Out of 771 households 10% (i.e. 78) households of Ward No.-20 have been randomly selected for the study. Secondary data have been collected from Tamluk Municipality office. Cadastral map is collected from DLRO. Urban life is measured with some indicators. Findings: i) At present 73.08% of the total sample houses are CCC in nature. ii) Public Transport and market facility are poor. Iii) 98.72% of family depends upon water supply as a source of drinking water. 87.18% of family depends upon water supply as a source of bathing water. 73.08% of family depends upon water supply as a source of washing water. Suggestion: Water Supply will create crisis in future. Pond may be used for bathing and washing. Attention should be given to provide tertiary economic activities (market and public transport).
Contemporary Theory of Management: A Comparative Study on Quantitative Approa...inventionjournals
1) The document compares three contemporary management theories: the quantitative approach, system approach, and contingency approach.
2) The quantitative approach uses mathematical tools and techniques to optimize managerial decision making through modeling and analysis.
3) The system approach views an organization as a system of interrelated sub-systems and focuses on the interactions and interdependencies between internal and external factors.
4) The contingency approach suggests that the most effective management style depends on the specific context or situation, and that a single rigid style is not always optimal.
We here try to apply the concept of Possible/Parallel Worlds from Logic, which came to our knowledge through the hands of Graham Priest, and through a French movie, to Psychiatry. We think this concept is ideal because we can make use of mathematical elements to draw theories of control, and diagnosis, and therefore also therapeutic theories. We will make use of the new model of psyche proposed by us to expand on a few items. Perhaps the best use of this paper is empowering the professionals of Psychiatry, and Psychology by providing new tools for their studies, and work. The main focus is the human psyche. In order to explain the World of God, Inner Reality, and Outer Reality, which are divisions that are obtained from applying the concept of parallel worlds to the studies on the human psyche, we end up paying a light, and perhaps, an enlightening, visit to the concepts of schizophrenia, autism, Down Syndrome, and psychopathy.
Using Granger Causality to Examine the Relationship Between Economic Growth a...inventionjournals
This study refers to Okun's Law on the economy in North Sumatera Province. Difference with previous studies, in this study the data used is not aggregate data but the data of each economic sector. In addition, the unemployment variable is proxy with the absorption of labor rate. The data analysis was tested by Granger Causality to determine the direction of the relationship between variables for growth of each economic sectors and absorption of labor. By using the Granger Causality Test analysis we concluded that the agricultural sector has a two-way direction relationship between economic growth and absorption of labor. Mining and Quarrying sector, construction sector, transport and communication sector and services sector only have one-way direction relationship from absorption of labor to economic growth. Electricity, gas and water supply have one-way direction relationship from economic growth to absorption of labor. Three other sectors are sectors manufacturing industry sector; trade, hotel and restaurant sector and finance, real estate and business service have no relationship at all between economic growth and absorption of labor.
Unmanned Aerial Vehicles (UAVs): An Emerging Technology for Logisticsinventionjournals
Unmanned Aerial Vehicles (UVAs), commonly known as drones have extensively been utilized in military operations during the last decade for surveillance, monitoring enemy activities, collecting information, and even attacking military targets and terrorist hideouts. They are also increasingly finding uses in civil applications, such as policing and firefighting and nonmilitary work, such as inspection of power lines and pipelines. Furthermore, corporations utilized them in commercial applications, such as agriculture, logistics, delivering small packages to rough terrain locations, and medication to emergency locations. UAVs are often preferred for missions that are too ―dull, dirty or dangerous‖ for manned aircraft. This paper is exploratory in nature and describes the past and current usage in logistics and military. It further explores design and development considerations of UAVs. This is an emerging technology that will change the landscape of logistics and supply chain management. This research article provides a basic foundation to academicians, researchers, and commercial companies.
Consumer Response to Different Types of Website Interactivityinventionjournals
This paper aims to explore the impact of different types of interactivity on consumer perception. A quantitative research methodology using scenario-based experiment was employed. An experiment was conducted using research participants from Turkey. The findings of this study suggest that person interactivity leads to higher levels of attitude towards website, ease of use, and e-loyalty than machine interactivity. The results also reveal that person interactivity combined with high contact interactivity is the optimal strategy for e-retailers
This document discusses several examples of successful people who changed careers from their original profession. It describes Walt Disney starting as a newspaper editor but becoming an animator and film producer. It also mentions Chetan Bhagat working as an investment banker but becoming a famous writer, and Rowan Atkinson studying engineering but becoming a famous comedian known for his character Mr. Bean. The document provides several other examples of people changing careers from fields like policing, football, engineering, medicine, and more to pursue their passions in other industries like acting, writing, dancing, and photography.
The Influence of Service Quality, and Customer Relationship Management (CRM) ...inventionjournals
Indonesian National Army Hospitals (RS TNIs) is one of hospitals that servicing the Indonesian National Army (TNI) member, their family, civil servant and public community. In the competitive business situation like today, RS TNIs have to manage the change due to the new policy of health services in hospital. In 2014, the fundamental change of health services were occurred in correlation to National Health Insurance (JKN) for all of Indonesian people. This change concerned to financial management, funding, membership, treatment procedures, types of services, referral system, pattern rates, claim, supervision and evaluation. The number of regulatory changes in the newera of health care in Indonesia have triggered other changes, particularly hospital customer behavior. Population in this research were patient in 17 TNI level two hospitals all over Indonesia, who have been treated twice or more in TNI level two hospitals, at class 1, class 2 and class 3 rooms. Analyzing data using Generalized Least Square Estimation (GLS), Analysis Structural Equation (SEM) model, the proportional random sampling method and applying software Amos 22, on 246 respondents. The model testing (fit) of research data may viewed from GFI, AGFI, TLI, CFI, RMSEA and CMIN/DF values, which respectively were 0.922,0.914, 0.962, 0.973, 0.062 and 1.636 that all of those in the expected value range thus the model can be accepted. Results of this research indicated that: 1). Service quality is influencing patient satisfaction. 2). Service quality is influencing brand image. 3). Service quality is influencing trust. 4). Service quality is influencing patient loyalty. 5). Customer relationship management (CRM) is influencing patient satisfaction. 6). Customer relationship management (CRM) is influencing brand image. 7). Customer relationship management (CRM) is influencing trust. 8). Customer relationship management (CRM) is insignificantly influence patient loyalty. 9). Patient satisfaction is influencing patient loyalty. 10). Patient satisfaction is insignificantly influence brand image. 11). Brand image is influencing trust. 12). Brand image is influencing patient loyalty. 13). Trust is influencing on patient loyalty
Promoting Export-Led Economic Growth in Nigeria –The Export Processing Zone O...inventionjournals
The volatility in crude oil production in Nigeria, which in recent times, have been heightened by militant attacks on critical oil installations in the Niger Delta area and the continued price spiral in international oil market has once again brought to the front burner anxieties about the future of the oil sector in the Nigerian economy. The unfolding scenario has again exposed the Nigerian economy to downside risks of volatility in oil prices with attendant consequences and multiple effects on the economy and businesses as well.. Since the third quarter of 2015, fallen prices of crude oil and fluctuations in crude oil production in Nigeria have conspired to put the country’s economy in dire straits. The oil price has fallen by more than 50 percent since June 2014, when it was $115 a barrel. It is now consistently below $50 and has been as low as $37. These developments have put the nation’s fiscal operations in quandary. The government has rightly responded by putting in place various fiscal and monetary measures to stem the tide. The federal government has adopted some austere measures to cushion the effect of the persistent drop in revenue. However, the implementation of these short-term measures to shore up revenue could be impeded by political exigencies which often times overrides economic rationality. Thus, a more comprehensive and alternative approach that will promote non-oil export will be a better option. To this end, the authors recommend the revitalization and retooling of the Export Processing Zone (EPZ) Scheme in order to effectively diversify the economy away from oil to an export-led economy.
