Serological Tests Of Syphilis In HIV Infection

Serological tests for syphilis may show varying results in association with HIV infection.Thus care should be taken to interpret these result

Analysis of Claims and Reimbursements made under Mediclaim Policy of the General Insurance Corporation of India

Mediclaim insurance run by government owned insurance company General Insurance Corporation of India (GIC) is the only private voluntary health insurance scheme available in India currently. This scheme has been in operation since 1986 and from time to time a number of revisions have been carried out to address the needs of their clients. The documentation on claims and reimbursement of this scheme is scanty. This paper analyses 621 claims and reimbursements data pertaining to policy initiation years 1997-98 and 1998-99 of Ahmedabad branch of one of the subsidiary companies of the General Insurance Corporation of India. The analysis suggests that the number of policies and premiums collected have grown at significant rates, more than 30 per cent during 1998-99 and 50 per cent during the year 1999-00. The growth had implications for the management of scheme in terms of problems of adverse selection or provider induced demand and falling premiums per insured person. It was found that the number of claims increased by about 93 per cent during the year 1998-99 when polices sold grew at 32 per cent. The study estimates that about 1/3rd of claim amount increase is because of the problems of adverse selection or provider induced demand. The analysis of break-up of reimbursements suggests that about 40 per cent of reimbursements are made towards doctors fees. This is followed by diagnostic charges, which accounts for about 30 per cent. This makes the insurance claims highly vulnerable to provider-induced use of resources. The findings also suggest that the insurance company took on an average 121 days to settle the claim. It is pointed out given the demand side and supply side imperfections in the healthcare markets and absence of appropriate regulatory mechanisms in place, the Insurance and Development Regulatory Authoritys proposal to ensure payment settlement within 7 days is highly ambitious. The study also analyses reasons for the delay and cases where reimbursements have been less than claims submitted.

Financing issues in proposed HIV/AIDS intervention of providing anti-retroviral drugs to selected regions in India

The development of antiretroviral therapy has given a new hope for people living with acquired immuno deficiency syndrome. In the face of increased disease burden due to HIV the global and political commitment towards controlling the pandemic has received renewed thrust in recent times. The Government of India has initiated antiretroviral treatment as a part of national public health programme in the six high-prevalence states. The aim of the paper is to provide the programme planners and other stakeholders, information about the impact of initiating antiretroviral therapy programme in the country. The paper discusses the global commitment towards fighting the disease in the light of the development in affordability and accessibility of antiretroviral drugs therapy. The paper highlights the importance of infrastructure and logistic requirement for developing a comprehensive treatment programme for the affected population in India. Finally, the paper has drawn broad financial implications of the antiretroviral therapy under different treatment scenarios. The estimated financial requirement for treatment vary from Rs. 92 crores per annum if focusing on 400,000 HIV/AIDs cases to identify patients requiring ARV Therapy to 1008 crores per annum if all 4 million patients are screened for coverage. Against this NACO has allocated total of Rs. 113 crores for treatment part of the proposed intervention. Even under the most conservative estimate achieving the treatment target in India with the proposed programme budget will be a challenging task.

Time series analysis of private healthcare expenditures GDP: cointegration results with structural breaks

This paper analyses the time-series behaviour of private health expenditure and GDP to understand whether there is long-term equilibrium relationship between these two variables and estimate income elasticity of private health expenditure. The study uses cointegration analysis with structural breaks and estimates these relationships using FM OLS (fully modified ordinary least squares) method. The findings suggest that income elasticity of private health expenditures is 1.95 indicating that for every one per cent increase in per capita income the private health expenditure has gone up by 1.95 per cent. The private health expenditure was 2.4 per cent of GDP in 1960 and this has risen to 5.8 per cent in 2003. In nominal terms it has grown at the rate of 11.3 per cent since 1960 and during 1990’s the growth rate is 18 per cent per annum. The study discusses four reasons for this high growth experience. These are: (i) financing mechanisms including provider payment system, (ii) demographic trends and epidemiological transition, (iii) production function of private health services delivery system, and (iv) dwindling financing support to public health system. In developing countries where per se the need for spending on health is high, high levels of private health expenditures pose serious challenge to policy makers. The sheer size of these expenditures once it has risen to high levels can impede control of health expenditures itself. The high private health expenditures are also cause of concern because most of these expenditures are out-of-pocket, insurance mechanisms cover small segment of population, provider payment systems are primarily based on fee-for-services and the professional regulation and accountability systems are weak and non-functioning in many ways. It is not clear whether these expenditures are sustainable as it can have number of undesirable consequences making the health system high cost, unaffordable, and vulnerable to provider payment system.