EFL Students’ Perceptions and Attitudes towards Facebook as anEducational Lea...inventionjournals
The purpose of this study was to examine EFL students’ perceptions and attitudes towards Facebook as an educational learning tool.Participants were twenty eight undergraduate female students who experienced teaching and learning through Facebook and some classroom and face-to-face sessions. The researcher, to collect data, prepared and used two instruments; The first was face-to-face interview, while the second was Facebook Perception and Attitudes Questionnaire. Having conducted interviews, and administered the Facebook Perception and Attitudes Questionnaire, data were analyzed quantatively and qualitatively. The findings revealed that students had high and positiveperceptions of Facebook and its activities as a learning environment. Also, students had good and favourable attitudes towards using Facebook on teaching and learning.
The Study is titled ―Leadership Styles: A Case Study of Syria‖. The main objectives of the research work are to identify and then analyze the political leadership style in Syria, to generate a profile of past, current and emerging leaders of Syria, to study the reasons that led to the uprising in Syria and to assess the future consequences of the decisions taken by the Political Leadership. The study will be descriptive in nature. Keeping in mind the objectives of the study, appropriate data will be collected from people and organizations from both, official and non-official, taking a look at the current and emerging leadership Styles in Syria. Survey for the political, security and economic situation will be carried. Both primary and secondary sources of data will be used for present research. For analysis and conclusion of the results of the survey, appropriate statistical tools and analysis will be done
Social Representations of Learning in Mexican High School Students: A Compara...inventionjournals
The quantity of studies of social representations in the field of Education in Mexico, is still lacking, then, understanding and interpreting the images and conceptions built by the Knowledge Society is a crucial point to make a more assertiveness Teaching intervention in students. The aim of this study was to compare the social representations on Mexican High School students by using the technique and theory of Natural Semantic Network (NSN). A cross-sectional and mixed paradigm study was made, it was used the method of research-action. There were included 77Mexican students from the first and second quarter of high school, which were divided into two different groups: first quarter and second quarter (FQ and SQ). Results showed that it exists similarities between the FQ and SQ social representations about the meaning of learn, with the words: learning, school and life (FQ and SQ M value = 71,40; 38,30; 30,13). The conclusion of the study was that students share social representations about learning, in three different categories: learn as a process, school and life.
Este documento presenta una introducción al enfoque de competencias en la educación. Explica que una competencia implica la capacidad de resolver problemas utilizando conocimientos, habilidades y actitudes. También describe los elementos clave del enfoque como planificar, enseñar y evaluar por competencias. Finalmente, analiza algunas acciones realizadas en la región para evaluar las competencias de las personas.
La periostitis tibial es una inflamación del periostio que recubre el hueso de la tibia, causada principalmente por el impacto repetitivo del entrenamiento. Sus síntomas incluyen dolor en la tibia durante y después del ejercicio. Su tratamiento consiste en descanso, hielo, fisioterapia y fortalecimiento muscular para prevenir futuras lesiones.
To Investigate the Impact of Cultural Practice and Beliefs Affecting Schools ...inventionjournals
Cultural practice such as pastoralist has hindered education for children in both early childhood development education and primary school in Darwed ward which is their legitimate right like all learners in part of world. Education nurture the children to be meaningful people of the society and regardless of their physical, intellectual social, emotional, linguistics, spiritual, economic or any other conditions including learners from arid and semi-arid land in pastoral communities. Many interventions have been made to draw attention for education for all to achieve universal education millennium development goal. The child act 2002 emphasized that every child has a fundamental right to education must be given an opportunity to achieve and maintain an acceptable level of education. School going children from all levels in pastoral communities move together with their parents from one place to another following rainfall distribution patterns and security reasons. The pastoral way of life subjected to school children affects school enrolments in both levels. This pastoral ways of life promote cultural practice which has slow down education progress and they are gender bias
Enhancement of Student Preparation for Global Serviceinventionjournals
University students are expected to acquire proficiency in skills used in the profession and to serve globally as they graduate. Efficacy of this has been supported in studies in which skill mastery was enhanced through provision of experiential assignments. Service learning is a teaching and learning strategy that integrates meaningful community service with instruction and reflection to enrich the learning experience. Problem-based learning provides active, hands-on learning that is centered on real-world problems or issues. A qualitative study was conducted by the researchers with five online courses in graduate counselor education and a total of 536 students over a 2.5 year period to assess student application of course concepts in a realworld environment with cultural diversity. Student projects focused on identification of needs and individual work to serve those needs, such as volunteering with a cultural group other than their own and development of websites to address collective population issues of need. This paper shares reflections and benefits found in student projects with these courses. Results of the study supported efficacy of Service Learning and ProblemBased Learning to enhance student mastery of course content and preparation for global service after degree completion.
Este documento establece disposiciones sobre la inscripción de contratos de prendas especiales sin desplazamiento constituidos antes de la vigencia de la Ley de Garantía Mobiliaria. Indica que dichos contratos podrán inscribirse en el Registro Mobiliario de Contratos o en los Registros Jurídicos de Bienes Muebles dentro de los 90 días siguientes a la entrada en vigencia de un decreto supremo. También señala que para los actos presentados antes de la vigencia de otro decreto supremo se aplicarán las tasas establecidas en
Dilemma of Electorates when Corruption and Threat became a Cultureinventionjournals
Most of the politicians usually adopted various techniques and strategies to get their ends beyond electoral integrity. One or either form of corrupt practices appears widely in India’s northeast too which greatly demeans democracy. In the backdrop of various demands of different ethnic-based insurgencies, elections are also conducting in regular interval in this India’s Northeast. The state of democracy in India’s northeast is clear example of flawed democracy where elections are in servitude. This study is based on quantitative and empirical methods through SPSS interpretation. Sources of data were mainly from structured questionnaire collected on the basis of random sampling method from electorates of India’s northeast. In contemporary, many insurgent groups have been interfering in the elections since they entered peace dialogue with government of India. This paper attempts to analyse corrupt practices and modus operandi of electioneering practices. Majority of electorates were also on the whims of perpetrators.
The Relationship between Socio-Economic and Socio-Cultural Structures of High...inventionjournals
The purpose of this study is to put forth attitudes of students to English class within the scope of socio-cultural structure. Scanning method was used in the study.5 point likert scale was used as a data collection tool. Questionnaire scale was composed of two parts. In the first part, demographical question items providing general information about students were included and in the second part, 5-point attitude items aiming at determining students' attitudes to English class were included. The questionnaire was prepared by scanning the relevant literature and scope and face validity of the questionnaire was tried to be fulfilled through opinions and suggestions provided by English teachers and expert Pedagogues. The items ranked in the questionnaire as "Strongly Disagree", "Disagree", "Neither Agree nor Disagree", "Agree", "Strongly Agree" were scored with 1, 2, 3, 4, 5. High schools at the center of Siirt were chosen as population of the research. While determining the sample, easily accessible and random sampling methods were utilized. In this regard, students in Anatolian High School (Public High School), High School of Social Sciences, Vocational High School, High School of Athletics and High School of Fine Arts which are located in different socioeconomical environments in Siirt was chosen. After removing questionnaires responded by students in an uninterested and wrong way, resting 849 questionnaires were analyzed for data. In analyzing, SPSS 21 Package program was utilized and kruskall wallis analysis was used for descriptive statistics, frequency, crosstabs, independent groups t test, one-way variance and non-parametric tests. Cronbach alpha reliability coefficient of the questionnaire was found 0.96. As a result, it was determined that students had a view of "undecided" for 38 items regarding attitudes to English class and although not being a very high average, "Agree" for 16 items in the questionnaire. It was determined there was a significant difference in favor of males between attitudes of students in High schools as to English classes in line with the independent variable 'gender'; on the other hand, there was not any significant difference between their attitudes in terms of independent variables 'Number of Family Members', 'Self-Expression' and 'Field of Teacher'
INFLUCENCE OF POLITICS ON HEALTH POLICIES OF INDIA 20-9.pptxsangeetachatterjee10
The document discusses the influence of politics on health policies in India. It outlines several domains of government's role in health development, including leadership and governance, health service delivery, health care financing, and human resource development. It also discusses India's public and private healthcare systems, noting positives like growing facilities but also challenges like uneven quality and rural-urban disparities. It concludes by recommending that governments prioritize health spending and strengthen core public health functions to improve health outcomes and access across India.
The document discusses the healthcare industry and provides context for analyzing delays in patient discharge processes at a hospital from May to July 2015. It describes the objectives of studying delays, the sample size, tools used, and limitations. It then provides an overview of the global healthcare industry, key segments including hospitals, providers and professionals, models for healthcare delivery, and the market size of the industry in different regions. Porter's five forces model is applied to analyze competition in the healthcare industry.
The document discusses strategies that will reshape the healthcare industry landscape in the future. It predicts that healthcare delivery will transform due to epidemiological, demographic, technological and quality pressures as well as emerging infections and consumerism. Specifically, it anticipates a growth in ambulatory and day care due to lower costs, more emphasis on outsourcing services by hospitals, and a focus on technology, efficiency and value-based care. Universal health coverage is also discussed as a goal to ensure all people can access needed health services without financial hardship.
Why the 21st centuries bigeast health challenge is our shared responsibility.pdfQadirBuxQadir
Non-communicable diseases (NCDs) such as heart disease, cancer, diabetes and respiratory diseases are a major global health challenge, responsible for over 70% of deaths worldwide. NCDs disproportionately impact low and middle-income countries and account for more than 60% of deaths in countries like India. To address this growing epidemic, the document calls for strengthening health systems, adopting a holistic approach to well-being that includes social and environmental factors, and fostering public-private partnerships to develop sustainable solutions and leverage new technologies. A multi-sectoral response is needed to combat NCDs through prevention, management, treatment and national policy measures.
India aims to provide universal health coverage to its citizens by 2017, but currently relies heavily on private healthcare due to inadequate public services. Most households pay out-of-pocket for medical care, resulting in over 60% of total health expenditures and increased financial hardship. While various government schemes cover portions of the population, only 17% are insured overall. To achieve universal coverage, India must increase public financing to at least 2.5% of GDP, expand infrastructure and the health workforce, and ensure effective implementation and monitoring of health programs across all areas.
Unit II Project Benefits of Organizational Diversity You a.docxmarilucorr
Unit II Project
Benefits of Organizational Diversity
You are the consultant assigned to study the organizational environment in the Miami, Florida, and the Kansas City, Missouri, offices. Both are service call centers for Fig Technologies. The workforces have a large cross-section of locals from the area, university graduates from nearby institutions, and transfers from other offices within the organization. The offices are facing issues in several areas.
The two offices have a friendly rivalry with regard to professional sports and local college teams. In the Florida office, there have been concerns raised, including some complaints that the rivalry has gone to extremes.
Contingent software developers in both offices from Brazil and South Africa have been unable to get people excited about fútbol instead of football. A few individuals in the Kansas City office have begun hanging out together and talking in the break areas about their relationships with same-sex partners, multiple partners, and some encounters of homosexual and heterosexual relationships together. A petition is circulating around the Kansas City office about these types of discussions being banned.
You are being sent to assess the environment and provide a report of your findings. The report should be in three sections:
1: assessment of findings in Miami, FL;
2: assessment of findings in Kansas City, MO; and
3: recommendation for addressing these findings to the Executive Leadership Council (ELC) for review.
In your assessment of findings, be sure to evaluate how organizational cultures are perceived and how problem solving and creativity are promoted with organizational diversity.
In your recommendations for the ELC, contrast the benefits and disadvantages of diversity, and establish the value of working through these issues to create a dynamic organizational culture.
How will you channel this diversity and help create a positive atmosphere?
Support your recommendation through the use of at least two sources, one of which can be the textbook. Content should be three to four pages in length. Length does not include an assessment tool, if used, though it may be added as an addendum (recommended, not required). All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.
All references and citations used must be in APA style.
Have some fun with the assignment. Use your creative thinking along with your critical thinking to include your perspective of the findings and how to address the issue.
Discussion 14
Please paraphrase the previous one and Compare and contrast the governance, population access, and availability of technology and electronic health records to Saudi Arabia
· be sure to draw from, explore, and cite credible reference materials, including at least one scholarly peer-reviewed reference.
Due date 19/12/2017
HEALTH CARE SYSTEM IN THE UNITED ARAB EMIRATES (UAE)
Int ...
This document discusses health care in India and provides a vision for 2020. It summarizes key issues and prospects. In 3 sentences:
India has made progress in key health indicators like life expectancy and infant mortality over the past 50 years, but still faces major challenges in reducing disparities between states/regions and social classes. The public health infrastructure has expanded greatly but gaps remain in funding, staffing, and service delivery. Looking ahead, priorities include strengthening rural health services, integrating public and private systems, and ensuring universal access to adequate and affordable care.
Fortis Hospitals is one of the largest private healthcare companies in India with a network of 28 hospitals and about 3,300 beds. It aims to grow aggressively to have 40 hospitals and 6,000 beds across India by 2012. The healthcare industry in India is dominated by private sectors due to lower public expenditure and a growing and aging population. India also offers highly cost competitive medical treatment and is emerging as a hub for medical tourism, providing huge opportunities for growth in the private healthcare sector. However, the industry remains slow in adopting information technology and faces threats from increasing healthcare options in other countries like China.
This document discusses community-based health insurance (CBHI) in Nigeria, including its prospects and challenges. CBHI is advocated as a strategy to achieve universal health coverage, though uptake in Nigeria remains poor. The document examines different types of CBHI schemes, including those initiated by communities, healthcare providers, and governments. It notes that while CBHI could help reduce out-of-pocket costs that deter healthcare access, many schemes fail due to lack of sufficient contributions to maintain themselves financially. Government support may be needed for CBHI to be sustainable and benefit more Nigerians.
Demand for Healthcare jobs on the rise -Coronavirus Pandemic, shows data By.D...Healthcare consultant
The outstanding need for healthcare professionals won't disappear once the virus has been contained. Demand is projected to increase for healthcare workers in the coming years.
An aging indian population is projected to drive a surge in a diversity of healthcare jobs: Physicians ,ENT specialists ,Pulmonologist, Internal medicine and anaesthetists nursing aides, physical therapist assistants, physician assistants, nurse practitioners and healthcare managers and administrators. There's opportunity in health across the spectrum of educational paths.
Rashtriya swasthya bima yojna health insurance for the poor - a brief analys...iaemedu
This document provides an overview of the Rashtriya Swasthya Bima Yojna (RSBY) health insurance scheme in India, which aims to provide health insurance coverage to below poverty line families. It discusses the challenges of access to healthcare in India, including high out-of-pocket costs that push many into poverty each year. Previous government-run health insurance schemes had low enrollment and claims ratios. The document examines the implementation of RSBY in Kerala state through interviews with hospitals and insurers, finding some of the same challenges reported elsewhere, such as with enrollment and fraud. Further research is needed to improve the effectiveness of the program.
This document provides an overview of the healthcare industry in India. It discusses various aspects of the industry including emerging diseases, infrastructure issues, the growth of telemedicine and health insurance, the nutraceuticals and medical tourism markets, ayurveda, surgical equipment, and the pharmaceutical industry. The pharmaceutical industry in India is one of the largest by volume globally but is still dominated by foreign companies operating through Indian subsidiaries. The industry has grown significantly since patents for drugs and formulations expired in the 1970s.