A Study of Factors Affecting the Renewal of Health Insurance Policy

Health insurance policies are generally one-year policies and to remain part of the insurance poll, policyholders are required to renew their policies each year. Understanding the factors that affect the demand and renewal decisions to continue in health insurance programme is imperative for future growth and development of the insurance sector. We extend our previous work on factors affecting the decision to purchase health insurance to understand the factors affecting the renewal of insurance policy. We find the factors affecting health insurance renewal are not the same as factors affecting health insurance purchase decision. This has implications for insurance providers. The study also suggests customer satisfaction as an important factor influencing the renewal decision of policyholder.

Union Budget 2004-05 and the Health Sector

The Union Budget 2004-05 of Government of India in some way marks a deviation from its preceding budgets in terms of its specific focus on social sector. The budget document is basic policy paper of the government and in some sense provides a mirror of government’s priorities. However, one basic question remains how to translate these policies into implementable plans and how to make sure that the government is able to deliver the planned development. Many times we focus on priorities and policies without giving due consideration to ground level realities and the policy pronouncements remain rhetoric. In some ways the recent budget has done the same with the health sector. There is probably lack of clarity on issues the health sector is facing. We aim at addressing some of these issues in context of health sector and describe how this year’s budget has missed the focus.

Analysis of Public Expenditure on Health Using State Level Data

Increasingly the governments are facing pressures to increase budgetary allocations to social sectors. Recently there has been suggestion to increase the government budget allocations to health sector and increase it to 3 per cent of GDP. Is this feasible goal and in what time-frame? Health being State subject in India and much depends on the ability of the State governments to allocate higher budgetary support to health sector. This inter alia depends on what are current levels of spending, what target spending as per cent of income the States assume to spend on health and given fundamental relationship between income levels and public expenditures, how fast expenditures can respond to rising income levels. We present analysis of public expenditures on health using state level public health expenditure data to provide preliminary analysis on these issues. The findings suggest that at state level governments have target of allocating only about 0.43 per cent of SGDP to health and medical care. This does not include the allocations received under central sponsored programmes such as family welfare. Given this level of spending at current levels and fiscal position of state governments the goal of spending 2 to 3 per cent of GDP on health looks very ambitious task. The analysis also suggests that elasticity of health expenditure when SGDP changes in only 0.68 which suggest that for every one percent increase in state per capita income the per capita public healthcare expenditure has increased by around 0.68 per cent.

Mycotoxin food safety risk in developing countries

"Mycotoxins are produced by fungi, commonly known as mold. These toxins can develop during production, harvesting, or storage of grains, nuts, and other crops. Mycotoxins are among the most potent mutagenic and carcinogenic substances known. They pose chronic health risks: prolonged exposure through diet has been linked to cancer and kidney, liver, and immune-system disease. Because mycotoxins occur more frequently under tropical conditions and diets in many developing countries are more heavily concentrated in crops susceptible to mycotoxins, these chronic health risks are particularly prevalent in developing countries." from TextFood safety ,food security ,Public health ,

Dividend Behaviour of Indian Companies Under Monetary Policy Restrictions

In this study we examine the dividend behaviour of Indian companies. We use GMM estimator, which is the most suitable methodology in a dynamic setting. Our results show that the Indian firms have lower target ratios and higher adjustment factors. The most significant result is that the restricted monetary policies have significant influence on the dividend behaviour of Indian firms, causing about 5-6 percent reduction in the payout ratios. The significance of macro economic policy variable suggest that monetary policy restrictions do have impact on cost of raising funds, and the information asymmetry between lenders and borrowers increases that forces companies to reduce their dividend payout.

Human resource issues and its implications for health sector reforms

Given the growing complexities and challenges the health sector faces, reforms in this sector are inevitable. Often health sector reforms aimed to address many of these deficiencies and ensuring effectiveness and efficiency of resource use, they focus on making the health systems responsive through strengthening financial systems, ensuring local participation and public private partnerships, and autonomy of health facilities. The reform process, among other things, intrinsically makes some fundamental assumptions some of which are as follows: high organisational commitment of health care providers, high professional commitment of health care providers, and adequate skills of health care providers. This paper examines the commitment of district level health officials in the newly carved out state of Chhattisgarh in India. Since development oriented HR practices (HRD) are powerful tools to commit people working in health sector to enhance the quality of care, we believe that health sector reforms will have to concentrate on human resource issues and practices more than ever before in near future. The papers attempts to examine the following questions: (i) what is status of professional commitment, organisational commitment and technical competencies of health officials? (ii) what are the characteristics of human resource management practices in the health sector in the state? and (iii) how these management practices are linked with professional and organisational commitment? Finally the paper discusses the implications of these to health sector reform process.