Leveraging Consumer-Facing Technologies to Improve Health OutcomesCognizant
The document discusses leveraging consumer-facing technologies to improve health outcomes. It describes how healthcare information technology (HIT) can help reduce medical errors, improve adherence to guidelines, and enable more effective disease management and remote patient monitoring. HIT includes electronic health records, computerized physician order entry, and other integrated data sources. The document also covers benefits of telehealth/telemedicine, which can improve access to care and reduce costs through reduced travel, hospitalizations, and mortality rates. Overall, the document advocates that HIT and telehealth can help improve quality of care while increasing efficiency and reducing costs.
The value of health to an economy is hard to quantify, but its importance is undeniable. A population’s health plays a key role in economic progress, and in coming years healthcare will be a key area of focus for policymakers, payers,providers and the public alike. Financing the future: Choices and challenges in global health studies the role of healthcare against a backdrop of changing demographic patterns, rising healthcare costs and technological innovation.
The document summarizes health and human rights challenges in several countries in Africa and the United States. In Kenya, availability, accessibility, acceptability and quality of health services are issues, especially in rural areas. In Uganda, challenges include poor working conditions for health workers, inequitable access to services for patients, and corruption within the health system. Rwanda struggles with high maternal and infant mortality as well as health workforce shortages. Burundi faces issues with the cost of healthcare, shortages of health workers, and women's vulnerability to HIV/AIDS.
Ghana faces a dual burden of both communicable and non-communicable diseases. While malaria and diarrhea remain problems, non-communicable diseases like hypertension, stroke and diabetes are increasingly common causes of death. Ghana's health system struggles to address this growing disease burden due to underfunding and understaffing of the National Health Insurance system. Policy changes are needed to improve sanitation, health education, and ensure universal access to healthcare through increased funding from taxes and the formal sector.
Similar to Unsatisfaction Pacient in Healthy Industrial in Indonesia (20)
Rainfall intensity duration frequency curve statistical analysis and modeling...bijceesjournal
Using data from 41 years in Patna’ India’ the study’s goal is to analyze the trends of how often it rains on a weekly, seasonal, and annual basis (1981−2020). First, utilizing the intensity-duration-frequency (IDF) curve and the relationship by statistically analyzing rainfall’ the historical rainfall data set for Patna’ India’ during a 41 year period (1981−2020), was evaluated for its quality. Changes in the hydrologic cycle as a result of increased greenhouse gas emissions are expected to induce variations in the intensity, length, and frequency of precipitation events. One strategy to lessen vulnerability is to quantify probable changes and adapt to them. Techniques such as log-normal, normal, and Gumbel are used (EV-I). Distributions were created with durations of 1, 2, 3, 6, and 24 h and return times of 2, 5, 10, 25, and 100 years. There were also mathematical correlations discovered between rainfall and recurrence interval.
Findings: Based on findings, the Gumbel approach produced the highest intensity values, whereas the other approaches produced values that were close to each other. The data indicates that 461.9 mm of rain fell during the monsoon season’s 301st week. However, it was found that the 29th week had the greatest average rainfall, 92.6 mm. With 952.6 mm on average, the monsoon season saw the highest rainfall. Calculations revealed that the yearly rainfall averaged 1171.1 mm. Using Weibull’s method, the study was subsequently expanded to examine rainfall distribution at different recurrence intervals of 2, 5, 10, and 25 years. Rainfall and recurrence interval mathematical correlations were also developed. Further regression analysis revealed that short wave irrigation, wind direction, wind speed, pressure, relative humidity, and temperature all had a substantial influence on rainfall.
Originality and value: The results of the rainfall IDF curves can provide useful information to policymakers in making appropriate decisions in managing and minimizing floods in the study area.
Build the Next Generation of Apps with the Einstein 1 Platform.
Rejoignez Philippe Ozil pour une session de workshops qui vous guidera à travers les détails de la plateforme Einstein 1, l'importance des données pour la création d'applications d'intelligence artificielle et les différents outils et technologies que Salesforce propose pour vous apporter tous les bénéfices de l'IA.
Gas agency management system project report.pdfKamal Acharya
The project entitled "Gas Agency" is done to make the manual process easier by making it a computerized system for billing and maintaining stock. The Gas Agencies get the order request through phone calls or by personal from their customers and deliver the gas cylinders to their address based on their demand and previous delivery date. This process is made computerized and the customer's name, address and stock details are stored in a database. Based on this the billing for a customer is made simple and easier, since a customer order for gas can be accepted only after completing a certain period from the previous delivery. This can be calculated and billed easily through this. There are two types of delivery like domestic purpose use delivery and commercial purpose use delivery. The bill rate and capacity differs for both. This can be easily maintained and charged accordingly.
Redefining brain tumor segmentation: a cutting-edge convolutional neural netw...IJECEIAES
Medical image analysis has witnessed significant advancements with deep learning techniques. In the domain of brain tumor segmentation, the ability to
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scans holds profound implications for diagnosis. This study presents an ensemble convolutional neural network (CNN) with transfer learning, integrating
the state-of-the-art Deeplabv3+ architecture with the ResNet18 backbone. The
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image analysis and enhance healthcare outcomes. This research paves the way
for future exploration and optimization of advanced CNN models in medical
imaging, emphasizing addressing false positives and resource efficiency.
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Applications of artificial Intelligence in Mechanical Engineering.pdfAtif Razi
Historically, mechanical engineering has relied heavily on human expertise and empirical methods to solve complex problems. With the introduction of computer-aided design (CAD) and finite element analysis (FEA), the field took its first steps towards digitization. These tools allowed engineers to simulate and analyze mechanical systems with greater accuracy and efficiency. However, the sheer volume of data generated by modern engineering systems and the increasing complexity of these systems have necessitated more advanced analytical tools, paving the way for AI.
AI offers the capability to process vast amounts of data, identify patterns, and make predictions with a level of speed and accuracy unattainable by traditional methods. This has profound implications for mechanical engineering, enabling more efficient design processes, predictive maintenance strategies, and optimized manufacturing operations. AI-driven tools can learn from historical data, adapt to new information, and continuously improve their performance, making them invaluable in tackling the multifaceted challenges of modern mechanical engineering.
AI for Legal Research with applications, toolsmahaffeycheryld
AI applications in legal research include rapid document analysis, case law review, and statute interpretation. AI-powered tools can sift through vast legal databases to find relevant precedents and citations, enhancing research accuracy and speed. They assist in legal writing by drafting and proofreading documents. Predictive analytics help foresee case outcomes based on historical data, aiding in strategic decision-making. AI also automates routine tasks like contract review and due diligence, freeing up lawyers to focus on complex legal issues. These applications make legal research more efficient, cost-effective, and accessible.
Software Engineering and Project Management - Software Testing + Agile Method...Prakhyath Rai
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Agile Methodology: Before Agile – Waterfall, Agile Development.
Unsatisfaction Pacient in Healthy Industrial in Indonesia
1. International Journal of Humanities and Social Science Invention
ISSN (Online): 2319 – 7722, ISSN (Print): 2319 – 7714
www.ijhssi.org ||Volume 5 Issue 10||October. 2016 || PP.55-63
www.ijhssi.org 55 | Page
Unsatisfaction Pacient in Healthy Industrial in Indonesia
Ahmad Zafrullah Tayibnapis1
, Lucia E. Wuryaningsih2
1
Lecturer of Business and Economic Faculty of Surabaya University
2
Lecturer of Faculty Pharmacy of Surabaya University
ABSTRACT: The porpose of this article is to assess and comparethe needs of public health services withthe
healthcare business in Indonesia in line with the increased catastrophic disease and the high prevalence of
mental disorders due to economic pressures, unhealthy lifestyle, poor environmental conditions, workload and
family company which result in the detriment of state finances and family economy. Meanwhile, high education
has made people, with upper middle income, havegood awareness of personal hygiene and tend to seek health
services that can provide information and education on current health, including in selecting the type of
insurance. Most of them entered the Y gene, as tech-savvy, and want the best facilities, including in selecting
hospitals, laboratories, and medicines. This research uses descriptive qualitative approach byexploring the
primary data and secondary data to obtain conclusion that healthcare business is very prospective.Although
this business hasa formidable challenge, it will not be diminished by the development time.In 2014,healthcare
businessinpharmaceutical industry in Indonesia reached IDR 58.2 trillion, and the government has determined
the pharmaceutical and medical equipment industriesas the mainstay and priorities until 2035, given the high
amount of expenditures per capita on health service each year.The increased level of life satisfaction in terms of
healthcareresults in the high level of satisfaction of patients and families with health providers, but the concern
isstill more focused on the high price of medicines and services.
Keywords: Healthcare business, Medical Services - Economic Burden
I. INTRODUCTION
Diabetes mellitus (DM) is now the third largest cause of death in Indonesia after stroke and coronary
heart disease. In 2014, the death from diabetes and complications was 6.7%, coronary heart disease 12.9%, and
stroke 21.1% (Sample Registration Survey, 2014). Infectious disease, tuberculosis is a leading cause of death,
reaching 67,000 per year with a prevalence of 647 per 100,000 people.
People in big cities are susceptible to stress because ofworkload and demands of work, while in small
towns, the causes of stress are dominated by economic problems, such as difficulties in finding a job due to a
low educational background and poor family condition. Mental emotional disorders, like stress, anxiety and
depression, are not only the monopolyof urban society, but also the people living in villages and even those in
outer islands, such as in Tojo Una-Una District in Central Sulawesi Province, Talaud District in North Sulawesi
Province, Central Tapanuli, North Toraja, and Jember.
The Association of Indonesian Anesthesiology and Intensive Therapy Specialists (2016) states that
currently there have been 1,720 specialist doctors in Indonesia, 450 of whom are in Jakarta and surrounding
areas, but less than 20 Anesthesia Specialist Physiciansare in Papua. This means that the distribution of
Anesthesia Specialists is quite uneven because most of them are in the big cities. Class C hospital in district or
small town requires at least 4 basic medical specialists and three supporting medical specialists, while additional
medical personnel are needed along with the increasing number of participants of the National Health Insurance
(JKN) program. At present there are 169 million JKN participants, with2,553 partnering hospitals. The limited
number of Anesthesia Specialist Physicianshas caused the patients to move to general practitioners, thus
threatening the safety of the patients themselves.
In 2009, total amount of health spending in Indonesia wasUS$ 18.9 billion, and it reached US$ 31.4
billion in 2014, or with an average annual increase of 13.23%. The annual expenditure per capita also rose
sharply, fromUS$ 64.20 billion in 2009 to US$ 109.40 billion in 2014, or with an average annual increase of
14.08% (Global Health Expenditure - WHO, 2015). Meanwhile Frost & Sullivan Research Bureau (2014) states
that Indonesia's expenditure per capita on health care is expected to rise to US$ 237 billion in 2018 with the rate
of growth of about 14%.
Current population of Indonesia is 258 million people, with health service consumption expenditure of
IDR 363 trillion. If the population of Indonesia reaches 262 million people in 2018, it can be estimated thatthe
health service consumption expenditurewill be approximatelyIDR 817 trillion. This means that the economic
burden of the country and the families can reach thousands of trillions of rupiah just for health service
expenditure alone. It isfeared that there will be a decline in service productivity, which in turn causing the loss
of demographic dividend, including the disruption in the achievement of Sustainable Development Goals
(SDGs).
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On the one hand, the handling of non-communicable diseases, such as heart disease, stroke, diabetes,
cancer, and kidney is very costly. Similarly, economic pressures, workload, poor urban planning, difficulty of
getting a job in the village, and the chronic diseases suffered have cause the people stressed, thus resulting in
unfavorable labor productivity, social disruption and increased severity of disease. On the other hand, if there is
no good control, the cost of health and the country’s economic burden may reach thousands of trillions of IDR
per year, then the nation's productivitywill be low and the opportunities to become developed country through
demographic bonuses will also be threatened. The public health expenditure that goes beyond the annual
economic growth would be an opportunity of investment in pharmaceutical and medical equipment industries, in
the establishment of new or expansion of hospitals, clinics, laboratories, and others to offset the increase in the
number of patients every year, both communicable diseases and non-communicablediseases, and to avoid an
increase in medicine prices and hospital costs. The sales value of the domestic pharmaceutical industry in 2014
was 36.4 trillion IDR and foreign pharmaceutical industry wasIDR 15.6 trillion, or totaling IDR 56 trillion. The
sum will continue to rise as the pharmaceutical and medical equipment industries have been set to become the
mainstay industries and priority industries until 2035.
II. LITERATURE REVIEW
Basically, market is formed because there isa balance of demand and supply. There are many factors
that affectthe demand and supply in the market. Demand is influenced by the income, taste, price of items, scale
of preference, and others. Meanwhile, supplyis more influenced by the use of factors of production, such as raw
materials, auxiliary materials, labor, technology, capital, and others.
Healthcare market has been experiencing rapid growth due to advances in science, medical and
pharmaceuticaltechnology, increased public revenue, increased public awareness on the health, better health
services, and the implementation of National Healthcare Insurance (JKN) through the Social Security
Administrators (BPJS). Excess demand for health services in Indonesia is mainly due to economic pressures,
poor nutrition, poor and unhygienic environment, lack of knowledge about health, and the increasingnumber of
patients with infectious and catastrophic disease. The number of pharmaceutical and medical equipment
industries, hospitals, specialists, and others is still inadequate. Upper middle-income communities tend to
require more services, such as VIP / VVIP rooms, high-quality medicine, quick service, and competent doctors.
Conversely,poor and lower-income communities rely more on the Healthy Indonesia Card (KIS) and Social
Security Administrators (BPJS), for both outpatient and inpatient.
Public health spending is also affected by the amount of savings owned, loan, sales of personal
property, the awareness of health and daily lifestyle. Meanwhile, additional supply tends to slow down because
ofthe lack of capital for investment, the amount of taxes borne, and unfavorable economic conditions causingthe
healthcare costs to be extremely expensive. The government, with the support of the budget from tax revenues
and non-tax revenues,also faces limited health budget allocation each year.
Figure 1: Relationship between Physician and Patient
Source: http://en.wikipedia.org/wiki/Supplier_induced_demand in Tri Wahyuni Kusumawati, 2014
Charles Phelps (1997) explains that 30% of patients, with fee for service payment system to the doctor,
are scheduled to make a return visit, in which more than 50% of the usefulness of the medical care provided is
questionable. Liao and Cheng Chia (2001) explain that some physicians utilize the additional services to further
increase their income. Christian E. van Dijk (2012) suggests that there has been a moral hazard by doctors as a
result of supplier induced demand made on fee for service payment system.
The supply curve becomes stiff and the doctor seeks to shift the patient demand curve to the right so
that the price to be increased (La Belle, nd). The doctor assures the patient to increase the use of medical
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treatment without lowering the price set (Ricardson, 1999). Additional treatments will affect the well-being of
patient (J.Ahmed, 2009). Additional service in developing countries is easy because of the asymmetry of
information between doctors and patients that implies domination ofthe doctorsin decision making. Disruption
in the agency relationship occurs when doctors encourage patients to consume more than they need for their
medical problems, and doctors actually know that it has minimal benefit (Folland, 2012, in Tri Wahyu
Kusumawati, 2014).
The instinct to survive makes the people always want to live healthily and strive to find the cause of
various diseases affecting them. Interaction of people’s behavior with the environment can cause health
problems or disease, and the incidence of a disease is actually rooted in the ecosystems and cultures in the
region. Disease is basically the result of the interactive relationship between human beings and behavior on the
one hand, and the habits with the components of the environment on the other hand. Factor of population may
affect the transmission or transfer of disease from one person to another, in addition,waste production could
adversely affect the human. Lack of supervision has madesome producers addadditives, such as preservative and
coloring material, and expired material to foods and beverages that could cause healthproblems and socio-
economic losses.
Quality is the desire to satisfy, and satisfaction is basically a sense of pleasure or disappointment over
the performance of the product produced. The relationship between both of them can explain the acceptance or
refusal of medical service. According to Berry, et al., 1990, in Purnomolastu (2011), there are five (5) factors
that affect the quality of service: (1) tangibility; (2) reliability; (3) responsiveness: (4) assurance and, (5)
empathy. Stages to examine the relationship between performance and customer satisfaction can be started from
the expectations prior to treatment, performance or products, the expected meeting and its performance, and
performance assessment. Furthermore, the tabulation of the responses of the patients will produce an index
number, that is, Customer Satisfaction Index t which shows the level of patient satisfaction with institutions and
health products.
III. RESEARCH METHODOLOGY
This study uses qualitative descriptivemethod because it analyzesthe condition of the existing problems
and health phenomenon in Indonesia economically. The method used in this study is focused on interpretive
natural condition, observations and interviews that become the key of this research. Researchers seek to capture,
record, interpret and review information by always adhering to in-depth and comprehensive data collection
analysis. In addition, the researchers also draw up the level of patient satisfaction by comparing the patient
expectations with the performance of healthcare industry in the context of preparing the development strategy
and the recommendations related to the results of the study.
Literature review is important for the deepening of the study in order to explain the phenomenon and
examine previous studies to demonstrate the linkages between the research being done andthe previous one.
This qualitative study is based ontriangulation data derived from interviews, participatory observation,
andreview of data from the Ministry of Health of the Republic of Indonesia, Surabaya Health Department, and
Social Security Administrators (BPJS)
The level of patient satisfaction with the healthcare industry is obtained from a survey of 100
respondents or inpatients 5-10 days in the hospital by means of comparing the patient and family expectation
withthe health providers in respecting the patient selection, obtaining accurate and objective information, and
discussing to choose and make strategic decisions so as to create a mutually beneficial relationship between both
parties.
IV. RESEARCH FINDINGS AND DISCUSSION
The case of catastrophic disease in Indonesia tends to increase sharply every year due to the lack of
public awareness of controlling blood sugar level, changing in pattern of life, andlow compliance in taking
medication. People in big cities prefer to consume foods containing high carbohydrate and are fond of fast food.
Theyoften go to cafes and restaurants to enjoy menu with high fat and sugar and colored drinks.
Regulation of the Minister of Health of the Republic of Indonesia Number 30 of 2014 on the Inclusion
of the information on the content of sugar, salt and fat and health messages for processed food, andestablishment
of normal limit of sugar, salt, and fat intake for fast food. The regulation is intended to educate the public in
order to be smart in controlling food intake and reduce the risk of non-infectious diseases. People with sugar
intake more than 50 grams, sodium or salt more than 2,000 milligrams, and total fat67 grams per day will have
ahigher risk of hypertension, stroke, diabetes, and heart attacks. High level of sugar, salt and fat in the body, in a
certain period of time, will interfere with the work mechanism in the vascular system, and initially it will be
visible from obesity.
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Table 1:Prediction of Catastrophic Disease Cases in Indonesia
Year Inpatient
( X Patient)
Outpatient
( X Patient)
2014
2015
2016
2017
2018
2019
1,901,805
2,277,367
2,690,660
3,112,908
3,543,801
3,783,861
1,359,013
1,627,387
1,922,72
2,224,458
2,532,370
2,703,915
Source: Ministry of Health of the Republic of Indonesia, 2015
The changing pattern of disease caused by economic progress and increasing life expectancy in big
cities and small towns is relatively the same. The main cause is the equal distribution of unhealthy food and
beverage products and the consumption of drugs and herbal medicine without the doctor's knowledge. This
indicates that the pattern of life cannot be separated from changes in the demographic structure and changes in
the social structure of society.
The economic burden for handling catastrophic disease in Indonesia in 2014 was very big, both for
outpatient and inpatient, in which 8.1% of cases absorbed30% of the budget for outpatient, and 28.2% of cases
absorbed 33.5%of the budget for inpatient. The sum charged did not include BPJS financing, treatment cost
payment by the patient during in hospital, and the cost charged for patients treated with primary health care
facilities.
Table 2:Catastrophic Disease Cost Burden,2014
Disease Outpatient Inpatient
Case Cost (IDR) Case Cost (IDR)
All Diseases 12.76 million 3.45 triliun 2.61 million 12.66 triliun
Catastrophic Disease 1.03 million 1.03 triliun 735.827 4.24 trilliun
Catastrophic Cost Burden 8.1 % 30% 28.2% 33.5%
Source: Ministry of Health of the republic of Indonesia, 2015
The number of people with DM (diabetes mellitus) in a number of countries, including Indonesia,
increases every year and it is quite alarming, giventhe prevalence of 5.7% in 2007 and 6.9% in 2014 or as many
as 12.2 million people. The number of patients with DM, both diagnosed (30.4%) and not diagnosed (69.6%),
results in the state economic burden and the number of people with DM is getting bigger every year. In its
report, WHO estimates that losses due to DM in the world from 2010 to 2030 canreach 1.7 trillion US dollars of
global GDP, and for the patients, it leads to decreased productivity, disability and premature mortality. The
decreased productivity and economic burden greatly affectthe patient's family. Based on the data from the
World Economic Forum's publication in April 2015, the potential loss due to non-communicable diseases in
Indonesia from 2010 to 2030 is US$ 4.47 trillion or 5.1 times as much as the GDP of Indonesia in 2012. The
National Health Insurance (JKN) claimcoming into BPJS Healthcare in 2015 was more than IDR 5 trillionfor
the treatment of heart disease and dialysis as general complication of the patient with diabetes mellitus.
Less healthy lifestyle is also demonstrated by the increasing prevalence of tobacco consumption, for
both male and female. The prevalence of smoking in male is 66% and in female is 2.3%, in which 300,000
households show the average cigarette consumption of 10.5 cigarettes per day. The results of the Global Adult
Tobacco’s survey in Indonesia (2011) show that for the age of fifteen up has the prevalence of smoking in male
67.4%, and in female 4.5%. WHO (2015) reported that the incidence of lung cancer in men in Indonesia was
25.332 people, with a death rate of 21.8%per 103,100 people. The incidence of lung cancer in women was
smaller or 9,374 people, with a death rate of 9.1% per 92,200 people. Li Zhang (2016), a Professor of Medical
Oncology, Sun Yat University (Kompas, April 29, 2016) explains that lung cancer is the trigger of death in men,
and more than half of lung cancer patients in the world are in Asia. In 2020, East Asia and Southeast Asia will
face NSCLC lung cancer or non-small cell with mutations in the Epidermal Growth Factor Receptor (EGFR).
In Indonesia, DM is now the third largest cause of death after stroke and coronary heart disease. In
2014, the percentage of death from diabetes and complications was 6.7%, coronary heart disease 12.9%, and
stroke 21.1% (Sample Registration Survey, 2014). Calculation of the World Economic Forum (2015) mentions
that five types of non-communicable diseases in Indonesia, namely cardiovascular, cancer, tuberculosis,
diabetes, and mental health disorders between 2012 and 2030 lead to a loss of US$ 4.47 trillion, or IDR 58,000
trillionin the exchange rate of US$ 1 = IDR 13,000 or comparable with 232 million per person. Atthe same
period, in India, with more number of people(five-fold as many as Indonesian people) has equivalent to IDR
56.000 trillion.
Furthermore, related to infectious disease, tuberculosis (TB) is the leading cause of death in Indonesia,
reaching 67,000 deaths per year. Ministry of Health data show that the prevalence of TB in 2014 was 647 people
per 100,000 people, and down to 30% compared with the condition in 1990 as many as 1,045 people per
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100,000 people. The mortality rate also dropped to 41 cases per 100,000 people in 2014 from 65 cases per
100,000 people in 1990. Patient with regular stage of TB must take medication for 6-9 months without a break
with the cost per case from IDR 400,000 to IDR 1,200,000. Unfortunately, the patients tend to be indiscipline in
taking medications,in which itcan trigger TB germs to become resistant to the regular TB drugs resulting in
more expensive treatment cost, or as much as IDR 100 millionper case with a 50-70% chance of recovery only.
If therapy is not successful then the treatment cost could reach IDR 300 million -l 400 millionper case with a
chance of recovery of 10-30%. (M. Subuh, the Ministry of Health, 2016)
The surge in public demand for health services, both basic and premium services, makes BPJS
experienced a deficit ofIDR 1.93 trillionin 2014, given the magnitude of the cost of benefits in the form
promotion, prevention, curative, and rehabilitation fees. The research findings show that BPJS participants are
often excluded from those who pay with their own money, and many participants have to queue up to 3 months
to obtain health service, such as dialysis. Even some health facilities are reluctant to accept BPJS patients. The
differencein service rate between private hospital and government hospital in Indonesia Case Base Groups
(INA-CBG) is only 5%. It seems to be so insignificant that many private hospitals have not been keen to join
and cooperate with BPJS. Health experts say that the significant difference should be 30% so that private
hospitals are able to survive in the system of National Health Insurance (JKN), able to grow and improve health
services for the patients.
An increase in sales of pharmaceutical products and generic medicines in Indonesia from 2010 to 2015
was quite good and promising, considering that the implementationof the National Health Insurance(JKN)
system, with BPJS as the administrator, has been runningthough it still has not met the public expectations. The
coverage of BPJS Healthcare in 2014 was about 40-50% of Indonesia's population and is targeted to be 100% of
the population, or as many as 250 million people, in 2019. Total health care spending in 2010 amounted to IDR
168 trillion, and it was estimated to reach IDR 343 trillion in 2016 (Business Monitor International, 2015)
The number of hospitals in Indonesia has increased to 40.56% in the last 3 years, with an average
increase of 13.78% per year. The addition of hospital beds is in line with the increasing number of hospitals in
order to meet the high number of people requiring inpatient services. Frost & Sullivan (2015) predictedthat there
would be an addition of 35,000 new beds in 2020, and the medical device market would grow 12.5% per year
until 2018. Geographically, the majority of hospitals are located in Java Island, such as Jakarta, West Java,
Banten, Central Java, Yogyakarta and East Java, while in outside Java, the concentration is in North Sumatra
and South Sulawesi. Similarly, the location of doctors is in line with the location of the hospitals, in which most
of them are in big cities and medium towns.
Pharmaceutical industry, as the supplier of the needs of hospitals, health clinics and pharmacies has
already been successfully producing innovative products or patented medicines for chronic diseases, such as
cancer, hepatitis, and diabetes. However, the majority of the medicines existing in the list of JKN electronic
catalogs are generic medicines. Patients, with excess income, hope to be able to choose patented medicines by
paying the difference in cost. This means that it requires a mechanism so that the patients can pay the difference
in cost to obtain better or quality medicine. The medicines resulting from innovations are generally in the term
of patent or are just produced from the development research of previous medicinesfor the same disease, while
generic medicines are manufactured according to the formula of the old medicines whose patent already
expired. As an illustration, the patient can be handled more quickly using patented medicines and inpatient time
becomes shorter. Actually,the price, either expensive or cheap, of medicines consumed by the patient is not a
determinant of health servicecost efficiency, but it will become inefficient whenthe treatment time in hospital is
longer.
BPJS findsthat the medicines included in National Formulary or the list of JKN medicines and
electronic catalogs are selected by experts by considering the efficiency and effectiveness of the medicines for
the interests of patients. BPJS Healthcarehas no authority to determine the medicines used in hospitals, as long
as the medicinesare in accordance with the diagnosis of the disease. The hospitals are not prohibited, too, from
using the medicines outside the electronic catalog as long as the entire health service costs do not exceed the
INA-CBG rate and the patient does not need to pay the extra fee. The application of INA-CBG package rate
requires the hospital management to able to streamline costs and optimize the hospital financial management,
including in terms of quality control, cost control, and access through the calculation of service charge of each
clinical pathway based on the calculation of cost unit owned by the hospital.
Table 3: Market of Pharmacy and Generic Medicine in Indonesia
Year Sales of Pharmaceutical
Product ( x Bn USD)
% of GDP Sales of Generic
Medicine( x Bn USD)
% Number of Medicine
Sales
2010
2011
2012
2013
2014
4.00
4.58
4.85
5,.88
6.61
0.57
0.56
0.56
0.56
0.54
1.58
1.83
2.00
2.50
2.89
65.8
67.3
68.7
70.2
71.7
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2015 7.4 0.53 3.32 73.1
Description: CAGR Product & Pharmacy 2011–2015:13%, and CAGR Generic Medicine 2010–2015:16%
Source: G P. Farmasi, 2016
The sales of pharmaceutical products and generic medicines from 2010 to 2015 showed a fairly
moderate increase in line with the increase of the number of patients, and contributed0.53% to the GDP. Market
of pharmacy and medicine in Indonesia is very large, but in the circulation of distribution indicates that the drug
and medicine control system is still very weak resulting in the abuse committed by those who want to rake in
huge profits from the trade of medicines, such as the disclosure of the case of the circulation of fake vaccines,
and high- dose medicineswhich are traded freely by individual or entity who is not entitled to or violates the
rules. Such condition causes the nation's health to be mortgaged and the sustainability of the National Health
Insurance (JKN) program is threatened. Food and Drug Administration (BPOM), in cooperation with the
International Crime Police Organization (ICPO), launched Pangea Operation IX in 32 provinces in Indonesia
from May 30 to June 7, 2016 and found 1,312 items of illegal pharmaceutical products, including fake products
with economic value reaching more than IDR 56 billion.
Pharmaceutical industrybusiness prospect in Indonesia is very conducive along with the increasing
Indonesian macro-economy and the seriousness of the government to improve all business aspects, as reflected
in the economic policy packages I - XII. National industry turnover in 2014 amounted to IDR 36.4 trillion and
foreign-owned pharmaceutical industry amounted toIDR 15.6 trillion, or totaling IDR 56 trillion. Most of the
pharmaceutical industries in Indonesia are on the island of Java and in the regions that havecomplete
infrastructures, such as seaports, airports, toll roads, telecommunication networks, electricity, and others in order
to reduce logistics costs, approaching the availability of labor and proximity to potential markets, such as
Jakarta and Surabaya.
The rapid development of pharmaceutical industry has not been followed the cheap medicine price.
This is mostly caused by unfair business competition and no determination of the highest retail price (HET) for
patented medicines, except for generic drugs. Until now, patented medicines and unbranded genericsstill have
not had the price limit yet resulting in the unfair escalation of the medicine price, and the medicine
manufacturers tend to market the medicine with different approaches or trading strategies, such as dealing
directly with physicians and providing interesting remuneration. Similarly, the manufacturers allegedly play the
gamewith certain pharmacies, giving rise to unfair competition at the retail level through discounts,so that the
medicine prices to be cheaper than other pharmacies.
A number of pharmaceutical companies have recorded a good performance and made the stockholders
enjoy salaries and dividends, such as PT. Kimia Farma Tbk which was able to achieve a net profit of IDR 234.6
billionin 2014, or an increase of 9.3% from IDR 215.6 billion in 2013. The profit increase was driven by
anincrease in the revenue rate from IDR 4.3 trillionin 2013 toIDR 4.5 trillion in 2014 and created net profit of
IDR 2.06 trillion, or increased 7.5% from the previous year of IDR 1.91 trillion. The net sales of PT. Kalbe
Farma Tbk increased from IDR 16 trillionin 2013 to IDR 17.36 trillionin 2014. Overall, pharmaceutical market
in Indonesia grew from IDR 53.8 trillionin 2013 to IDR 58.2 trillionin 2014.
One cluster of healthcare industry in Indonesia that is experiencing rapid growth is the hospital
industry, both organized by the local government or state-owned and organized by private enterprises. However,
lack of supervision and indecision of government have caused many hospitals in Indonesia to have no
accreditation. Less competence doctors may result in the dissatisfaction of patients and their families, such as
malpractice cases and abandoned patients which result in the enmity between patients and hospital.
Geographically, most hospitals are located in Java, such as in Jakarta, West Java, Central Java, East
Java, Banten and Yogyakarta, while outside Java are in North Sumatera and South Sulawesi. The distribution of
doctors is also in accordance with the location of the hospitals, that is, in Java and the big cities. Referring to the
calculation of ideal physician workload set by the government, the actual ratio of one doctor for 2,500 residents
has actually been exceeded. The ratio is calculated based on the population with the assumption of 20 patients,
size of area, workload, and service timing. According to the data from the Indonesian Medical Council (KKI)
per May 9, 2016, there are 110,720 doctors in Indonesia, which means that one doctor serves 2,270 people.The
government target of one doctor for 2,500 people or 41 doctors for 100,000 people was achieved in 2015, and
the target of one doctor for 2,000 people is expected to be reached in 2025. It is projected that Indonesia will
have a population of 285 people, so with the ratio of one doctor for 2,000 people Indonesia will need 142,500
doctors. The target will be metin the next 4-5 years, as long as the production of doctors remains as it is
now,from 7,000 to 8,000 per year.
It should be noted that the distribution of doctors in Indonesia seems very uneven across provinces, for
example,the distribution of doctors between Jakarta and NTT is quite unbalance. The ratio of one doctor for
2,500 people still cannot be implemented evenly becauseeach province has different circumstances. In West
Java, Central Java and East Java, for example, the target has been unmet because the population is too
large,while in Eastern Indonesia, the targetis difficult to meet because of the spacious area, limited
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infrastructure, and remote population. So,the problem is not related to the number of doctors available but the
uneven distribution. The target is even more difficult to meet in the remote areas, such as Sebatik, Tarakan,
Malinau, Tanjung Selor, Papua, West Papua, and West Sulawesi.
Based on the information, of the 9,731 health centers in Indonesia, 5% of them haveno doctor at all,
and 9% have doctors but living very far away from the health centers which are located in remote areas. So it
can be said that it is not because of the fewer number of doctors available, but ratheron uneven distribution of
the doctors. In addition, doctors tend to work in areas that can provide better welfare, including adequate
facilities and infrastructure, to support the profession. There are only few specialist doctors and dentists in
Indonesia because being a doctor requires enormous costs and a long-time study. Most specialist doctors /
dentists settle in big cities. Today and in the future,the most needed effort is to maintain professional standards
and competence standards of Indonesian doctors so as not to experience the condition as occurred in the
Philippines where the salary of a doctor is so low that he prefers to work in the United States though only as an
assistant physician or other health professional because his competence is not recognized by the United States.
Judging from the increase in the number of disease cases and public revenues, the prospect of
healthcare business in Indonesia is excellent and promising. Pharmaceutical and health industries are the
mainstay of industrialization until 2035. The priority of pharmaceutical and cosmetic industries is divided into
three stages: from 2015 to 2019; from 2020 to 2024; and from 2025 to 2035. The priority of pharmaceutical and
cosmetic industries in Indonesia can be realized if there is development, control,and utilization of industrial
technology to improve efficiency, productivity, value added, competitiveness, and the independence of the
national industry.
Figure 1: Level of Patient Satisfaction with Pharmaceutical Industry
Source: Researchers 2016
Relating to the need of hospitals, laboratories, medical equipment and pharmacy, it can be illustrated
that the number of cancer patients in Jakarta has increased drastically. Every year 18.6% of women in 100,000
people in Jakarta are contracted breast cancer. There are currently 10,000 new cases in Jakarta, 7,000 cases of
which have entered advanced stage of cancer. Patients with BPJS Healthcare facility have to wait in line for 2-3
months for radiation treatments or chemotherapy, whereas patients with advanced stage always race against
time. Another problem is that most palliative patients occupy hospital bed because they require mental and
spiritual supports, pain relievers, and comfort to die in dignified way, whereas patients with curative care also
require the hospital beds. Resultof the illustration explains that Indonesia really needs a lot of hospitals with all
complete facilities, a number of competent health personnel, and affordable medicine price, as well as a good
service standard. The number of health facilities and doctors is still very few and not in accordance with the
ideal ratio.
The level of patient satisfaction with the pharmacy is quite high because the programsof consultation,
information, and education have gone so well that the patients understand how to use and the efficacy of
medicine, as well as the medicine price. Since the enactment of BPJS, many patients, who come to the hospital
for treatment, haveto wait in a long queue, but they have a significant trust to the hospital and they seem
satisfied with the hospitals that have implemented health services with a focus on patient. The level of patient
satisfaction with BPJS has not been high enough because of the limited capacity and medical devices in
hospitals, including the ratio of doctors which is not adequate for areas outside major cities. The level of patient
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satisfaction with the pharmaceutical industry is focused more on the high price of medicine that is often
unaffordable by most people, let alone the patient should consume imported medicines. The level of patient
satisfaction with physician practices is quite high, but dissatisfaction appears when doctors fail to give
information on the illness of the patientand the prescription to be bought in pharmacies.
The level ofhappiness of Indonesian citizens in 2014 was 5.348, or ranked number 76 in the world,
where the level of life satisfaction in terms of the health aspect was 69.72 or improved 3.32 compared with
66.40 in 2012. Health is one measure of the welfare of Human Development Index. In the future, the level of
life satisfaction in terms of health aspect should be increased in order to be equal with the neighboring countries,
such as Singapore, Malaysia, and Vietnam, by constantly improving the service quality of hospitals,
laboratories, clinics, and pharmacies although the government still imposes a low cost, considering that
consumer is an important and strategic factor in the health business. In the perspective of the patients and their
family, the most important issue is transparency in the cost, quality, outcome, and retailing of health servicethat
become response to the needs of consumers. The health business actors who are able to survive are not the
strong ones, but those who are brave and adaptable to any changes.
V. CONCLUSION
Cases of catastrophic diseases in Indonesia, both outpatient and inpatient, have increased
dramaticallyresulting in the economic burden of the state and the family every year. The number of such cases
even surpassed India which has a population of five times as much asthe population of Indonesia. The high
cases of patient's illness turn out to be caused by unhealthy lifestyles, false consumption patterns, lack of
exercise, economic pressures, workload, poor urban planning, and chronic disease affected. These allcause
people to experience stress, social disruption and decreased work productivity. Patient handling
requiresenormous costs,in which up to now the costs have notbeen fully protected even though the National
Health Insurance (JKS) has been working to bear part of the costs of treatment, so the patients and families have
to incur additional costs for the unavailable medicines with lengthy waiting lists.
The health business prospect in Indonesia is very excellent and favorable, such as in the fields of
hospitals, pharmaceutical industry, polyclinic laboratory, medical equipment industry, and pharmacies.
Unfortunately,it is followed by the low price of medicines because of unhealthy competition and no
determination of the highest retail rate for the medicines, unless the generic medicines. Lack of supervision and
indecision of government cause a lot of hospitals to have no accreditation and competent doctors resulting in the
dissatisfaction of patients and families.
The government should facilitate the development and the establishment of pharmaceutical raw
materials industry for import substitution and strengthen the health infrastructure in an effort to implement the
Indonesian Pharmacopoeia standards for the pharmaceutical industry, including the establishment of large-scale
and export-oriented pharmaceutical industry. The development of upstream petrochemical sector to reduce
dependence on imported raw materials, the establishment of internationally standardized manufacturing
capabilities and the establishment ofaccredited clinical testing laboratory are urgently needed.
ACKNOWLEDGEMENTS
This research supporting by Surabaya University in Surabaya, Indonesia. Thank you for the supporting of
reviewer of this research.
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